Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Phosphates Enema BP Formula B (Long Tube)
⚠ This medicine appears to have been discontinued
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Disodium phosphate dodecahydrate, Sodium dihydrogen phosphate dihydrate may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
What it is and what it is used for
for
Phosphates Enema BP Formula B is a bowel cleanser which acts by drawing water into the bowel, making the stools softer and encouraging evacuation. It is used: to evacuate and clean the bowel before and after certain operations before childbirth before diagnostic procedures such as colonoscopy or x-ray examination to treat constipation. 2.
What you need to know before you take it
e Phosphates Enema BP Formula B
Do not use Phosphates Enema BP Formula B and tell your doctor if: –
–
you are allergic to sodium dihydrogen phosphate dihydrate or disodium phosphate dodecahydrate or any of the other ingredients of this medicine (listed in section 6) you have a swollen large bowel (also known as megacolon) you have a narrowing or incomplete opening of the anus or rectum you have a blockage of the lower colon (Hirschsprung's disease) you have a suspected blockage of the gut you have blockage of the gut or failure of normal bowel movements (sometimes called paralytic ileus) you have been told by your doctor that you may have:
- appendicitis
- a pierced/damaged or blocked gut
- an active inflammatory bowel disease (such as Crohn's disease or ulcerative colitis) you have bleeding of the back passage you have congestive heart failure (your heart is unable to properly pump blood around the body) you have recently been sick or feel sick or thirsty the patient is under 3 years of age you have kidney problems.
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Warnings and precautions Talk to your doctor or pharmacist before using Phosphates Enema BP Formula B if you: –
suffer from electrolyte disturbances (change of salt levels in the body such as low calcium, low potassium, high phosphate or high sodium levels) have a blockage in the gut (bowel obstruction) are elderly, frail (debilitated) or have a neurological disorder such as paralysis of the lower part of the body or a stroke are taking other medicines have a heart or kidney condition have uncontrolled blood pressure suffer from ascites (excess fluid in the belly) suffer from rectal ulceration (ulceration of the back passage) or fissures (tears in the skin of the back passage) have had a colostomy are pregnant or breast-feeding.
Children Do not give this medicine to children under 3 years of age because it is unlikely to be safe. Other medicines and Phosphates Enema BP Formula B Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, especially: medicines for the treatment of high blood pressure (hypertension) such as angiotensinconverting enzyme-inhibitors (ACE-inhibitors) (e.g. enalapril, ramipril, lisinopril) and angiotensin receptor blockers (e.g. losartan, candesartan, eprosartan, irbesartan, olmesartan, telmisartan, valsartan) or angina (calcium channel blockers). medicines to empty the bladder (diuretics). certain medicines for mental disorders (lithium). any other medicines that could make you dehydrated or alter the salt levels (potassium, sodium, phosphate or water) in your body, known as your electrolyte balance. certain medicines for cleaning the bowel (sodium phosphates). medicines that alter the rhythm of your heart (prolong the QT interval); such as amiodarone, arsenic trioxide, astemizole, azithromycin, erythromycin, clarithromycin, chlorpromazine, cisapride, citalopram, domperidone, terfenadine, procainamide. non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen. Pregnancy, breast-feeding and fertility If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. Driving and using machines Whilst there are no direct effects of Phosphates Enema BP Formula B on your ability to drive or use machinery, you should remain near toilet facilities after using this medicine. Phosphates Enema BP Formula B contains benzalkonium chloride. This may cause irritation. 3.
How to take it
Phosphates Enema BP Formula B
Always use this medicine exactly as described in this leaflet or as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. Adults, elderly and children over 12 years old: Use one enema no more than once daily or as directed by your doctor.
