Description
Generic
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.
Pharmacology
Lactulose is a disaccharide that has been synthesized. Lactulose is metabolized in the colon by saccharolytic bacteria, which produces low molecular weight organic acids (primarily lactic acid), which lowers the pH of the colon contents, promotes water retention via an osmotic effect, and thus increases peristaltic activity.
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 significant drug interactions. In abuse, potassium deficiency can amplify the glycosidic effect of cardiac glycosides.
Contraindications
Galactose and/or lactose hypersensitivity; galactose-free diet; gastro-cardinal symptom complex; suspected intestinal obstruction
Side Effect
Flatulence, cramps, and abdominal discomfort may occur at the start of treatment; this is quickly resolved by lowering the dose. Overdosing can cause diarrhea. Electrolyte loss is a common side effect of drug abuse (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 much 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 place. Keep out of children’s reach.