Phosphate

How it works

Supplemental phosphate replenishes the body's phosphate pool, supporting cellular energy metabolism, bone mineralisation and acid-base buffering.

Prescribing in practice

• Avoid or use with great caution in significant renal impairment and hyperphosphataemia, as accumulation can cause dangerous hyperphosphataemia and metabolic disturbance.
• Intravenous phosphate must be infused slowly with cardiac and biochemical monitoring because rapid administration risks hypocalcaemia, arrhythmia and hypotension.
• Co-administered potassium and sodium content of phosphate preparations should be accounted for, particularly in renal or cardiac patients.

Monitoring

Monitor serum phosphate, calcium, potassium and renal function during replacement, especially with parenteral therapy.

Counselling the patient

• Oral phosphate can cause diarrhoea or stomach upset; take as directed.
• Attend for the blood tests your team arranges to check your phosphate and calcium levels.

Evidence & guidelines

Phosphate replacement is standard practice in correcting hypophosphataemia, with parenteral use guided by established critical-care and electrolyte-management protocols.