Lactulose Oral Liquid 10 g/15 mL
Description
Lactulose Oral Liquid 10 g/15 mL is a clear to yellowish, sweet-tasting, viscous liquid for oral administration. It contains Lactulose, a synthetic disaccharide (a type of sugar) composed of fructose and galactose. Lactulose is non-digestible by human enzymes and reaches the colon largely unchanged. It acts as an osmotic laxative and also has properties that can help reduce ammonia levels in the blood. The concentration indicates that 15 milliliters of the liquid contain 10 grams of lactulose.
Advantages
- Effective Laxative: Provides effective relief from chronic constipation by drawing water into the colon, softening stools, and increasing bowel movements.
- Safe for Long-Term Use: Generally considered safe for long-term use in chronic constipation, including in elderly patients and children (under medical supervision).
- Reduces Ammonia Levels: Crucial for managing hepatic encephalopathy by reducing the absorption of ammonia and other toxins from the gut.
- Non-Absorbable: As it is minimally absorbed into the bloodstream, it has a low systemic side effect profile.
- Prebiotic Effect: Acts as a prebiotic, promoting the growth of beneficial bacteria in the colon.
- Convenient Liquid Form: Easy to measure and administer, especially for those who have difficulty swallowing pills.
Uses
Lactulose Oral Liquid 10 g/15 mL is primarily used for:
- Chronic Constipation: Treatment of chronic constipation by increasing stool water content and stimulating bowel movements. It is particularly useful when increased stool bulk and softening are desired.
- Hepatic Encephalopathy (Portosystemic Encephalopathy): Prevention and treatment of hepatic encephalopathy, a brain disorder caused by liver disease. It works by reducing the production and absorption of ammonia and other nitrogenous waste products from the gut, thereby improving neurological function.
- Preparation for Colonoscopy/Surgery (Less Common): Sometimes used as part of a bowel preparation regimen before certain medical procedures, though other agents are more commonly used.
Nature
Lactulose is a synthetic disaccharide composed of D-galactose and D-fructose. Its therapeutic effects are primarily mediated in the colon, as it is not significantly hydrolyzed or absorbed in the small intestine.
Its mechanism of action involves:
- Osmotic Laxative Effect: When lactulose reaches the colon, it is fermented by colonic bacteria into low molecular weight organic acids (e.g., lactic acid, acetic acid). These acids increase the osmotic pressure within the colon, drawing water into the lumen. This increase in water softens the stool and increases its bulk, promoting peristalsis and facilitating bowel movements.
- Ammonia Reduction (in Hepatic Encephalopathy):
- The fermentation of lactulose by colonic bacteria leads to the production of organic acids, which lowers the pH of the colon.
- This acidic environment favors the conversion of ammonia (NH3) (which is readily absorbed) into ammonium ions (NH4+) (which are poorly absorbed). The ammonium ions are then trapped in the colon and excreted in the feces.
- Additionally, the osmotic laxative effect helps to accelerate the transit of stool, reducing the time for ammonia production and absorption.
- Lactulose may also shift nitrogen from the blood to the gut lumen, where it can be converted to ammonium.
Essentially, lactulose works by manipulating the osmotic balance and the gut microbiome to either facilitate defecation or reduce systemic toxin levels.
Storage
- Room Temperature: Store Lactulose Oral Liquid 10 g/15 mL at controlled room temperature, typically between 20°C to 25°C (68°F to 77°F). Some manufacturers may recommend storage up to 30°C.
- Protect from Freezing: Do not freeze the liquid, as this can alter its consistency and effectiveness.
- Protect from Extreme Heat and Direct Sunlight: Keep the bottle tightly closed and away from direct sunlight and excessive heat.
- Keep Out of Reach of Children: Store the medication in a secure place, out of sight and reach of children and pets.
- Check Expiry Date: Always check the expiry date on the packaging. Do not use the medication after this date.
- Crystallization: In very cold temperatures, the solution may become very thick, but warming it will usually return it to its normal consistency. Crystallization of sugar may occur at very low temperatures, but it does not generally affect the quality of the product.