THERAPY/ CLASS: Constipation / Osmotically Acting Laxatives
Mechanism of Action:
It is a synthetic product that cannot be hydrolysed by any gastrointestinal enzyme. Orally administered Lactulose reaches the colon virtually unchanged. In the colon, normal bacterial flora degrade it into lactic acid and small amounts of formic and acetic acid. This acidic environment ionizes ammonia in the colon to the ammonium ion. Once ionized, ammonia, now in the form of the ammonium ion, cannot diffuse across the colon membrane and is ultimately excreted in the stool. This process reduces blood ammonia levels by 25—50%, which usually has a beneficial effect on the patient’s mental status. It also can inhibit nonbacterial, glutamine-dependent ammonia production in the intestinal wall. Intracolonic breakdown of lactulose also increases osmotic pressure, causing fluid accumulation that softens the stool and distends the colon, enhancing peristalsis.
Indications:
- For Treatment of Constipation
- For Treatment and Prevention of Hepatic Encephalopathy
DOSAGE / ADMINISTRATION:
- For Treatment of Constipation: 1 to 2 g/kg/day (1.5 to 3 mL/kg/day) orally divided once or twice daily.
- For Treatment and Prevention of Hepatic Encephalopathy: 40 to 90 mL/day (27 to 60 g/day) orally in 3 to 4 divided doses. Adjust dose every 1 to 2 days to produce 2 to 3 soft stools/day.
HOW SUPPLIED:
- SMILOVAC is available as Syrup in 100 ml pack.
References:
Kot TV, Pettit-Young NA. Lactulose in the management of constipation: a current review. Annals of Pharmacotherapy. 1992 Oct;26(10):1277-82.
Sudeshika SH, Panagoda GJ, Tennakoon IU. Microbiological quality of paediatric oral liquid drug formulations during consumption. International Journal of Scientific and Research Publications. 2014 Sep;4(9).
