Duphalac - syrup Lactulose - 66.7g/100ml 1 300ml Bottle(s) / 300ml Bottle Abbott Introduction: Duphalac is a type of sugar used to treat constipation. It is known as a laxative and makes your stool easier to pass by drawing water into your bowel. It is also used to treat hepatic encephalopathy (a liver disease causing confusion, tremor, decreased level of consciousness). Duphalac can be taken with or without food. You should take this medicine as advised by your doctor. Use this medicine regularly to get the maximum benefit and try to take it at the same time(s) each day. Your dose may go up or down depending on how well it is working. Do... Uses of Duphalac: ConstipationHepatic encephalopathy Side effects of Duphalac: Abdominal painNauseaVomitingDiarrhea How to use Duphalac: Take this medicine in the dose and duration as advised by your doctor. Check the label for directions before use. Measure it with a measuring cup and take it by mouth. Shake well before use. Duphalac may be taken with or without food, but it is better to take it at a fixed time. How Duphalac works: Duphalac works by drawing water into the intestine through osmosis, which makes the stool soft and easier to pass. What if you forget to take Duphalac?: If you miss a dose of Duphalac, skip it and continue with your normal schedule. Do not double the dose. Indication: Constipation, Hepatic encephalopathy Adult Dose: Constipation Solution: 15-30 mL (10-20 g) PO once daily; may be increased to 60 mL (40 g) once daily Portal Systemic Encephalopathy Prophylaxis 30-45 mL (20-30 g) PO q6-8hr, adjusted until 2-3 soft stools/day; if acute, may be given q1-2hr until 2-3 soft stools/day Treatment 20-30 g (30-45 mL) PO q1hr to induce rapid defecation; reduced to 20-30 g q6-8hr after defecation achieved; titrated to produce 2-3 soft stools/day Child Dose: Constipation 0.7-2 g/kg/day (1-3 mL/kg/day) PO in divided doses; not to exceed 40 g/day (60 mL/day) Portal Systemic Encephalopathy Prophylaxis Infants: 2.5-10 mL/day (1.7-6.67 g/day) PO in divided doses; titrated to produce 2-3 soft stools/day Children and adolescents: 40-90 mL/day (26.7-60 g/day) PO in divided doses; titrated to produce 2-3 soft stools/day Contraindication: Lactulose is contraindicated in patients with galactosaemia and intestinal obstruction. Mode of Action: Lactulose promotes peristalsis by producing an osmotic effect in the colon with resultant distention. In hepatic encephalopathy, it reduces absorption of ammonium ions and toxic nitrogenous compounds, resulting in reduced blood ammonia concentrations. Precaution: It should be used with caution in patients with lactose intolerance and diabetes. Lactation: Unknown whether drug is distributed into milk; use with caution Side Effect: Initial dosing may produce flatulence and intestinal cramps, which are usually transient. Excessive dosage can lead to diarrhoea, dehydration, nusea, vomiting, hypokalemia. Interaction: May prevent release of mesalazine in the colon. Decreased effect with oral neomycin, antacids.