Lactulose - 9 reviews, instructions for use

Description:

Transparent viscous liquid from colorless to yellow with a brownish tint.

Pharmacotherapeutic group:

laxative.

ATX code:

A06AD11.

Pharmacological properties

Pharmacodynamics

It has a hyperosmotic laxative effect, stimulates intestinal motility, improves the absorption of phosphates and calcium salts, and promotes the excretion of ammonium ions.

Lactulose is broken down by the intestinal flora of the colon into low molecular weight organic acids, which leads to a decrease in pH and an increase in osmotic pressure and, as a result, an increase in the volume of intestinal contents. These effects stimulate intestinal motility and affect stool consistency. The physiological rhythm of emptying the large intestine is restored.

In hepatic encephalopathy and hepatic (pre)coma, the effect is due to the suppression of proteolytic bacteria by increasing the number of acidophilic bacteria (for example, lactobacilli); the transition of ammonia into ionic form due to acidification of the contents of the colon; bowel movements due to a decrease in pH in the colon and the osmotic effect; as well as reducing nitrogen-containing toxic substances by stimulating bacteria that utilize ammonia for bacterial protein synthesis.

Lactulose as a prebiotic substance enhances the growth of beneficial bacteria such as bifidobacteria and lactobacilli, which in turn helps to suppress the growth of potentially pathogenic bacteria such as Clostridium and E.coli, and provides a more favorable balance of intestinal flora.

Has the ability to inhibit the growth and reproduction of salmonella and shigella. Does not reduce the absorption of vitamins and is not addictive.

The effect occurs 24-48 hours after administration (the delay is due to the passage of the drug through the gastrointestinal tract).

Pharmacokinetics

Absorption is low (renal excretion is 3%). Without being absorbed, it reaches the large intestine, where it is broken down by intestinal flora. Completely metabolized at doses of 40-75 ml; at higher dosages, it is partially excreted unchanged through the intestines.

Kefir with lactulose

During clinical examinations, it was revealed that the combined intake of kefir and lactulose increases the number of lactobacilli and bifidobacteria in the human body. If you take this remedy regularly, you may notice several beneficial changes:

Suppression of pathogenic and conditionally pathogenic microflora.
Minimize intestinal disorders.
Eliminate constipation.
Reduction of atopic dermatitis.
Increased appetite.

For the purpose of prevention, it is recommended to take kefir containing lactulose for adults and children.

Directions for use and doses

The drug is intended for oral administration,

during or after meals.

Lactulose may be given as a single daily dose, or the dose may be divided into two doses using a measuring cup.

All dosages must be selected individually. If one dose is prescribed per day, it should be taken at the same time, for example, during breakfast.

For constipation:

children under 1 year: 5 ml/day;
children from 1 to 6 years: 5-10 ml/day;
children from 7 to 14 years: 15 ml/day;
children over 14 years of age and adults: in the first three days, 15-45 ml/day, then 10-30 ml/day.

The laxative effect of the drug develops during the first two days of administration. The duration of treatment is from 4 weeks to 3-4 months.

With hepatic coma, (pre)coma, encephalopathy

The initial dose is 30-45 ml 3 times a day. Then the dose is selected so that soft stools are produced 2-3 times a day. Treatment can last up to 3 months or more.

For hepatic coma, (pre)coma and hepatic encephalopathy: 30-50 ml orally 3 times a day, the daily dose can be 90-190 ml; then in an individually selected maintenance dose (providing a stool pH of 5-5.5) 2-3 times a day.

In the postoperative period

Adults: 10-30 ml 3 times a day, children over 1 year: 5-10 ml 2-3 times a day, up to 1 year: 5 ml 2-3 times a day. The drug is prescribed 18-24 hours after surgery for 3-5 days.

Composition and release form

The drug Lactulose is available in several forms. In pharmacies you can find the drug in the form of tablets or syrup of different dosages. The composition of the drug includes the main substance - lactulose. 1 ml of syrup or 5 mg tablet contains 670 mg of lactulose.

