Lactulose

Constipation (Chronic Constipation): In every case of chronic constipation, initial treatment should consist of a diet rich in fiber (vegetables, salads, fruits etc.) a generous amount of liquids and much physical exercise. Actilac is only to be taken when these measures prove insufficient.
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Constipation (Chronic Constipation): In every case of chronic constipation, initial treatment should consist of a diet rich in fiber (vegetables, salads, fruits etc.) a generous amount of liquids and much physical exercise. Actilac is only to be taken when these measures prove insufficient.
Intestinal flora disturbances:
In damaged to intestinal flora (e.g. following long-term antibiotic treatment)
Gall bladder diseases
Intestinal diseases (Colitis, Diverticulosis, Megacolon)
Increased blood ammonia levels (hyper ammoniemia in hepatopathy, portal-systemic encephalopathy)

In constipation ( chronic constipation):
Adults
: Initially 3-6 tea-spoons daily, In long-term therapy 1½-6 tea-spoons daily
Children up to 14 years
: Initially 3 tea-spoons daily, In long-term therapy 1-2 tea-spoons daily
Infants and toddlers
: Initially 1-2 tea-spoons daily, In long-term therapy 1 tea-spoon daily
In damaged intestinal flora:
Adults
: 1-2 tea-spoons daily
Children
: 1 tea-spoon daily
For reduction of blood ammonia level:
Hyper-ammoniemia in hepatopathy
: a maximum of 18-30 tea-spoons daily.
In portal systemic encephalopathy
: hourly doses of 6-9 tea-spoons of Lactulose solution may be used to induce the rapid laxation. When the laxative effect has been achieved, the dose may then be reduced.

Occasionally flatulence, cramp and abdominal discomfort can occur at the beginning of treatment; this is rapidly eliminated by reducing the dose. Overdose can result in diarrhoea. In abuse, loss of electrolytes (primarily potassium).

Lactulose is a synthetic disaccharide. Lactulose is metabolized in the colon by the saccharolytic bacteria, producing low molecular weight organic acids (mainly lactic acid), which lowers the pH of the colon contents, promote the retention of water by an osmotic effect; thus increasing peristaltic activity. Lactulose is minimally absorbed; therefore, the pharmacokinetics of the absorbed material are not relevant to the principal therapeutic action.