Instructions for the use of Duphalac syrup for constipation in adults and children
The content of the article:
- Composition and description
- Mechanism of action
- Indications for use
- Contraindications
- Application during pregnancy and lactation
-
Method of administration and dosage
- How much and how to take Duphalac correctly for constipation
- Dosage for hepatic encephalopathy
- Use in the elderly and patients with renal impairment
- Side effect
- Overdose
- Interaction with other medicinal products
- special instructions
- Release form
- Storage conditions
- Shelf life
- Terms of dispensing from pharmacies
Lactulose is considered one of the most effective treatments for constipation. Due to its mechanism of action, proven efficacy and high safety, drugs based on it are successfully used in the treatment of not only adult patients, but also children and pregnant women. On the Russian market, the leader among all drugs with lactulose is Duphalac. We will take a closer look at the instructions for using Duphalac syrup for constipation by adult patients and children.
Duphalac is effective and safe (when taken correctly) and can be used by both adults and children
Composition and description
Duphalac is available in the form of a syrup, 100 ml of which contains 66.7 lactulose.
The drug has the appearance of a viscous transparent liquid, from colorless to light yellow in color with a sweet taste.
Mechanism of action
The microflora of the large intestine breaks down lactulose into organic low molecular weight acids. This causes an increase in osmotic pressure and a decrease in pH, which, in turn, contributes to an increase in the volume and softening of feces, stimulation of intestinal peristalsis. As a result of these processes, the natural mechanism of bowel emptying is restored.
The therapeutic effect of Duphalac in hepatic encephalopathy is explained by the following effects of the drug:
- promotes the growth of acidophilic microflora in the large intestine, which suppress the activity of proteolytic bacteria;
- shifts the pH to the acidic side, which facilitates the conversion of ammonia molecules into the ionic form;
- makes the vital activity of the intestinal microbial flora more active, which uses ammonia for protein synthesis;
- increases osmotic pressure and thus has a laxative effect, removing toxic products from the intestines.
According to the opinions of doctors and patients, taking Duphalac and its analogues has a quick therapeutic effect in intestinal dysbiosis. This is due to the fact that lactulose is a prebiotic, that is, a substance that enhances the growth of lactobacilli and bifidobacteria. They, in turn, inhibit the development of potentially pathogenic microflora, in particular, clostridia and Escherichia coli.
When taken orally, the drug is not absorbed into the systemic circulation and reaches the large intestine in practically unchanged form, where it is broken down by the intestinal microflora. When taken in a dose over 40–75 ml, Duphalac is partially excreted from the body unchanged.
Indications for use
In accordance with the instructions, the indications for the appointment of Duphalac are:
- normalization of the physiological rhythm of defecation (treatment of constipation);
- softening of the stool in a number of diseases (anal fissure, conditions after surgery on the rectum, hemorrhoids, acute myocardial infarction);
- hepatic encephalopathy (the drug can be used both for the prevention and treatment of hepatic coma).
Contraindications
The main contraindications to the use of Duphalac are:
- glucose-galactose malabsorption;
- lactase deficiency;
- intolerance to fructose or galactose;
- increased individual sensitivity to the drug;
- intestinal obstruction;
- risk of perforation or perforation of the hollow organs of the gastrointestinal tract;
- galactosemia.
Application during pregnancy and lactation
Lactulose is not absorbed into the bloodstream and has no systemic effect on the body. Therefore, the drug can be used during pregnancy and breastfeeding.
Method of administration and dosage
Duphalac is taken orally undiluted or diluted. The dose intended for one dose must be swallowed without holding it in the mouth.
It is advisable to take the medicine at the same time, with food or after a meal.
During the course of treatment with laxatives, including lactulose, the patient should drink a sufficient amount of liquid (at least 6-8 glasses of water per day).
For correct dosage of the drug, it is necessary to use the measuring cap supplied with each vial of the drug.
How much and how to take Duphalac correctly for constipation
The daily dose of the drug should be taken once. When treating elderly patients and children, it can be divided into two steps.
The laxative effect usually develops 2-3 days from the start of treatment. Depending on the reaction of the body, the initial dosage may be changed by the attending physician.
The approximate doses of the drug recommended in the manufacturer's instructions are presented in the table:
| Patient age | Daily dosage (ml) | ||
| Initial | Supportive | ||
| Children of the first year of life | Not more than 5 ml | No more than 5 ml | |
| Children from 1 to 6 years old | 5 to 10 ml | 5 to 10 ml | |
| Children from 7 to 14 years old | 15 ml | 10 to 15 ml | |
| Teens over 15 and adults | 15 to 45 ml | 15 to 30 ml | |
Dosage for hepatic encephalopathy
The drug helps well in the complex treatment of hepatic encephalopathy. The initial adult dose is 30-45 ml, this amount should be taken every 6-8 hours. In the future, they switch to a supporting individual dosage, which should provide soft stools no more than three times a day.
For children and adolescents, Duphalac is not prescribed for the treatment of hepatic encephalopathy, since there is no data on the effectiveness and safety of such therapy in this category of patients.
Use in the elderly and patients with renal impairment
Considering that the systemic effect on the body of lactulose is insignificant, a dosage reduction is not required when prescribing Duphalac to patients with chronic renal failure and the elderly.
Side effect
The first few days of taking the drug, patients may experience flatulence (bloating). With the continuation of the course of treatment, this phenomenon goes away on its own.
When using large doses of Duphalac, patients may develop diarrhea, leading to the development of violations of the water-salt balance.
Overdose
When taking a large dose of the drug, the following symptoms may occur:
- diarrhea;
- abdominal pain;
- nausea, vomiting.
Treatment consists in completely withdrawing the drug or reducing the dosage. With severe vomiting and diarrhea, oral rehydration or fluid therapy may be required to correct water-salt imbalance.
Interaction with other medicinal products
To date, there are no data on the interaction of lactulose with other drugs, since such studies have not been conducted.
special instructions
If taking the drug for 2-3 days does not lead to the proper therapeutic effect, the patient should consult a doctor, as in this case, it may be necessary to increase the dosage.
Duphalac contains a small amount of associated sugars:
- fructose;
- lactose;
- epilactosis;
- galactose.
5 ml of Duphalac syrup contains 0.075 XE (bread units). This must be taken into account when prescribing the drug (especially in large doses) to patients with diabetes mellitus.
Any laxatives, including those based on lactulose, should be used in the treatment of children only if indicated and as prescribed by the attending physician. During therapy, they may experience disorders of the colon-emptying reflex.
The drug does not affect the ability to drive vehicles and perform work that requires increased concentration.
Release form
It is produced in the form of a syrup containing 667 mg of lactulose in each ml. It is bottled in white polyethylene bottles with a polypropylene cap (with first opening control) with a volume of 200, 500 and 1000 ml. A small cap is put on top of the lid, which serves as a measuring cup for dispensing the drug.
It is convenient to measure the dose using the supplied measuring cup
Duphalac is also available in packs of 15 ml in disposable double-layer bags made of aluminum foil and polyethylene. Packages with the drug are packaged in 10 pieces in cardboard boxes.
Storage conditions
The syrup is stored out of the reach of children, at a temperature not exceeding 25 ° C.
Shelf life
The shelf life of the drug is 3 years from the date of issue. After the expiration date, it should not be taken.
Terms of dispensing from pharmacies
It is sold in pharmacy chains in the departments of non-prescription goods dispensing.
Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
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