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Active ingredients
Lactulose
Release form
Syrup
Composition
100 ml of syrup contain 66.7 g of lactulose concentrate. ; Auxiliary substances: purified water.
Pharmacological effect
Laxative drug. Lactulose under the influence of intestinal microflora breaks down in the colon into low molecular weight organic acids. The formation of acids leads to a decrease in the pH of the intestinal contents and the activation of its peristalsis. Along with this, the volume increases and the softening of the feces occurs. Under the influence of the drug, the formation of nitrogen-containing toxic substances in the proximal colon and their absorption into the systemic circulation also decreases. In addition, the movement of ammonium ions from the blood into the intestine is enhanced. ; The effect of the drug occurs within 24-48 hours after ingestion.
Pharmacokinetics
Lactulose is practically not absorbed from the gastrointestinal tract (no more than 3% of the accepted dose is absorbed), does not reduce the absorption of vitamins, does not cause addiction.
Indications
- constipation (including chronic); - the need to soften the stool for medical purposes (with hemorrhoids, the need for surgery on the colon and / or anus, pain syndrome after removal of hemorrhoids, the postoperative period); - intestinal dysbiosis; - hepatic encephalopathy; - hepatic precoma and coma (treatment and prevention); - hyperammonemia; - enteritis caused by Salmonella, Shigella, Salmonella carrier; - putrid dyspepsia syndrome (in young children as a result of acute food vleniye).
Contraindications
Hypersensitivity to lactulose or other components of the drug, galactosemia, intestinal obstruction, rectal bleeding (which is not caused by hemorrhoids), colo-ileostomy, appendicitis suspicion.
Use during pregnancy and lactation
Data on the safety of the drug during pregnancy and lactation (breastfeeding) are not available.
Dosage and administration
The dose of the drug is selected individually. ; In the treatment of constipation and to soften the stool: initial dose (three days); continued treatment; Children under 1 year; 5 ml of syrup; (1 teaspoon); 5 ml of syrup; (1 teaspoon); children from 1 to 6 years; 5-10 ml of syrup; (1-2 teaspoons); ; 5-10 ml of syrup; (1-2 teaspoons); children from 7 to 14 years old; 15 ml of syrup; (1 tablespoon); 10 ml of syrup; (2 teaspoons); adults; 15-45 ml of syrup; (1-3 tablespoons); 15-30 ml of syrup; (1-2 tablespoons); The drug is best taken in the morning during or after meals, one at a time or divided into two doses.The drug can be taken with water or other liquid. The patient can select and change the dose and time of taking the drug on demand. The laxative effect of the drug develops during the first two days of administration. The duration of treatment for constipation ranges from 4 weeks to 3-4 months. ; In the treatment of hepatic (portal) encephalopathy, hepatic coma and precoma: 30-50 ml of syrup (2-3 tablespoons) three times a day. ; In the initial phase of treatment, doses of 30-45 ml of syrup can be administered every 1-2 hours to achieve a quick effect (first bowel emptying). Then they switch to a maintenance dose, selecting it individually, in order to receive soft stools 2-3 times a day. ; In the treatment of dysbiosis and to normalize the intestinal microflora: The drug is prescribed during or after meals, 2-4 times a day. ; ; Single dose; Children under 1 year; ; 1.5-3 ml of syrup; Children from 1 year to 3 years; ; 3 ml of syrup; Children from 3 to 7 years; ; 5 ml syrup (1 teaspoon); Adults and children over 7 years; ; 5-10 ml of syrup (1-2 teaspoons); The duration of treatment is 10-14 days, repeated courses are prescribed with weekly breaks.
Side effects
Side effects are usually mild and reversible and are the result of dose overdose. ; On the part of the digestive system: cramps, discomfort and abdominal pain, diarrhea (can be eliminated by lowering the dose); at the beginning of treatment - flatulence (disappears in a few days). The sugary taste of the drug in some patients may cause nausea and vomiting. ; On the part of metabolism: with prolonged therapy in high doses, a violation of water and electrolyte balance. ; Other: skin rash. ;
Overdose
Symptoms: taking the drug in excessive doses can cause diarrhea with loss of fluid and electrolytes, in more severe cases, hypernatremia and hypokalemia. ; Treatment: in mild cases, it is enough to cancel the drug. If necessary, conduct symptomatic therapy. There is no specific antidote. Hypokalemia can worsen the condition in case of hepatic coma and even provoke its development. In this case, the introduction of potassium chloride is necessary. ;
Interaction with other drugs
When using lactulose in therapeutic doses, there was no clinically significant interaction with other drugs, however, it is not recommended to take Portalak within 2 hours after taking another drug.; At the same time, lactulose may inactivate drugs, for the release of which in the colon creates an unfavorable environment (for example, drugs containing mesalazine).
special instructions
In connection with the presence in the preparation of an insignificant amount of sugars (15 ml of syrup contain up to 1.7 g of galactose and up to 1 g of lactose), it is necessary to observe precautions when prescribing the drug to patients with diabetes. With caution should appoint the drug to patients with gastrocardiac syndrome. In this case, the treatment begins with low doses and increases them gradually to avoid the occurrence of flatulence. ; Do not prescribe the drug on the background of abdominal pain, nausea, vomiting. ; In the treatment of hepatic encephalopathy, especially in the initial phase of therapy, other laxatives should not be used. Enhanced bowel movement may lead to the erroneous conclusion that an adequate dose has been reached for the treatment of encephalopathy. ; The patient should be warned that if constipation persists for several days of taking the drug or if the condition worsens again after stopping the drug, you should consult a doctor. ; Influence on ability to drive vehicles and work with mechanisms; In recommended doses, Portalak does not affect the ability to drive vehicles and work with mechanisms. ;