Therapeutic action
Indications
- Prevention of constipation in patients taking opioid analgesics (e.g. codeine, morphine)
Forms and strengths
- 10 g/15 ml oral solution, to be administered using a measuring device (oral syringe,measuring spoon, or cup with graduations)
Dosage and duration
- Child under 1 year: 5 ml daily (3.3 g daily)
- Child from 1 to 6 years:5 to 10 ml daily (3.3 to 6.7 g daily)
- Child from 7 to 14 years: 10 to 15 ml daily (6.7 to 10 g daily)
- Child over 14 years and adult:15 to 45 ml daily (10 to 30 g daily)
Start lactulose when analgesic treatment continues more than 48 hours. Lactulose must be taken daily, until the end of the opioid treatment.Regular follow up (frequency/consistency of stools) is essential in order to adjust dosage correctly.
Contra-indications, adverse effects, precautions
- Do not administer to patients with Crohn’s disease,ulcerative colitis, intestinal obstruction, undiagnosed abdominal pain.
- May cause: abdominal discomfort, flatulence and diarrhoea.
- In the event of diarrhoea, exclude a faecal impaction and intestinal obstruction; reduce the dose.
- Pregnancy: no contra-indication
- Breast-feeding: no contra-indication
Remarks
- It may take up to 48 hours, or even longer, before the treatment is effective. Lactulose is not indicated in acute constipation where a rapid result is needed.
- If necessary, lactulose may be given in combination with a stimulant laxative (e.g. bisacodyl, senna).
- The oral solution may be taken undiluted, or diluted in water.
- The treatment should be accompanied by dietary measures(fluids and fibre).
Storage
- Below 25 °C. Do not store in a refrigerator (cristallisation).