What is lactulose? Milk with golden lactulose Milk with lactulose

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Difficulties with bowel movements are probably familiar to everyone. In the fight against this problem, the main thing is to find a medicine that helps the body cope with it without any side effects. A group of drugs that promote easy bowel movements are lactulose preparations.

In this article you will learn:

Composition and form of release

The composition of all laxatives in this group includes the active substance - lactulose, the share of this substance fluctuates at the level of 47-53%. Excipients in the composition of drugs in this group:

• galactose;
• lactose;
• fructose;
• epilactosis;
• water;
• starch.

The release form of the drug is different, for ease of use there is also lactulose in tablets. Lactulose syrups and granular powders for suspension preparation are widely used. Finished preparations containing lactulose may contain citric acid or flavors. Such medicines are often given to children, they have a sweetish taste. The release form of lactulose does not change its effect on the rectum and gastrointestinal tract. The medicine in liquid form is easy to give to children, and tablets to drink on the road or at work.

The drug Lactulose is prescribed for both adults and children.

Properties of lactulose

The properties of this drug are such that taking it for the patient only benefits, and lactulose can cause harm only in case of intolerance to the active substance. Also, a direct contraindication to taking the drug is a rare, but inherited disease - galactosemia.

The drug is unique, because it does not affect the stomach in any way, it is not absorbed into the intestines.

The action of the drug begins in the large intestine, where it directly acts on the accumulated feces, thinning and increasing their mass. Perilstatics of the rectum increases. The action is mild, the intestines are emptied on their own. The patient can ensure the maximum effect of the drug himself. To do this, he needs to drink an increased amount of water. The action occurs after 24-48 hours.

The drug Lactulose is not prescribed for people suffering from the hereditary disease galactosemia.

There are other products based on lactose, and they are often confused due to the similarity of the name of the active substance. Therefore, it is important to know what is the difference between lactose and lactulose? The second substance is a derivative of the first. That is, lactose (milk sugar) is broken down to an oligosaccharide, obtaining lactulose. Difference in action on the gastrointestinal tract. In the first case, the enzyme - lactase, contained in lactose, acts on the work of the stomach, in the second, the substance acts only in the rectum under the action of bifidumbacteria.

Indications for use

The tool has a beneficial effect during the course of various diseases. The indications for taking this drug are as follows:

1. Different types of constipation.
2. Food poisoning, leading to putrefactive dyspepsia in children.
3. Dysbacteriosis, malfunction of the intestines after undergoing chemotherapy, radiation therapy and taking strong antibiotics.
4. Hepatic encephalopathy.
5. Anal fissures and hemorrhoids, as well as the recovery period after operations on the rectum.

Dysbacteriosis is also an indication for prescribing the drug.

Preparations with lactulose for constipation can be used for a long period. For patients suffering from hemorrhoids, this remedy may be the only way to painless emptying. A remedy that contains lactulose for babies is safe from the moment they reach the age of six weeks.

If a laxative based on lactulose is taken for a long time, about six months, then you need to control the composition of the blood. This is especially true for the elderly and children under 10 years of age.

Dosage and application features

The dosage of drugs with this active substance depends on the form of release, the disease and the age of the patient. Dosing is done for each drug individually and the data on this is indicated in the attached instructions. The list of drugs with lactulose is presented in the table.

Name of the drug	Release form	Dosing
Lactulose Poslabin	Syrup	Children aged 6 weeks - 1 year: 5 ml; 1 year - 7 years: 5-10 ml; 7 - 14 years: 15 ml at the beginning, 10 ml for maintenance; adults - 15-45 ml in the first three days of admission, then 10-25 ml to maintain the effect.
Duphalac	Syrup
Normase	Syrup
Good luck	Syrup
Portalak	Syrup
Poslabin	Tablets	Adults: 8 tablets per day; Children over 5 years: 2 tablets per day. Divide the quantity into two doses.
Lisilac	Powder for suspension preparation	It is diluted in accordance with the description and taken in the same way as a syrup.

