لاکتالوز
Lactulose Solution (Lactulose Solution)
لاکتالوز

نام ژنریک

Lactulose

شکل دارویی

اشكال دارويي:


Syrup: 10 g/15 ml


Powder for solution: 10g

موارد مصرف

موارد و مقدار مصرف


الف) يبوست.


بزرگسالان: 20-10 گرم (15 تا 30 ميلي ليتر) از راه خوراکي روزانه ، تا مقادير 40 گرم قابل افزايش است.


کودکان: g 5 (5/7 ميلي ليتر) روزانه به صورت تک دوز بعد از صبحانه (مصرف باليني تأييد نشده است).


ب) پيشگيري و درمان آنسفالوپاتي کبدي، از جمله مراحل قبل از اغما و اغما در بيماري شديد کبدي.


بزرگسالان: ابتدا، مقدار 30-20 گرم (45-30 ميلي ليتر) سه يا چهار بار در روز از راه خوراکي مصرف مي شود تا 3-2 بار در روز مدفوع نرم دفع شود. مقدار معمول مصرف g/day 100-60 در مقادير منقسم است، که مي‌ تواند از طريق تنقيه احتباسي نيز استفاده شود.به صورت مخلوط کردن 200 گرم (300 ميلي ليتر) از لاکتولوز با 700 ميلي ليتر آب يا نرمال سالين که براي مدت 60 دقيقه کافي است و در صورت لزوم هر 6-4 ساعت تکرار مي شود. اگر زمان احتباس کمتر از 30 دقيقه است بلافاصله مي‌ توان دوز را تکرار کرد.


کودکان و نوجوانان: ابتدا 27 تا 60 گرم (40 تا 90 ميلي ليتر) خوراکي روزانه در دوزهاي منقسم مصرف مي شود. دوز را هم يک يا دو روز يک بار براي رسيدن به 2 الي 3 بار دفع در روز تنظيم کنيد.


نوزادان: ابتدا 67/1 تا 67/6 گرم (5/2 تا 10 ميلي ليتر) خوراکي روزانه در دوزهاي منقسم مصرف مي شود. هر يک يا دو روز يک بار براي رسيدن به 2 الي 3 بار دفع در روز دوز را تنظيم کنيد.


پ) بعد از استفاده از باريم به عنوان مسهل.


بزرگسالان: 3/3 تا 7/6 گرم (5 تا 10 ميلي ليتر) خوراکي دو بار در روز برا ي يک الي 4 هفته.


ت) براي برگرداندن عملکرد در روده بعد از هموروئيدکتومي.


بزرگسالان: 10 گرم (15 ميلي ليتر) خوراکي دو بار در روز قبل از جراحي تا 5 روز بعد از جراحي مصرف مي شود.

موارد منع مصرف

موارد منع مصرف و احتياط


موارد منع مصرف: حساسيت به دارو يا ديگر اجزاء فرمولاسيون گالاکتوزمي (يا بيماراني که محدوديت گالاکتوز در رژيم غذايي خود دارند).


موارد احتياط: در مواردي که دارو براي مدت طولاني (بيشتر از 6 ماه) مصرف مي شود يا در بيماران مستعد به اختلالات الکتروليتي مانند افراد مسن ، بيمار را به صورت دوره‌اي از نظر اختلالات الکتروليتي مانيتور کنيد.


به دليل محتواي لاکتوز و گالاکتوز در بيماران ديابتي با احتياط به کار رود.


مصرف همزمان لاکتولوز و داروهاي ضدعفونت خوراکي ممکن است باعث کاهش پاسخ دهي به لاکتولوز شود.


روش تجويز: قبل از تجويز دارو از طريق NG تيوب، آن را با 120-60 ميلي‌ليتر آب رقيق کنيد. از فرم شربت براي تهيه محلول‌هاي رکتال استفاده مي‌شود.

عوارض جانبی دارو

ملاحظات اختصاصي


بعد از مصرف لاکتولوز از طريق لوله بيني - معدي (NG-Tube)، براي اطمينان از عبور کامل دارو به معده بايد لوله توسط آب شسته شود.


براي به حداقل رساندن طعم شيرين دارو مي‌ توان آن را با آب يا آب ميوه رقيق کرد.


