Visicol (Oral)

Sodium phosphate dibasic and sodium phosphate monobasic combination is used to clean or empty your bowels before an imaging procedure called colonoscopy. This medicine works by cleaning your colon and causing you to have diarrhea. This helps your doctor see the inside of your colon more clearly during the colonoscopy.

This medicine is available only with your doctor's prescription.

It is very important for your doctor to check your progress after taking this medicine. This will help your doctor see if the medicine is working correctly. Blood and urine tests and an electrocardiogram (ECG) may be needed to check for unwanted effects.

Do not take this medicine with other laxatives or enemas that contain sodium phosphate. Doing so may lead to serious unwanted effects.

This medicine may cause serious kidney problems. These are more likely if you are over 55 years old, dehydrated, have low blood volume, and are taking medications that could harm your kidneys (for example, diuretics or water pills, certain blood pressure medicines, NSAID pain or arthritis medicine). Contact your doctor right away if you notice bloody urine, a decrease in how much or how often you urinate, lower back or side pain, trouble breathing, weight gain, or swelling in your face, fingers, or lower legs.

Taking more than one dose of over-the-counter (OTC) sodium phosphate medicine in 24 hours may cause serious kidney and heart problems. Check with your doctor if you experience any of the following symptoms: confusion, decreased urination, dizziness, dry mouth, fainting, increased heart rate, rapid breathing, or unusual tiredness or weakness.

Contact your doctor immediately if you notice any changes in your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you have had a heart rhythm problem, such as QT prolongation.

This medicine may cause serious allergic reactions, including anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you experience a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after using this medicine.

Call your doctor immediately if you have any unusual symptoms that concern you, such as bloating, abdominal or stomach pain, seizures, nausea, vomiting, or headaches.

Do not take other medicines unless your doctor has discussed them with you. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a medicine, you and your doctor need to consider the risks and benefits. For this medicine, keep the following in mind:

Allergies

Let your doctor know if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, inform your healthcare professional about any other types of allergies, such as to foods, dyes, preservatives, or animals. For over-the-counter products, read the label or package ingredients carefully.

Pediatric

Studies have not been conducted to determine how OsmoPrep® tablets work in children. Safety and effectiveness have not been established for this age group.

Geriatric

Current studies have not found any specific problems in elderly patients that would limit the use of OsmoPrep® tablets. However, older adults may be more sensitive to the effects of OsmoPrep® tablets than younger adults and may also have age-related kidney issues, which may require caution for patients taking this medicine.

Breast Feeding

There are no adequate studies to determine the risk to infants when using this medication while breastfeeding. Consider the potential benefits and risks before taking this medication during breastfeeding.

Interactions with Medicines

Some medicines should never be used together, while others may be used together even if there could be an interaction. In these cases, your doctor might want to adjust the dose or take other precautions. It's very important for your healthcare professional to know if you are taking any of the medicines listed below. The following interactions have been chosen based on their potential importance and are not an exhaustive list.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide against treating you with this medication or change some of the other medicines you take.

• Bepridil
• Burosumab-twza
• Cisapride
• Dronedarone
• Levoketoconazole
• Mesoridazine
• Pimozide
• Piperaquine
• Saquinavir
• Sparfloxacin
• Terfenadine
• Thioridazine
• Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some situations. If both medicines are prescribed together, your doctor may adjust the dose or how often you take one or both of the medicines.