Preparations with lactulose for children are best used in the form of a syrup. This makes it easier to choose the dosage and ensure maximum results. The instructions for the use of lactulose for newborns are especially carefully studied. In this case, self-treatment is not necessary, the doctor will give recommendations about taking the medicine and its dosage.

Based on lactulose, many different drugs are produced.

Side effects and overdose

Side effects with this drug are rare:

• In the early days, increased gas formation may occur, but it decreases and passes quickly.
• Allergic reactions.
• Arrhythmia.
• Myalgia.
• Weakness, fatigue.

In case of exceeding the specified dose of the drug, symptoms occur:

• Nausea, diarrhea, abdominal pain.
• Headache, convulsions, dizziness.
• Dehydration, impaired metabolism of water and electrolyte substances.

Lactulose during pregnancy can be used if there are reasons for this, but in limited quantities. Many pregnant women suffer from constipation, and the laxative lactulose can safely relieve the problem.

As side effects of taking the drug, increased fatigue and drowsiness may be noted.

Drug analogues

In addition to the drugs already mentioned, there are several more similar drugs that contain lactulose. Among them are Evikt, Prelaksan, Legendal, Livoluk-PB and others. But this substance can also be obtained from products, in a natural way. To normalize digestion, it is important to know which foods contain lactulose:

• Dairy products. You can make your own yogurt or biolact using VIVO starter.
• Meat semi-finished products and sausage products. Here, the substance is used to increase the shelf life, reduce the risk of developing salmonellosis, and improve the color of the product.
• Diet food is often enriched with lactulose. Also, this substance is found in chicory.
• Modern manufacturers of confectionery and bakery products also add this substance to their products.

Providing nutrition with lactulose-containing foods is not difficult. You need to study the composition of the goods on the packaging in the store. Eating such foods will keep the balance of beneficial bacteria in the intestines and prevent constipation.

Gross formula

Pharmacological group of the substance Lactulose

Nosological classification (ICD-10)

CAS code

Characteristics of the substance Lactulose

White powder, highly soluble in water, molecular weight - 322.3.

Pharmacology

Pharmacodynamics

Lactulose is a disaccharide consisting of galactose and fructose, which is not hydrolyzed by disaccharidases of the small intestine mucosa. It has a hyperosmotic laxative effect, stimulates intestinal motility, improves the absorption of phosphates and calcium salts, promotes the excretion of ammonium ions.

Lactulose is broken down by the intestinal flora of the large intestine 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 the consistency of the stool. The physiological rhythm of emptying the large intestine is restored.

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

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

Pharmacokinetics

Absorption is low. Lactulose is absorbed from the small intestine only by 0.4-2%, then it reaches the large intestine, where it is broken down by the intestinal microflora.

Completely metabolized when used in doses up to 45-70 ml (as a syrup, 667 mg / ml). When used in higher doses, it is partially excreted unchanged.

Application of the substance Lactulose

Constipation (including chronic); the need to soften the 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 dysbacteriosis; enteritis caused by salmonella, shigella, salmonella carriage; putrefactive dyspepsia syndrome (in young children as a result of acute food poisoning).

Contraindications

Hypersensitivity to lactulose; intestinal obstruction; intolerance to fructose, galactose; lactase deficiency; glucose-galactose malabsorption; galactosemia; rectal bleeding (which is not caused by hemorrhoids); colo- or ileostomy; suspicion of appendicitis, acute inflammatory diseases of the abdominal cavity.

Application restrictions

Diabetes.

Use during pregnancy and lactation

It is used during pregnancy and during breastfeeding, only if the benefit to the mother outweighs the potential risk to the fetus and child.

