Phosphate is actively involved in many important biochemical pathways, such as 
energy and nucleic acid metabolism, cellular signaling, and bone formation. 
Hypophosphatemia, defined as serum phosphate levels below 2.5 mg/dL 
(0.81 mmol/L), is frequently observed in the course of treatment with commonly 
used drugs, such as diuretics, bisphosphonates, antibiotics, insulin, and 
antacids. Furthermore, this undesired effect may complicate the use of several 
novel medications, including teriparatide, denosumab, parenteral iron, and 
antiviral and antineoplastic agents. This review addresses drug-associated 
hypophosphatemia, focusing on underlying mechanisms and the most recent 
knowledge on this topic, in order to increase the insight of clinicians, with 
reference to early diagnosis and appropriate management.