• Adagrasib
• Alfuzosin
• Amiodarone
• Amisulpride
• Amitriptyline
• Amoxapine
• Anagrelide
• Apomorphine
• Aripiprazole
• Aripiprazole Lauroxil
• Arsenic Trioxide
• Asenapine
• Astemizole
• Atazanavir
• Azithromycin
• Bedaquiline
• Buprenorphine
• Buserelin
• Ceritinib
• Chloroquine
• Chlorpromazine
• Ciprofloxacin
• Citalopram
• Clarithromycin
• Clofazimine
• Clomipramine
• Clothiapine
• Clozapine
• Crizotinib
• Dabrafenib
• Dasatinib
• Degarelix
• Delamanid
• Desipramine
• Deslorelin
• Deutetrabenazine
• Dexmedetomidine
• Disopyramide
• Dofetilide
• Dolasetron
• Domperidone
• Donepezil
• Droperidol
• Efavirenz
• Encorafenib
• Entrectinib
• Erdafitinib
• Erythromycin
• Escitalopram
• Etrasimod
• Fexinidazole
• Fingolimod
• Flecainide
• Fluconazole
• Fluoxetine
• Formoterol
• Foscarnet
• Fostemsavir
• Gatifloxacin
• Gemifloxacin
• Gepirone
• Glasdegib
• Gonadorelin
• Goserelin
• Granisetron
• Halofantrine
• Haloperidol
• Histrelin
• Hydroxychloroquine
• Hydroxyzine
• Ibutilide
• Iloperidone
• Imipramine
• Inotuzumab Ozogamicin
• Ivabradine
• Ivosidenib
• Ketoconazole
• Lapatinib
• Lefamulin
• Lenvatinib
• Leuprolide
• Levofloxacin
• Lofexidine
• Lopinavir
• Lumefantrine
• Macimorelin
• Mefloquine
• Methadone
• Metronidazole
• Mifepristone
• Mirtazapine
• Mobocertinib
• Moxifloxacin
• Nafarelin
• Nilotinib
• Norfloxacin
• Nortriptyline
• Octreotide
• Ofloxacin
• Olanzapine
• Ondansetron
• Osilodrostat
• Osimertinib
• Oxaliplatin
• Ozanimod
• Pacritinib
• Paliperidone
• Panobinostat
• Paroxetine
• Pasireotide
• Pazopanib
• Phenobarbital
• Pimavanserin
• Pitolisant
• Ponesimod
• Posaconazole
• Primidone
• Procainamide
• Prochlorperazine
• Promethazine
• Propafenone
• Protriptyline
• Quetiapine
• Quinidine
• Quinine
• Quizartinib
• Ranolazine
• Relugolix
• Ribociclib
• Selpercatinib
• Sertraline
• Sevoflurane
• Siponimod
• Solifenacin
• Sorafenib
• Sotalol
• Sulpiride
• Sunitinib
• Tacrolimus
• Telavancin
• Telithromycin
• Tetrabenazine
• Trazodone
• Triclabendazole
• Trimipramine
• Triptorelin
• Vandetanib
• Vardenafil
• Vemurafenib
• Vilanterol
• Vinflunine
• Voclosporin
• Voriconazole
• Zuclopenthixol

Using this medicine with any of the following medicines may increase the risk of certain side effects, but using both medicines may be the best option for you. If both medicines are prescribed, your doctor may modify the dose or how often you take one or both of them.

• Aluminum Carbonate, Basic
• Aluminum Hydroxide
• Aluminum Phosphate
• Calcium Acetate
• Calcium Carbonate
• Calcium Citrate
• Dihydroxyaluminum Aminoacetate
• Dihydroxyaluminum Sodium Carbonate
• Magaldrate
• Magnesium Carbonate
• Magnesium Hydroxide
• Magnesium Oxide
• Magnesium Trisilicate

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken near mealtimes or with certain foods due to possible interactions. Using alcohol or tobacco with some medicines may also lead to interactions. Talk to your healthcare professional about the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

Other medical issues may affect how this medicine works. Make sure to tell your doctor if you have any other medical conditions, especially:

• Acute phosphate nephropathy (a serious kidney issue caused by too much phosphate), confirmed by biopsy or
• Stomach or bowel issues (e.g., blockage, perforation) or
• Stomach surgery (e.g., bypass, stapling) or
• Toxic colitis (inflammation of the colon) or
• Toxic megacolon (severe irritation of the colon)—This medicine should not be used in these conditions.

