Lactulose

Details About Generic Salt ::  Lactulose 

Main Medicine Class:: Gastrointestinal System   Sub Medicine Class ::  Cathartics,Laxatives,Fecal Softeners

7C. CATHARTICS/LAXATIVES/FECAL SOFTENERS in 7. GASTROINTESTINAL SYSTEM
LACTULOSE
OSMOTIC LAXATIVE
PK: A: Poor M: Colonic flora E: Feces, urine

Indications & Dose: CONSTIPATION PO Adult Initially 10-20g/day in single dose or in 2 divided doses, may be adjust dose according to response Child 1 month–1 yr: 2.5mL BID, 1–5 yrs: 2.5–10mL BID, 5–18 yr: 5–20mL BID, adjust dose according to response | PORTAL SYSTEMIC ENCEPHALOPATHY PO Adult Prevention: 20-30g (30-45mL) TID/QID, adjust dose q1-2days to produce 2-3 soft stools/day. Treatment: 20-30g (30-45mL) q1h to induce rapid laxation, reduce to 20-30g (30-45mL) TID/QID after laxation Child Prevention: Infants: 1.7-6.7g/day (2.5-10mL/day) in divided doses, Children: 26.7-60g/day (40-90mL/day) in divided doses, adjust dose to produce 2-3 stools/day | RECTAL Adult Dilute 200g (300mL) with 700mL water or NS given via rectal balloon catheter for 30-60min, may be repeat q4-6h if needed

Contra: Patients requiring low-galactose diet, galactosemia, intestinal obstruction

Precautions: DM, elderly, children, lactose intolerance

ADR: Serious: hypokalemia, Others: hypernatremia, nausea, vomiting, diarrhea, intestinal cramps, abdominal distention, flatulence, hyperglycemia

DDI: Serious Coumarins increases the risk of over-anticoagulation (long-term use)

Diet: With/without food

Monitor: BP (standing/supine), serum electrolytes, serum ammonia, bowel movement patterns, fluid status

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