Adult Constipation Initially 15-30 mL daily, may be increased to 60 mL daily. Acute treatment of portal systemic encephalopathy 30-45 mL every 1 hr. Reduce to 30-45 mL tid to qid after laxation is achieved. Prevention of portal systemic encephalopathy 30-45 mL tid to qid, then adjust dose every 1-2 days to produce 2-3 soft stools daily. Childn 40-90 mL daily in divided doses, then adjust dose to produce 2-3 stools daily. Infant 2.5-10 mL daily in divided doses, then adjust dose to produce 2-3 stools daily.
Chronic/excessive use of laxative may lead to dependence; fluid & electrolyte imbalance, steatorrhea, osteomalacia, diarrhea, cathartic colon & liver disease; laxative abuse syndrome. Rectal bleeding or failure to respond to therapy. Women w/ depression, personality disorders or anorexia nervosa. Diabetic patients. Electrocautery procedures during proctoscopy or colonoscopy. Adequate fluid intake 4-6 glasses (8 oz) of water daily; proper dietary habits including increasing fiber intake. Periodically measure serum electrolytes eg, K, Cl, CO2 in geriatric, debilitated patients who receive lactulose for >6 mth. Concomitant use w/ other laxatives. Pregnancy & lactation. Young childn & adolescents.
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