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Sodium Glycerophosphate

Also known as: Sodium Glycerophosphate, NaGP, Sodium α-Glycerophosphate, Glycophos

Overview

Sodium glycerophosphate (NaGP) is a synthetic phosphate salt primarily used in clinical settings as a source of phosphorus and sodium. It is administered parenterally to correct or prevent hypophosphatemia, particularly in hospitalized patients, neonates, and individuals unable to consume oral phosphate. NaGP is water-soluble and stable in solution, exhibiting a lower propensity to form precipitates with calcium compared to inorganic phosphates. Research on NaGP is moderately mature, with several clinical trials and post-marketing surveillance studies supporting its use, although large-scale randomized controlled trials and systematic reviews are limited. Available evidence generally supports its efficacy and safety, particularly in real-world clinical applications.

Benefits

Sodium glycerophosphate is effective in increasing serum phosphate levels in patients with hypophosphatemia. Studies indicate that, compared to inorganic phosphate, NaGP is associated with higher serum phosphate levels, lower alkaline phosphatase (ALP) levels, and a reduced incidence of seizures, especially in pediatric populations. There is also some evidence suggesting that NaGP may improve bone density in preterm infants when administered at higher doses, although this benefit is marginal and limited to specific populations. The clinical significance of NaGP lies in its ability to prevent complications associated with hypophosphatemia, such as seizures and respiratory failure, with effects on serum phosphate typically observed within hours to days of administration.

How it works

Sodium glycerophosphate provides bioavailable phosphate that is crucial for ATP synthesis, bone mineralization, and various cellular metabolic processes. It supports the musculoskeletal, cardiovascular, and neurological systems by maintaining phosphate homeostasis. The phosphate from NaGP is absorbed and utilized via phosphate transporters in the kidneys and intestines. Once absorbed, it is incorporated into essential molecules such as ATP, DNA, and the bone matrix. When administered parenterally, NaGP exhibits nearly 100% bioavailability, ensuring efficient phosphate delivery to the body's tissues and systems.

Side effects

Sodium glycerophosphate is generally considered safe, with extensive post-marketing experience involving over 6 million patients. Common side effects are rare, with most studies reporting no significant adverse events directly attributable to its use. Uncommon side effects, occurring in 1-5% of patients, are not well-documented but may include mild electrolyte disturbances. Severe adverse events are extremely rare, with none reported in clinical trials as directly related to treatment. Drug interactions are possible with calcium-containing solutions if not properly compounded, although the risk of precipitate formation is lower than with inorganic phosphates. Contraindications include hyperphosphatemia and severe renal impairment. It is considered safe in neonates and pediatric patients when dosed appropriately.

Dosage

Dosage of sodium glycerophosphate is individualized based on the patient's phosphate status and needs. Typical dosage ranges are 10–20 mmol/day for adults, adjusted for weight and clinical status in pediatric patients. There is no established maximum safe dose, and dosing should not exceed the patient's phosphate requirements to avoid hyperphosphatemia. It is typically administered as part of parenteral nutrition over 24 hours. The parenteral form is standard, ensuring complete bioavailability. Monitoring of calcium and phosphate levels is recommended during administration. There are no specifically required cofactors, but careful monitoring helps prevent imbalances.

FAQs

Why is sodium glycerophosphate preferred over inorganic phosphates?

Sodium glycerophosphate is preferred in parenteral nutrition due to a lower risk of precipitate formation and better compatibility with calcium, reducing the likelihood of complications during administration.

Is sodium glycerophosphate safe?

Extensive post-marketing data support the safety profile of sodium glycerophosphate, with no significant adverse events directly linked to its use when administered appropriately.

How is sodium glycerophosphate administered?

It is best administered as part of a parenteral nutrition regimen, with careful monitoring of serum phosphate and calcium levels to ensure optimal balance and prevent complications.

What are the expected results of sodium glycerophosphate treatment?

Sodium glycerophosphate is expected to rapidly correct hypophosphatemia and prevent related complications, such as seizures or respiratory failure, in patients requiring phosphate supplementation.

Is sodium glycerophosphate a natural supplement?

No, sodium glycerophosphate is not a natural supplement. It is a synthetic phosphate salt intended for clinical use in patients with specific medical needs, not for routine use in healthy individuals.

Research Sources

https://www.mdpi.com/2227-9067/12/2/229 – This comparative clinical study focused on pediatric patients receiving parenteral nutrition. The key finding was that sodium glycerophosphate, when compared to inorganic phosphate, resulted in higher serum phosphate levels, lower alkaline phosphatase (ALP) levels, and a reduced incidence of seizures, suggesting a more favorable outcome for phosphate supplementation in this population.
https://pubmed.ncbi.nlm.nih.gov/36255046/ – This clinical trial involved neonates and pediatric patients, examining the effects of sodium glycerophosphate (NaGP) supplementation. The study found that the use of NaGP increased calcium and phosphate intake, although the intake remained below recommended ranges. Importantly, the study reported no adverse events, indicating that NaGP is a safe option for phosphate supplementation in these vulnerable populations, even if optimal intake levels were not achieved.
https://archive.hshsl.umaryland.edu/bitstream/handle/10713/17711/Sodium%20phosphate_Final_2021_10.pdf?sequence=1&isAllowed=y – This systematic review and post-marketing surveillance study analyzed data from over 6 million patients. The study found no treatment-related serious adverse events or deaths, suggesting a high level of safety. However, the efficacy of sodium glycerophosphate was deemed marginal except at high doses in specific populations, highlighting the need for careful dose adjustment and patient selection.
https://clinicaltrials.eu/inn/sodium-glycerophosphate/ – This entry from ClinicalTrials.eu provides information on clinical trials involving sodium glycerophosphate. While it doesn't offer specific results, it serves as a resource for identifying ongoing or completed studies, which can provide further insights into the efficacy and safety of sodium glycerophosphate in various clinical settings.
https://www.tga.gov.au/sites/default/files/auspar-sodium-glycerophosphate-200213.docx – This document from the Therapeutic Goods Administration (TGA) in Australia provides an assessment report for sodium glycerophosphate. It includes details on the drug's pharmacology, efficacy, and safety, as well as the TGA's evaluation and decision regarding its approval for use in Australia, offering a regulatory perspective on the use of sodium glycerophosphate.