Lactulose (20 sachets/box)

Indications

• Chronic constipation.
• Treatment of hepatic encephalopathy (HE), hepatic coma.

Contraindications

• Known hypersensitivity to any of the active substance or excipients.
• Patients with galactosemia or requiring a low lactose diet.

Compositon/Ingredients

Dosage and administration

Chronic constipation:

• Adults: 15 – 30ml daily, given in a single dose or in 2 divided doses, increase 60ml daily if necessary, adjust doses to the needs of the individual.
• Children 1 month – 1 years: 2.5ml twice daily, 1 – 5 years: 5ml twice daily, 5 – 10 years: 10ml twice daily, 10 – 18 years: 15ml twice daily, adjust doses according to response;
• To restore bowel movements in hemorrhoidectomy patients: 15ml twice during the day before surgery and twice daily for 5 days postoperatively; geriatric patients with colonic retention of barium and severe constipation: 5 – 10ml twice daily for 1 – 4 weeks.

Hepatic encephalopathy: Initial 30 – 45ml, 3 times daily, subsequently adjust the dose every 1 – 2 days as necessary to produce two or three soft stools each day or measuring stool pH (with indicator paper) at the start of therapy and adjusting the dosage until stool pH is about 5; acute episodes of hepatic encephalopathy: 30 – 45ml, given at 1 to 2 hour intervals to induce rapid laxation, reduce to the amount required to produce 2 or 3 soft stools daily; Hepatic pre-coma or coma: Lactulose is used rectally, and other preparation is recommended; newborn to 18 years of age: The safety and efficacy have not been established.

Precaution

• Painful abdominal symptoms of undetermined cause before starting the treatment.
• Insufficient therapeutic effect after several days.
• The dose used in the treatment of hepatic encephalopathy is usually much higher and may need to be taken into consideration for diabetics.
• Unadjusted doses and misuse can lead to diarrhoea and disturbance of the electrolyte balance.
• Patients with rare hereditary problems of galactose or fructose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption: should not use.
• Use of laxatives in children should be exceptional and under medical supervision.

Storage

Store at temperature below 30°C, protect from light.