Actulose
Generic Name
Lactulose oral solution
Manufacturer
Example Pharmaceutical Co. Ltd.
Country
Bangladesh / Global
Loading images...
Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| actulose 335 gm oral solution | ৳ 60.22 | N/A |
Description
Overview of the medicine
Actulose (Lactulose) is a synthetic disaccharide used to treat chronic constipation and prevent/treat hepatic encephalopathy. It works as an osmotic laxative, drawing water into the colon to soften stools, and also reduces ammonia absorption in the gut for liver conditions.
Uses & Indications
Dosage
Adults
Constipation: Initially 15-45 mL daily; maintenance 15-30 mL daily. Hepatic Encephalopathy: Initially 30-45 mL 3-4 times daily, adjusted to produce 2-3 soft stools daily.
Elderly
Similar to adult dosage; adjust based on individual response and tolerance.
Renal_impairment
No dose adjustment required as it is minimally absorbed and renally excreted.
How to Take
Actulose oral solution may be taken undiluted or mixed with water, fruit juice, or milk. For constipation, it is usually taken once daily. For hepatic encephalopathy, doses are typically divided throughout the day.
Mechanism of Action
Lactulose is metabolized by colonic bacteria into lactic acid and other organic acids, which lowers colonic pH. This increased acidity draws water into the colon (osmotic effect), softening stool and promoting peristalsis for constipation. In hepatic encephalopathy, the acidic environment converts ammonia (NH3) to ammonium ions (NH4+), which are unabsorbable and subsequently excreted, thus reducing blood ammonia levels.
Pharmacokinetics
Onset
Constipation: 24-48 hours. Hepatic Encephalopathy: 24-48 hours, but full therapeutic effect may take 2-3 days.
Excretion
Primarily excreted unchanged in feces. Absorbed portion (negligible) is excreted in urine.
Half life
Not applicable as it is minimally absorbed and primarily acts locally in the gut.
Absorption
Minimally absorbed (less than 3%) orally, reaching the colon largely unchanged.
Metabolism
Metabolized by colonic bacteria into low molecular weight organic acids (lactic acid, acetic acid).
Side Effects
Contraindications
- Galactosemia
- Intestinal obstruction (known or suspected)
- Acute abdominal pain of unknown cause
- Hypersensitivity to lactulose or any components of the solution
Drug Interactions
Antacids
May diminish the desired reduction in colonic pH.
Other laxatives
Increased risk of dehydration and electrolyte imbalance if used concurrently with other laxatives.
Oral antibiotics (e.g., neomycin)
May reduce the efficacy of lactulose by altering gut flora necessary for its metabolism.
Storage
Store at room temperature (15-30°C or 59-86°F). Do not refrigerate or freeze, as this may cause crystallization. Keep bottle tightly closed and protect from light.
Overdose
Symptoms of overdose include diarrhea, abdominal cramping, and electrolyte disturbances (especially hypokalemia). Treatment involves supportive care, including fluid and electrolyte replacement.
Pregnancy & Lactation
Lactulose is minimally absorbed and generally considered safe for use during pregnancy and breastfeeding. Consult your doctor or pharmacist for advice.
Side Effects
Contraindications
- Galactosemia
- Intestinal obstruction (known or suspected)
- Acute abdominal pain of unknown cause
- Hypersensitivity to lactulose or any components of the solution
Drug Interactions
Antacids
May diminish the desired reduction in colonic pH.
Other laxatives
Increased risk of dehydration and electrolyte imbalance if used concurrently with other laxatives.
Oral antibiotics (e.g., neomycin)
May reduce the efficacy of lactulose by altering gut flora necessary for its metabolism.
Storage
Store at room temperature (15-30°C or 59-86°F). Do not refrigerate or freeze, as this may cause crystallization. Keep bottle tightly closed and protect from light.
Overdose
Symptoms of overdose include diarrhea, abdominal cramping, and electrolyte disturbances (especially hypokalemia). Treatment involves supportive care, including fluid and electrolyte replacement.
Pregnancy & Lactation
Lactulose is minimally absorbed and generally considered safe for use during pregnancy and breastfeeding. Consult your doctor or pharmacist for advice.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture. Refer to the expiry date on the product packaging.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials have established the efficacy and safety of lactulose for the treatment of chronic constipation and hepatic encephalopathy across various patient populations.
Lab Monitoring
- Serum electrolyte levels (especially potassium and sodium) should be monitored, particularly in elderly, debilitated patients, or those on prolonged high-dose therapy for hepatic encephalopathy.
Doctor Notes
- Patients should be educated on the importance of adequate hydration while on lactulose therapy.
- Monitor fluid and electrolyte status, especially in patients with co-morbidities or those on high doses.
- Diarrhea indicates overdosage; the dose should be reduced to achieve 2-3 soft stools per day for hepatic encephalopathy.
Patient Guidelines
- Drink plenty of fluids (6-8 glasses of water) daily while taking this medicine.
- Do not use for more than 7 days without consulting your doctor, unless specifically directed for hepatic encephalopathy.
- Report severe diarrhea, persistent abdominal pain, or changes in mental status (for hepatic encephalopathy) to your doctor immediately.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Actulose is not expected to affect the ability to drive or operate machinery. However, if you experience dizziness or severe abdominal discomfort, avoid these activities until you feel well.
Lifestyle Advice
- Increase dietary fiber intake through fruits, vegetables, and whole grains.
- Engage in regular physical activity to promote bowel regularity.
- Maintain a balanced diet and adequate hydration.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.