براي مصرف دارو از طريق تنقيه احتباسي، 300 ميلي ليتر دارو با 700 ميلي ليتر آب يا محلول نمکي نرمال رقيق شده و توسط کاتتر بالوني مقعد به کار برده شود (اين عمل ممکن است هر 6-4 ساعت تکرار گردد). بيمار بايد دارو را به مدت 60-30 دقيقه نگه دارد. در صورت دفع دارو در کمتر از 30 دقيقه، مصرف دارو بايد بلافاصله تکرار شود. درمان خوراکي بايد قبل از قطع تنقيه احتباسي شروع شود.


دفعات دفع و قوام مدفوع پيگيري شود.


در مصارف طولاني سطح پتاسيم، کلر و دي اکسيد کربن را مانيتور کنيد.

موارد قابل توجه

-

تداخل دارویی

تداخل دارويي


در صورت مصرف همزمان با نئومايسين و آنتي بيوتيکهاي د يگر، ممکن است اثربخشي لاکتولوز به لحاظ تئوريک کاهش يابد، زيرا اين آنتي بيوتيک‌ها باکتريهاي لازم برا ي هضم لاکتولوز و تبديل آن به شکل فعال را دفع مي‌ کنند. اين اثر از لحاظ باليني مشخص نشده است.


آنتي اسيدهاي غيرقابل جذب با کاهش pH کولون مانع اثربخشي لاکتولوز مي شوند. همزمان با هم استفاده نکنيد.

مکانیزم اثر

تداخل دارويي


در صورت مصرف همزمان با نئومايسين و آنتي بيوتيکهاي د يگر، ممکن است اثربخشي لاکتولوز به لحاظ تئوريک کاهش يابد، زيرا اين آنتي بيوتيک‌ها باکتريهاي لازم برا ي هضم لاکتولوز و تبديل آن به شکل فعال را دفع مي‌ کنند. اين اثر از لحاظ باليني مشخص نشده است.


آنتي اسيدهاي غيرقابل جذب با کاهش pH کولون مانع اثربخشي لاکتولوز مي شوند. همزمان با هم استفاده نکنيد.

فارماكوكینتیك

فارماكوكينتيك


جذب: جذب لاکتولوز بسيار کم است. شروع اثر فرم خوراکي 24 الي 48 ساعت بعد است.


پخش: لاکتولوز به صورت موضعي عمدتاً در کولون انتشار مي‌ يابد.


متابوليسم: لاکتولوز توسط باکتريهاي کولون متابوليزه مي شود (بخش جذب شده متابوليزه نمي شود).


دفع: بيشترين مقدار لاکتولوز از طريق مدفوع دفع مي شود. بخش جذب شده از طريق ادرار دفع مي شود.

سایر اطلاعات

طبقه‌بندي فارماكولوژيك: دي ساکاريد.


طبقه‌بندي درماني: خنثي کننده آمون يوم.


طبقه‌بندي مصرف در بارداري: رده B


نکات قابل توصيه به بيمار


براي بهتر کردن طعم دارو ، آن را با آب ميوه ميل کنيد.


مصرف در سالمندان: غلظت الکتروليت‌هاي سرم بيمار بايد پيگيري شود. بيماران سالخورده نسبت به بروز زيادي سديم خون حساس تر هستند.


مصرف در شيردهي: ترشح دارو در شير مشخص نيست. با احتياط به کار رود.


عوارض جانبي


دستگاه گوارش: کرامپهاي شکمي، آروغ زدن، نفخ، اتساع روده به وسيله گاز، اسهال (دوزهاي بالا ).


توجه: در صورت بروز درد شديد شکمي، بايد مصرف دارو قطع شود.


مسموميت و درمان


تظاهرات باليني: اسهال، کرامپهاي شکمي.

Lactulose Solution (Lactulose Solution)

Lactulose Solution USP,
10 g/15 mL

FOR ORAL OR RECTAL ADMINISTRATION FOR THE PREVENTION AND TREATMENT OF PORTAL-SYSTEMIC ENCEPHALOPATHY

DRUG DESCRIPTION

Lactulose is a synthetic disaccharide in solution form for oral or rectal administration. Each 15 mL of Lactulose Solution USP contains 10 g lactulose (and less than 1.6 g galactose, less than 1.2 g lactose, and 0.1 g or less of fructose). It also contains D&C Yellow No. 10, FD & C Yellow No. 6 and Purified Water.