Side effects of the substance Lactulose

The frequency of side effects is classified in accordance with WHO recommendations: very often - ≥10%; often - ≥1-<10%; нечасто — ≥0,1-<1%; редко — ≥0,01-<0,1%; очень редко (включая единичные случаи) — <0,01%; частота неизвестна — недостаточно данных для оценки частоты явления в популяции.

From the side of nutrition and metabolism: very rarely - hypernatremia; frequency unknown - violations of water and electrolyte metabolism.

From the gastrointestinal tract: very often - nausea, vomiting, abdominal pain, flatulence, bloating, diarrhea.

Interaction

With simultaneous use with diuretics, corticosteroids, amphotericin B, an increase in potassium loss is possible.

Antacids and antibiotics active against lactobacilli and bifidobacteria (including neomycin, clindamycin, rifaximin) reduce the effect of lactulose.

Overdose

Symptoms: nausea, vomiting, diarrhea, hypokalemia, hypernatremia.

Treatment: symptomatic.

Routes of administration

inside.

Lactulose Substance Precautions

Lactulose should not be used for inflammatory diseases of the gastrointestinal tract in the acute stage, as well as for violations of water and electrolyte metabolism.

Influence on the ability to drive vehicles and mechanisms. The use of lactulose does not affect the performance of actions that require increased concentration of attention and speed of psychomotor reactions.

Interactions with other active substances

Trade names

The drug helps to increase the number of lactobacilli in the large intestine, soften the stool and increase the motor activity of the intestine.

In addition to the laxative effect, it has the ability to inhibit the growth of salmonella (causative agents of intestinal infection - salmonellosis), as well as stimulate liver function. It is practically not absorbed from the intestines into the blood. It is a white crystalline substance without a pronounced odor.

Lactulose is recognized as a safe laxative, so it is allowed to be used in children (including newborns), adults, the elderly, pregnant and breastfeeding women.

Release form

• tablets 500 mg, 30 pcs. packaged;
• syrup (Content of Lactulose in 15 ml - 10 g) in a 15 ml bottle or in a bottle with a volume of 200 to 1000 ml;
• syrup (Lactulose content in 5 ml - 3.325 g) in a bottle of 200 or 240 ml.

Instructions for use Lactulose

Indications for use

• Constipation of various origins;
• hepatic encephalopathy - a reversible disorder of the functional abilities of the central nervous system, which is associated with liver failure;
• salmonellosis, salmonellosis;
• food poisoning with putrefactive dyspepsia syndrome in children;
• intestinal dysbacteriosis;
• restoration of normal bowel function after antibiotic treatment, radiation therapy and chemotherapy;
• hemorrhoids, anal fissures, postoperative period in case of operations of the large intestine.

Contraindications

• Individual intolerance to Lactulose;
• galactosemia (hereditary disease);
• suspected appendicitis.

Side effects

Treatment with Lactulose

Dosage of Lactulose
For various diseases, the dosage of Lactulose is different:

• For constipation - from 15 to 45 ml of syrup 1 time per day. At the discretion of the physician, the dose may be increased to 60 ml. In the presence of positive results, the dose is reduced to 10-30 ml of syrup per day; it is possible to reduce the frequency of administration (up to 3 times a week).
• With hepatic encephalopathy - from 30 to 50 ml 2-3 times a day; the maximum dose is 190 ml of syrup per day.
• With salmonellosis - 15 ml three times a day. Treatment lasts 10-12 days; the course is repeated after a 7-day break.
• In the treatment of salmonella carriers - 20 ml per day; the duration of therapy can be 2-3 weeks.

What is lactulose for - video

Lactulose for children

For constipation in children, Lactulose is prescribed in the following doses:

• Children under 1 year old - 10 ml of syrup per day, with a gradual transition to a maintenance dose - 5 ml per day;
• Children 1-6 years old - 15 ml per day, maintenance dose - 10 ml;
• Children 7-14 years old - 25-30 ml, maintenance dose - 20 ml.