Tablets are packaged at 500 mg - this is 30 pieces per package.

The syrup is also packaged in specific doses:

5 ml of syrup contains 3.325 g of lactulose, which is contained in packages of 200 and 240 ml.
15 ml of syrup contains 10 g of lactulose, which is contained in packages of 200 to 1000 ml.

Side effect

Side effects are usually mild and reversible and are a consequence of exceeding the dose.

In the first days of taking lactulose, flatulence may occur, which, as a rule, disappears after 1-2 days. If high doses are used for a long time in the treatment of hepatic encephalopathy, the patient may develop electrolyte imbalances as a result of diarrhea and, as a result, convulsions, flatulence, nausea, headache, dizziness, arrhythmia, myalgia, increased fatigue, and weakness.

Hydrogen breath test with Lactulose

If you have an allergic reaction to the main component - lactulose, then you may be prescribed a hydrogen breath test. The test is performed in this way, the patient exhales into a special device to collect air.

With such exhalation, experts determine the presence of hydrogen.

After this procedure, the patient is required to drink Lactulose in any form. After this, such samples should be taken after 20 minutes and repeated for about two hours.

With this procedure, 10 breath samples are obtained, transferred to the laboratory and the data is processed. The result of this procedure can be found out within 10 days after delivery.

Before starting the test, special preparation is required:

It is not recommended to take antibiotics in two weeks and during them;
The day before the examination, the following products should be excluded:

Nuts;
Legumes;
Grain bread.

Smoking is prohibited. After the examination is completed, all prohibitions are lifted.

special instructions

If there is no therapeutic effect within two days or if constipation returns after treatment, the patient is advised to consult a doctor.

The drug should be administered with caution to patients with galactose intolerance. Please note that the drug may contain small amounts of bound sugars (for example, lactose, galactose, epilactose).

When treating hepatic (pre)coma, higher doses of the drug are usually prescribed, which should be taken into account in patients with diabetes mellitus.

When treating children, laxatives should be used in exceptional cases and under medical supervision. It must be taken into account that during treatment, disorders of the emptying reflex may occur.

Patients with rare congenital disorders such as galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption should not use this drug.

With long-term use of the drug (more than 6 months), the concentration of potassium, chlorine and carbon dioxide in the blood plasma should be regularly monitored.

For gastrocardial syndrome, doses should be increased gradually to avoid flatulence.

Indications for use

The use of the drug begins with certain indications and symptoms. The most common indicators are the following:

Postoperative period (colon surgery);
Anal fissures;
Radiation therapy;
Chemotherapy;
Restoring normal bowel function after antibiotic use;
Intestinal dysbiosis;
Food poisoning in children;
Putrefactive dyspepsia syndrome in children;
Salmonellosis;
Hepatic encephalopathy;
Constipation of various origins.

Lactulose crystalline substance (Lactulose-cristallum)

Instructions for medical use of the drug

Description of pharmacological action

Stimulates the proliferation of lactic acid bacteria and intestinal motility (acts only in the colon). The microflora of the colon hydrolyzes lactulose to lactic acid (mainly) and partially to formic and acetic acids. At the same time, the osmotic pressure increases and the contents of the intestine are acidified, which leads to the retention of ammonium ions, migration of ammonia from the blood to the intestine and its ionization. Inhibits the formation and absorption of nitrogen-containing toxins in the proximal colon. Reduces the concentration of ammonium ions in the blood by 25–50% and reduces the severity of hepatogenic encephalopathy, improves mental state and normalizes the EEG.

Indications for use

Constipation (including chronic); the need to soften stool for medical purposes (for hemorrhoids, the need for surgery on the colon and/or anus, pain after removal of hemorrhoids, in the postoperative period); hepatic encephalopathy, including coma and precoma (treatment and prevention); hyperammonemia; intestinal dysbiosis; enteritis caused by Salmonella, Shigella, Salmonella carriage; putrefactive dyspepsia syndrome (in young children as a result of acute food poisoning).