Lactulose is a colonic acidifier for treatment and prevention of portal-systemic encephalopathy.

The chemical name for lactulose is 4-O-β-D-galactopyranosyl-D-fructofuranose. It has the following structural formula:

Lactulose Structural Formula Illustration

The molecular weight is 342.30. It is freely soluble in water.

What are the possible side effects of lactulose (Enulose, Generlac, Kristalose)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using lactulose and call your doctor at once if you have severe or ongoing diarrhea.

Less serious side effects may include:

  • bloating, gas;
  • stomach pain;
  • diarrhea; or
  • nausea, vomiting.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA...

Read All Potential Side Effects and See Pictures of Lactulose Solution »

Last reviewed on RxList: 7/16/2008
This monograph has been modified to include the generic and brand name in many instances.

INDICATIONS

For the prevention and treatment of portal-systemic encephalopathy, including the stages of hepatic pre-coma and coma.

Controlled studies have shown that lactulose solution therapy reduces the blood ammonia levels by 25 to 50%; this is generally paralleled by an improvement in the patients' mental state and by an improvement in EEG patterns. The clinical response has been observed in about 75% of patients, which is at least as satisfactory as that resulting from neomycin therapy. An increase in patients' protein tolerance is also frequently observed with lactulose therapy. In the treatment of chronic portal-systemic encephalopathy, lactulose has been given for over 2 years in controlled studies.

DOSAGE AND ADMINISTRATION

Oral

Adult: The usual adult, oral dosage is 2 to 3 tablespoonfuls (30 to 45 mL, containing 20 g to 30 g of lactulose) three or four times daily. The dosage may be adjusted every day or two to produce 2 or 3 soft stools daily.

Hourly doses of 30 to 45 mL of lactulose solution may be used to induce the rapid laxation indicated in the initial phase of the therapy of portal-systemic encephalopathy. When the laxative effect has been achieved, the dose of lactulose may then be reduced to the recommended daily dose. Improvement in the patient's condition may occur within 24 hours but may not begin before 48 hours or even later.

Continuous long-term therapy is indicated to lessen the severity and prevent the recurrence of portal-systemic encephalopathy. The dose of lactulose for this purpose is the same as the recommended daily dose.

Pediatric: Very little information on the use of lactulose in young children and adolescents has been recorded. As with adults, the subjective goal in proper treatment is to produce 2 or 3 soft stools daily. On the basis of information available, the recommended initial daily oral dose in infants is 2.5 to 10 mL in divided doses. For older children and adolescents, the total daily dose is 40 to 90 mL. If the initial dose causes diarrhea, the dose should be reduced immediately. If diarrhea persists, lactulose should be discontinued.

Rectal

When the adult patient is in the impending coma or coma stage of portal- systemic encephalopathy and the danger of aspiration exists, or when the necessary endoscopic or intubation procedures physically interfere with the administration of the recommended oral doses, lactulose solution may be given as a retention enema via a rectal balloon catheter. Cleansing enemas containing soap suds or other alkaline agents should not be used.

Three hundred mL of lactulose solution should be mixed with 700 mL of water or physiologic saline and retained for 30 to 60 minutes. Lactulose enema may be repeated every 4 to 6 hours. If this lactulose enema is inadvertently evacuated too promptly, it may be repeated immediately.

The goal of treatment is reversal of the coma stage in order that the patient may be able to take oral medication. Reversal of coma may take place within 2 hours of the first enema in some patients. Lactulose given orally in the recommended doses, should be started before lactulose by enema is stopped entirely.

HOW SUPPLIED

Lactulose Solution USP (Oral or Rectal Solution), 10 g/15 mL, is a clear, yellow to golden-yellow solution supplied in one pint (473 mL) and two quart (1.89 L) bottles. Lactulose solution contains: 667 mg lactulose/mL (10 g/15 mL).

Store at 25° C (77° F); excursions permitted to 15-30°C (59-86°F) (see USP Controlled Room Temperature). Do not freeze. Keep tightly closed.

Under recommended storage conditions, a normal darkening of color may occur. Such darkening is characteristic of sugar solutions and does not affect therapeutic action.