The desired effect with a properly selected dose usually occurs after 2-4 days from the start of treatment.

Hydrogen breath test with Lactulose

During the test, the patient blows into a special air collection device. The presence of hydrogen is determined in the exhaled air. After taking the primary sample, the patient should drink a syrup or solution of Lactulose; then air samples are taken every 20 minutes. The procedure lasts 2 hours. The received samples (10 pieces) are processed in laboratory conditions. The result of the analysis is ready in about 10 days.

The hydrogen breath test requires special preparation of the patient: antibiotics should not be taken within 2 weeks before the test; a day before the examination, grain bread, legumes, nuts should be excluded from the diet; smoking is also prohibited. After the test, all restrictions are removed.

Kefir with Lactulose

With regular use of this lactic acid product, pathogenic and conditionally pathogenic microflora is suppressed. Constipation is eliminated and other manifestations of intestinal disorders are minimized. Reduced manifestations of atopic dermatitis, improves appetite.

Lactulose does not affect the taste of kefir at all.

Analogues of Lactulose

• Duphalac;
• Good luck;
• Poslabin Lactulose;
• Lactulose Stada;
• Lactulose Poly;
• Lizalak;
• Legendary;
• Normase;
• Romfalac;
• Prelaks;
• Portalac;
• Livolyuk-PB and others.

Duphalac or Lactulose?

Duphalac is a synonym for Lactulose, its structural analogue. Like Lactulose, it comes in the form of a syrup. Even the dosage of these drugs is the same. Therefore, the question of which is better in this case does not make sense: Dufalac and Lactulose are one and the same.

Learn more about Lactulose

Lactulose is a white, odorless, crystalline substance, highly soluble in water. It is a product of deep milk processing: it is made from milk sugar lactose. Lactulose belongs to the class of oligosaccharides, a subclass of disaccharides: its molecule consists of residues of galactose and fructose.

The history of the discovery of lactulose

Lactulose was first synthesized and described by Hudson and Montgomery in 1929. It was obtained by studying the structure of disaccharides by heat treatment of lactose with an alkaline solution.

In 1948 F. Petueli and J. Kristan isolated from human milk a substance that activates the growth of bifidobacteria, and, not knowing its structure, they identified it as a bifidus factor. It is believed that the first attempts to use lactulose in medical practice date back to 1951, when the bifidus factor was used to treat children with enteritis. And only in 1957, almost 30 years after the discovery of Hudson and Montgomery, F. Petueli determined the chemical structure of the bifidus factor as a carbohydrate from the group of disaccharides and called it lactulose.

Subsequent studies have shown that when feeding an infant with conventional infant formula or milk, the content of bifidobacteria in the fecal microflora was 20%. However, when added to baby products 2% lactulose nutrition index of bifidobacteria increased to 90%.

What is lactulose?

Lactulose belongs to the class of prebiotic substances, that is, it:

• is not broken down by digestive enzymes in the upper sections of the gastrointestinal tract (GIT),
• unchanged reaches the lower sections of the gastrointestinal tract (large intestine),
• selectively stimulates the growth and development of the protective (beneficial) intestinal microflora of bifidobacteria, lactobacilli, etc.

Lactulose consists of one molecule of galactose and one molecule of fructose connected by a b-glycosidic bond. The international non-proprietary name for lactulose is 4-0-?-galactopyranosyl-D-fructose. Gross formula: C 12 H 22 O 11 . Molecular weight = 342.3

Lactulose is broken down by enzymes of the intestinal microflora (bifido- and lactobacilli) to organic acids: lactic acid, acetic acid, butyric acid, etc.