Release form

substance; double-layer polyethylene bag (bag) 10 kg paper bag (bag) 1; substance; double-layer polyethylene bag (bag) 15 kg paper bag (bag) 1; substance; two-layer polyethylene bag (bag) 25 kg paper bag (bag) 1;

Pharmacodynamics

Pharmacokinetics

The removal of bound ammonium ions occurs with the development of a laxative effect. The effect occurs 24–48 hours after administration. Its delay is due to the passage of the drug through the gastrointestinal tract. The components of lactulose are poorly absorbed into the blood and their daily excretion in urine is about 3%.

Use during pregnancy

FDA category of effect on the fetus is B.

Contraindications for use

Hypersensitivity, galactosemia, intestinal obstruction, rectal bleeding (the cause of which is not hemorrhoids), colo- or ileostomy, suspected appendicitis.

Side effects

Flatulence, diarrhea, abdominal pain, loss of electrolytes.

Directions for use and doses

Inside. The dose is set individually. For hepatic encephalopathy, adults are prescribed up to 45-90 ml of syrup in 2-3 doses (up to 90-190 ml/day), for other indications - 15-45 ml/day. Children over 1 year old - 5-15 ml/day, under 1 year old - 5 ml/day.

Overdose

Symptoms: diarrhea, abdominal pain. Treatment: the drug should be discontinued.

Interactions with other drugs

Antibiotics (neomycin) and non-absorbable antacids reduce the effect.

Precautions for use

Use with caution in patients with diabetes (especially in the treatment of hepatic encephalopathy). For gastrocardial syndrome, doses should be gradually increased to avoid flatulence; Usually, flatulence disappears on its own after 2–3 days of treatment. Do not prescribe against the background of abdominal pain, nausea and vomiting. If diarrhea occurs, treatment is discontinued. During long-term treatment (more than 6 months) with increased doses, serum electrolyte levels should be regularly monitored.

Storage conditions

In a dry place, protected from light, at a temperature of 5–25 °C.

Best before date

36 months

ATX classification:

A Digestive tract and metabolism

A06 Laxatives

A06A Laxatives

A06AD Laxatives with osmotic properties

A06AD11 Lactulose

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** The Drug Directory is intended for informational purposes only. For more complete information, please refer to the manufacturer's instructions. Do not self-medicate; Before starting to use the drug Lactulose crystalline, you should consult a doctor. EUROLAB is not responsible for the consequences caused by the use of information posted on the portal. Any information on the site does not replace medical advice and cannot serve as a guarantee of the positive effect of the drug.

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Lactose and Lactulose - what is the difference?

Lactose is a special substance that is found in all dairy products and is also a sugar in natural milk. Lactose has many benefits for the human body.

The most common utility indicators are the following:

A drug for the prevention of cardiovascular diseases.
Stimulates the nervous system.
Supports normal intestinal microflora.
Normalizes calcium metabolism in the human body.
Source of energy.

Lactose itself is a beneficial substance. A contraindication to its use can only be the inability of the body to absorb it. This is possible if there is not enough lactase in the body.

Lactulose is part of the class of pribiotics. She does:

Stimulating the growth and development of beneficial intestinal microflora of lactobacilli and eufidobacteria.
Without changes, it can reach the lower sections of the gastrointestinal tract.
It is not broken down by digestive enzymes in sections of the gastrointestinal tract.

The main actions that lactulose performs are:

Absorption of minerals and strengthening bones.
Suppression of toxic metabolites and harmful enzymes.
Suppression of harmful bacteria and the vital activity of bifidobacteria.
Stimulation of liver functions.
Relieving constipation.
Anti-carcinogenic effect.
Inhibition of the formation of secondary bile acids.

These substances are similar in their benefits for the human body. But lactose is a component that helps normalize microflora, and lactose also gives a laxative effect.