Prolonged exposure to temperatures above 86° F (30° C) or to direct light may cause extreme darkening and turbidity which may be pharmaceutically objectionable. If this condition develops, do not use. Prolonged exposure to freezing temperatures may cause change to a semisolid, too viscous to pour. Viscosity will return to normal upon warming to room temperature.

Dispense in a tight, light-resistant container as defined in the USP, with a child-resistant closure.

Manufactured by: Novex Pharma, Richmond Hill, Ontario Canada L4C 5H2. Manufactured for: Apotex Corp. Weston, FL 33326. July 2003. FDA rev date: 7/28/2003

Last reviewed on RxList: 7/16/2008
This monograph has been modified to include the generic and brand name in many instances.

SIDE EFFECTS

Precise frequency data are not available.

Lactulose may produce gaseous distention with flatulence or belching and abdominal discomfort such as cramping in about 20% of patients. Excessive dosage can lead to diarrhea with potential complications such as loss of fluids, hypokalemia, and hypernatremia. Nausea and vomiting have been reported.

Read the Lactulose Solution (lactulose solution) Side Effects Center for a complete guide to possible side effects »

DRUG INTERACTIONS

There have been conflicting reports about the concomitant use of neomycin and lactulose solution. Theoretically, the elimination of certain colonic bacteria by neomycin and possibly other anti-infective agents may interfere with the desired degradation of lactulose and thus prevent the acidification of colonic contents. Thus the status of the lactulose-treated patient should be closely monitored in the event of concomitant oral anti-infective therapy.

Results of preliminary studies in humans and rats suggest that nonabsorbable antacids given concurrently with lactulose may inhibit the desired lactulose-induced drop in colonic pH. Therefore, a possible lack of desired effect of treatment should be taken into consideration before such drugs are given concomitantly with lactulose.

Other laxatives should not be used, especially during the initial phase of therapy for portal-systemic encephalopathy because the loose stools resulting from their use may falsely suggest that adequate lactulose dosage has been achieved.

Last reviewed on RxList: 7/16/2008
This monograph has been modified to include the generic and brand name in many instances.

WARNINGS

A theoretical hazard may exist for patients being treated with lactulose solution who may be required to undergo electrocautery procedures during proctoscopy or colonoscopy. Accumulation of H2 gas in significant concentration in the presence of an electrical spark may result in an explosive reaction. Although this complication has not been reported with lactulose, patients on lactulose therapy undergoing such procedures should have a thorough bowel cleansing with a non-fermentable solution. Insufflation of CO2 as an additional safeguard may be pursued but is considered to be a redundant measure.

PRECAUTIONS

General: Since lactulose solution contains galactose (less than 1.6 g/15 mL) and lactose (less than 1.2 g/15 mL), it should be used with caution in diabetics.

In the overall management of portal-systemic encephalopathy, it should be recognized that there is serious underlying liver disease with complications such as electrolyte disturbance (e.g., hypokalemia) for which other specific therapy may be required.

Infants receiving lactulose may develop hyponatremia and dehydration.

Carcinogenesis, Mutagenesis, Impairment of Fertility: There are no known human data on long-term potential for carcinogenicity, mutagenicity, or impairment of fertility.

There are no known animal data on long-term potential for mutagenicity.

Administration of lactulose solution in the diet of mice for 18 months in concentrations of 3 and 10 percent (v/w) did not produce any evidence of carcinogenicity.

In studies in mice, rats, and rabbits, doses of lactulose solution up to 6 or 12 mL/kg/day produced no deleterious effects on breeding, conception, or parturition.

Pregnancy: Teratogenic Effects; Pregnancy Category B. Reproduction studies have been performed in mice, rats, and rabbits at doses up to 2 or 4 times the usual human oral dose and have revealed no evidence of impaired fertility or harm to the fetus due to lactulose. There are, however, no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

Nursing Mothers: It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when lactulose solution is administered to a nursing woman. Pediatric Use: Very little information on the use of lactulose in pediatric patients has been recorded (see DOSAGE AND ADMINISTRATION).

Last reviewed on RxList: 7/16/2008
This monograph has been modified to include the generic and brand name in many instances.

OVERDOSE

Signs and Symptoms: There have been no reports of accidental overdosage. In the event of overdosage, it is expected that diarrhea and abdominal cramps would be the major symptoms. Medication should be terminated.

