Drug Information Center · Agouza Hospital
Glycophos® Clinical Suite
Sodium Glycerophosphate 216 mg/mL Concentrate · Fresenius Kabi
Interactive Calculator & Physician Guide · v1.0 · 2026
📌 Key Conversion · 1 mL Glycophos = 1 mmol PO₄³⁻ = 2 mmol Na⁺ · 1 vial (20 mL) = 20 mmol PO₄ = 40 mmol Na⁺
Vial Composition — 20 mL
Indications
| Component | Amount |
|---|---|
| Sodium glycerophosphate pentahydrate | 4.32 g |
| Phosphate (PO₄³⁻) | 20 mmol |
| Sodium (Na⁺) | 40 mmol |
| pH | ≈ 7.4 |
| Osmolality | ≈ 2,760 mOsm/kg |
Parenteral Nutrition — Phosphate supplementation in PN admixtures
Hypophosphatemia — IV treatment when oral/enteral route is unavailable
Refeeding Syndrome — Prophylaxis of phosphate depletion on nutrition initiation
PN Maintenance Doses
| Patient Group | PO₄ Dose | Glycophos |
|---|---|---|
| Adults | 10–20 mmol/day | 10–20 mL/day |
| Children (>1 yr) | 0.5–1.0 mmol/kg/day | 0.5–1.0 mL/kg/day |
| Infants (≤1 yr) | 1.0–2.0 mmol/kg/day | 1.0–2.0 mL/kg/day |
Pediatric ranges per ESPEN guidance; follow institutional PN protocol.
Severity Classification
| Severity | Serum PO₄ | IV Dose | Duration |
|---|---|---|---|
| Mild | 0.6–0.8 mmol/L | 0.1–0.15 mmol/kg | 4–6 h |
| Moderate | 0.3–0.6 mmol/L | 0.2–0.25 mmol/kg | 4–6 h |
| Severe | <0.3 mmol/L | 0.4–0.5 mmol/kg | 6–12 h |
⚠ Note: Weight-based dosing is not universally standardized. Many centers use fixed-dose protocols (20–40 mmol/day). Always follow institutional guidelines.
Calculation Mode
Calculate the daily phosphate requirement for inclusion in a parenteral nutrition admixture.
Enter weight and current serum phosphate to receive severity classification and IV replacement dosing guidance.
⛔
Glycophos must always be diluted before administration. Never infuse undiluted.
Compatible Diluents
- Sodium Chloride 0.9%
- Glucose 5%
- PN admixtures (validated Ca²⁺–PO₄³⁻ ratio)
Infusion Rate Limits
| Setting | Duration | Max Rate |
|---|---|---|
| PN (maintenance) | 12–24 h | With PN bag |
| Mild–moderate (10–20 mmol) | 4–6 h | ≤ 7.5 mmol/hr |
| Severe (>20 mmol) | 6–12 h |
❌ Prohibited routes: IV bolus · Intramuscular · Subcutaneous | Risk of hypocalcemia, arrhythmia, hypotension, metastatic calcification.
Calcium Compatibility
Avoid direct mixing with calcium-containing solutions outside of PN admixtures. Within PN, Glycophos (organic phosphate) offers superior calcium compatibility compared to inorganic phosphate salts (e.g., potassium dihydrogen phosphate), significantly reducing precipitation risk. Always use validated Ca²⁺–PO₄³⁻ compatibility charts for PN preparation.
Tap items to mark as checked. Checklist resets on page reload.
Laboratory Parameters
-
✓Serum PhosphateTherapeutic endpoint; guides repeat dosingBefore → 2–4 h post → Daily
-
✓Serum CalciumInverse homeostatic relationship with PO₄With each PO₄ check
-
✓Serum MagnesiumHypomagnesemia impairs PO₄ repletion; correct if lowBaseline; correct if low
-
✓Renal Function (eGFR / SCr)Risk of phosphate accumulation in renal impairmentBefore & during therapy
Clinical Parameters
-
✓Fluid & Sodium Balance40 mmol Na⁺ per vial — account in sodium-restricted patientsDaily (high-risk patients)
-
✓ECGHypophosphatemia and hypocalcemia can cause arrhythmiasSevere / cardiac risk
-
✓IV Site (Peripheral)Monitor for phlebitis; use well-diluted solutionsEach nursing assessment
-
✓Hemodynamic StatusCorrect dehydration/shock before initiating infusionBefore administration
Refeeding Syndrome: Begin phosphate monitoring and prophylactic supplementation before initiating PN or enteral feeding in at-risk patients (prolonged starvation, severe malnutrition, chronic alcohol use). Maintain close surveillance through the first 72 hours.