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Reduce the dose in proportion to the child's weight, i.e. for a 35 kg (51⁄2 stone) child give half the contents of the bottle. If unsure, check the dose with your doctor or pharmacist. Do not administer to children under 3 years of age. For rectal use only Unless directed by your doctor, Phosphates Enema BP Formula B should not be used for more than one week. Administration of more than one enema in a 24-hour period can be harmful. Administration: Phosphates Enema BP Formula B is available in a long tube version and a short tube version, which can be identified on the carton. The administration is different betweeen the versions as indicated below. SHORT TUBE VERSION 1. Warm the bottle before use, in warm water. 2. Remove the cap. If required, apply a lubricant (e.g. petroleum jelly) to the nozzle. 3. Lie on a towel, on your side with both knees bent towards the chest. 4. Insert the full length of the nozzle into the rectum and squeeze the bottle gently until empty. For a young child, the nozzle should only be inserted to half its length. Do not use force especially in children, the elderly or frail, if the lower body is paralysed, or in stroke patients. 5. Put the used bottle back into the carton for disposal. LONG TUBE VERSION 1. Warm the bottle before use, in warm water. 2. Remove the cap, and screw on the applicator tube. If required, apply a lubricant (e.g. petroleum jelly) to the nozzle. 3. Lie on a towel, on your side with both knees bent towards the chest. 4. Insert the full length of the nozzle into the rectum and squeeze the bottle gently until empty. For a young child, the nozzle should only be inserted to half its length. Do not use force especially in children, the elderly or frail, if the lower body is paralysed, or in stroke patients. 5. Put the used bottle back into the carton for disposal. If rectal bleeding is noticed, administration must be discontinued immediately, and you must contact a doctor immediately. After using the enema, if you have not had a bowel movement (usually within 5 to 10 minutes), contact your doctor for advice. Do NOT use another enema. Drink plenty of clear fluids e.g. water, clear soups, tea or diluted cordials/fruit juice without pulp (but not red or purple coloured juices) to avoid dehydration. In general, you should drink 250 ml (a small tumbler-sized glass) every hour until the effect of the Phosphates Enema BP Formula B has worn off. After this, drink clear fluids, preferably water, to satisfy your thirst until after your hospital procedure, or as directed by your doctor. If you use more Phosphates Enema BP Formula B than you should or swallow some by mistake, seek medical advice. If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
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4.
Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them. STOP using the enema and seek medical help immediately if you have any of the following allergic reactions: difficulty breathing or swallowing, swelling of the face, lips, tongue or throat severe itching of the skin, with a red rash or raised lumps. Tell your doctor as soon as possible if you: faint after using the enema. This mostly happens to elderly patients. Other side effects: Very common: may affect more than 1 in 10 people high levels of phosphorus in the blood (hyperphosphataemia) anal discomfort and pain abdominal pain abdominal cramping vomiting rectal irritation (redness, itching, pain, discomfort) Common: may affect up to 1 in 10 people low levels of calcium in the blood (hypocalcaemia) dizziness nausea diarrhoea general malaise chills Very rare: may affect up to 1 in 10 000 people blister pruritus stinging Not known: frequency cannot be estimated from the available data hypersensitivity: allergic reactions (with or without rash) high levels of sodium in the blood (hypernatremia) low levels of potassium in the blood (hypokalaemia) dehydration metabolic acidosis (when acids build up in your body) muscle twitches and spasms due to changes in the amounts of salts (electrolytes) in the blood. Long term use of the enema may irritate the anal passage, or the bowel may become lazy. It may also affect the amount of salts in your blood, your doctor may check for this. Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine. 5.
How to store it
Phosphates Enema BP Formula B
Keep this medicine out of the sight and reach of children. 4
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Do not use this medicine after the expiry date which is stated on the on the carton after 'Exp' and the end of the tube as month/year. The expiry date refers to the last day of that month. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment. Do not store above 25°C. 6.
Contents of the pack and other information
What Phosphates Enema BP Formula B contains The active substances are sodium dihydrogen phosphate dihydrate 10% w/v and disodium phosphate dodecahydrate 8% w/v The other ingredients are disodium edetate, benzalkonium chloride and purified water What Phosphates Enema BP Formula B looks like and contents of the pack The rectal solution is a clear liquid in a plastic bottle for single dose use. Marketing Authorisation Holder Chemidex Pharma Ltd. trading as Essential Generics 8a Crabtree Road, Egham Surrey TW20 8RN Manufacturer: Purna Pharmaceuticals NV, Rijksweg 17, 2870 Puurs, Belgium This leaflet was last revised in September 2025.
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Frequently asked questions about Phosphates Enema BP Formula B (Long Tube)
What is the active substance in Phosphates Enema BP Formula B (Long Tube)?
The active substance in Phosphates Enema BP Formula B (Long Tube) is disodium phosphate dodecahydrate, sodium dihydrogen phosphate dihydrate.
Are there equivalent medicines to Phosphates Enema BP Formula B (Long Tube)?
