Normalac, L.Molteni & C..dei F.lli Alitti Societa di Esercizio
indications:
Hepatic encephalopathy. Constipation (adjustment of excretion).
Composition:
15 ml of syrup contains 10 g of lactulose. The product contains lactose and traces of other sugars: galactose, tagatose, fructose, epilactose.
Action:
A laxative with an osmotic effect. Lactulose is a synthetic disaccharide that does not decompose under the influence of disaccharidases in the small intestine. In an unchanged form, the drug reaches the large intestine, where under the influence of bacteria (Lactobacillus acidophilus, Lactobacillus bifidus), decomposes to carbon dioxide and low-molecular organic acids - mainly to lactic acid, acetic acid, formic acid. Due to the presence of these acids, there is: lowering the pH in the large intestine and transformation of ammonia absorbed by the intestinal mucosa into the ammonium ion, which is not absorbed, and intensifies the flow of ammonia from the blood into the intestinal lumen; inhibiting the action of proteolytic flora and preventing the production of ammonia and other toxic substances derived from the catabolism of proteins that can not be metabolized by the liver in severe liver failure and which, when passing through the blood-brain barrier, impair cerebral metabolism; makes organic anions, the product of lactulose decomposition, not absorbed, increasing the volume of water in the colon on the basis of osmosis. As a result, the water content in the stool mass increases, facilitating defecation. Lactulose is a synthetic disaccharide which, due to the lack of its specific enzyme in the small intestine, reaches the colon unchanged.
Contraindications:
Hypersensitivity to lactulose or to any of the excipients. Galactosemia. Bowel obstruction. acute inflammatory bowel diseases including ulcerative colitis and rectum, Crohn's disease. Do not use together with other medicines used in constipation.
Precautions:
Do not use the medicine in cases of abdominal pain, nausea and vomiting. In case of persistent constipation, consult a physician. In the case of long-term use of the drug, a check of blood electrolytes should be performed (the doctor decides about the necessity of the examination after assessing the clinical condition of the patient). It may increase the effect of Digoxin due to increased potassium loss, especially at high doses. The drug contains traces of absorbable sugars (lactose, galactose and tagatose) - patients with diabetes should consult a doctor. It should not be used in patients with rare, hereditary galactose intolerance, fructose, Lapp lactase deficiency or malabsorption of glucose-galactose.
Pregnancy and lactation:
Caution should be exercised when prescribing to pregnant women and during breast-feeding.
Side effects:
Common: excessive gas donation, abdominal pain, bloating, diarrhea (when using too high doses). Not known: electrolyte imbalance due to diarrhea.
Dosage:
Orally. Patients with hepatic encephalopathy: 90-190 ml daily in 2-3 divided doses. The drug can be administered along with water, fruit juice, milk.
(C)
