Everyone experiences constipation sooner or later. Difficulties with bowel movements cause a lot of troubles, anxiety, and deterioration in well-being. To eliminate this problem, you can use medications and traditional medicine. Laxatives, the main active ingredient in which is lactulose, are very popular. They are in demand because they have a number of advantages:
- safety;
- soft impact;
- efficiency;
- a minimum set of unpleasant side effects.
In addition, the body does not get used to drugs of this group, so there is no need to fear that intestinal motor functions will decrease.
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.
Lactulose Farmland syrup 667 mg/ml in 15 ml bags No. 10
Name
Lactulose Farmland syrup 667 mg/ml per bag. 15 ml in pack No. 10
Description
Transparent viscous liquid from light yellow to brownish yellow, sweet in taste.
Main active ingredient
lactulose as lactulose
Release form
Syrup
Dosage
15ml
Pharmacological properties
Lactulose is a synthetic derivative of lactose. It does not disintegrate in the stomach and small intestine due to the lack of appropriate enzymes and is practically not absorbed. Once in the intestines, it stimulates peristalsis, improves the absorption of phosphates and calcium salts, increases the diffusion of ammonia from the blood into the intestines and promotes its excretion from the body. In the large intestine, lactulose, under the influence of intestinal flora, is broken down into low molecular weight organic acids - mainly lactic acid and partially formic and acetic acids. At the same time, the osmotic pressure increases and the pH in the lumen of the large intestine decreases, the volume of stool increases, which stimulates the peristalsis of the large intestine and normalizes the consistency of the stool. This helps eliminate constipation and restore the physiological rhythm of bowel movements. The removal of bound ammonium ions occurs with the development of a laxative effect. The laxative effect appears 24 to 48 hours after administration. In addition, lactulose removes bile acids from feces, resulting in a decrease in cholesterol levels in the blood and bile. In hepatic encephalopathy or hepatic precoma/coma, the effect is attributed to suppression of proteolytic bacteria by increasing the number of acidophilic bacteria (eg, lactobacilli); the transition of ammonia into ionic form due to acidification of the contents of the colon; bowel emptying due to decreased pH in the colon and 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, promotes the growth of bifidobacteria and lactobacilli, while the growth of opportunistic clostridia and Escherichia coli can be suppressed. This promotes a favorable balance of intestinal microflora.
Indications for use
— constipation: regulation of the physiological rhythm of bowel movements; - softening of stool for medical purposes (hemorrhoids, operations on the colon and anus, in the postoperative period); - hepatic encephalopathy: treatment and prevention of hepatic precoma or coma.
Directions for use and doses
Lactulose Farmland is taken orally. The duration of treatment and dose are determined by the doctor individually. Farmland lactulose can be taken either diluted or undiluted. It is necessary to immediately swallow the single dose taken without holding it in the mouth. All dosages must be selected individually. If a single daily dose is prescribed, it must be taken at the same time, for example, during breakfast. During laxative therapy, it is recommended to take a sufficient amount of fluid (1.5-2 liters) per day. Prevention of constipation: Should be taken once a day. The clinical effect occurs within 1-2 days. The dose is increased if no improvement in the patient's condition is observed within 2-3 days of taking the drug. Adults and adolescents: the initial dose is 15-45 ml, the maintenance dose is 15-30 ml. Children: up to 1 year of age, initial dose – up to 5 ml, maintenance dose – up to 5 ml; from 1 year to 6 years, the initial dose is 5-10 ml, maintenance dose is 5-10 ml; from 7 to 14 years, the initial dose is 15 ml, maintenance dose is 10-15 ml. As a rule, the dose can be reduced after 2 days of administration depending on the patient's needs. Reception for softening stool: The dosage of the product for softening stool is the same as for constipation. For the prevention of hepatic encephalopathy, hepatic precoma or coma (adults): Initial dose of 30-45 ml 3-4 times a day, and then switch to an individually selected maintenance dose so that there are soft stools 2-3 times a day. Children The safety and effectiveness of use in children (under 18 years of age) with hepatic encephalopathy has not been established due to a lack of data. Elderly patients and patients with renal or hepatic impairment: There are no specific dosing recommendations as systemic exposure to lactulose is negligible.
Use during pregnancy and lactation
Before using the drug, pregnant and lactating women should consult a doctor. If necessary, the drug can be prescribed during pregnancy and lactation, since the systemic effect of lactulose is insignificant. No effect on reproductive function is expected.
Precautionary measures
If abdominal pain of unknown origin occurs before starting treatment or there is no therapeutic effect several days after starting the drug, you should consult your doctor. Lactulose should be administered with caution to patients with lactose intolerance. The dose usually used in the treatment of constipation does not require adjustment for patients with diabetes mellitus. When treating hepatic encephalopathy, higher doses are usually prescribed, which should be taken into account in relation to diabetes mellitus. Continuous use of uncorrected doses and abuse can lead to diarrhea and fluid and electrolyte imbalance. It must be taken into account that the drug contains lactose, galactose and a small amount of fructose, therefore this drug should not be prescribed to patients with galactose or fructose intolerance, lactase deficiency or glucose-galactose malabsorption. Lactulose can be used in small children and infants only in exceptional cases under the supervision of a physician. Taking lactulose in children may cause disruption of the voiding reflex.
Interaction with other drugs
Interaction studies with other drugs have not been conducted.
Contraindications
- hypersensitivity to the components of the drug; - galactosemia; - obstruction of the gastrointestinal tract, perforation or risk of perforation of the gastrointestinal tract.
