Nephromag (Buffered Phosphate Solution | Mertiatide)

Nephromag provides intravenous phosphate repletion for conditions affecting phosphate balance.

• Hypophosphatemia: restores serum phosphate levels in patients with low phosphate.
• Renal dialysis: supplies phosphate in dialysis fluid to maintain electrolyte homeostasis.
• Peri‑operative care: delivers phosphate during major surgery to prevent metabolic disturbances.

• Buffered Phosphate Solution delivers inorganic phosphate ions directly into the bloodstream, where they participate in cellular energy metabolism, bone mineralization, and acid‑base buffering. The formulation maintains a physiologic pH, allowing rapid correction of serum phosphate without causing significant shifts in calcium or acid‑base status.

Nephromag may be associated with a range of infusion‑related reactions.

Common Side Effects

• Hyperphosphatemia: elevated serum phosphate levels.
• Infusion site pain or erythema.
• Nausea or vomiting.
• Mild hypotension during rapid administration.
• Transient calcium reduction.
• Electrolyte imbalance (e.g., potassium shift).

Serious or Rare Side Effects

• Severe hyperphosphatemia leading to calcium‑phosphate precipitation.
• Anaphylactic or severe allergic reaction.
• Cardiac arrhythmias secondary to electrolyte disturbances.
• Metabolic acidosis in susceptible patients.

Nephromag requires careful monitoring and patient assessment before and during therapy.

• Serum phosphate monitoring: check levels before infusion and periodically thereafter.
• Calcium balance: assess calcium levels to avoid precipitation risk.
• Renal function: evaluate kidney function, especially in patients with chronic kidney disease.
• Contraindications: avoid in patients with known hyperphosphatemia or severe hypercalcemia.
• Infusion rate: administer at the rate recommended by the prescriber to reduce infusion reactions.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Nephromag can interact with other agents that affect calcium or phosphate metabolism.

Major Interactions (Avoid)

• Calcium‑containing IV solutions: risk of calcium‑phosphate precipitation.
• Vitamin D analogues: may exacerbate hypercalcemia.
• Aluminum‑containing antacids: reduce phosphate absorption.

Moderate Interactions (Monitor Closely)

• Loop diuretics: may increase calcium excretion.
• ACE inhibitors or ARBs: monitor renal function and electrolytes.
• Parathyroid hormone analogues: adjust phosphate dosing as needed.