Lactulose
Lactulose: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. Drug interactions
- 12. Analogs
- 13. Terms and conditions of storage
- 14. Terms of dispensing from pharmacies
- 15. Reviews
- 16. Price in pharmacies
Latin name: Lactulose
ATX code: A06AD11
Active ingredient: lactulose (lactulose)
Producer: JSC "Avva Rus" (Russia), Teva Pharmaceutical Enterprises Ltd. (Israel), STADA Arzneimittel AG (Germany)
Description and photo update: 2019-20-08
Prices in pharmacies: from 824 rubles.
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Lactulose is a laxative with osmotic properties.
Release form and composition
Dosage form - syrup (200, 500 or 1000 ml in plastic bottles, in a cardboard box 1 bottle complete with a measuring cup).
The active ingredient of the drug is lactulose, in 1 ml - 667 mg.
Auxiliary components: citric acid, purified water.
Pharmacological properties
Pharmacodynamics
Lactulose is characterized by a hyperosmotic laxative effect. Also, this drug enhances the excretion of ammonium ions, has a positive effect on the absorption of calcium salts and phosphates, and activates intestinal peristalsis.
Lactulose is broken down in the colon by the action of the local intestinal flora, forming low molecular weight organic acids, which causes an increase in osmotic pressure and a decrease in pH. The consequence of this is an increase in the volume of intestinal contents. These effects stimulate intestinal peristalsis and affect the consistency of the stool. The drug ensures the restoration of the physiological rhythm of colon emptying.
In patients with hepatic precoma / coma and hepatic encephalopathy, the effect is due to inhibition of the activity of proteolytic bacteria, which is carried out due to an increase in the number of acidophilic bacteria (for example, lactobacilli), the conversion of ammonia into an ionic form due to acidification of the contents of the large intestine, and bowel emptying due to the osmotic effect and lowering the pH in the colon, as well as decreasing the concentration of nitrogen-containing toxins by stimulating the activity of microorganisms that utilize ammonia for bacterial protein synthesis.
Lactulose is a prebiotic that enhances the growth of beneficial bacteria (lacto- and bifidobacteria), which in turn inhibits the growth of potentially pathogenic microorganisms (Escherichia coli, Clostridium) and improves the balance of the intestinal flora. The drug is capable of inhibiting the growth and reproduction of Shigella and Salmonella, does not reduce the absorption of vitamins, and its use does not lead to addiction. Lactulose begins to act 24–48 hours after ingestion, which is explained by the passage of the substance through the gastrointestinal tract.
Pharmacokinetics
The degree of absorption of lactulose when passing through the gastrointestinal tract is low. Only 3% of the dose taken is excreted through the kidneys. Without being absorbed, the drug reaches the large intestine, where it is broken down by the action of the intestinal flora. Lactulose is metabolized almost 100% when taken in a dose range of 40–75 ml. When the drug is prescribed in higher doses, the active substance is partially excreted in the feces unchanged.
Indications for use
- Constipation, including hemorrhoids, pregnancy or chronic;
- Preparing the patient for colon surgery;
- The period of rehabilitation after surgery in the anus and / or in the colon;
- Softening stool to facilitate bowel movements for pain after removal of hemorrhoids;
- Hepatic coma and precoma;
- Hepatic encephalopathy.
Contraindications
- Rectal bleeding;
- Hereditary diseases: lactase deficiency, lactose intolerance, glucose-galactose malabsorption, galactosemia;
- Colostomy or ileostomy;
- Bowel obstruction;
- Suspected appendicitis;
- Hypersensitivity to lactulose.
According to the instructions, Lactulose should be used with caution in patients with diabetes mellitus, gastrocardial syndrome.
Instructions for use of Lactulose: method and dosage
Lactulose syrup is taken orally, if desired, it can be diluted with water or juice.
The daily dose and the period of treatment are prescribed by the doctor based on clinical indications.
