Lactulose

Lactulose

Class:laxatives

Mechanism of action

The bacterial degradation of lactulose resulting in an acidic PH inhibits the diffusion of NH₃ to NH₄+;also enhances the diffusion of NH₃ from the blood into the gut where conversion to NH₄+ occurs;produces an osmotic effect in the colon with resultant distention promoting peristalsis.

Pharmacokinetics

Absorption:oral:not absorbed appreciably following administration;this is desirable since the intended site of actin is within the colon.Metabolism:by colonic flora to lactic acid and acetic acid,requires colonic flora for primary drug activation.Elimination:primarily in feces and urine.

Indications

Lactulose is indicated for the treatment of constipation,portal systemic encephalopathy(PSE)

Contraindications

Galactosemia and require a low galactose diet.

Precautions

Lactulose contain lactose(less than 0.9 g/15 ml).this should be taken into account when treating patients with lactose intolerance.

Side effects

During the first few days of treatment meteorism and increased flatulence may occur.these symptoms usually disappear under continued therapy of lactulose.

Pregnancy and lactation

Pregnancy risk factor B.Lactulose does not appear in the breast milk of lactating mother,and so the baby will not suffer from diarrhea.

Drug interaction

Decreased effect:Oral neomycin,laxatives,antacids

Dosage

Constipation/maintenance:Dose is taken preferably with breakfast.Adults:15-45 ml per day.Children:5-15 ml per day.Portal systemic encephalopathy(PSE):Starting dose:30-50 ml three times a day.

Brands

Syp.Duphalac,Syp.Lilac