Parenteral Manual

Phosphate (sodium phosphate)

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Electrolyte supplement
Original Date: 
May 2006
Revised Date: 
December 2019
  • Treatment and prevention of hypophosphatemia, when oral therapy is not possible
Reconstitution and Stability: 
  • Stable at room temperature
  • Each mL of sodium phosphate contains 4 mmol of sodium and 3 mmol of phosphate
  • Use a 5 micron filter needle to withdraw solution from  vial and use a 0.22 micron in-line filter when administering the final IV admixture to patients

- Solutions Compatible: dextrose, saline, dextrose-saline combinations       

- Additive/buretrol Compatible: TP (amino acids/dextrose) under certain conditions of concentration, pH, etc.     

- Y-site Compatible: no information

- Incompatible: amiodarone, ciprofloxacin, dobutamine, ringer's solution, ringer's lactate, calcium: compatible in TPN For more detailed information about phosphate and calcium compatibility, please contact the Pharmacy


(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

IV Direct


IV Intermittent Infusion YES- reserved for severe depletion situations; requires cardiac and respiratory monitoring
        -use a 0.22 micron inline tubing when administering

Usual dilution - Peripheral line  0.05 mmol of phospate/mL
                          - Central line  0.1 mmol of phosphate/mL
Infusion time: 6 hours
IV Continuous Infusion

YES - use a 0.22 micron inline tubing when administering

Usual dilution - Periperal line  0.05 mmol of phosphate/mL            
                          - Central line  0.1 mmol of phosphate/mL

Usual rate: Do not exceed 0.06 mmol of phosphate/kg/hour


(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Dosages are expressed in terms of mmol of phosphate

- Treatment of hypophosphatemia:

  • Low dose: 0.08 mmol of phosphate/kg IV over 6 hours, up to 30 mmol/dose
  • Intermediate dose: 0.16-0.24 mmol/kg IV over 6 hours, up to 45 mmol/dose
  • High dose: 0.36 mmol/kg IV over 6 hours, up to 60 mmol/dose
  • Maximum dose: 80 mmol/24 hrs

- Maintenance:

  • pediatric: 0.5-1.5 mmol of phosphate/kg/day IV
  • adult: 40-70 mmol of phosphate/day
Potential hazards of parenteral administration: 
  • Must be well diluted prior to use; may cause pain if administered in high concentrations into small veins  
  • Hyperphosphatemia, hypernatremia, hypocalcemia
  • Tetany, mental confusion, paresthesias of extremities, seizures, headache
  • Hypotension
  • Edema    
  • Acute renal failure
  • Nausea and vomiting
  • Patients must be on a cardiac monitor during intermittent infusion
  • Monitor vitals every 15 minutes for the first hour, every 30 minutes for the second hour, and every 1 hour thereafter
  • Monitor serum phosphorus, calcium, and sodium levels
  • Monitor renal function, blood pressure and urine output  
  • Contraindicated in hypernatremia, hyperphosphatemia, hypocalcemia, severe renal impairment, severe tissue trauma, CHF
  • Use with caution in patients with renal impairment, adrenal insufficiency, cardiac disease
  • Should be administered only in patients with adequate urine flow
  • Must be diluted before IV use and infused slowly

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