TULAC 100ML(LACTULOSE)

Overview & Mechanism of Action

• Tulac 100ml Syrup contains Lactulose ($10\text{g}/15\text{ml}$ equivalent), providing dual-action osmotic laxative and systemic ammonia-lowering properties:
• Colonic Fermentation & Osmotic Fluid Retention: Resists digestion in the upper gastrointestinal tract and reaches the colon intact, where colonic bacteria break it down into low-molecular-weight organic acids (primarily lactic and acetic acids). This lowers colonic pH and increases osmotic pressure, drawing water into the intestinal lumen to soften stool and stimulate normal peristalsis.
• Ammonia Trapping in Hepatic Encephalopathy: Colonic acidification converts free diffusible ammonia ($\text{NH}_3$) into non-absorbable ammonium ions ($\text{NH}_4^+$), trapping it within the bowel lumen and reducing systemic blood ammonia concentration.
• Microbiome Normalization: Serves as a prebiotic substrate, encouraging the proliferation of beneficial acidophilic bacteria (such as Lactobacillus) while suppressing putrefactive organism growth.

Clinical Indications & Uses

• Tulac 100ml Syrup is indicated for:
• Symptomatic treatment of acute and chronic constipation
• Conditions requiring soft stool for easy evacuation (e.g., hemorrhoids, anal fissures, post-coloproctological surgery)
• Prevention and treatment of portal-systemic encephalopathy (hepatic coma and precoma)

Usage Guidance & Safety Precautions

Administration:

• May be administered diluted with water, milk, or fruit juice, or taken undiluted. Taking with or after breakfast is recommended.

Recommended Dosage:

• Adult Constipation: Initial daily dose of 15ml to 45ml daily as a single or divided dose, adjusted to a maintenance dose of 15ml to 30ml daily.
• Children 7–14 years: 15ml daily.
• Children 1–6 years: 5ml to 10ml daily.
• Hepatic Encephalopathy: 30ml to 45ml 3 to 4 times daily, adjusted to produce 2 to 3 soft stools daily.

Precautions & Warnings:

• For oral administration only. Contraindicated in patients with galactosemia, severe inflammatory bowel disease, or acute gastrointestinal obstruction. Use with caution in diabetic patients, as the solution contains residual amounts of free galactose and lactose. Transient flatulence, abdominal cramps, or bloating may occur during initial therapy. Prolonged unmonitored use may lead to electrolyte imbalances due to diarrhea. Store below $25^\circ\text{C}$ in a cool, dry place. Keep out of reach of children.