Hepatolac

Constipation. Conditions where stool softening & easy defecation are required for medical benefits eg, hemorrhoids, post colonic/anal surgery. Hepatic encephalopathy. Treatment & prevention of portal-systemic encephalopathy including stages of hepatic pre-coma & coma.

Constipation or when stool softening & easy defecation are required for medical benefits Adult 10-20 g (15-30 mL) daily. May increase to 40 g (60 mL) daily if necessary. Childn 7-14 yr Initially 15 mL daily. Maintenance dose: 10-15 mL daily, 1-6 yr Initial/maintenance dose: 5-10 mL daily. Infant <1 yr Initial/maintenance dose: Up to 5 mL daily. Acute treatment of portal systemic encephalopathy Adult 20-30 g (30-45 mL) every 1 hr to induce rapid laxation. Reduce to 20-30 g (30-45 mL) tid to qid after laxation is achieved to produce 2-3 soft stools daily. Prevention of portal systemic encephalopathy Adult 20-30 g (30-45 mL) tid to qid. Adjust dose every 1-2 days to produce 2-3 soft stools daily. Childn 26.7-60 g (40-90 mL) daily in divided doses. Adjust dosage to produce 2-3 stools daily. Infant 1.7-6.7 g (2.5-10 mL) daily in divided doses. Adjust dosage to produce 2-3 stools daily.

May be taken with or without food: May mix w/ fruit juice, water or milk.

Hypersensitivity. Nausea, vomiting or other symptoms of appendicitis; fecal impaction; intestinal obstruction; undiagnosed abdominal pain. Patients requiring low galactose diet.

Laxative abuse syndrome (fluid & electrolyte imbalances, steatorrhea, osteomalacia, diarrhea, cathartic colon & liver disease) w/ chronic use. Rectal bleeding or failure to respond to therapy. Women w/ depression, personality disorders or anorexia nervosa. Diabetic patients. Ensure adequate fluid intake (4-6 glasses of water daily); proper daily exercise & dietary habits including increase in fiber intake; thorough bowel cleansing w/ nonfermentable soln when undergoing electrocautery procedures during proctoscopy or colonoscopy. Periodically monitor patients for fluid & electrolyte imbalance; measure serum electrolytes (eg, K, Cl, CO₂) in elderly & debilitated patients receiving lactulose for >6 mth. Restrict self-medication to short-term therapy of constipation. Concomitant laxative use. Pregnancy & lactation. May develop hyponatremia & dehydration in infants. Young childn & adolescents w/ portal-systemic encephalopathy. Elderly.

Dehydration, hypernatremia, hypokalemia; abdominal discomfort & distention, belching, cramping, diarrhea (excessive dose), flatulence, nausea, vomiting.

False interpretation w/ additional laxatives. Possible inadequate response w/ oral anti-infectives eg, neomycin. May inhibit decrease in fecal pH in the colon w/ antacids.

Laxatives, Purgatives

A06AD11 - lactulose ; Belongs to the class of osmotically acting laxatives.

NDD