OsmoPrep, a product used for bowel cleansing prior to colonoscopies has been linked to an increased risk of acute phosphate nephropathy.
OsmoPrep: An Overview
OsmoPrep® is a bowel cleansing medication prescribed to individuals prior to surgery, colonoscopy, or x-ray procedure. The medication comes in tablet form and is produced by Salix Pharmaceuticals. Despite being an effective laxative, OsmoPrep is also known to cause a number of severe side effects.
What side effects have been associated with OsmoPrep?
The side effects of OsmoPrep vary widely from person to person. The most common symptoms include abdominal bloating & pain, headache, and nausea. However, the drug poses other more serious side effects such as severe kidney damage, hyperphosphatemia, and acute phosphate nephropathy. In reported instances, patients taking the drug have been diagnosed with hypokalemia.
What is Acute Phosphate Neuropathy?
Acute phosphate neuropathy refers to kidney damage caused by the formation of phosphate crystals within the renal tubules, which can cause acute renal failure. It frequently occurs following the ingestion of oral sodium phosphate solution like OsmoPrep. The condition may be aggravated by advanced age, dehydration, in the presence of hypertension, or if the patient is taking an ACE inhibitor or angiotensin receptor blocker.
FDA Warning on OsmoPrep
In 2008, the FDA issued a safety alert that warned of the risks of using OsmoPrep, Visicol, and Fleet Phospho-Soda, specifically warning of the risk of acute kidney injury. The manufacturer of OsmoPrep also added a ‘black box warning’ to the medications label stating:
“There have been rare, but serious reports of acute phosphate nephropathy in patients who received oral sodium phosphate products for colon cleansing prior to colonoscopy. Some cases have resulted in permanent impairment of renal function and some patients required long-term dialysis. While some cases have occurred in patients without identifiable risk factors, patients at increased risk of acute phosphate nephropathy may include those with increased age, hypovolemia, increased bowel transit time (such as bowel obstruction), active colitis, or baseline kidney disease, and those using medicines that affect renal perfusion or function (such as diuretics, angiotensin converting enzyme [ACE] inhibitors, angiotensin receptor blockers [ARBs], and possibly nonsteroidal anti-inflammatory drugs [NSAIDs]).”