Oral LD50: The acute oral LD50 of the drug is 48.8 mL/kg in mice and greater than 30 mL/kg in rats.

Dialysis: Dialysis data are not available for lactulose. It's molecular similarity to sucrose, however, would suggest that it should be dialyzable.

CONTRAINDICATIONS

Since lactulose solution contains galactose (less than 1.6 g/15 mL), it is contraindicated in patients who require a low galactose diet.

Last reviewed on RxList: 7/16/2008
This monograph has been modified to include the generic and brand name in many instances.

CLINICAL PHARMACOLOGY

Lactulose causes a decrease in blood ammonia concentration and reduces the degree of portal-systemic encephalopathy. These actions are considered to be results of the following:

Bacterial degradation of lactulose in the colon acidifies the colonic contents.

This acidification of colonic contents results in the retention of ammonia in the colon as the ammonium ion. Since the colonic contents are then more acid than the blood, ammonia can be expected to migrate from the blood into the colon to form the ammonium ion.

The acid colonic contents convert NH3 to the ammonium ion (NH4)+, trapping it and preventing its absorption.

The laxative action of the metabolites of lactulose then expels the trapped ammonium ion from the colon.

Experimental data indicate that lactulose is poorly absorbed. Lactulose given orally to man and experimental animals resulted in only small amounts reaching the blood. Urinary excretion has been determined to be 3% or less and is essentially complete within 24 hours.

When incubated with extracts of human small intestinal mucosa, lactulose was not hydrolyzed during a 24-hour period and did not inhibit the activity of these extracts on lactose. Lactulose reaches the colon essentially unchanged. There it is metabolized by bacteria with the formation of low molecular weight acids that acidify the colon contents.

Last reviewed on RxList: 7/16/2008
This monograph has been modified to include the generic and brand name in many instances.

PATIENT INFORMATION

No information provided. Please refer to the WARNINGS and PRECAUTIONS sections.

Last reviewed on RxList: 7/16/2008
This monograph has been modified to include the generic and brand name in many instances.

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PATIENT INFORMATION

No information provided. Please refer to the WARNINGS and PRECAUTIONS sections.

Last reviewed on RxList: 7/16/2008
This monograph has been modified to include the generic and brand name in many instances.

Lactulose Solution USP,
10 g/15 mL

FOR ORAL OR RECTAL ADMINISTRATION FOR THE PREVENTION AND TREATMENT OF PORTAL-SYSTEMIC ENCEPHALOPATHY

DRUG DESCRIPTION

Lactulose is a synthetic disaccharide in solution form for oral or rectal administration. Each 15 mL of Lactulose Solution USP contains 10 g lactulose (and less than 1.6 g galactose, less than 1.2 g lactose, and 0.1 g or less of fructose). It also contains D&C Yellow No. 10, FD & C Yellow No. 6 and Purified Water.

Lactulose is a colonic acidifier for treatment and prevention of portal-systemic encephalopathy.

The chemical name for lactulose is 4-O-β-D-galactopyranosyl-D-fructofuranose. It has the following structural formula:

Lactulose Structural Formula Illustration

The molecular weight is 342.30. It is freely soluble in water.

Last reviewed on RxList: 7/16/2008
This monograph has been modified to include the generic and brand name in many instances.

Lactulose Solution USP,
10 g/15 mL

FOR ORAL OR RECTAL ADMINISTRATION FOR THE PREVENTION AND TREATMENT OF PORTAL-SYSTEMIC ENCEPHALOPATHY

DRUG DESCRIPTION

Lactulose is a synthetic disaccharide in solution form for oral or rectal administration. Each 15 mL of Lactulose Solution USP contains 10 g lactulose (and less than 1.6 g galactose, less than 1.2 g lactose, and 0.1 g or less of fructose). It also contains D&C Yellow No. 10, FD & C Yellow No. 6 and Purified Water.

Lactulose is a colonic acidifier for treatment and prevention of portal-systemic encephalopathy.

The chemical name for lactulose is 4-O-β-D-galactopyranosyl-D-fructofuranose. It has the following structural formula:

Lactulose Structural Formula Illustration

The molecular weight is 342.30. It is freely soluble in water.

Last reviewed on RxList: 7/16/2008
This monograph has been modified to include the generic and brand name in many instances.