Physiological properties of lactulose preparations

Years of research have established that lactulose preparations provide a number of health benefits:

• vital activity of Bifidobacterium and suppression of harmful bacteria
  In studies by Japanese scientists, it was found that with a daily intake of 3 g of lactulose for 2 weeks, the number of bifidobacteria in feces increased significantly, and the number of lectinase-positive clostridia, including Clostridium perfinges and Bacteroidaceae, decreased significantly. As a result, the ratio of bifidobacteria to total bacteria increased from 8.3% before consumption to 47.4% after.
• suppression of toxic metabolites and harmful enzymes.
  With the use of lactulose preparations in humans, suppression of toxic metabolites and harmful enzymes was observed. It was found that after the use of lactulose preparations, the content of toxic metabolites (ammonia, skatol, indole, etc.) and harmful enzymes (b - glucuronidase, nitroreductase, azoreductase) in the feces decreased significantly, or there was a tendency to decrease.
• promote mineral absorption and strengthen bones.
  The effect of lactulose preparations on the bone hardness of experimental ovariectomized rats subject to osteoporosis was studied. The properties associated with the recovery of the hip after fractures improved with the introduction of lactulose preparations compared with the control. The data obtained suggested that the use of lactulose promotes calcium absorption, thereby increasing bone strength.
• constipation relief
  Consumption of lactulose preparations leads to softening of faeces by binding water and to improved bowel function. Lactulose, under the action of intestinal bifidobacteria, decomposes to short-chain fatty acids, and these acids lower the pH of the intestine, stimulate peristalsis and increase the moisture content of feces and their osmotic pressure. The use of lactulose preparations as laxatives has been patented in the pharmaceutical field in many countries.
• stimulation of liver functions
  Suppression of toxic metabolites facilitates the course of hepatic intoxication. Chronic portal systemic encephalopathy metabolically disrupts the central nervous system and is characterized by psychiatric and neurological disorders that can progress from mild mental illness to coma. This occurs when ammonia, produced in the intestines as a metabolite of putrefactive bacteria, leads to liver dysfunction and is transported to the brain, where it acts as a toxin. Lactulose lowers blood ammonia levels and relieves symptoms.
• inhibition of the formation of secondary bile acids
  The transformation of primary fatty acids into secondary fatty acids depends on intestinal pH. In studies, suppression of secondary bile acids in the intestine was observed after administration of a lactulose preparation to healthy volunteers.
• anticarcinogenic effect
  A number of reports have shown an anticarcinogenic effect in animal experiments. This effect is associated with the activation of the immune system by bifidobacteria cells, cell wall components and intercellular components. Scientists have evaluated the immunological properties and antibacterial effects of lactulose in patients with cirrhosis of the liver. It was suggested that the intercellular immune system, which was suppressed during cirrhosis of the liver, was activated.

The use of lactulose

Numerous studies of lactulose have proven its therapeutic and preventive properties, which stimulated the introduction of lactulose into both the pharmaceutical and food industries.

In medicine, lactulose, for more than 40 years of use, has been well studied and widely used in the treatment of intestinal dysbacteriosis, hepatic encephalopathy, chronic constipation, salmonellosis, etc. Known today more than 50 lactulose preparations manufactured by various pharmaceutical companies. In most countries of the world, lactulose preparations are dispensed in pharmacies without a doctor's prescription, which indicates the universal recognition of the safety of lactulose. Food products enriched with lactulose first appeared in Japan in the 1980s. Morinaga Milk Co. has been producing dairy products fortified with lactulose for over 20 years. In 2000, lactulose-containing food products also appeared in Russia. Today, more than 50 dairy plants in Russia produce dairy products (kefir, fermented baked milk, sour cream, milk, etc.) enriched with lactulose. Lactulose is also used in veterinary medicine as a feed additive (Vetelact), which provides the preventive properties of feed, and in cosmetics, as an ingredient in various kinds of creams, which provides protection against skin dysbacteriosis.

Therapeutic effect of lactulose

The therapeutic and prophylactic properties of lactulose are explained by its ability to reach the large intestine unchanged, where it selectively stimulates the growth and vital activity of the indigenous (own) saccharolytic microflora (bifidus and lactobacilli). Namely, the normal intestinal microflora, developing under the influence of lactulose, has a beneficial effect on the host organism.

