A Randomized, Single Blind Evaluation of Oral Sodium Phosphate Solution (OSPS) as Bowel Preparation with Different Hydration and Dosing Regimens

Dosing Considerations in the Use of Sodium Phosphate Bowel Preparations for Colonoscopy

“…35, 36 In a preliminary study of 321 patients, Rex et al 34 found that administration of 45 mL plus 30 mL of NaP solution (75 mL regimen containing 49.5 g of NaP) resulted in significantly less pronounced mean shifts from baseline in several laboratory parameters, including serum sodium and phosphate levels, compared with administration of the standard 45 mL plus 45 mL regimen of NaP solution (90 mL regimen containing 59.4 g of NaP) (p ≤ 0.01).…”

“…27 In addition, NaP solution is available in a lower-dose regimen of 75 mL versus 90 mL. 34 A limited number of studies, discussed below, suggest that administration of lower doses of NaP may translate into an improved safety profile with comparable or better efficacy. 34-36…”

“…5 In a study comparing 45 mL plus 30 mL of NaP solution versus the standard 45 mL plus 45 mL regimen, the lower dose regimen significantly reduced the incidence of vomiting (3% vs 8%; p = 0.04), abdominal cramps (36% vs 48%; p = 0.02), and overall discomfort (58% vs 69%; p = 0.03). 34 However, another study comparing these NaP liquid regimens failed to observe a difference in the frequency of reported AEs. 37 In a study comparing different NaP tablet formulations, Rex et al 35 reported significant reductions in the incidence of AEs (58% vs 68%; p = 0.03) and GI AEs (56% vs 66%; p < 0.05) in patients who received 32 MCC-free tablets (n = 239) compared with those who received 40 MCC-containing tablets (n = 238), respectively.…”

“…A larger study of 321 subjects reported comparable cleansing with 90 mL and 75 mL regimens; good or excellent cleansing was reported in 90% of patients who took the 90 mL regimen and in 87% of patients who took the 75 mL regimen. 34 While these preliminary trials were not powered to establish equivalence between the study arms, they suggest very similar efficacy for the 90 mL and 75 mL preparations.…”

“…The recommended dosing schedules for NaP preparations (Table 1) are supportedby severalclinicalstudies. [34][35][36][37][38][39][40][41][42][43][44][45][46] An importantcomponentof these schedules is split dosing, in which a portion of the dose is administered on the day before colonoscopy and the remaining dose is administeredon the day of the procedure.…”