Duphalac syrup 66.7%, 500 ml

• constipation: regulation of the physiological rhythm of colon emptying;

• softening of stool for medical purposes (hemorrhoids, colon and anus surgeries);

• hepatic encephalopathy - treatment and prevention of hepatic coma and precoma;

• intestinal dysbiosis;

• enteritis caused by salmonella, shigella, salmonellosis in the stage of bacterial carriage;

• putrid dyspepsia syndrome (in young children as a result of acute food poisoning).

The drug is intended for oral administration, as well as for rectal administration.

Dose for treating constipation or for softening stools for medical purposes.

Adults and adolescents for the treatment of constipation: the initial dose is 15-45 ml, the maintenance dose is 15-30 ml; children 7-14 years old: initial dose - 15 ml, maintenance dose - 10-15 ml; children 1-6 years old: initial and maintenance dose - 5-10 ml; children under 1 year old: initial and maintenance dose - up to 5 ml. Dose in the treatment of hepatic encephalopathy (adults)

For oral administration: Initial dose: 3-4 times a day, 30-45 ml. Then they switch to an individually selected maintenance dose so that soft stools are maximum 2-3 times a day.

For rectal administration: In the case of a precoma or coma, the drug can be administered as a retention enema (300 ml of the drug / 700 ml of water). The enema should be held for 30-60 minutes, the procedure should be repeated every 4-6 hours until it becomes possible to administer the drug orally

Active substance:

lactulose

excipient:

purified water - up to 100 ml

in polyethylene bottles of 200, 500 or 1000 ml with a screw cap, complete with a measuring cup; in disposable sachets made of polyethylene and aluminum foil, 15 ml; in a cardboard box 10 bags.

• Rectal bleeding;

• colo-, ileostomy;

• suspicion of appendicitis;

• galactosemia;

• patients with lactose intolerance, lactase deficiency, glucose-galactose malabsorption;

• intestinal obstruction; hypersensitivity to lactulose.

pharmachologic effect

Laxative. It causes a change in the flora of the colon (an increase in the number of lactobacilli), which leads to an increase in acidity in the lumen of the colon and stimulates its peristalsis. Along with this, the volume increases and the feces soften. As a result, a laxative effect develops, without a direct effect on the mucous membrane and smooth muscles of the colon. Under the action of lactulose, ammonia is also absorbed in the large intestine, the formation of nitrogen-containing toxic substances in its proximal part decreases and, accordingly, they are absorbed into the vena cava system. Has the ability to inhibit the growth of Salmonella in the colon. Does not decrease absorption of vitamins and is not addictive. Practically not absorbed from the intestines.

Pharmacokinetics

After oral administration, lactulose passes by passage into the large intestine, where it is metabolized by bacteria that break down sugar. As a result, simple organic acids are formed - mainly lactic acid and to a lesser extent acetic and formic acid. A small amount of lactulose is absorbed and excreted in the urine unchanged.

Indications of the active substances of the drug DuphalacЃ

Constipation, incl. chronic, during pregnancy, hemorrhoids; after surgery on the colon and / or anus, to prepare for surgery on the colon; for softening the stool (facilitating bowel movements) with pain syndrome after removal of hemorrhoids; hepatic encephalopathy; hepatic precoma and coma.

Dosage regimen

the drug is intended for oral administration, as well as for rectal administration. Dose for treating constipation or for softening stools for medical purposes. Adults and adolescents for the treatment of constipation: the initial dose is 15-45 ml, the maintenance dose is 15-30 ml; children 7-14 years old: initial dose - 15 ml, maintenance dose - 10-15 ml; children 1-6 years old: initial and maintenance dose - 5-10 ml; children under 1 year old: initial and maintenance dose - up to 5 ml. Dose in the treatment of hepatic encephalopathy (adults) For oral administration: Initial dose: 3-4 times a day, 30-45 ml. Then they switch to an individually selected maintenance dose so that soft stools are maximum 2-3 times a day. For rectal administration: In the case of a pre-coma or coma, the drug can be administered as a retention enema (300 ml of the drug / 700 ml of water).The enema should be held for 30-60 minutes, the procedure should be repeated every 4-6 hours until it becomes possible to administer the drug orally

Side effect

On the part of the digestive system: in the first days of admission, flatulence may appear (usually gradually decreases and disappears); when taken in doses exceeding the recommended ones, abdominal pain and diarrhea are possible, which requires dose adjustment; rarely - nausea.

When used in high doses for a long time for the prevention and treatment of hepatic precoma and coma, diarrhea and impaired water-electrolyte metabolism are possible.

From the nervous system: rarely - convulsions, headache, dizziness.

Others: possibly - allergic reactions; rarely - arrhythmias, myalgia, fatigue, weakness.

Contraindications for use

• Rectal bleeding;

• colo-, ileostomy;

• suspicion of appendicitis;

• galactosemia;

• patients with lactose intolerance, lactase deficiency, glucose-galactose malabsorption;

• intestinal obstruction; hypersensitivity to lactulose.

Application during pregnancy and lactation

May be used during pregnancy and lactation (breastfeeding) according to indications.

special instructions

Should not be used for abdominal pain, nausea, vomiting without verification of the diagnosis.

Use with caution in patients with gastrocardiac syndrome. In such cases, treatment should be started at low doses and increased gradually to avoid the development of flatulence.

It is used with caution in patients with diabetes mellitus, especially in inflammatory lesions of the colon.

With long-term treatment (more than 6 months), the level of potassium, chlorine and carbon dioxide in the blood plasma should be regularly monitored.

If diarrhea occurs, lactulose should be discontinued.

Drug interactions

With simultaneous use with broad-spectrum antibiotics, it is possible to reduce the therapeutic efficacy of lactulose.

With the simultaneous use of lactulose can disrupt the release of active substances from enteric drugs with a pH dependent release due to the fact that it lowers the pH of the intestinal contents.