Probably, every modern person faced the problems of constipation and dysbacteriosis. At first glance, they do not seem dangerous, but with a long course, they can seriously impair the quality of life and even cause the development of other diseases.

Drugs that help cleanse the body and normalize the intestinal microflora help to cope with them. One of the most effective and safe among them is the drug Lactulose, which is an artificial analogue of lactose.

But what effect does it have on the human body, how to take it correctly, and does it have contraindications and side effects? These are the questions you should ask yourself before you start taking this medicine.

Properties

Lactulose is a disaccharide, which consists of two molecules of monosaccharides fructose and galactose. Its main feature is that it is not destroyed in the aggressive environment of the stomach and is not absorbed in the human small intestine.

This is because a person does not produce enzymes that can break down Lactulose to its simplest components, and therefore absorb this substance. This property of Lactulose gives it a pronounced laxative effect and the ability to cleanse the body of toxins and toxins.

It builds up osmotic pressure in the patient's intestines and draws water into the intestinal lumen. This helps to significantly increase the volume of feces and change their consistency, making it more liquid and plastic. As a result, there is an increase in intestinal peristalsis, which ensures a gentle cleansing of the body.

But Lactulose is recommended to be taken not only for constipation, but also for the treatment of dysbacteriosis. The fact is that when it enters the human large intestine, it becomes a breeding ground for beneficial lactobacilli and bifidobacteria, which are able to absorb it.

During this metabolic process, bacteria secrete substances that oxidize the pH environment in the large intestine, which prevents the reproduction of pathogenic microorganisms. This helps to normalize the intestinal microflora and completely cope with the symptoms of dysbacteriosis.

Shifting the pH of the environment to the acidic side not only destroys harmful bacteria, but also fights the processes of putrefaction in the human intestine. This allows you to minimize the amount of toxins formed during the digestion of food, including hazardous ammonia.

But if a small amount of ammonia and other putrefactive toxins still accumulate in the patient's intestines, they will still become completely harmless to the body. This is due to the fact that acidic pH ionizes ammonia molecules that are not able to be absorbed in human blood, and therefore have a toxic effect on internal organs and tissues.

This property of Lactulose is highly valued in the treatment of hepatic encephalopathy, liver failure, alcoholic liver damage and other organ diseases in which its ability to neutralize the harmful effects of ammonia is impaired.

The benefits of Lactulose for the body:

1. Helps to cope even with severe constipation;
2. Promotes an increase in the number of beneficial lactobacilli and bifidobacteria;
3. Helps the body to better absorb calcium and magnesium, which are necessary for healthy bones and teeth;
4. Stimulates the secretion of bile, improves the functioning of the liver and gallbladder;
5. Helps to remove toxic and carcinogenic substances from the body.

It is important to note that Lactulose is not an instant drug and the effect of taking it usually begins to appear only on the second day of treatment.

However, it has a very gentle effect on the body and, when used correctly, helps to eliminate constipation without any discomfort.

Instructions for using the medicine

Sugar level

The drug Lactulose is available in three different forms, namely syrup, tablets and powder. Lactulose syrup has a light yellow color and a pleasant sweet taste that even small children will like. It can be purchased at a pharmacy in a plastic bottle of 200, 500 and 1000 ml. For ease of dosage, a special measuring cup is attached to it.

Powder Lactulose is a fine white powder, which also has a pronounced sweet taste. It is intended for the preparation of a suspension, for which the required amount of the drug must be dissolved in a small volume of water and mixed well until the particles are completely dissolved.

Lactulose tablets are the most convenient form of medication, as they can be taken not only at home, but also at work, school, and even in transport. They are mostly intended for adults and teenagers over 12 years old.

