Sinalac
Generic Name
Lactulose
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| sinalac 335 gm oral solution | ৳ 70.00 | N/A |
Description
Overview of the medicine
Sinalac contains Lactulose, a synthetic disaccharide used as an osmotic laxative to treat chronic constipation and hepatic encephalopathy by increasing stool water content and reducing ammonia absorption.
Uses & Indications
Dosage
Adults
Constipation: 15-45 mL orally once daily; Hepatic Encephalopathy: 30-45 mL orally 3-4 times daily to achieve 2-3 soft stools per day.
Elderly
No specific dosage adjustment needed for age, follow adult dosage.
Renal_impairment
No specific dosage adjustment needed.
How to Take
Administer orally. May be mixed with water, fruit juice, or milk to improve palatability. Do not heat.
Mechanism of Action
Lactulose is metabolized by colonic bacteria into low molecular weight organic acids, which acidify the colon contents. This increases osmotic pressure, drawing water into the colon, softening stools, and stimulating peristalsis. In hepatic encephalopathy, it reduces ammonia absorption by trapping ammonia ions in the acidic colon.
Pharmacokinetics
Onset
Constipation: 24-48 hours; Hepatic encephalopathy: 24-48 hours for initial effect, 24-72 hours for therapeutic effect
Excretion
Unabsorbed drug is excreted unchanged in feces; absorbed portion is excreted in urine
Half life
Not applicable due to minimal systemic absorption
Absorption
Minimally absorbed systemically (less than 3%)
Metabolism
Not metabolized by human enzymes; metabolized by colonic bacteria
Side Effects
Contraindications
- Galactosemia
- Intestinal obstruction
- Hypersensitivity to lactulose
Drug Interactions
Antacids
May diminish the desired colonic pH decrease caused by lactulose, potentially reducing effectiveness in hepatic encephalopathy.
Other laxatives
Concurrent use may cause excessive fluid loss.
Non-absorbable antacids
Same as above.
Storage
Store at room temperature (below 30°C). Do not refrigerate or freeze. Keep away from direct sunlight.
Overdose
Symptoms include abdominal pain, diarrhea, electrolyte disturbances. Management involves supportive care and correction of electrolyte imbalances.
Pregnancy & Lactation
Category B in pregnancy. Generally considered safe during pregnancy and lactation as it is minimally absorbed.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from manufacturing date.
Availability
Available in pharmacies nationwide
Approval Status
Approved by DGDA/FDA
Patent Status
Generic available, original patent expired
WHO Essential Medicine
YesClinical Trials
Numerous clinical trials support the efficacy and safety of lactulose for chronic constipation and hepatic encephalopathy.
Lab Monitoring
- For hepatic encephalopathy, monitor serum ammonia levels and electrolyte balance. For chronic use, periodic electrolyte monitoring may be considered.
Doctor Notes
- Warn patients about potential bloating and flatulence, especially at the start of therapy.
- Adjust dose to achieve desired bowel movements (2-3 soft stools daily) in hepatic encephalopathy.
- Ensure adequate hydration.
Patient Guidelines
- Drink plenty of fluids while taking this medicine.
- Do not stop taking without consulting your doctor.
- Inform your doctor if diarrhea persists or worsens.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not double the dose.
Driving Precautions
Generally no impact on driving or operating machinery. If dizziness occurs, avoid such activities.
Lifestyle Advice
- Increase dietary fiber intake.
- Maintain adequate hydration.
- Engage in regular physical activity.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.