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 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, this medicine 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.

Use Visicol (Oral) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

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.

Stop using this medicine 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 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.

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.