Needless to say, a procedure called “colonoscopy” is not a very pleasant thing. However, if the need is ripe for it, and it is prescribed by the attending physician, it means that you need to prepare your body in order for the studies to be effective. For several years now, in order to prepare the colon for colonoscopy, healthcare providers have recommended that patients use the modern Flit Phosphosoda soda medication. Instructions for use regulate it as a progressive laxative with osmotic effect.
Main components and scope
A medication is an oral solution. Available in 45 ml plastic bottles, 2 bottles in one cardboard pack. The main active ingredients of the drug are disodium phosphate dodecahydrate and sodium dihydrogen phosphate dihydrate. In 1 ml of the drug they contain respectively 240 and 542 mg. There are also certain additional components.
The main purpose of the medicine “Phospho Fleet Soda” is its use for therapeutic cleaning procedures, if it is necessary to empty the intestines and colon before the upcoming surgery or for examinations for diagnostic purposes (radiological, endoscopic).
Pharmacodynamics and pharmacokinetics
The medication is a saline laxative. The principle of its work is a volume increase in liquid content in the intestinal lumen, which, in turn, leads to a softening of feces and facilitating the process of colon liberation. An increase in fluid volume in the ileum stimulates intestinal motility.
Flit Phospho-Soda only has a local effect. It is not absorbed into the general bloodstream and is practically not absorbed in the gastrointestinal tract (the absorption of a small amount of sodium ions and phosphates depends on the dose of the drug). True, a slight change in the level of electrolytes in blood plasma was observed, however, it does not have any clinical significance and disappears after 12-24 hours.
Who should not take the medicine?
Any drug has contraindications. “Flit Phospho-soda” is no exception. Instructions for use of this drug warns of the presence of certain conditions under which its use is unacceptable. Firstly, this is the presence of hypersensitivity to the main and auxiliary components of the drug. Further: the use of the medication is not allowed for those patients who have been diagnosed with partial or complete bowel obstruction. You can not prescribe the drug in the presence (and even with suspicion) of such problems as a violation of the integrity of the intestine, any inflammatory diseases of this organ. Nausea, vomiting, abdominal pain are also sufficient grounds to refuse to take "Fleet".
In addition, the "Fleet Phospho-Soda" instruction for use prohibits taking people with heart and severe renal failure. Particular care must be taken to take the drug in elderly patients suffering from angina pectoris in an unstable form after acute myocardial infarction. It is very undesirable to prescribe this drug to patients under 15 years of age and women during gestation and lactation. Patients on a salt-free diet should be attentive to their condition during treatment with this laxative.
Possible side effects
In most cases, the feedback from the patients “Fleet Phospho-Soda” is positive. As a rule, the drug is well tolerated. However, in some cases, some side effects were observed. As for the reactions from the cardiovascular system, one can hear about the appearance of pain in the chest, a violation of the heart rhythm, in very rare cases, the development of myocardial infarction is possible.
Gastrointestinal tract can respond by the appearance of pain in the epigastric region, vomiting, nausea, diarrhea, bloating. Possible distortion of the results of a colonoscopy.
Undesirable reactions to the drug from the side of metabolism were observed. Here we can talk about dehydration (dehydration, a decrease in the amount of fluid in the body below the physiologically necessary norm), tetany (convulsions caused by impaired calcium metabolism), metabolic acidosis (increased acidity in the body due to the accumulation of acidic products in tissues, their binding and destruction are not effective) . In addition, Flit Phosphosoda can provoke an increase in plasma concentrations of sodium and phosphates and a decrease in potassium and calcium.
Possible reactions from the central nervous system and its peripheral departments may be headache, dizziness, loss of consciousness, paresthesia (numbness, tingling sensation, creeping creeps), tonic convulsions.
Allergic reactions in the form of urticaria, skin itching, allergic dermatitis can be observed. In addition to the above described unpleasant phenomena, sometimes patients talk about general weakness, chills, impaired renal function. Perhaps the development of nephrocalcinosis (accumulation of deposits of calcium salts in the kidneys).
If any adverse reactions develop, you must immediately stop taking the drug and seek medical advice.
Excessive dose, treatment
Acceptance of unacceptably large doses of the drug for patients suffering from intestinal obstruction can provoke serious deviations in the balance of electrolytes (dehydration, hypernatremia, hyperphosphatemia, hypokalemia, hypocalcemia). When taking large volumes of Fleet Phosphosoda soda (instructions, reviews of health workers confirm this information), the development of tachycardia, a fall to dangerous BP values, and the appearance of pain in the abdomen are likely.
There may be anxious feelings for no apparent reason, emotional lability. If the medication is not stopped, and the dose continues to increase, this can lead to cardiac arrest, the development of a shock state, convulsive muscle contractions, respiratory failure and paralytic intestinal obstruction.
At the moment, the instructions for use do not report the presence of an antidote for Fleet Phospho-Soda, it is absent. The main measures aimed at eliminating the consequences of exceeding the allowable dose are to restore and maintain at the right level of water-electrolyte balance. All medical measures should be taken at the facility. If the degree of intoxication is sufficiently high, it may be necessary to carry out activities aimed at maintaining the functions of the cardiovascular and respiratory systems. It may also be necessary to administer (intravenously) calcium preparations.
