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.
Features of lactulose-based laxatives
Duphalac is a drug that helps the intestines.
Lactulose is considered a synthetic disaccharide; such a substance does not exist in nature; it is a product of human industrial activity. The absorption of lactulose begins only in the large intestine.
Until this moment, the substance passes through the gastrointestinal tract without changes. In the large intestine, lactulose is broken down under the influence of lactic acid bacteria and bifidobacteria.
The product of this process is certain organic acids, the osmotic activity of which promotes rapid bowel movement.
Evacuation occurs due to the softening of stool. After all, the organic acids mentioned above promote the flow of fluid into the intestines.
The presence of fluid not only helps to moisten the intestinal contents, but also increases the volume of feces. Expanding in volume, they begin to put pressure on the intestinal walls, stimulating its motor functions. As a result, peristaltic contractions begin, which lead to quiet bowel movements.
This feature of the action of lactulose-based drugs helps to quickly get rid of constipation and ease bowel movements.
What is this?
Lactulose is a drug for restoring microflora
Lactulose is an organic compound similar in nature to prebiotics. Its structural formula includes one molecule each of fructose and galactose, linked to each other by one of the types of glycosidic bonds. Lactulose is not broken down by many digestive enzymes of the stomach and enters the large intestine without changing its structure. In the human body, lactulose is responsible for the reproduction processes of microorganisms and lactobacilli that inhabit the intestines.
Under normal conditions, lactulose is found in the form of a white crystalline substance. It dissolves well in aqueous media and is odorless. It is obtained by long-term processing of milk, directly from its constituent lactose, which is milk sugar. Lactulose is also considered an isomeric compound of lactose. According to its properties, lactulose is classified as an oligosaccharide, since it is broken down by water into one molecule of fructose and galactose.
Lactulose was first isolated and studied by scientists Montgomery and Hudson by heating lactose with alkali dissolved in water. This discovery was made at the beginning of the twentieth century. Subsequently, lactulose began to be isolated from breast milk of nursing mothers, on the basis of which various infant formulas began to be produced.
Today, lactulose is an essential component of many substances necessary for the development of intestinal microflora in humans.
Reception features
The auxiliary agent of the drug is only water.
Another feature of all these drugs is the need to wait for the onset of the effect within a day or two.
The specific time is determined individually, it depends on the activity of bacteria populating the intestines. They must destroy the shell of the drugs so that the active substance begins to “work”.
The products mentioned above have one active ingredient - lactulose. However, Dinolak also contains simethicone. This active substance is an indispensable component for increased gas formation.
Lactulose-ratiopharm 200 ml syrup
Instructions for medical use of the drug Lactulose-ratiopharm Trade name Lactulose-ratiopharm International nonproprietary name Lactulose Dosage form Syrup 66.7 g/100 ml 200 ml Composition 100 ml of solution contain the active substance - lactulose 50% 132.00 g Description Transparent, colorless or slightly brownish-yellow viscous liquid Pharmacotherapeutic group Laxatives. Osmotic laxatives. Lactulose ATC code A06AD11 Pharmacological properties Pharmacokinetics When taken orally, the absorption of lactulose is low. In unchanged form, lactulose reaches the large intestine, where it is broken down by intestinal flora into low molecular weight organic acids. Completely metabolized at doses of 25-50 g or 40-75 ml; at higher dosages, it is partially excreted unchanged by the kidneys. Pharmacodynamics Products of lactulose metabolism help lower the pH of the colon lumen and have a hyperosmotic effect, resulting in an increase in the volume of intestinal contents. This stimulates intestinal motility and normalizes stool consistency. As a result, constipation is eliminated and the physiological rhythm of the large intestine is restored. In hepatic encephalopathy or hepatic (pre)coma, the therapeutic effect is explained by the following mechanisms: inhibition of the growth of proteolytic bacteria due to the proliferation of acidophilic bacteria (for example, lactobacilli), uptake of ammonia in ionic form through oxidation of the colon contents, bowel emptying due to the low pH value of the colon contents and osmotic effect, as well as the utilization of ammonia for intracellular protein synthesis as a result of changes in the bacterial metabolism of nitrogenous compounds. Lactulose-ratiopharm as a prebiotic substance enhances the growth of beneficial bacteria, such as bifidobacteria and lactobacilli, and inhibits the growth of potentially pathogenic bacteria, such as clostridium and E. coli. This may create a more favorable balance of intestinal flora. Indications for use - constipation (regulation of the physiological rhythm of the large intestine) - conditions requiring softening of the stool for medical purposes (hemorrhoids, condition after surgery on the