Medicines with the same active substance, strength and form include: Cleen Ready-to-Use Enema, Fletcher’s Phosphate Enema (Long Tube), Fletcher’s Phosphate Enema (Short Tube). In total there are 4 equivalent products. They are interchangeable only if your prescriber or pharmacist says so.
Where does this information come from?
This leaflet reproduces the patient information leaflet approved for Phosphates Enema BP Formula B (Long Tube), as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Can I get Phosphates Enema BP Formula B (Long Tube) without a prescription?
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
About this leaflet
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
- Source: electronic medicines compendium (emc), Datapharm
- Active substance: disodium phosphate dodecahydrate, sodium dihydrogen phosphate dihydrate
- Official document: view the original leaflet on emc →
⚕For healthcare professionals — Summary of Product Characteristics (SmPC)Full SmPC: dosage, interactions, contraindications, warnings+
4.1. Therapeutic indications
Routine treatment of constipation. Pre- and post-operative cleansing of the bowel, in obstetrics and prior to proctoscopy, sigmoidoscopy or X-ray examination.
4.2. Posology and method of administration
Posology
Adults, elderly and children over 12 years old:
One enema no more than once daily or as directed by a physician (see section 4.4).
Children aged 3 years to less than 12 years:
As directed by a physician (see sections 4.4 and 4.9).
Reduce adult dosage in proportion to body weight.
Children under 3 years of age:
Fletchers' Phosphate Enema is contraindicated in children under 3 years of age (see section 4.3).
Renal impairment
Do not administer to patients with clinically significant impairment of renal function (see section 4.3).
The product should be used with caution in patients with impaired renal function, when the clinical benefit is expected to outweigh the risk of hyperphosphataemia (see section 4.4).
Method of administration
For rectal administration only. The enema may be administered at room temperature or warmed in water before use.
4.3. Contraindications
Fletchers' Phosphate Enema is contraindicated in patients with:
• Hypersensitivity to the active substances or to any of the excipients listed in section 6.1.
• Conditions causing increased absorptive capacity or decreased elimination capacity, such as when bowel obstruction or decreased bowel motility is present; e.g.,
- congenital or acquired megacolon
- imperforate anus
- anorectal stenosis
- Hirschsprung's disease
- suspected intestinal obstruction
- paralytic ileus.
• Undiagnosed gastrointestinal pathology, e.g.,
- symptoms suggestive of appendicitis, intestinal perforation or active inflammatory bowel disease.
• Undiagnosed rectal bleeding.
• Congestive heart failure.
• Dehydration.
• Children under 3 years of age.
• Clinically significant impairment of renal function.
No other sodium phosphate preparations including sodium phosphate oral solution or tablets should be given concomitantly (see section 4.5).
4.4. Special warnings and precautions for use
Do not use Fletchers' Phosphate Enema when nausea, vomiting or abdominal pain is present unless directed by a physician.
Patients should be advised to expect liquid stools and should be encouraged to drink clear liquids to help prevent dehydration, especially patients with conditions that may predispose to dehydration or those taking medications which may decrease glomerular filtration rate, such as diuretics, angiotensin converting enzyme inhibitors (ACE-Is, e.g. enlaparil, ramipril, lisinopril), angiotensin receptor blockers (ARBs, e.g. losartan, candesartan, eprosartan, irbesartan, olmesartan, telmisartan, valsartan) or non-steroidal anti-inflammatory drugs (NSAIDs).
Since Fletchers' Phosphate Enema contains sodium phosphate, there is a risk of elevated serum levels of sodium and phosphate and decreased levels of calcium and potassium and consequently hypernatremia, hyperphosphatemia, hypocalcemia and hypokalemia may occur with clinical signs like tetany and renal failure. Electrolyte shifts are of particular concern in children with megacolon or any other condition where there is retention of enema solution, and in patients with co-morbidities. That is why Fletchers' Phosphate Enema should be used with caution in: elderly or debilitated patients and in patients with uncontrolled arterial hypertension, ascites, heart disease, rectal mucosal changes (ulcers, fissures), colostomy patients who are taking diuretics or other medications which may affect electrolyte levels, who are taking medications known to prolong the QT interval (such as amiodarone, arsenic trioxide, astemizole, azithromycin, erythromycin, clarithromycin, chlorpromazine, cisapride, citalopram, domperidone, terfenadine, procainamide), or pre-existing electrolyte imbalance such as hypocalcaemia, hypokalaemia, hyperphosphataemia, hypernatraemia. Use also with caution in patients who are taking medications known to affect renal perfusion or function, or hydration status. Where electrolyte disorders are suspected and in patients who may experience hyperphosphataemia, electrolyte levels should be monitored before and after administration of Fletchers' Phosphate Enema.
