Green Enema Rectal Saline
Diabasic Sodium Phosphate + Monobasic Sodium Phosphate
(19 gm+7 gm)/118 ml
Greenland Pharmaceuticals Ltd.
| Pack size | 133 ml bottle |
|---|---|
| Price | 249.00 BDT |
Indications
Green Enema Rectal Saline is used for:
Cleansing of the colon, Constipation, Bowel Cleansing
Adult Dose
Oral
Tablets are indicated for cleansing of the colon as a preparation for colonoscopy in adults 18 years of age or older.
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).
As Rectal Enema
Constipation & Bowel Cleansing
For the relief of occasional constipation. For use where bowel cleansing is required, such as before and after lower bowel surgery, delivery and post-partum, before proctoscopy, sigmoidoscopy or colonoscopy and before radiological examinations of the lower bowel.
1 bottle PR; not to exceed 1 administration/24 hr
Child Dose
As Rectal Enema
Constipation & Bowel Cleansing
Indicated as laxative in the relief of occasional constipation and as part of a bowel cleansing regimen in preparing the colon for surgery, x-ray or endoscopic examination
<2 years: Do not use
2-4 years: Administer one-half bottle PR of pediatric enema (ie, ~30 mL); prepare dose by unscrewing cap from bottle and removing 2 tablespoons of liquid (30 mL) with a measuring spoon, replace cap and administer remaining liquid
5-11 years: Administer 1 bottle PR of pediatric enema (ie, 59 mL)
12 years or older: Administer as in adults (adult enema)
Renal Dose
Use with caution
Administration
Remove orange protective shield from enema tip before inserting; with steady pressure, gently insert enema tip into rectum with a slight side-to-side movement, with tip pointing toward navel
Insertion may be easier if person receiving enema bears down, as if having a bowel movement; this helps relax the muscles around the anus
Do not force enema tip into rectum as this can cause injury
Squeeze bottle until nearly all liquid is gone; it is not necessary to empty the bottle completely, as it contains more liquid than needed
Remove enema tip from rectum and maintain position until urge to evacuate is strong (usually 1-5 minutes)
Do not retain enema solution for more than 10 minutes
Positions for using this enema
Left-side position: Lie on left side with knee bent, and arms resting comfortably
Knee-chest position: Kneel, and then lower head and chest forward until left side of face is resting on surface with left arm folded comfortably
Contra Indications
Sodium Phosphates is contraindicated in diseases where high sodium, high phosphorus or low calcium levels may be encountered.
Known allergy or hypersensitivity to sodium phosphate salts or any component
Biopsy-proven acute phosphate nephropathy, Gastrointestinal (GI) obstruction, Gastric bypass or stapling surgery, Bowel perforation, Toxic colitis, Toxic megacolon.
Enema: Renal failure, CHF, ascites, obstruction, megacolon, perforated bowel, ulcerative colitis, fecal impaction
Precautions
Rare reports of acute phosphate nephropathy with oral sodium phosphate products used for colon cleansing before colonoscopy
Some cases have resulted in permanent renal function impairment requiring long-term hemodialysis
Risk factors for acute phosphate nephropathy include age >55 yr, hypovolemia, baseline kidney disease, bowel obstruction, active colitis, and those using medicines that affect renal perfusion or function (eg, diuretics, ACE inhibitors, ARBs, NSAIDs)
Advise patients of the importance of following the recommended split dosage regimen and importance of adequate hydration before, during, and after the use of this product; avoid additional sodium phosphate-based purgative or enema products.
Phosphorus replacement therapy with sodium phosphates should be guided primarily by the serum inorganic phosphorus levels and the limits imposed by the accompanying sodium (Na+) ion.
Use with caution in patients with renal impairment, cirrhosis, cardiac failure or in conjunction with other edema causing medications. It should not be used with sodium retaining medications.
Caution must be exercised in the administration of parenteral fluids especially those containing sodium ion, to patients receiving corticosteroids or corticotropin.
Renal impairment may occur. Assess renal function before treatment and during therapy
Seizures due to electrolyte abnormalities can occur
Use caution in patients with higher risk of arrhythmias, eg, cardiomyopathy, prolonged QT, uncontrolled arrhythmias, or recent MI
Adequately hydrate before, during and after dosing (5.4)
Use caution in patients with history of Inflammatory Bowel Disease
Frequent monitoring of serum calcium and sodium as well as renal function is recommended.
Pregnancy-Lactation
Pregnancy
There are no available data on sodium phosphate use in pregnant women to inform a drug-associated risk for adverse developmental outcomes
Animal data
Animal reproduction studies have not been conducted with sodium phosphate
Lactation
There are no data available to assess presence of sodium phosphate in human milk, effects of drug on breastfed infant, or on milk production; the lack of clinical data during lactation precludes a clear determination of risk of this product to a child during lactation
The developmental and health benefits of breastfeeding should be considered along with mother’s clinical need for Diabasic Sodium Phosphate + Monobasic Sodium Phosphate and any potential adverse effects on the breastfed child from this product or from underlying maternal condition
Interactions
Contraindicated (1)
sodium phosphate rectal
Serious (2)
baloxavir marboxil
potassium phosphates, IV
Adverse Effects
Side effects of Diabasic Sodium Phosphate + Monobasic Sodium Phosphate :
Hypersensitivity,Pruritus,Dehydration,Hyperphosphatemia,Hypocalcemia,Hypokalemia,Hypernatremia,Metabolic acidosis,Nausea,Vomiting,Abdominal pain,Abdominal distension,Diarrhea,Gastrointestinal pain,Chills,Blistering,Stinging,Anal discomfort,Proctalgia
Mechanism of Action
Saline cathartic effect. Draws water into the lumen of the gut where it causes osmotic effect; causes abdominal distention and promotes peristalsis and evacuation of the bowel.
Note
Green Enema (19 gm+7 gm)/118 ml Rectal Saline manufactured by Greenland Pharmaceuticals Ltd.. Its generic name is Diabasic Sodium Phosphate + Monobasic Sodium Phosphate. Green Enema is availble in Bangladesh.
DIMS information on Green Enema Rectal Saline is not intended for diagnosis, medical advice or treatment; neither intended to be a substitute for the exercise of professional judgment.