Generic

Lactulose

Indications

Constipation (Chronic Constipation): The initial treatment for chronic constipation should include a high-fiber diet (vegetables, salads, fruits, etc. ), plenty of liquids, and plenty of physical activity. Lactulose should only be used if these measures are ineffective.

Disturbances in intestinal flora: When the intestinal flora is damaged, it can lead to a variety of problems (e.g. following long-term antibiotic treatment)
Intestinal disorders gall bladder illnesses ( Colitis, Diverticulosis, Megacolon)
Ammonia levels in the blood have risen (hyper ammonium in hepatopathy, portal-systemic encephalopathy)

Pharmacology

Lactulose is a disaccharide that has been synthesized. Lactulose is digested in the colon by saccharolytic bacteria, which produces low molecular weight organic acids (mostly lactic acid), which lowers the pH of the colon contents, promotes water retention via an osmotic action, and so increases peristaltic activity. Because lactulose is only slightly absorbed, the pharmacokinetics of the absorbed substance has no bearing on the primary therapeutic effect.

Dosage & Administration

In constipation ( chronic constipation):

• Adults: Initially 3-6 tea spoons daily, In long-term therapy 1½-6 tea-spoons daily
• Children up to 14 years: Initially 3 tea spoons daily, In long-term therapy 1-2 tea-spoons daily
• Infants and toddlers: Initially 1-2 tea spoons daily, In long-term therapy 1 tea-spoon daily

In damaged intestinal flora:

• Adults: 1-2 tea-spoons daily
• Children: 1 tea-spoon daily

For reduction of blood ammonia level:

• Hyper-ammonium in hepatopathy: a maximum of 18-30 teaspoons daily.
• In portal-systemic encephalopathy: hourly doses of 6-9 tea spoons of Lactulose solution may be used to induce rapid laxation. When the laxative effect has been achieved, the dose may then be reduced.

Interaction

With lactulose, there are no notable medication interactions. In misuse, potassium deprivation can amplify the glycosidic action of cardiac glycosides.

Contraindications

Galactose and/or lactose hypersensitivity; galactose-free diet; gastro-cardinal symptom complex; possible intestinal obstruction

Side Effects

Flatulence, cramps, and abdominal discomfort may occur at the start of treatment; this is quickly resolved by lowering the dose. Overdosing might cause diarrhea. Electrolyte loss is a common side effect of drug misuse (primarily potassium).

Pregnancy & Lactation

Lactulose is classified as a pregnancy category B by the US Food and Drug Administration. Lactulose has been shown in studies to have no negative effects. A registered physician must make decisions about use during pregnancy and lactation.

Precautions & Warnings

Patients who are intolerant to lactulose should be given the sugar with caution. The dose used in the treatment of (pre) coma hepatic is usually substantially higher, and diabetics should be aware of this.

Therapeutic Class

Purgatives based on osmotic pressure

Storage Conditions

Keep away from light and heat in a dry location. Keep out of children’s reach.

Pharmaceutical Name

Drug International Limited