The product should be used with caution in patients with impaired renal function, when the clinical benefit is expected to outweigh the risk of hyperphosphataemia.
Use with caution in patients with intestinal obstruction. Care should be taken not to use undue force in administration of the enema especially in the elderly or debilitated patients or those with neurological disorders. Patients should be warned to stop administration if resistance is encountered as forced administration of the enema may cause injury. Rectal bleeding after using Fletchers' Phosphate Enema may indicate a serious condition. If this occurs, administration must be discontinued immediately and the condition of the patient assessed by a physician.
Repeated and prolonged use of Fletchers' Phosphate Enema is not recommended as it may cause habituation. Administration of more than one enema in a 24-hour period can be harmful. Unless directed by a physician Fletchers' Phosphate Enema should not be used for more than one week.
In general, evacuation occurs approximately 5 minutes after sodium phosphate enema administration. Retention time over 10 minutes is not recommended. If evacuation does not occur after using sodium phosphate enema or if the retention time lasts for more than 10 minutes, phosphatemia could occur. No further administrations should be given and the condition of the patient should be assessed by a physician who will decide if laboratory tests should be completed in order to detect possible electrolyte abnormalities and to minimise the risk of severe hyperphosphatemia (see sections 4.8 and 4.9).
Fletchers' Phosphate Enema and Phosphates Enema BP Formula B contain benzalkonium chloride which may cause local irritation.
Keep all medicines out of the sight and reach of children.
4.5. Interaction with other medicinal products and other forms of interaction
Use with caution in patients taking calcium channel blockers, diuretics, lithium treatment or other medications that might affect electrolyte levels as hyperphosphataemia, hypocalcaemia, hypokalaemia, hypernatraemic dehydration and acidosis may occur (see section 4.4).
No other sodium phosphate preparations including sodium phosphate oral solution or tablets should be given concomitantly (see section 4.3).
4.6. Fertility, pregnancy and lactation
As there is no relevant data available to evaluate the potential for foetal malformation or other foetotoxic effects when administered during pregnancy, Fletchers' Phosphate Enema should only be used as directed by a physician at the time of delivery or postpartum.
4.7. Effects on ability to drive and use machines
Fletchers' Phosphate Enema has no or negligible influence on the ability to drive and use machines.
4.8. Undesirable effects
Within each frequency grouping, undesirable effects are presented in order of decreasing seriousness.
Organized by MedDRA System Organ Class the undesirable effects are listed below using the following frequency classification: very common (≥ 1/10); common (≥ 1/100 to < 1/10); uncommon (≥ 1/1,000 to < 1/100), rare (≥ 1/10,000 to < 1/1,000), very rare (< 1/10,000), not known (cannot be estimated from the available data):
Immune system disorders
Not known: hypersensitivity e.g. urticaria.
Metabolism and nutrition disorders
Very common: hyperphosphataemia.
Common: hypocalcaemia.
Not known: hypernatremia, hypokalaemia, dehydration, metabolic acidosis, tetany.
Nervous system disorders
Common: dizziness.
Not known: syncope (primarily observed in elderly patients).
Gastrointestinal disorders
Very common: anal discomfort and proctalgia, abdominal pain and cramp, vomiting.
Common: nausea, diarrhoea.
Skin and subcutaneous tissue disorders
Very rare: blister, pruritus, stinging.
General disorders and administration site conditions
Very common: rectal irritation, pain, stinging.
Common: general malaise, chills.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
4.9. Overdose
There have been fatalities when phosphate enema has been administered in excessive doses or retained, used in children or used in obstructed patients.
Hyperphosphataemia, hypocalcaemia, hypernatraemia, hypernatraemia dehydration, hypokalemia, hypovolemia, acidosis and tetany may occur in overdose or retention.
Recovery from the toxic effects can normally be achieved by rehydration. Treatment of electrolyte imbalance may require immediate medical intervention with appropriate electrolyte and fluid replacement therapy.
💬 Ask about this leaflet
Ask anything about Phosphates Enema BP Formula B (Long Tube). The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.