Lactulose Solution USP,
10 g/15 mL

FOR ORAL OR RECTAL ADMINISTRATION FOR THE PREVENTION AND TREATMENT OF PORTAL-SYSTEMIC ENCEPHALOPATHY

DRUG DESCRIPTION

Lactulose is a synthetic disaccharide in solution form for oral or rectal administration. Each 15 mL of Lactulose Solution USP contains 10 g lactulose (and less than 1.6 g galactose, less than 1.2 g lactose, and 0.1 g or less of fructose). It also contains D&C Yellow No. 10, FD & C Yellow No. 6 and Purified Water.

Lactulose is a colonic acidifier for treatment and prevention of portal-systemic encephalopathy.

The chemical name for lactulose is 4-O-β-D-galactopyranosyl-D-fructofuranose. It has the following structural formula:

Lactulose Structural Formula Illustration

The molecular weight is 342.30. It is freely soluble in water.

Last reviewed on RxList: 7/16/2008
This monograph has been modified to include the generic and brand name in many instances.

Lactulose Solution Patient Information Including Side Effects

Brand Names: Enulose, Generlac, Kristalose

Generic Name: lactulose (Pronunciation: LAK too lose)

What is lactulose (Lactulose Solution)?

Lactulose is a type of sugar. It is broken down in the large intestine into mild acids that draw water into the colon, which helps soften the stools.

Lactulose is used to treat chronic constipation.

Lactulose may also be used for other purposes not listed in this medication guide.

What are the possible side effects of lactulose (Lactulose Solution)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using lactulose and call your doctor at once if you have severe or ongoing diarrhea.

Less serious side effects may include:

  • bloating, gas;
  • stomach pain;
  • diarrhea; or
  • nausea, vomiting.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Read the Lactulose Solution (lactulose solution) Side Effects Center for a complete guide to possible side effects »

What is the most important information I should know about lactulose (Lactulose Solution)?

You should not use this medication if you are on a special diet low in galactose (milk sugar).

Before taking lactulose, tell your doctor if you have diabetes or if you need to have any type of intestinal test using a scope (such as a colonoscopy).

It may take up to 48 hours before you have a bowel movement after taking lactulose.

Stop using lactulose and call your doctor at once if you have severe or ongoing diarrhea.

The liquid form of lactulose may become slightly darken in color, but this is a harmless effect. However, do not use the medicine if it becomes very dark, or if it gets thicker or thinner in texture.

If you use lactulose over a long period of time, your doctor may want you to have occasional blood tests. Do not miss any scheduled appointments.

Side Effects Centers

Lactulose Solution Patient Information including How Should I Take

What should I discuss with my healthcare provider before taking lactulose (Lactulose Solution)?

You should not use this medication if you are on a special diet low in galactose (milk sugar).

Before taking lactulose, tell your doctor if you have:

  • diabetes; or
  • if you need to have any type of intestinal test using a scope (such as a colonoscopy).

If you have any of these conditions, you may need a dose adjustment or special tests to safely take lactulose.

FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether lactulose passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take lactulose (Lactulose Solution)?

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

The liquid form of lactulose may become slightly darken in color, but this is a harmless effect. However, do not use the medicine if it becomes very dark, or if it gets thicker or thinner in texture.

Lactulose powder should be mixed with at least 4 ounces of water. You may also use fruit juice or milk to make the medication better.

It may take up to 48 hours before you have a bowel movement after taking lactulose.

If you use lactulose over a long period of time, your doctor may want you to have occasional blood tests. Do not miss any scheduled appointments.

Store lactulose at room temperature away from moisture and heat.

Side Effects Centers

Lactulose Solution Patient Information including If I Miss a Dose

What happens if I miss a dose (Lactulose Solution)?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose (Lactulose Solution)?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include diarrhea, stomach pain, hot and dry skin, confusion, uneven heart rate, extreme thirst, increased urination, leg discomfort, and muscle weakness or limp feeling.

What should I avoid while taking lactulose (Lactulose Solution)?

Avoid using antacids without your doctor's advice. Use only the specific type of antacid your doctor recommends. Antacids contain different medicines and some types can make it harder for your body to absorb lactulose.

What other drugs will affect lactulose (Lactulose Solution)?

There may be other drugs that can interact with lactulose. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about lactulose.


Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.11. Revision date: 12/15/2010.

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