GENERIC
Lactulose
Indications
Constipation (Chronic Constipation): In every case of chronic constipation, initial treatment should consist of a diet rich in fiber (vegetables, salads, fruits etc.) a generous amount of liquids and much physical exercise. Lactulose H H is only to be taken when these measures prove insufficient. ... Read more Constipation (Chronic Constipation): In every case of chronic constipation, initial treatment should consist of a diet rich in fiber (vegetables, salads, fruits etc.) a generous amount of liquids and much physical exercise. Lactulose H H is only to be taken when these measures prove insufficient. Intestinal flora disturbances:
In damaged to intestinal flora (e.g. following long-term antibiotic treatment)
Gall bladder diseases
Intestinal diseases (Colitis, Diverticulosis, Megacolon)
Increased blood ammonia levels (hyper ammoniemia in hepatopathy, portal-systemic encephalopathy)
Pharmacology
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.
Dosage and 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-ammoniemia in hepatopathy : a maximum of 18-30 tea-spoons daily.
In portal systemic encephalopathy : hourly doses of 6-9 tea-spoons of Lactulose solution may be used to induce the rapid laxation. When the laxative effect has been achieved, the dose may then be reduced.
Interactions
There is no significant drug interactions with Lactulose H H. The glycosidic effect of cardiac glycosides can be intensified by potassium deficiency in abuse.
Contraindications
Hypersensitivity to either galactose and or lactose; galactose-free diet, gastro-cardial symptom complex, suspected intestinal obstruction.
Side effects
Occasionally flatulence, cramp and abdominal discomfort can occur at the beginning of treatment; this is rapidly eliminated by reducing the dose. Overdose can result in diarrhoea. In abuse, loss of electrolytes (primarily potassium).
Pregnancy and lactation
US FDA Pregnancy Category of Lactulose is B. Studies show that Lactulose has no adverse effects. Decisions regarding use during pregnancy and lactation must be made by registered physician.
Precautions and warnings
Lactulose H H should be administered with care to patients who are intolerant to Lactulose H H. The dose used in the treatment of (pre) coma hepaticum is usually much higher and may need to be taken into consideration for diabetics.
Overdose
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.
Storage
Keep in a dry place away from light and heat. Keep out of the reach of children.
Clinical information is taken from the most complete brand listing (Lactulose H); it applies to the active ingredient.
Brands of Lactulose
| # | Brand | Company | Form | Strength | Price |
|---|---|---|---|---|---|
| 31 | Livoton | Kemiko Pharmaceuticals Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
| 32 | Loctoz | Amico Laboratories Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
| 33 | Mebolos | Millat Pharmaceuticals Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
| 34 | Mylac | Mystic Pharmaceuticals Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
| 35 | Niprolac | NIPRO JMI Pharma Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
| 36 | Onlac | One Pharma Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
| 37 | Oralax | Somatec Pharmaceuticals Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
| 38 | Osmolax | Square Pharmaceuticals PLC | Oral Solution | 3.35 gm/5 ml | Not listed |
| 39 | P Lac | Pharmadesh Laboratories Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
| 40 | Polylac | Silco Pharmaceutical Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
| 41 | Regulose | General Pharmaceuticals Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
| 42 | Rewat | Kumudini Pharma Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
| 43 | Serelose | Beximco Pharmaceuticals Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
| 44 | Sinalac | The IBN SINA Pharmaceutical PLC | Oral Solution | 3.35 gm/5 ml | Not listed |
| 45 | Sivolac | Sharif Pharmaceuticals Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
| 46 | Tonilax | OSL Pharma Limited | Oral Solution | 3.35 gm/5 ml | Not listed |
| 47 | Tulac | Eskayef Pharmaceuticals Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
| 48 | Tulos | ACME Laboratories Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
| 49 | Veelac | Albion Laboratories Limited | Oral Solution | 3.35 gm/5 ml | Not listed |
| 50 | Xylose | Delta Pharma Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
| 51 | Zenilac | Zenith Pharmaceuticals Ltd. | Oral Solution | 3.35 gm/5 ml | Not listed |
This page is general information and is not medical advice. It does not replace a registered doctor, and it is not a prescription or a recommendation to use any medicine or test. Prices are listed prices and may change. Always follow the advice of your doctor or pharmacist.