Recommended dosage:
- Constipation: the initial dose for adult patients is 15-45 ml for the first 3 days, maintenance dose is 10-25 ml; the initial dose for children aged 7-14 years is 15 ml, the maintenance dose is 10 ml. The initial and maintenance dose of Lactulose syrup for children aged 1-6 years - 5-10 ml; from 1.5 months to 1 year - 5 ml. The drug should be taken once a day during breakfast;
- Hepatic encephalopathy: 30-50 ml 2-3 times a day, to achieve a clinical effect, an increase up to 190 ml per day is possible. In order to prevent the development of hepatic coma, patients with severe liver damage are prescribed 25 ml of syrup 3 times a day;
- Salmonellosis: 15 ml 3 times a day, the period of admission is 10-12 days. After a break (7 days), the course should be repeated. If necessary, it is possible to carry out the third course of treatment at a dose of 30 ml 3 times a day.
Side effects
The use of Lactulose can cause undesirable effects:
- Digestive system: possibly - flatulence (usually at the beginning of treatment, gradually disappears in the future), pain in the abdomen, diarrhea, imbalance in water and electrolyte balance (when taking high doses); rarely - nausea;
- Nervous system: rarely - dizziness, headache, convulsions;
- Others: possibly - the development of allergic reactions; rarely - weakness, myalgia, arrhythmia, fatigue.
Overdose
When taking Lactulose syrup in very high doses, diarrhea and abdominal pain may occur. In this case, the dose of lactulose is reduced or the drug is completely canceled. Vomiting or diarrhea can cause significant fluid loss, therefore, correction of fluid and electrolyte imbalances may be required.
special instructions
During pregnancy and breastfeeding, it is possible to use the syrup according to clinical indications.
You can not use the drug without establishing an accurate diagnosis if you feel nausea, abdominal pain or vomiting.
In order to prevent the development of flatulence in patients with gastrocardiac syndrome, the initial dosage should be lower than the recommended one, it must be increased gradually, bringing it to a therapeutically effective dose.
If diarrhea occurs, Lactulose should be discontinued.
The drug is especially carefully used for inflammatory lesions of the colon in patients with diabetes mellitus.
In patients taking the drug for more than 6 months, it is recommended to regularly monitor the level of potassium, carbon dioxide and chlorine in the blood plasma.
Influence on the ability to drive vehicles and complex mechanisms
Taking Lactulose does not affect the speed of psychomotor reactions and the ability to drive vehicles, machines and mechanisms, when interacting with which an increased concentration of attention is required.
Application during pregnancy and lactation
The drug can be taken by pregnant and breastfeeding women.
Pediatric use
For the treatment of children, Lactulose should be used according to age recommendations for dosing.
Drug interactions
The clinical effect of the drug can be reduced by broad-spectrum antibiotics. The action of lactulose lowers the pH of the intestinal contents, therefore, when taken simultaneously with enteric drugs with a pH-dependent release, the release of their active substances may be impaired.
Analogs
Lactulose analogs are: Duphalak, Goodlak, Livolyuk-PB, Romfalak, Portalak, Normaze, Forlax, Dinolak, Exportal, etc.
Terms and conditions of storage
Keep out of the reach of children and protected from light at a temperature of 5 to 25 ° C.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Available without a prescription.
Reviews about Lactulose
Basically, there are positive reviews about Lactulose, in which patients note the mild action of the drug and its delayed effect. It also helps pregnant women well with constipation. Adverse reactions during administration are rare.
Price for Lactulose in pharmacies
At the moment, the price of Lactulose remains unknown, since the drug is not available for sale in pharmacy chains. The cost of an analogue, Duphalac syrup, varies from 270 to 346 rubles for a 200 ml bottle, from 465 to 566 rubles for a 500 ml bottle, from 845 to 1020 rubles for a 1000 ml bottle.
Lactulose: prices in online pharmacies
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Drug name Price Pharmacy |
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Lactulose syrup 667mg / ml fl. 1000ml No. 1 824 RUB Buy |
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Lactulose 667 mg / ml syrup 1000 ml 1 pc. 860 RUB Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
