Isolac

Can be taken undiluted or diluted with water, fruit juice, or milk. Take once daily for constipation, preferably in the morning. For hepatic encephalopathy, doses are typically divided throughout the day. Ensure adequate fluid intake.

Lactulose is a synthetic disaccharide that is not absorbed or metabolized in the small intestine. It reaches the colon intact, where it is broken down by colonic bacteria into low molecular weight organic acids (lactic acid, acetic acid). These acids acidify the colonic contents, leading to several effects: 1) Increased osmotic pressure draws water into the colon, softening stools and increasing stool volume, thereby stimulating peristalsis and promoting defecation. 2) The lowered colonic pH inhibits the diffusion of ammonia from the colon into the blood and promotes the diffusion of ammonia from the blood into the colon, where it is converted to ammonium ions (NH4+). Ammonium ions are non-absorbable and are subsequently excreted in the feces, thus reducing blood ammonia levels in hepatic encephalopathy.

• Galactosemia (a hereditary disorder where the body cannot process galactose)
• Intestinal obstruction
• Hypersensitivity to lactulose or any component of the formulation
• Patients on a low-galactose diet

Store at room temperature (below 30°C). Do not freeze. Keep out of reach of children. Crystallization may occur at low temperatures, but this does not affect efficacy.

Symptoms of overdose include abdominal pain, diarrhea, and electrolyte disturbances (e.g., hypokalemia, hyponatremia) due to excessive fluid loss. Management involves discontinuing the drug, correcting fluid and electrolyte imbalances, and providing symptomatic and supportive care.

Pregnancy: Lactulose is poorly absorbed, and adverse effects on the fetus are not expected. Can be used if clinically indicated. Lactation: Lactulose is minimally excreted in breast milk and is considered compatible with breastfeeding. Consult a physician before use.