Application: mode, dosage
If the purpose of using the medication is to prepare for a colonoscopy, Fleet Phosphosoda should be taken the day before going to a medical institution. The time of admission to the hospital (first or second half of the day) is important, since the dosage regimen depends on this.
During the morning reception (one day before the diagnosis), for breakfast, take any clear liquid in the amount of at least 1 cup (water, juice, tea, coffee).
Next, you need to take the first dose of the medication (a solution of 45 ml of the medication and 125 ml of water) and drink cold water (250 ml or more). At lunchtime, at least 750 ml of clear liquid (3 glasses) is drunk, at dinner - 1 or more glasses. At the end of dinner, a second dose of laxative is drunk (1 bottle of medication (45 ml) per 125 ml of water), and you need to drink it with another glass of water. Before midnight, it is advisable to drink the liquid additionally. Typically, bowel movements occur in the period from 0.5 to 6 hours.
If the diagnosis is scheduled in the afternoon, this allows you to take light meals at lunch (with the exception of solid foods) the day before the procedure. Instead of dinner, 250 ml (as much as possible) of liquid is drunk, then you need to take the first dose and drink the laxative Fleet Phospho-Soda with one glass of water. Preparation continues in the evening and until midnight and consists in taking at least 750 ml of water.
At 7 o’clock in the morning on the day of the diagnosis, you need to drink 250 ml of water. Next, you need to take 1 bottle of laxative (diluted in 125 ml of water) and drink a glass or more of cold water. The intake of solid food can be resumed after the diagnosis or after a certain period after surgery.
What to look for?
The laxative “Fleet Phospho-soda” is forbidden to use the instructions for use to solve problems with constipation. With caution, the drug is prescribed for debilitated patients and elderly people suffering from various heart diseases, colostomy, patients with reduced renal activity, and diets low in salt.
It is not recommended to use this medication during pregnancy, since there is no information about the degree of its toxic effect on the fetus and / or the ability to provoke abnormal intrauterine development. If the need to resort to taking Fleet Phosphosoda soda occurs in a nursing woman, breastfeeding should be stopped for the entire period of the use of a laxative and for another 24 hours after taking the last dose. This is due to the fact that sodium phosphate is able to be excreted in breast milk.
The opinion of patients is wrong that if you drink both bottles at once, at one time - the medication will work more efficiently. The contents of the intestines will only liquefy, but cleansing will not occur. If the patient is faced with the choice of “Fortrans” or “Fleet Phospho-soda”, then he should know that the last drug does not require a long period of fasting, and its use does not carry a serious water load on the body for a short period of time (1 liter of liquid in 1 hour).
Interaction with other drugs
"Fleet Phospho-soda" instructions for use (medical reviews confirm the information) recommends very carefully prescribed in parallel with diuretics, NSAIDs, other laxatives and lithium preparations. Undesirable concurrent use of "Fleet" with drugs that can increase the QT interval.
In addition, Fleet Phospho-Soda can significantly reduce the effectiveness of certain oral contraceptives and hypoglycemic agents, drugs for the treatment of epilepsy, and some antibiotics.
Medicines - analogues
A lot of laxatives with osmotic effects are now available. However, most often, when it comes to preparing for a colonoscopy, patients are advised to conduct preparatory procedures using the Fortrans drug. If we compare it with Fleet Phospho-Soda, the patients' reviews agree that both drugs have a similar effect, which is not surprising, because they are intended for the same purpose. However, in the process of taking "Fortrans" you can not take any food, and the amount of fluid that must be taken depends on the weight of the patient. That is, for every 20 kg of body weight, you need to drink 1 liter of solution, and all the necessary volume of liquid should be consumed at most 2 times, and even better - for one. If the patient is large enough, then preparation for diagnostic procedures becomes problematic.
In addition, the Fleet Phospho-Soda preparation itself is classified as a group of drugs that can provide significant assistance to patients suffering from intestinal atony. It also includes (and can be considered full-fledged analog medicines) “Belozor Bolotniy”, “Kalimin forte”, “Glyciram” - tablets of 0.05 g.
Another very common medicine for preparing the intestines for the colonoscopy procedure is Lavacol, which performs the functions declared by the instruction with equal efficiency, and at the same time its cost is several times lower than that of Flit Phosphosoda.
The opinion of patients and proctologists
Like any medicine, Flit Phospho-Soda has both positive and negative reviews from patients. Most negative replicas are associated with the high price of the drug, someone really did not like the taste of the drug. Some patients had a feeling of nausea and pain in the intestines. The number of positive reviews prevails over the negative. The drug is highly effective, the majority of consumers do not cause any side effects and negative feelings.
Patients who previously used Fortrans evaluate Fleet Phospho-Soda on the most positive side: not everyone can drink 4-5 liters of liquid at a time.
Proctologists also speak very positively about the Flit Phospho-Soda medication (its analogues, by the way, are not always so effective): the intestines are cleaned perfectly, patients rarely complain of side effects. If a person carried out preparatory measures in strict accordance with the instructions for use of the drug, then, as a rule, during the diagnosis there are no problems. All sections of the intestine are available to the attention of the doctor, and the patient can get reliable information about his health condition first-hand.