Sodium biphosphate and sodium phosphate is a combination medicine used in adults to treat constipation and to clean the bowel before a colonoscopy.

Sodium biphosphate and sodium phosphate may also be used for purposes not listed in this medication guide.

You should not use this medicine if you have kidney disease, a bowel obstruction, a perforated bowel, colitis or toxic megacolon, or a history of gastric bypass surgery or stomach stapling.

In rare cases, this medicine can cause kidney failure, especially if you have: kidney disease, congestive heart failure, severe constipation, inflammatory bowel disease, if you are over 55, or if you are dehydrated. Using certain other medicines can also increase your risk of kidney problems.

Use exactly as directed on the label, or as prescribed by your doctor.

Using too much of this medicine can cause rare but life-threatening side effects on your kidneys and heart.

Read and carefully follow any Instructions for Use provided with your medicine. Ask your doctor or pharmacist if you do not understand these instructions.

To keep from getting dehydrated, drink plenty of water or other clear liquid before, during, and after taking this medicine. Avoid milk, liquids that are colored red or purple, juice that contains pulp, or drinks that contain alcohol.

Carefully follow your doctor's dosing instructions about the timing of this medication and your procedure.

You may need to follow a special diet while treating constipation or preparing for your colonoscopy. Follow your doctor's instructions about any restrictions on food or beverages.

Store at room temperature away from moisture and heat. Throw away any leftover medicine after your treatment ends.

You should not use oral sodium biphosphate and sodium phosphate if you are allergic to it, or if you have:

• kidney disease (or if you have ever had a biopsy showing a kidney problem caused by too much phosphate);

• a bowel obstruction;

• a perforated bowel;

• colitis or toxic megacolon; or

• a history of gastric bypass surgery or stomach stapling.

In rare cases, sodium biphosphate and sodium phosphate can cause kidney failure, especially if:

• you have kidney disease;

• you have congestive heart failure;

• you have severe constipation or inflammatory bowel disease;

• you take certain medicines to treat high blood pressure or heart disease;

• you take an NSAID (nonsteroidal anti-inflammatory drug);

• you are older than 55; or

• you are dehydrated.

Do not use Osmoprep if you have already used it within the past 7 days.

Ask a doctor or pharmacist if this medicine is safe to use if you have:

• kidney disease;

• heart disease;

• dehydration or an electrolyte imbalance (such as high or low levels of calcium, potassium, sodium, phosphorous, or magnesium in your blood);

• a seizure;

• stomach surgery;

• an intestinal disorder (such as ulcerative colitis or inflammatory bowel disease);

• trouble swallowing, gastroesophageal reflux disease (GERD);

• withdrawal from drug or alcohol addiction;

• if you are on a low-salt diet; or

• if you have already used a laxative for 7 days or longer.

Ask a doctor before using this medicine if you are pregnant or breast-feeding.

Do not give this medicine to a child without medical advice.

Call your doctor for instructions if you miss a dose or do not finish all doses required before your colonoscopy.

Do not use more than the recommended dose of sodium biphosphate and sodium phosphate in any 24-hour period.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Do not use other laxatives or enemas.

Sodium biphosphate and sodium phosphate can make it harder for your body to absorb other medicines you take by mouth. Avoid taking oral medicines within 1 hour before or after you take sodium biphosphate and sodium phosphate.

Get emergency medical help if you have signs of an allergic reaction: hives; dizziness; wheezing, difficult breathing; swelling of your face, lips, tongue, or throat.

sodium biphosphate and sodium phosphate may cause serious side effects. Stop using sodium biphosphate and sodium phosphate and call your doctor at once if you have:

• no bowel movement after using this medicine;

• severe stomach pain, rectal bleeding or bright red bowel movements;

• fast, slow, or uneven heart rate;

• little or no urination;

• a seizure (black-out or convulsions); or

• headache, dizziness, and vomiting.

Common side effects of sodium biphosphate and sodium phosphate may include:

• bloating;

• nausea, vomiting; or

• stomach pain.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Ask a doctor or pharmacist before using sodium biphosphate and sodium phosphate with any other medications, especially:

• a diuretic or "water pill";

• blood pressure medication;

• medicine to treat a kidney problem;

• seizure medication;

• a sedative--alprazolam, diazepam, triazolam, Valium, Xanax, and others; or

• NSAIDs (nonsteroidal anti-inflammatory drugs)--aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve), celecoxib, diclofenac, indomethacin, meloxicam, and others.

This list is not complete. Other drugs may affect sodium biphosphate and sodium phosphate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.