ZETALAX PHOSPHATE ENEMA*133ML

ZETALAX PHOSPHATE ENEMA
Monosodium phosphate monohydrate and disodium phosphate heptahydrate

What it is and what it is used for
ZETALAX PHOSPHATE ENEMA contains the active ingredients monosodium phosphate monohydrate and disodium phosphate heptahydrate, which belong to the group of medicines called osmotic laxatives. These medicines are used to facilitate bowel movements.
ZETALAX PHOSPHATE ENEMA is indicated for adults and adolescents over 12 years of age for the short-term treatment of occasional constipation and for bowel emptying in preparation for certain clinical examinations, such as radiological or rectoscopic examinations.
Consult your doctor if you do not notice any improvement or if you feel worse after 7 days.

What you need to know before taking the medicine
Do not use ZETALAX PHOSPHATE ENEMA
- if you are allergic to monosodium phosphate monohydrate, disodium phosphate heptahydrate or any of the other ingredients of this medicine (listed in section 6);
- if you experience acute or unexplained abdominal pain;
- if you have nausea or vomiting;
- if you suffer from intestinal or ano-rectal obstruction or narrowing (intestinal stenosis or anorectal stenosis);
- if you have a bowel blockage due to a real obstruction (mechanical ileus) or only partial obstruction (sub-intestinal occlusion);
- if you have a bowel blockage or a defect in normal bowel emptying (paralytic ileus);
- if you suffer from inflammatory bowel disorders and other conditions that may increase the absorption of the medicine;
- if you have a perforation of the anal wall;
- if you suffer from specific bowel problems (colon abnormalities such as Hirschsprung's disease or congenital or acquired megacolon);
- if you have unexplained rectal bleeding;
- if you have an acute haemorrhoidal crisis with pain and bleeding;
- if you are severely dehydrated;
- if you suffer from heart disorders or problems;
- if you have severe kidney problems (severe renal failure) or high levels of phosphate in your blood (hyperphosphatemia);
- in children under 12 years of age;
- if you are taking other medicines containing sodium phosphate (such as oral solutions or tablets).

Warnings and precautions
Talk to your doctor or pharmacist before using ZETALAX PHOSPHATE ENEMA:

- if you have been constipated for more than 2 weeks;
- if you notice changes in your usual bowel movements or stool characteristics;
- if you do not show improvement after using these medicines;
- if you are elderly;
- if you are not in good health;
- if you suffer from high blood pressure, heart problems, an increase in abdominal fluid volume (ascites) or ulcers and fissures in the rectal mucosa;
- if you often have difficulty with bowel movements or if you suffer from chronic constipation.

What you need to know about laxatives:
- prolonged use of a laxative for the treatment of constipation is not recommended;
- to treat constipation, medicines should only be an aid to hygiene-dietary treatment (e.g., increased intake of vegetable fibers and liquids in the diet, regular physical activity);
- you should drink at least 6-8 glasses of water or other liquids during laxative treatment to help soften stools;
it is advisable to correct your eating habits by supplementing your diet with more fiber and water during episodes of constipation.

Use this medicine only if necessary or when advised by your doctor.
If you abuse laxatives by using this medicine excessively, frequently, or incorrectly, you may experience persistent diarrhea, resulting in loss of water, mineral salts (especially potassium), and other essential nutrients.
In more severe cases, you may experience dehydration and low potassium levels in the blood (hypokalemia), with possible heart, nerve, and muscle problems, especially if you are simultaneously taking medicines to stimulate heart function (digitalis/cardiac glycosides), to increase urine production (diuretics), or medicines called corticosteroids (anti-inflammatories).
You may experience a state of dehydration, especially if you are simultaneously taking medicines that modify renal filtration such as diuretics, ACE inhibitors, and sartans (drugs to reduce hypertension that act on angiotensin) or NSAIDs (anti-inflammatories), or you may have an alteration in the levels of certain mineral salts in the blood, which can manifest as severe renal problems (renal failure) and muscle stiffness (tetany).

If you use this medicine excessively or incorrectly, you could develop dependence (with a consequent need to progressively increase the dose), long-term (chronic) constipation, and loss of normal bowel function (intestinal atony).

Use this medicine only occasionally.

The treatment of chronic or recurrent constipation always requires medical intervention for diagnosis, prescription of medicines, and monitoring during therapy.

Health education notes
First of all, it should be kept in mind that in most cases, a balanced diet rich in water and fiber (bran, vegetables, and fruit) can permanently solve the problem of constipation.
Many people think they suffer from constipation if they don't have a bowel movement every day.
This is an incorrect belief, as this situation is completely normal for a large number of individuals.
Instead, constipation is considered to occur when bowel movements are reduced compared to one's personal habits and are associated with the passage of hard stools.
Consult your doctor if episodes of constipation occur repeatedly.

Children
This medicine cannot be used in children under 12 years of age.

Elderly
If you are elderly, talk to your doctor before using this medicine.

Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.

The side effects that may occur with the use of ZETALAX PHOSPHATE ENEMA are:
- crampy abdominal pain (isolated);
- non-continuous abdominal pain (abdominal colic);
- diarrhea with loss of fluids and salts, more frequent in cases of severe constipation (difficulty passing stools);
- redness with burning or pain (irritation) in the rectal area;
- nausea and vomiting;
- hypersensitivity reactions (e.g., urticaria);
- blisters, itching, and burning on the skin.

The following side effects occur rarely:
- high levels of phosphate in the blood (hyperphosphatemia);
- high levels of sodium in the blood (hypernatremia);
- low calcium levels in the blood (hypocalcemia);
- low potassium levels in the blood (hypokalemia);
- calcium accumulation (calcification) in tissues.

Reporting of side effects
If you get any side effects, including any not listed in this leaflet, talk to your doctor or pharmacist. You can also report side effects directly via the national reporting system at: https://www.aifa.gov.it/content/segnalazionireazioni-avverse.
By reporting side effects you can help provide more information on the safety of this medicine.