LACTU

Constipation, hepatic encephalopathy.

Synthetic Disaccharide; Osmotic Laxative

Lactulose is a synthetic disaccharide. Lactulose is metabolized in the colon by the saccharolytic bacteria, producing low molecular weight organic acids (mainly lactic acid), which lowers the pH of the colon contents, promote the retention of water by an osmotic effect; thus increasing peristaltic activity. Lactulose is minimally absorbed; therefore, the pharmacokinetics of the absorbed material are not relevant to the principal therapeutic action.

Constipation: Initially Osmolax solution may be given twice daily. In due course the dose should be adjusted according to the needs of the individual, but the following serves as a guide line:- Starting dose: Adults: (including the elderly) - 15 ml twice daily. Children: 5 to 10 years - 10 ml twice daily. Children under 5 years - 5 ml twice daily. Children under 1 year - 2.5 ml twice daily. Osmolax solution may, if necessary, be taken with water, fruit juice etc. Hepatic encephalopathy: Adults (including the elderly): Initially 30-50 ml three times a day. Subsequently adjust the dose to produce two or three soft stools each day. Children: No dosage recommended for this indication. Because of Lactulose’s physiological mode of action it may take up to 48 hours before Effects are obtained. However, clinical experience has shown that this medicament does exhibit a ‘carry-over’ Effect, which may enable the patient to reduce the dose gradually over a period of time. A maintenance dose of 15 ml per day provides only 14 kilocalories & is therefore, unlikely to adversely affect diabetic patients.

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

Galactosaemia. gastro-intestinal obstruction, lactose intolerance.

Meteorism & increased flatulence, diarrhoea.

If laxative therapy is needed in pregnancy, use of this drug is acceptable.

There have been no reports of accidental overdosage. In the event of acute overdosage it is expected that diarrhoea and abdominal cramps would be the major symptoms.

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