Overview & Mechanism of Action
- Lactulac Syrup (100ml oral solution containing Lactulose $3.33\text{g}/5\text{ml}$) acts non-systemically within the lower gastrointestinal tract to provide dual osmotic and metabolic benefits:
- Colonic Microflora Fermentation: Passes unabsorbed through the upper gastrointestinal tract into the colon, where native bacterial flora break it down into low-molecular-weight organic acids (lactic acid and acetic acid).
- Osmotic Fluid Accumulation & Peristalsis: The resulting organic acids decrease colonic pH and draw water osmotically into the intestinal lumen, increasing stool volume, softening bowel contents, and triggering physiological peristaltic movements.
- Ammonia Trapping in Hepatic Encephalopathy: Acidification of the colonic lumen converts toxic, diffusable ammonia ($\text{NH}_3$) into non-absorbable ammonium ions ($\text{NH}_4^+$), trapping it in the bowel and inhibiting systemic absorption to lower blood ammonia levels.
Clinical Indications & Uses
- Lactulac Syrup 100ml is indicated for:
- Symptomatic relief of chronic or acute constipation and restoration of natural colonic rhythm
- Prevention and treatment of portal-systemic/hepatic encephalopathy (PSE) in patients with severe liver cirrhosis or hepatic impairment
- Stool softening to facilitate painless evacuation in patients with hemorrhoids, anal fissures, or post-colorectal surgical recovery
Usage Guidance & Safety Precautions
Administration:
- May be taken directly or diluted with water, fruit juice, or milk. Doses may be taken as a single daily dose (preferably with breakfast) or divided into two daily doses.
Recommended Dosage:
- Constipation (Adults): Initial dose is 15ml to 45ml daily, adjusted to a maintenance dose of 15ml to 30ml daily once initial bowel movements stabilize.
- Hepatic Encephalopathy: 30ml to 45ml 3 to 4 times daily, adjusted to achieve 2 to 3 soft stools per day.
Precautions & Warnings:
- For oral administration only. Contraindicated in patients with galactosemia, intestinal obstruction, gastrointestinal perforation, or acute unmonitored inflammatory bowel disease. Contains small amounts of free galactose and lactose; exercise caution in diabetic patients or individuals with severe lactose intolerance. Initial treatment may cause transient flatulence, abdominal bloating, or mild intestinal cramping, which typically resolves within a few days. Store below $25^\circ\text{C}$ in a cool, dry place; do not freeze. Keep out of reach of children