If you are currently being treated with any of the following medications, you should not use phosphorus preparations without first talking with your health care provider.
Alcohol -- Alcohol (ethanol) may pull out phosphorus from the bones and deplete it from the body.
Antacids -- Antacids containing aluminum, calcium, or magnesium (such as Mylanta, Amphojel, Maalox, Riopan, and Alternagel) can bind phosphate in the gut and prevent its absorption, potentially leading to low phosphate levels (hypophosphatemia) when used long-term (chronically).
Anticonvulsants -- Some anticonvulsants (including phenobarbital and carbamazepine or Tegretol) may lower phosphorus levels and increase levels of alkaline phosphatase, an enzyme that helps remove phosphate from the body.
Bile acid sequestrants -- Bile acid sequestrants are drugs that lower cholesterol and include cholestyramine (Questran) and colestipol (Colestid). They can decrease the oral absorption of phosphates from the diet or from supplements. Therefore, oral phosphate supplements should be administered at least 1 hour before or 4 hours after these drugs.
Corticosteroids -- Corticosteroids, including prednisone (Deltasone) or methylprednisolone (Medrol), may increase urinary phosphorus levels.
Diuretics -- The use of diuretics such as hydrochlorothiazide (Hydrodiuril) or furosemide (Lasix) may increase the elimination of phosphorus from the body in the urine, causing symptoms of phosphorus deficiency.
Insulin -- High doses of insulin may decrease blood levels of phosphorus in people with diabetic ketoacidosis (a condition caused by severe insulin insufficiency). This serious condition is treated in a hospital and replacement of phosphorous takes place under the direction of a doctor.
Potassium supplements or potassium-sparing diuretics -- Using phosphorus supplements along with potassium supplements or potassium-sparing diuretics (including spironolactone or Aldactone and triamterene or Dyrenium) taken together with a phosphate may result in high blood levels of potassium (hyperkalemia). Hyperkalemia can be a serious problem, resulting in life-threatening heart rhythm abnormalities (arrhythmias).
Other drugs -- Drugs called angiotensin-converting enzyme (ACE) inhibitors, normally used for high blood pressure, may decrease phosphorus levels. They include benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Zestril, Prinivil), quinapril (Accupril), or ramipril (Altace). Other drugs include cyclosporine (used to decrease the immune system), cardiac glycosides (digoxin or Lanoxin), heparins (blood thinning drugs), anti-inflammatory drugs (such as ibuprofen or Motrin). Salt substitutes also contain high levels of potassium which may lower phosphorus levels if used long-term (chronically).
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