Loctoz
Generic Name
loctoz-335-gm-oral-solution
Manufacturer
Acme Pharmaceuticals
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| loctoz 335 gm oral solution | ৳ 100.00 | N/A |
Description
Overview of the medicine
Lactulose is a synthetic disaccharide used to treat constipation and hepatic encephalopathy by increasing osmotic pressure in the colon and reducing ammonia absorption.
Uses & Indications
Dosage
Adults
For constipation: Initially 15-45 mL daily, adjusted to response (usually 15-30 mL daily). For hepatic encephalopathy: Initially 30-45 mL three to four times daily, adjusted to produce 2-3 soft stools per day.
Elderly
Same as adults, start with lower doses and adjust based on response and tolerability.
Renal_impairment
No dose adjustment needed as it is minimally absorbed and primarily acts locally in the colon.
How to Take
Administer orally. Can be taken directly or mixed with water, fruit juice, or milk. For constipation, it can be taken once daily. For hepatic encephalopathy, doses should be spread throughout the day.
Mechanism of Action
Lactulose is metabolized by colonic bacteria into low molecular weight organic acids. This process increases the osmotic pressure, drawing water into the colon, softening stools, and promoting defecation. In hepatic encephalopathy, it reduces colonic pH, which converts ammonia (NH3) to ammonium (NH4+), trapping it in the colon and preventing its absorption into the bloodstream.
Pharmacokinetics
Onset
For constipation, 24-48 hours. For hepatic encephalopathy, clinical improvement may take 24-48 hours.
Excretion
Primarily excreted unchanged in feces; absorbed portion (minimal) is excreted in urine.
Half life
Not applicable as it acts locally in the gut and is minimally absorbed.
Absorption
Minimally absorbed from the gastrointestinal tract (less than 3%).
Metabolism
Metabolized by colonic bacteria into lactic acid, acetic acid, and other organic acids.
Side Effects
Contraindications
- Hypersensitivity to lactulose or any component of the formulation.
- Patients with galactosemia (as lactulose contains galactose and lactose).
- Patients requiring a low-galactose diet.
- Intestinal obstruction, gastrointestinal perforation or risk of perforation.
Drug Interactions
Antacids
May diminish the desired acidic colonic pH effect of lactulose.
Laxatives (other)
Concurrent use may lead to excessive fluid and electrolyte loss.
Non-absorbable antacids
Can reduce the efficacy of lactulose in hepatic encephalopathy by altering the gut flora.
Storage
Store at room temperature (below 30°C). Do not freeze. Keep away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include diarrhea, abdominal cramps, and electrolyte disturbances (especially hypokalemia). Treatment is symptomatic and supportive, including fluid and electrolyte replacement.
Pregnancy & Lactation
Generally considered safe for use during pregnancy and lactation as it is minimally absorbed. However, use with caution and only if clearly needed under medical supervision.
Side Effects
Contraindications
- Hypersensitivity to lactulose or any component of the formulation.
- Patients with galactosemia (as lactulose contains galactose and lactose).
- Patients requiring a low-galactose diet.
- Intestinal obstruction, gastrointestinal perforation or risk of perforation.
Drug Interactions
Antacids
May diminish the desired acidic colonic pH effect of lactulose.
Laxatives (other)
Concurrent use may lead to excessive fluid and electrolyte loss.
Non-absorbable antacids
Can reduce the efficacy of lactulose in hepatic encephalopathy by altering the gut flora.
Storage
Store at room temperature (below 30°C). Do not freeze. Keep away from direct light and moisture. Keep out of reach of children.
Overdose
Symptoms of overdose include diarrhea, abdominal cramps, and electrolyte disturbances (especially hypokalemia). Treatment is symptomatic and supportive, including fluid and electrolyte replacement.
Pregnancy & Lactation
Generally considered safe for use during pregnancy and lactation as it is minimally absorbed. However, use with caution and only if clearly needed under medical supervision.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 3 years from the date of manufacture when stored properly.
Availability
Pharmacies, Hospitals
Approval Status
Approved
Patent Status
Expired
WHO Essential Medicine
YesClinical Trials
Lactulose has been extensively studied in numerous clinical trials confirming its efficacy and safety for the treatment of constipation and hepatic encephalopathy. Ongoing research focuses on optimizing dosing and exploring potential new uses.
Lab Monitoring
- Serum electrolytes (especially potassium and sodium) with prolonged high doses or in debilitated patients.
- Blood ammonia levels in patients with hepatic encephalopathy.
Doctor Notes
- Monitor fluid and electrolyte status, particularly in elderly or debilitated patients receiving high doses.
- Adjust dosage to achieve 2-3 soft stools per day for patients with hepatic encephalopathy.
- Advise patients on the delayed onset of action and the importance of adequate hydration.
- Caution against prolonged self-medication for constipation.
Patient Guidelines
- Ensure adequate fluid intake while taking lactulose.
- Be aware that the laxative effect may take 24-48 hours.
- Do not use for more than one week without consulting a doctor.
- Report any severe abdominal pain, persistent diarrhea, or vomiting.
Missed Dose Advice
If a dose is missed, take it as soon as you remember. If it is almost time for the next scheduled dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
Lactulose is not known to impair the ability to drive or operate machinery.
Lifestyle Advice
- Maintain a balanced diet rich in fiber.
- Stay adequately hydrated throughout the day.
- Engage in regular physical activity to promote bowel regularity.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.