Ezivac%25252525252525252525252525252520enema

# Ezivac Enema (Sodium Phosphate) ## Overview Ezivac is a hyperosmotic saline laxative containing sodium phosphate monobasic and sodium phosphate dibasic. It acts by drawing water into the lumen of the colon, which increases intraluminal pressure and stimulates evacuation. ## Primary Indications * Relief of occasional constipation. * Bowel evacuation prior to rectal examinations or endoscopic procedures (per local protocol). ## Adult Dosing * **Standard rectal administration:** 118 mL (one delivered dose) as a single dose per 24 hours. * **Maximum:** Do not exceed one unit per 24-hour period unless directed by a physician. ## Pediatric Dosing * **Children 12 years and older:** 118 mL once daily. * **Children 5 to 11 years:** 59 mL (half of a 118 mL unit) once daily. * **Children younger than 5 years:** Not recommended. * *Note:* Use age-appropriate pediatric-sized applicators. ## Dose Adjustments * **Renal Impairment:** Use with extreme caution. Contraindicated in patients with significant renal impairment due to the risk of hyperphosphatemia and electrolyte imbalances. * **Hepatic Impairment:** No specific adjustment, but monitor for fluid/electrolyte status. ## Contraindications * Hypersensitivity to sodium phosphates. * Megacolon (congenital or acquired). * Congestive heart failure if exacerbated by acute volume expansion. * Signs of bowel obstruction, perforation, or inflammatory bowel disease (ulcerative colitis, Crohn’s disease). * Known electrolyte disturbances (e.g., hyperphosphatemia, hypocalcemia). ## Adverse Effects * **Common:** Rectal irritation, burning, or pain. * **Serious:** Severe electrolyte disturbances (hyperphosphatemia, hypokalemia, hypocalcemia, hypernatremia), dehydration, metabolic acidosis, and symptomatic acute phosphate nephropathy (calcification of renal tubules). ## Key Drug Interactions * **Diuretics (loop/thiazide):** Increased risk of dehydration and electrolyte imbalance. * **ACE Inhibitors / ARBs:** Increased risk of renal impairment when used with phosphate laxatives. * **NSAIDs:** May increase the risk of nephrotoxicity. * **Calcium Channel Blockers:** Use with caution as phosphate load can affect calcium levels. ## Monitoring * Monitor serum electrolytes (phosphate, calcium, potassium, sodium, creatinine) in patients with baseline renal, cardiac, or hydration vulnerabilities. * Monitor for signs of dehydration (e.g., dizziness, decreased urine output). ## Clinical Pearls * **Caution:** Advise patients to use only when necessary. Excessive use can lead to dehydration and habituation. * **Administration:** Instruct patient to lie on the left side with knees bent while inserting the lubricated nozzle. Do not force the nozzle, as this can cause rectal perforation. * **Timing:** Evacuation usually occurs within 2 to 15 minutes. * **Safety:** Ensure the patient is adequately hydrated before and after administration. *** *Disclaimer: This information is for educational purposes only. Dosage may vary based on institutional protocols, clinical guidelines, and specific patient comorbidities. Always verify current prescribing information and local hospital policies before administration.*