Contraindications & Cautions
Storage & Preparation
HyperphosphatemiaAbsolute contraindication — do not use under any circumstance
Contraindicated
Severe Renal Impairment (eGFR <30 mL/min)Reduce dose; increase frequency of phosphate and calcium monitoring
Caution
HypercalcemiaElevated Ca²⁺ × PO₄³⁻ ion product → metastatic calcification risk
Caution
HypoparathyroidismImpaired calcium regulation amplifies calcification risk
Caution
Dehydration / Hemodynamic Instability / ShockCorrect fluid status and hemodynamics before initiating infusion
Caution
Hypernatremia / Sodium Overload StatesEach 20 mL vial = 40 mmol Na⁺ (≈ 0.93 g); factor into daily sodium balance
Caution
| Unopened vial | Below 25°C; do not freeze |
| Diluted solution | Use immediately; if prepared in advance, store at 2–8°C and use within 24 hours |
| Visual inspection | Discard if particulate matter or discoloration present |
Clinical Pearls
Refeeding Syndrome
Initiate phosphate supplementation prophylactically before PN in at-risk patients. Phosphate depletion can be precipitous. Monitor closely for the first 72 hours of nutrition initiation.
Refractory Hypophosphatemia
If PO₄ fails to correct despite adequate IV replacement, check serum magnesium. Hypomagnesemia impairs intracellular phosphate uptake and is a common reversible cause of refractoriness.
Organic vs. Inorganic Phosphate
Glycophos (organic phosphate) has significantly superior calcium compatibility in PN admixtures compared to inorganic phosphate salts, reducing precipitation risk at standard PN concentrations.
Sodium Load Awareness
A 40 mmol replacement dose (2 vials) contributes 80 mmol Na⁺ ≈ 1.86 g sodium. In sodium-restricted, edematous, or hypernatremic patients, always account for this in the daily fluid plan.
Calcium–Phosphate Product
Monitoring Ca × PO₄ product (target < 4.4 mmol²/L²) helps prevent metastatic calcification, particularly in patients with renal impairment or prolonged high-dose supplementation.
References: (1) Fresenius Kabi. Glycophos 216 mg/mL — Summary of Product Characteristics (SmPC). Current approved version. ·
(2) Mirtallo J, et al. Safe Practices for Parenteral Nutrition. JPEN. 2004;28(6):S39–S70. ·
(3) Pironi L, et al. ESPEN guideline on home parenteral nutrition. Clin Nutr. 2020;39(6):1671–1705. ·
(4) Gaasbeek A, Meinders AE. Hypophosphatemia: an update on its etiology and treatment. Am J Med. 2005;118(10):1094–1101. ·
(5) Stout SM, Cober MP. Metabolic effects of cyclic parenteral nutrition. Nutr Clin Pract. 2010.
Drug Information Center · Agouza Hospital · 2026
Prepared by: Dr. Ahmed Khaled
Drug Information Center · Agouza Hospital
Glycophos® Clinical Suite
Sodium Glycerophosphate 216 mg/mL Concentrate · Fresenius Kabi
Interactive Calculator & Physician Guide · v1.0 · 2026
📌 Key Conversion · 1 mL Glycophos = 1 mmol PO₄³⁻ = 2 mmol Na⁺ · 1 vial (20 mL) = 20 mmol PO₄ = 40 mmol Na⁺
Vial Composition — 20 mL
Indications
| Component | Amount |
|---|---|
| Sodium glycerophosphate pentahydrate | 4.32 g |
| Phosphate (PO₄³⁻) | 20 mmol |
| Sodium (Na⁺) | 40 mmol |
| pH | ≈ 7.4 |
| Osmolality | ≈ 2,760 mOsm/kg |
Parenteral Nutrition — Phosphate supplementation in PN admixtures
Hypophosphatemia — IV treatment when oral/enteral route is unavailable
Refeeding Syndrome — Prophylaxis of phosphate depletion on nutrition initiation
PN Maintenance Doses
| Patient Group | PO₄ Dose | Glycophos |
|---|---|---|
| Adults | 10–20 mmol/day | 10–20 mL/day |
| Children (>1 yr) | 0.5–1.0 mmol/kg/day | 0.5–1.0 mL/kg/day |
| Infants (≤1 yr) | 1.0–2.0 mmol/kg/day | 1.0–2.0 mL/kg/day |
Pediatric ranges per ESPEN guidance; follow institutional PN protocol.
Severity Classification
| Severity | Serum PO₄ | IV Dose | Duration |
|---|---|---|---|
| Mild | 0.6–0.8 mmol/L | 0.1–0.15 mmol/kg | 4–6 h |
| Moderate | 0.3–0.6 mmol/L | 0.2–0.25 mmol/kg | 4–6 h |
| Severe | <0.3 mmol/L | 0.4–0.5 mmol/kg | 6–12 h |
⚠ Note: Weight-based dosing is not universally standardized. Many centers use fixed-dose protocols (20–40 mmol/day). Always follow institutional guidelines.
Calculation Mode
Calculate the daily phosphate requirement for inclusion in a parenteral nutrition admixture.
Enter weight and current serum phosphate to receive severity classification and IV replacement dosing guidance.
⛔
Glycophos must always be diluted before administration. Never infuse undiluted.
