DBL Potassium Dihydrogen Phosphate Special Precautions

Potassium: The use of potassium salts in patients with chronic renal disease, adrenal insufficiency or any other condition which impairs potassium excretion, requires particularly careful monitoring of the serum potassium concentration and appropriate dosage adjustment.
Potassium should be used with caution in diseases associated with heart block since increased serum potassium may increase the degree of block.
Hyperkalaemia: monobasic potassium phosphates should be avoided in patients with hyperkalaemia. Sodium phosphates may be substituted.
In patients with impaired mechanisms for excreting potassium, administration of potassium salts can produce hyperkalaemia and cardiac arrest. This is an important concern in patients given IV potassium. Potentially fatal hyperkalaemia can develop rapidly and be asymptomatic. In patients being given potassium especially by IV, monitoring of serum electrolytes, the ECG and the patient's clinical status is indicated.
Phosphate: Phosphate should be administered with caution in conditions where high phosphate levels may be encountered, such as hypoparathyroidism, chronic renal disease, acute dehydration, pancreatitis, rhabdomyolysis, severe renal insufficiency and extensive tissue damage (such as severe burns).
Phosphate should be administered with caution in conditions where low calcium levels maybe encountered, such as hypoparathyroidism, osteomalacia, chronic renal disease, acute pancreatitis, rhabdomyolysis, rickets, myotonia congenita, and heart disease (particularly in digitalised patients) (see Interactions) since these conditions may be exacerbated by the potassium in the injection.
Caution should be used where patients may be hypocalcaemic.
Serum electrolyte and especially phosphate levels in the body and renal function should be monitored during treatment.
Phosphates should not be administered to patients with severely impaired renal function. Aluminium, calcium, or magnesium salts should not be administered concomitantly with phosphates as they bind phosphate thus impairing its absorption from the gastro-intestinal tract.
Effects on laboratory tests: Saturation of bone binding sites by phosphate ions may cause decreased bone uptake of technetium Tc^99m labelled contrast agents in bone imaging.
Effects on Ability to Drive and Use Machines: The effects of this medicine on a person's ability to drive and use machines were not assessed as part of its registration.
Use in Children: No data available.
Use in the Elderly: No data available.