• Angina (severe chest pain), unstable or
• Congestive heart failure or
• Recent heart attack or
• Heart disease (e.g., cardiomyopathy) or
• Heart rhythm problems (e.g., prolonged QT interval, poorly controlled arrhythmia), history of—This may increase the risk of arrhythmia.

• Arrhythmia (heart rhythm issue) or
• Dehydration or
• Electrolyte imbalance (e.g., high or low calcium, phosphate, potassium, or sodium in the blood) or
• Hypovolemia (low blood volume) or
• History of inflammatory bowel disease or
• History of seizures or
• Trouble swallowing or gastric reflux or
• Ulcerative colitis or
• Withdrawal from alcohol or benzodiazepines—Use with caution. This may worsen these conditions.

Along with its necessary effects, a medicine may cause some unwanted effects. Not all of these side effects may happen, but if they do, they may need medical attention.

Check with your doctor right away if any of the following side effects occur:

More common

• Bloating
• stomach pain

Incidence not known

• Agitation
• bloody or cloudy urine
• burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
• confusion
• cough
• decrease in the frequency or amount of urine
• decreased awareness or responsiveness
• depression
• difficult or labored breathing
• difficult or painful urination
• difficulty with swallowing
• dizziness
• fainting
• fast, slow, or irregular heartbeat
• headache
• hives, itching, skin rash
• hostility
• increased blood pressure
• increased thirst
• irritability
• large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals
• loss of appetite
• loss of consciousness
• lower back or side pain
• muscle twitching
• nausea
• noisy breathing
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• rapid weight gain
• redness of the skin
• seizures
• severe sleepiness
• sudden decrease in the amount of urine
• swelling of the face, ankles, or hands
• tightness in the chest
• unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
• vomiting

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

• Blurred vision
• chest pain or discomfort
• decreased frequency of urine
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• dry mouth
• increase in heart rate
• increased thirst
• lightheadedness
• loss of appetite
• lower back or side pain
• muscle cramps in the hands, arms, feet, legs, or face
• muscle pain
• pounding or rapid pulse
• rapid breathing
• restlessness
• stomach cramps
• sunken eyes
• sweating
• tremor
• weakness
• weight gain
• wrinkled skin

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Fleet Phospho-soda EZ-Prep
• OsmoPrep
• Phospho-Soda
• Visicol

Available Dosage Forms:

• Tablet
• Solution

Therapeutic Class: Laxative, Hyperosmotic

Take this medicine exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine should come with a Medication Guide. Read and follow these instructions carefully. Ask your doctor if you have any questions.

Take each dose (4 tablets) with 8 ounces of clear liquids. Examples of clear liquids include: water, flavored water, clear broth, herbal tea, black tea, coffee, clear soda, gelatin, popsicles, lemonade (no pulp), ginger ale, white grape juice, or apple juice. Do not eat or drink alcohol, milk, anything colored purple or red, or any foods that have pulp.

Eat or drink only clear liquids after 12:00 PM (noon) on the day before and until after your colonoscopy. Do not eat solid food.

Drink as much extra liquid as you can before, during, and after taking this medicine. This will help replace the fluids you are losing with your bowel movements. This will also keep your kidneys working well and help soften your bowel movements, making them easier to pass.

Do not take any oral medicines within 1 hour before or after each dose of OsmoPrep®.

Do not take this medicine if you have already used it in the last 7 days. Your doctor will tell you if you need to use this medicine again.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):For cleansing of the colon: Adults— Evening before the colonoscopy: Four tablets with 8 ounces (oz.) of clear liquids every 15 minutes (for a total of 20 tablets). Day of colonoscopy (starting 3 to 5 hours before the procedure): Four tablets with 8 oz. of clear liquids every 15 minutes (for a total of 12 tablets). Children—Use and dose must be determined by your doctor.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.