Compound
1 ml of syrup contains the active ingredient: lactulose in the form of lactulose (liquid) – 667 mg.
Overdose
Symptoms: when using a very high dose, diarrhea and abdominal pain are possible. Treatment: The dose should be reduced or the drug should be stopped. Large fluid losses due to diarrhea or vomiting may require correction of electrolyte imbalances.
Side effect
In the first days of taking lactulose, flatulence may occur. As a rule, it disappears after a few days. If high doses are used for a long time in the treatment of hepatic encephalopathy, the patient may develop electrolyte imbalance due to diarrhea. If the recommended doses are exceeded, abdominal pain and diarrhea may occur, which requires a dose reduction. Frequency of these undesirable effects: very often ≥1/10; often from ≥1/100 to ˂1/10; infrequently from ≥1/1000 to ˂1/100; rarely from ≥1/10000 to ˂1/1000; very rarely ˂1/10000. Gastrointestinal disorders: very often – diarrhea; often – flatulence, abdominal pain, nausea, vomiting. Impact on the results of laboratory and instrumental studies: infrequently - electrolyte imbalance due to diarrhea.
Storage conditions
Store at a temperature not exceeding 25ºС. Keep out of the reach of children.
Buy Lactulose Farmland syrup 667 mg/ml in 15 ml bags No. 10 in the pharmacy
Price for Lactulose Farmland syrup 667 mg/ml in 15 ml bags No. 10
Instructions for use for Lactulose Farmland syrup 667 mg/ml in 15 ml bags No. 10
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.
Pharmacodynamics and pharmacokinetics
What is Lactulose? Lactulose is a synthetic disaccharide 6-galactoside-fructose . The substance penetrates the large intestine, where its metabolic . Low molecular weight organic acids formed as a result of this process significantly reduce the pH of the environment. This process promotes the removal of toxins and the rapid evacuation of feces.
Lactulose preparations have a mild but quite intense laxative effect that does not require additional intake of large amounts of liquid. The medicine increases osmotic intraintestinal pressure , peristalsis , fluid is retained in the intestinal cavity and stool softens.
Thanks to the decrease in pH lactobacilli and bifidumbacteria , which use lactulose as a nutrient substrate , can now multiply . The number of pathogenic microorganisms and decaying microflora will be significantly reduced. Toxic substances such as ammonia heavy metal salts , and radionuclides are eliminated from the body faster.
enzyme in the digestive system that breaks down lactulose , so the substance easily penetrates the colon. The drug undergoes metabolic involving lactobacilli and bifidumbacteria . The main metabolites are lactic acid and other org. acids _
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.
Symptoms of deficiency and excess
The leading clinical sign of insufficient lactulose intake is the presence of persistent constipation. The problem disappears spontaneously when taking a prebiotic for several days. Other symptoms of nutrient deficiency include:
- attacks of nausea and vomiting;
- a sharp decrease in body weight;
- unpleasant sensations in the abdomen, flashes of pain.
Disorders of the gastrointestinal tract provoke metabolic disorders and improper functioning of the digestive organs.
If the recommended amounts of lactulose are exceeded, the consequences are unpleasant, but do not cause significant dysfunction of the body. Excessive consumption of fermented milk products and dietary supplements leads to the formation of a chronic form of diarrhea, active gas formation (flatulence) and rapid weight gain. There is a risk of inflammatory processes in the urinary organs, requiring long-term treatment.
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.
The body's needs for prebiotics
When used regularly, lactulose increases the number of beneficial bacteria tenfold, while simultaneously reducing the number of harmful microbes by a hundredfold. To obtain a similar effect, daily use of dietary supplements with a prebiotic is required. The daily intake of the substance is 3-4 g for an adult.
Taking lactulose is justified for patients:
- with chronic constipation;
- dysfunction of the gastrointestinal tract;
- increased activity of pathogens in the intestines;
- liver dysfunction;
- elevated cholesterol levels;
- unstable metabolism - regular slowdown of metabolism.
The use of lactulose requires special caution in case of diabetes mellitus, increased or decreased acidity of gastric juice. The presence of these pathologies requires restrictions on the consumption of any fermented milk products or the intake of dietary supplements.
Lactulose is a substance that combines optimally with minerals. When taking the drug, accelerated absorption of individual elements in the intestine is observed. The list includes iron, calcium, magnesium, zinc. The prebiotic optimizes the production of secondary bile acids and lowers levels of bad cholesterol in the body.
Lactulose price
The price of Lactulose syrup for children is about 170 rubles.
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Lactulose analogues
Level 4 ATC code matches:
Romphalac
Transipeg
Normolakt
Medulak
Fortrans
Exportal
Fleet Phospho-Soda
Good luck
Sorbitol
Duphalac
Normaze
Forlax
The most common analogues: Depurax, Lactuvit, Bioforlax, Duphalac, Lactulose-MIP, Normolakt, Diagnol, Medulak, Portalak, Magnesium sulfate, Transulose, Forlax, Moviprep, Fortrans, Endofalk , Normaze .
Indications for use
Drugs with this active ingredient are usually prescribed:
- for chronic constipation ;
- as part of complex treatment of hepatic encephalopathy ;
- for digestive disorders;
- for salmonellosis ;
- pregnant and lactating women;
- infants older than 1.5 months who are bottle-fed;
- elderly people with digestive disorders;
- after resection of hemorrhoids .
