Actilac
Generic Name
Lactulose
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| actilac 335 gm oral solution | ৳ 140.00 | N/A |
Description
Overview of the medicine
Lactulose is a synthetic disaccharide used to treat constipation and hepatic encephalopathy. It works by drawing water into the colon, softening stools, and stimulating bowel movements. In hepatic encephalopathy, it lowers ammonia levels in the blood.
Uses & Indications
Dosage
Adults
Constipation: 15-45 mL daily; Hepatic Encephalopathy: 30-45 mL 3-4 times daily adjusted to 2-3 soft stools per day.
Elderly
Similar to adults, start with lower doses.
Renal_impairment
No dose adjustment needed as minimal systemic absorption.
How to Take
Oral, can be diluted with water or fruit juice. Take once daily for constipation, divided doses for hepatic encephalopathy.
Mechanism of Action
Lactulose is poorly absorbed and reaches the colon largely unchanged. In the colon, it is broken down by colonic bacteria into low molecular weight organic acids (lactic acid, acetic acid), which lowers the pH of the colon. This acidic environment draws water into the colon (osmotic effect), softening stool and promoting peristalsis. In hepatic encephalopathy, the acidic environment converts ammonia (NH3) into ammonium ions (NH4+), which are not absorbed and are excreted in feces, thus reducing blood ammonia levels.
Pharmacokinetics
Onset
Constipation: 24-48 hours; Hepatic encephalopathy: 24-48 hours for effect
Excretion
Primarily excreted unchanged in feces; absorbed portion excreted renally.
Half life
Not directly applicable due to minimal absorption; eliminated unchanged or metabolized by gut flora.
Absorption
Poorly absorbed (less than 3%)
Metabolism
Metabolized by colonic bacteria into organic acids.
Side Effects
Contraindications
- Galactosemia
- Intestinal obstruction
- Acute abdominal pain
- Hypersensitivity to lactulose
Drug Interactions
Antacids
May reduce the effect of lactulose (clinically not significant usually).
Neomycin
May interfere with the metabolism of lactulose in the colon, affecting its efficacy in hepatic encephalopathy.
Other laxatives
Concurrent use can lead to severe diarrhea/dehydration.
Storage
Store below 30°C, protect from light and moisture. Do not refrigerate.
Overdose
Symptoms include diarrhea, abdominal cramps, dehydration, and electrolyte imbalance. Treatment is supportive (fluid and electrolyte replacement).
Pregnancy & Lactation
Generally considered safe (Pregnancy Category B). Use with caution and consult a doctor.
Side Effects
Contraindications
- Galactosemia
- Intestinal obstruction
- Acute abdominal pain
- Hypersensitivity to lactulose
Drug Interactions
Antacids
May reduce the effect of lactulose (clinically not significant usually).
Neomycin
May interfere with the metabolism of lactulose in the colon, affecting its efficacy in hepatic encephalopathy.
Other laxatives
Concurrent use can lead to severe diarrhea/dehydration.
Storage
Store below 30°C, protect from light and moisture. Do not refrigerate.
Overdose
Symptoms include diarrhea, abdominal cramps, dehydration, and electrolyte imbalance. Treatment is supportive (fluid and electrolyte replacement).
Pregnancy & Lactation
Generally considered safe (Pregnancy Category B). Use with caution and consult a doctor.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years (check product label)
Availability
Pharmacies, Hospitals
Approval Status
Approved by regulatory bodies (e.g., DGDA)
Patent Status
Expired
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials support the efficacy and safety of lactulose in treating constipation and hepatic encephalopathy.
Lab Monitoring
- Electrolytes (with prolonged high dose use)
- Ammonia levels (in hepatic encephalopathy)
Doctor Notes
- For hepatic encephalopathy, adjust dose to achieve 2-3 soft stools daily.
- Monitor electrolytes in vulnerable patients (e.g., elderly, those with pre-existing conditions) receiving high doses or long-term therapy.
Patient Guidelines
- Drink plenty of fluids.
- Do not use for more than 7 days without consulting a doctor for constipation.
- Do not use if you have sudden abdominal pain.
Missed Dose Advice
Take the missed dose as soon as remembered. If it's near the next dose, skip and continue regular schedule. Do not double dose.
Driving Precautions
No specific precautions, does not impair ability to drive or operate machinery.
Lifestyle Advice
- Increase fiber intake.
- Maintain good hydration.
- Regular exercise.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.