INDICATION
1. Constipation
2. Hepatic encephalopathy (Portal systemic encephalopathy): hepatic coma
DOSAGE AND ADMINISTRATION
Constipation:
Initially Osmolax® solution may be given twice daily. In due course the dose should be adjusted according to the needs of the individual, but the following serves as a guide Starting dose:
Adults: (including the elderly): 15 ml twice daily.
Children:
5 to 10 years: 10 ml twice daily.
Children under 5 years: 5 ml twice daily.
Babies under 1 year: 2.5 ml twice daily. Osmolax® solution may, if necessary, be taken with water or fruit juice, etc.
Hepatic encephalopathy: Adults (including the elderly):
Initially 30-50 ml three times a day. Subsequently adjust the dose to produce two or three soft stools each day.
Children: No dosage recommended for this indication. Because of Lactulose’s physiological mode of action it may take up to 48 hours before effects are obtained. However, clinical experience has shown that this medicament does exhibit a ‘carry-over’ effect, which may enable the patient to reduce the dose gradually over a period of time. A maintenance dose of 15 ml per day provides only 14 kilocalories and is therefore, unlikely to adversely affect diabetic patients.
CONTRAINDICATION AND PRECAUTION
Galactosaemia. In common with other preparations used for the treatment of constipation, Lactulose should not be used when there is evidence of gastro-intestinal obstruction.
Lactose intolerance.
SIDE EFFECT
During the first few days of treatment, meteorism and increased flatulence may occur. These symptoms usually disappear under continued therapy. Diarrhoea may occur especially when used higher dosages, e.g. during treatment of portal systemic encephalopathy. Dosage should then be
adjusted to obtain two or three formed stools per day.
USE IN PREGNANCY
Wide clinical experience, together with data from animal reproduction studies has not revealed any increase in embryotoxic hazard to the foetus if used in the recommended dosage during pregnancy. If laxative therapy is needed in pregnancy, use of this drug is acceptable.
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