*For medical professionals only
Clinical decision making could be simpler
01 Constipation
1, Adult(domestic usage)
Indications: Chronic functional constipation, chronic habitual constipation, regulate the circadian rhythm of colon[1-2].
Usage and Dosage: Constipation and clinical need to maintain soft stools: Oral, the initial dose for adults is 30ml per day, and the maintenance dose is 10-25ml. After a few days of treatment, the dose can be reduced according to the patient’s condition. This product should be taken once with breakfast. According to the mechanism of action of lactulose, clinical effects can be achieved within 1-2 days. If there is no obvious effect after 2 days, please consult a doctor [2].
2. Adult(FDA usage)
Indications: Treat constipation. In patients with a history of chronic constipation, treatment with lactulose solution increases the number of bowel movements per day and the number of bowel movements [5-6].
Dosage: The usual dose is 1-2 tablespoons (15-30ml, containing 10-20g lactulose)/day. If necessary, the dose can be increased to 60ml/day. Normal bowel movements may take 24-48 hours [5-6].
02 Hepatic Encephalopathy
1, Adult(domestic usage)
Indications: Treatment and prevention of hepatic coma or pre-coma state [2].
Dosage: The initial dose is 30-50ml, three times a day. The maintenance dose should be adjusted to a maximum of two to three soft stools per day [2].
2. Adult(FDA usage)
Indications: Prevention and treatment of portal encephalopathy, including precoma and coma.
Dosage:
Oral administration
The usual oral dose for adults is 2-3 tablespoons (30-45ml, containing 20-30g lactulose solution), 3-4 times a day. The dose can be adjusted daily or every two days to produce 2-3 soft stools per day.
Lactulose solution at a dose of 30-45ml/h can be used for rapid defecation in the initial stage of portal encephalopathy. Once a laxative effect is achieved, the dose of lactulose solution can be reduced to the recommended daily dose.
The patient’s bowel movement may improve within 24 hours, but not to 48 hours or later.
Continued long-term treatment with lactulose reduces the severity of portal encephalopathy and prevents its recurrence. The dose of lactulose solution used for this purpose is the same as the recommended daily dose.
Rectal
When an adult patient presents with portal encephalopathy, is about to be comatose or is in the comatose stage, or needs an endoscopy or intubation procedure immediately after the recommended oral dose is administered, A lactulose solution can be used as an enema through a rectal balloon catheter; cleaning enemas containing soapy water or other alkaline agents should not be used.
300ml of lactulose solution should be mixed with 700ml of water or normal saline and left in the intestine for 30-60min. Lactulose solution enema can be repeated every 4-6 hours.
If the enema comes out too quickly, it can be repeated immediately. The goal of this treatment is to reverse the coma so that the patient can take oral medication. In some patients, coma reversal may occur within 2 hours of the first enema. Oral lactulose solution at the recommended dose should be started before the lactulose enema is completely discontinued [3-4].