Lactulose 670 mg/ml

Oral liquid

- Treatment of hepatic encephalopathy, hepatic coma (for people 18 years and older)
- Treatment of constipation

The lactulose solution may be administered diluted or undiluted. Each dose may if necessary be taken with water or fruit juices, etc.
Each dose of lactulose should be swallowed in one and should not be kept in the mouth for an extended period of time.
The posology should be adjusted according to the individual needs of the patient.
In case of single daily dose, this should be taken at the same time, e.g. during breakfast.
During the therapy with laxatives it is recommended to drink sufficient amounts of fluids (1.5–2 litres, equal to 6-8 glasses) during the day.
For lactulose in bottles the measuring cup may be used.
For lactulose in 15 ml single dose sachets the corner of the sachet should be torn off and contents taken immediately.
Dosing in constipation:
Lactulose may be given as a single daily dose or in two divided doses, for lactulose in bottles the measuring cup may be used.
After a few days the starting dosage may be adjusted to the maintenance dose based upon treatment response. Several days (2-3 days) of treatment may be needed before treatment effect occurs.

For a precise dosing for infants and children up to 7 years lactulose in bottles should be used.
Dosing in HE (for adults only):
Starting dose: 3 to 4 times daily 30-45 ml (6-9 x 5 ml spoonfuls) or 2-3 sachets. This dose may be adjusted to the maintenance dose to achieve two or three soft stools each day.
Paediatric population
The safety and efficacy in children (newborn to 18 years of age) with HE have not been established. No data are available.
Elderly patients and patients with renal or hepatic insufficiency
No special dosage recommendations exist, since systemic exposure to lactulose is negligible.