colon and perianal region) - hepatic encephalopathy (treatment and prevention of hepatic coma or precoma) Method of administration and dosage The dose of the drug is selected individually depending on the therapeutic effect. The syrup can be taken undiluted or diluted in water or other liquids, regardless of meals. The laxative effect may appear after 2-10 hours. For the treatment of constipation and softening of stools, the daily dose can be taken once or divided into two doses using a measuring cap. After a few days from the start of treatment, you can switch to a maintenance dose, depending on the therapeutic effect. It may take 2-3 days for the therapeutic effect to develop. Age Initial dose, per day Maintenance dose, per day Adults and adolescents 15-45 ml 15-30 ml Children 7-14 years old 15 ml 10-15 ml Children 1-6 years old 5-10 ml 5-10 ml Infants under 1 year up to 5 ml up to 5 ml For the treatment of hepatic coma and precoma in adults. The dosage should be with a gradual increase. The drug is prescribed in 7.5-15 ml (corresponding to 5-10 g of lactulose) 3-4 times a day. Then the dose is gradually increased to 30-45 ml (corresponding to 20-30 g of lactulose) 3-4 times a day, until soft stools are achieved 2-3 times a day. The course of treatment with Lactulose-ratiopharm should be continued until the symptoms of the disease are eliminated and laboratory parameters are normalized. Side effects Very often - nausea, vomiting, abdominal pain, flatulence in the first days of taking Lactulose-ratiopharm, which goes away after two days - diarrhea (when using high doses) Very rarely - water-electrolyte imbalance - convulsions - headache, dizziness - arrhythmias - myalgia - increased fatigue - hypernatremia (with hepatic encephalopathy) Contraindications - hypersensitivity to lactulose - acute inflammatory gastrointestinal diseases - intestinal obstruction, perforation or risk of perforation of the gastrointestinal tract - suspected appendicitis - rectal bleeding - colostomy, ileostomy - disorders water-electrolyte balance - galactose intolerance, Lapp lactase deficiency syndrome or glucose and galactose malabsorption syndrome) - pregnancy and lactation Drug interactions With simultaneous use of the drug Lactulose-ratiopharm and: - diuretics, corticosteroids, amphotericin B - increased loss of potassium - cardiac glycosides - enhancing the effect of glycosides - drugs that have a release dependent on the pH of the colon (such as 5-aminosalicylic acid preparations) - they may be inactivated as a result of a decrease in the pH of the colon. Special instructions If the therapeutic effect is insufficient within a few days after taking the drug, you should consult your doctor again. The drug Lactulose-ratiopharm should be prescribed with caution to patients with lactose intolerance. Lactulose-ratiopharm should be prescribed with caution in diabetes mellitus. The dose of Lactulose-ratiopharm used in the treatment of hepatic precoma and coma is usually much higher and therefore, when prescribing the drug to patients suffering from diabetes, it may be necessary to take into account the amount of lactulose. In elderly and debilitated patients taking lactulose for more than 6 months, it is recommended to regularly determine the concentration of blood electrolytes. If diarrhea occurs, treatment is discontinued. It is not recommended to take lactulose within 2 hours after taking other medications. In children, laxatives are used in exceptional cases and under medical supervision. It should be taken into account that in children the defecation reflex may be impaired as a result of treatment. The safety and effectiveness of use for hepatic encephalopathy in children under 18 years of age has not been established. Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms Lactulose-ratiopharm does not affect the ability to drive a car or potentially dangerous mechanisms. Overdose Symptoms: abdominal pain, diarrhea, electrolyte imbalance. Treatment: discontinuation or reduction of the dose of the drug, if necessary, correction of the electrolyte balance. Release form and packaging 200 ml of the drug is poured into polyethylene bottles with a screw cap. 1 bottle, along with a measuring cup and instructions for medical use in the state and Russian languages, is placed in a cardboard box. Storage conditions Store at a temperature not exceeding 25°C. Keep out of the reach of children! Shelf life: 3 years. The period of use of the drug after opening the bottle is 12 months. Do not use after the expiration date. Conditions for dispensing from pharmacies Without a prescription, Austria Packer "Merkle GmbH", Germany Owner of the registration certificate "ratiopharm GmbH", Germany Address of the organization that accepts claims from consumers on the quality of products (products) in the territory of the Republic of Kazakhstan Ratiopharm Kazakhstan LLP, 050040, g Almaty, Al-Farabi Ave., 19, BC Nurly-Tau, 1B, office 603, telephone, fax, e-mail
Contraindications, side effects
The presence of sugars makes these drugs undesirable in the treatment of patients with diabetes. If a person suffers from liver failure, these medications must be prescribed with extreme caution. There are other contraindications, including the following:
- intestinal obstruction;
- possible inflammation of the appendix;
- disruptions in glucose metabolism, sugar intolerance;
- bleeding of unknown etiology;
- intolerance to components (allergy).