However, it should be emphasized that Lactulose in liquid form is easier and faster absorbed by the body. Therefore, most often this drug is sold in the form of a syrup, which is suitable for patients of all ages from newborns and pregnant women to the elderly.

Indications for the use of Lactulose:

• Constipation with bowel diseases;
• Constipation in women during pregnancy;
• Severe pain during bowel movements in patients with hemorrhoids (dilutes feces and facilitates the process of defecation);
• The recovery period after surgical operations on the anus, colon or rectum and the removal of hemorrhoids;
• hepatic encephalopathy;
• Hepatic coma and precoma;
• intestinal dysbacteriosis;
• Hyperammonemia (impaired excretion of free ammonia from the body and its entry into the blood);
• Salmonellosis and salmonellosis;
• Enteritis caused by Shigella;
• Syndrome of putrefactive dyspepsia (a consequence of food poisoning in young children).

According to the guidelines for Lactulose, in the treatment of constipation, it should be used as follows:

1. Infants from 1 month to 1 year - 5 ml.;
2. Children from 1 to 6 years old - 5-10 ml;
3. Children from 7 to 14 years old - 15 ml in the first 3 days, 10 ml in the following days;
4. Adults - in the first 3 days, 15-45 ml, in the following days, 10-25 ml.

To get the most pronounced laxative effect, this drug is recommended to be taken in the morning during breakfast. It should not be taken on an empty stomach or in the evening before bed.

When infected with Salmonella, Lactulose should be given to the patient in the following dosages:

• The first course of admission - 10 days, 15 ml. three times a day;
• Mandatory break - 7 days;
• The second course - 12 days, 15 ml. three times a day;
• The third course (optional, prescribed in case of a severe course of the disease) - 10 days, 30 ml. three times a day.

For hepatic encephalopathy, the patient should receive Lactulose syrup in the following doses:

1. With mild and moderate liver encephalopathy - 30-50 ml. three times per day;
2. In severe course of the disease - up to 65 ml three times a day;
3. To prevent the development of hepatic precoma and coma in patients with alcoholic liver damage and - 25 ml each. three times a day.

Pregnant women and nursing mothers are allowed to take Lactulose syrup only as directed by a doctor. This drug is harmless to the child, however, like any drug, it has contraindications and side effects.

Therefore, it is very important for women in position to be examined by a specialist who will select a safe dosage of the drug for them and help to avoid undesirable consequences.

Side effects:

• From the gastrointestinal tract - increased gas formation, abdominal pain, diarrhea, nausea;
• From the side of the nervous system - pain in the head, dizziness;
• Other - an allergic reaction, increased fatigue, heart palpitations.

Contraindications:

1. Individual intolerance to Lactulose;
2. inflammation of the appendix;
3. Intestinal obstruction;
4. Rectal bleeding (with the exception of bleeding from hemorrhoids);
5. Colostomy or ileostomy;
6. Glucose-galactose malabsorption;
7. Lactase deficiency;
8. Allergy to fructose or galactose;
9. Acute inflammatory processes in the abdominal organs.

Lactulose is also forbidden to use for body shaping. In this case, a person's weight loss will be achieved by removing a large amount of fluid from the body, which can lead to a dangerous stage of dehydration.

In addition, with diarrhea, the body loses a large amount of useful substances, including vital minerals.

As a result, the work of the cardiovascular and nervous systems may be disrupted in the patient, which over time can lead to the development of dangerous diseases.

Price

Today, Lactulose syrup can be purchased at pharmacies in Russian cities at a fairly low price.

The cost of this drug in different parts of the country varies between 100-120 rubles. For this reason, Lactulose is considered one of the most affordable laxatives for children and adults.

The acquisition of analogues of Lactulose Syrup will cost the patient a more significant amount. Their prices range from 140 to 850 rubles.

On average, an analogue of this laxative costs from 300 to 450 rubles.

An expert will tell you about the methods of treating constipation in the video in this article.

Sugar level

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