Lactulose (Duphalac)

Indication/s

• Constipation: regulation of the physiological rhythm of the colon
• Where a soft stool is considered of medical benefit (hemorrhoids, post colonic/anal surgery)
• Hepatic Encephalopathy (HE): treatment and prevention of hepatic coma or precoma (adults)
• For bowel cleansing in preparation for colonoscopy (adults)
• As a prebiotic, helps create and maintain a healthy intestinal balance and stimulates intestinal absorption of minerals like calcium and magnesium (adults)

Contraindication/s

• Hypersensitivity to the active substance or ingredients
• Galactosemia
• Gastrointestinal obstruction, digestive perforation, or risk thereof
• Should not be used for bowel cleansing in unconscious patients or those with aspiration risk, severe dehydration, or swallowing issues

Storage Condition

Store at temperatures not exceeding 25°C. Protect from light.

Dosage and Administration

Adults and Adolescents (≥14 years):

• Starting dose: 15–45 mL per day
• Maintenance dose: 15–30 mL per day

Children (7–14 years):

• Starting dose: 15 mL per day
• Maintenance dose: 10–15 mL per day

Children (1–6 years):

• Usual dose: 5–10 mL per day

Infants (<1 year):

• Usual dose: Up to 5 mL per day

Special Instructions

• Administer with care to lactose-intolerant patients
• Usual constipation doses are safe for diabetics; HE doses may need caution
• Chronic misuse can cause diarrhea and electrolyte imbalance
• Contains lactose, galactose, and fructose — avoid in hereditary intolerance cases
• Refer to the patient leaflet for complete prescribing information

Mechanism of Action

• Draws water into the colon to soften stool and promote bowel movement
• Reduces blood ammonia by converting NH₃ to NH₄⁺ in the colon
• Metabolized by gut bacteria into SCFAs to lower pH and enhance laxative effect