Compatible Diluents
- Sodium Chloride 0.9%
- Glucose 5%
- PN admixtures (validated Ca²⁺–PO₄³⁻ ratio)
Infusion Rate Limits
| Setting | Duration | Max Rate |
|---|---|---|
| PN (maintenance) | 12–24 h | With PN bag |
| Mild–moderate (10–20 mmol) | 4–6 h | ≤ 7.5 mmol/hr |
| Severe (>20 mmol) | 6–12 h |
❌ Prohibited routes: IV bolus · Intramuscular · Subcutaneous | Risk of hypocalcemia, arrhythmia, hypotension, metastatic calcification.
Calcium Compatibility
Avoid direct mixing with calcium-containing solutions outside of PN admixtures. Within PN, Glycophos (organic phosphate) offers superior calcium compatibility compared to inorganic phosphate salts (e.g., potassium dihydrogen phosphate), significantly reducing precipitation risk. Always use validated Ca²⁺–PO₄³⁻ compatibility charts for PN preparation.
Tap items to mark as checked. Checklist resets on page reload.
Laboratory Parameters
-
✓Serum PhosphateTherapeutic endpoint; guides repeat dosingBefore → 2–4 h post → Daily
-
✓Serum CalciumInverse homeostatic relationship with PO₄With each PO₄ check
-
✓Serum MagnesiumHypomagnesemia impairs PO₄ repletion; correct if lowBaseline; correct if low
-
✓Renal Function (eGFR / SCr)Risk of phosphate accumulation in renal impairmentBefore & during therapy
Clinical Parameters
-
✓Fluid & Sodium Balance40 mmol Na⁺ per vial — account in sodium-restricted patientsDaily (high-risk patients)
-
✓ECGHypophosphatemia and hypocalcemia can cause arrhythmiasSevere / cardiac risk
-
✓IV Site (Peripheral)Monitor for phlebitis; use well-diluted solutionsEach nursing assessment
-
✓Hemodynamic StatusCorrect dehydration/shock before initiating infusionBefore administration
Refeeding Syndrome: Begin phosphate monitoring and prophylactic supplementation before initiating PN or enteral feeding in at-risk patients (prolonged starvation, severe malnutrition, chronic alcohol use). Maintain close surveillance through the first 72 hours.
Contraindications & Cautions
Storage & Preparation
HyperphosphatemiaAbsolute contraindication — do not use under any circumstance
Contraindicated
Severe Renal Impairment (eGFR <30 mL/min)Reduce dose; increase frequency of phosphate and calcium monitoring
Caution
HypercalcemiaElevated Ca²⁺ × PO₄³⁻ ion product → metastatic calcification risk
Caution
HypoparathyroidismImpaired calcium regulation amplifies calcification risk
Caution
Dehydration / Hemodynamic Instability / ShockCorrect fluid status and hemodynamics before initiating infusion
Caution
Hypernatremia / Sodium Overload StatesEach 20 mL vial = 40 mmol Na⁺ (≈ 0.93 g); factor into daily sodium balance
Caution
| Unopened vial | Below 25°C; do not freeze |
| Diluted solution | Use immediately; if prepared in advance, store at 2–8°C and use within 24 hours |
| Visual inspection | Discard if particulate matter or discoloration present |
Clinical Pearls
Refeeding Syndrome
Initiate phosphate supplementation prophylactically before PN in at-risk patients. Phosphate depletion can be precipitous. Monitor closely for the first 72 hours of nutrition initiation.
Refractory Hypophosphatemia
If PO₄ fails to correct despite adequate IV replacement, check serum magnesium. Hypomagnesemia impairs intracellular phosphate uptake and is a common reversible cause of refractoriness.
Organic vs. Inorganic Phosphate
Glycophos (organic phosphate) has significantly superior calcium compatibility in PN admixtures compared to inorganic phosphate salts, reducing precipitation risk at standard PN concentrations.
Sodium Load Awareness
A 40 mmol replacement dose (2 vials) contributes 80 mmol Na⁺ ≈ 1.86 g sodium. In sodium-restricted, edematous, or hypernatremic patients, always account for this in the daily fluid plan.
Calcium–Phosphate Product
Monitoring Ca × PO₄ product (target < 4.4 mmol²/L²) helps prevent metastatic calcification, particularly in patients with renal impairment or prolonged high-dose supplementation.
References: (1) Fresenius Kabi. Glycophos 216 mg/mL — Summary of Product Characteristics (SmPC). Current approved version. ·
(2) Mirtallo J, et al. Safe Practices for Parenteral Nutrition. JPEN. 2004;28(6):S39–S70. ·
(3) Pironi L, et al. ESPEN guideline on home parenteral nutrition. Clin Nutr. 2020;39(6):1671–1705. ·
(4) Gaasbeek A, Meinders AE. Hypophosphatemia: an update on its etiology and treatment. Am J Med. 2005;118(10):1094–1101. ·
(5) Stout SM, Cober MP. Metabolic effects of cyclic parenteral nutrition. Nutr Clin Pract. 2010.
Drug Information Center · Agouza Hospital · 2026
Prepared by: Dr. Ahmed Khaled