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 and 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

There are no significant drug interactions with lactulose. The glycosidic effect of cardiac glycosides can be intensified by potassium deficiency in abuse.

Contraindications

Hypersensitivity to either galactose and or lactose; galactose-free diet, gastro-cardial symptom complex, suspected 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

US FDA Pregnancy Category of Lactulose is B. Studies show that Lactulose has no adverse effects. Decisions regarding use during pregnancy and lactation must be made by a registered physician.

Precautions & Warnings

Lactulose should be administered with care to patients who are intolerant to lactulose. The dose used in the treatment of (pre) coma hepatic is usually much higher and may need to be taken into consideration for diabetics.

Therapeutic Class

Osmotic purgatives

Storage Conditions

Keep in a dry place away from light and heat. Keep out of the reach of children.

Pharmaceutical Name

Drug International Limited