Phosphate replacement
Phosphate
Brand names: Phosphate Sandoz, Phosphate-binders see separate entries
Adult dose
Dose: Hypophosphataemia mild: 1–2 effervescent tabs (16.1 mmol phosphate) TDS PO. Severe (<0.3 mmol/L): 9–18 mmol IV over 12h
Route: PO/IV
Frequency: per indication
Clinical pearls
- Refeeding syndrome — replace early per NICE NG32
- Severe (<0.3 mmol/L) requires IV cautious replacement
Contraindications
- Hyperphosphataemia
- Severe renal impairment (without monitoring)
- Hypoparathyroidism
- Hypercalcaemia
Side effects
- Diarrhoea (PO)
- Hypocalcaemia
- Hyperkalaemia (with K+ phosphate)
- Soft-tissue calcification (severe)
Interactions
- Calcium-containing antacids
- Iron
- Tetracyclines
- Quinolones (separate doses)
Monitoring
- Phosphate
- Calcium
- K+
- U&E
Reference: BNF; NICE NG32; UK guidelines; https://bnf.nice.org.uk/drugs/phosphate/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- Weight-Based Levothyroxine Dose Calculator · Thyroid
- Cryoprecipitate Dose Calculator for Fibrinogen Replacement · Transfusion Medicine
- Free Water Deficit in Hypernatraemia · Fluid / Electrolytes
- Calcium-Phosphate Product · Electrolytes
- Potassium Deficit Calculator · Electrolytes
- Indications for Renal Replacement Therapy (RRT) in AKI · Treatment Decision
Pathways
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Type 2 Diabetes Management · NICE NG28 2022
- Hyperthyroidism Management · BTA / ETA 2018
- Adrenal Insufficiency · Society of Endocrinology / ESE 2016
- Pituitary Apoplexy · ENEA 2011 / Pituitary Society
- Hypercalcaemia Management · NICE / Endocrine Society