Pharmacological properties
Lactulose has a laxative, hyperosmotic, hypoammonemic, stimulating intestinal peristalsis effect, normalizes intestinal microflora, improves the absorption of phosphates and calcium salts, promotes the excretion of protein breakdown products, is a nutrient medium for lactic acid bacteria and promotes its development and reproduction. Under its influence, the natural transformation of the drug in the large intestine to lactic, acetic, formic acid occurs completely, which contributes to an increase in acidity and osmotic pressure in the lumen of the large intestine, as well as increased intestinal peristalsis (wave-like movements), an increase in the volume of feces, so toxic products of protein breakdown (ammonia) are bound in the intestine. As a result, lactulose has a mild laxative effect, without irritating the intestinal mucosa, and also reduces the content in the blood of toxic products of protein breakdown, which are excreted from the body during the development of a laxative effect. Lactulose also inhibits the growth of proteolytic microorganisms, including Shigella, Salmonella. The effect develops 24-48 hours after administration, its delay is due to the passage of the drug through the gastrointestinal tract. When taken orally, lactulose is transformed in the intestine, the breakdown products are excreted with feces within 24-48 hours, no more than 3% of the drug is excreted unchanged in the urine.
Indication
Chronic and episodic (situational) constipation (including hemorrhoids, the need for surgical intervention on the large intestine and / or anus), postoperative atonic constipation, pain syndrome after removal of hemorrhoids, hepatic encephalopathy, liver failure, hepatic coma and precoma, chronic active hepatitis, hyperammonemia, intoxications of various etiologies, intestinal dysbacteriosis, putrefactive dyspepsia, salmonellosis.
Application
For constipation, pain syndrome after removal of hemorrhoids, putrefactive dyspepsia, it is prescribed according to the following scheme:
age In the first 3 days - initial dose, ml Over 3 days - maintenance dose, ml
| adults | 15-45 ml/day (1-3 tbsp.) | 15 ml/day (1 tbsp.) |
| Children aged 7-14 years | 15 ml/day (1 tbsp.) | 10 ml/day (2 tsp) |
| Children aged 1 to 6 years | 5-10 ml/day (1-2 teaspoons) | 5-10 ml/day (1-2 teaspoons) |
| Newborns and children under 1 year of age | 5 ml/day (1 tsp) | 5 ml/day (1 tsp) |
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The course of treatment ranges from 1-4 weeks to 3-4 months.
In case of salmonellosis, 5 ml (1 teaspoon) is prescribed 3 times a day for the first 10-12 days, then 5 ml (1 teaspoon) 5 times a day for 10-12 days after a one-week break.
In case of liver failure, coma and precoma, encephalopathy, as well as chronic hepatitis, hyperammonemia, intoxications of various etiologies, dysbacteriosis, it is prescribed orally, initially 30-60 ml (2-4 tablespoons) 3 times a day, then, as a rule, after 7-14 days of use, a maintenance dose of 10-25 ml (2-5 teaspoons) 2-3 times a day is prescribed. The course of treatment is up to 3 months.
Patients who are in hepatic coma or precomatose state, are prescribed rectally 300 ml of syrup per 700 ml of water or saline solution of sodium chloride, administered through a rectal balloon catheter and held for 30-60 minutes. If necessary, repeat every 4-6 hours.
When taken orally, the drug can be diluted with water or juice, except grapefruit juice.
The effect appears after 24-48 hours.
Contraindication
Galactosemia, intestinal obstruction, hypersensitivity to lactulose, rectal bleeding. It is not recommended to prescribe the drug for hepatic coma caused by hepatitis.
Side effects
Bioflorax is usually well tolerated, but in the first days of use, flatulence and increased gas formation may appear, which disappear on their own 2-3 days after the start of treatment. In the treatment of hepatic encephalopathy, temporary diarrhea is possible, nausea and intestinal cramps are also possible. Frequent use of the drug in high doses, especially in elderly patients, can cause diarrhea with impaired water and electrolyte balance.
Special instructions
At the beginning of treatment of liver failure, coma and precoma, encephalopathy, chronic active hepatitis, hyperammonemia, intoxications of various etiologies, when achieving a laxative effect, a maintenance dose is prescribed so that it provides softened stools 2-3 times a day.
Elderly people and patients with mental disorders are recommended to monitor the content of electrolytes in the blood during long-term treatment.
The drug is prescribed with caution to patients with diabetes due to the presence of sugar in the composition.
The drug can be used during pregnancy and breastfeeding, as well as in newborns and young children.
If diarrhea occurs, the drug is discontinued.
Interactions
It is not recommended to use Bioflorax simultaneously with neomycin and antacids to avoid a decrease in the effect. It is not recommended to use the drug within 2 hours after taking other medications.
Overdose
Diarrhea is possible, followed by dehydration, hypokalemia and hyponatremia, which disappear when the drug is discontinued or the dose is reduced. It is necessary to prescribe therapy to restore water and electrolyte balance.
Storage conditions
In a dry place, protected from light, at a temperature of 15-25 °C.
