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Indications - Constipation (Chronic Constipation): In every case of chronic constipation, initial treatment should consist of a diet rich in fiber (vegetables, salads, fruits etc.) a generous amount of liquids and much physical exercise. Lactulose is only to be taken when these measures prove insufficient. Intestinal flora disturbances: In damaged to intestinal flora (e.g. following long-term antibiotic treatment) gall bladder diseases intestinal diseases ( Colitis, Diverticulosis, Megacolon) Increased blood ammonia levels (hyper ammoniemia in hepatopathy, portal-systemic encephalopathy)

Dosage & Administration - In constipation ( chronic constipation): Adults: Initially 3-6 tea-spoons daily, In long-term therapy 1½-6 tea-spoons daily Children up to 14 years: Initially 3 tea-spoons daily, In long-term therapy 1-2 tea-spoons daily Infants and toddlers: Initially 1-2 tea-spoons daily, In long-term therapy 1 tea-spoon daily In damaged intestinal flora: Adults: 1-2 tea-spoons daily Children: 1 tea-spoon daily For reduction of blood ammonia level: Hyper-ammoniemia in hepatopathy: a maximum of 18-30 tea-spoons daily. In portal systemic encephalopathy: hourly doses of 6-9 tea-spoons of Lactulose solution may be used to induce the rapid laxation. When the laxative effect has been achieved, the dose may then be reduced.

Side Effects - Occasionally flatulence, cramp and abdominal discomfort can occur at the beginning of treatment; this is rapidly eliminated by reducing the dose. Overdose can result in diarrhoea. In abuse, loss of electrolytes (primarily potassium).

Contraindications - Hypersensitivity to either galactose and or lactose; galactose-free diet, gastro-cardial symptom complex, suspected intestinal obstruction.

Others - Pregnancy & Lactation US FDA Pregnancy Category of Lactulose is B. Studies show that Lactulose has no adverse effects. Decisions regarding use during pregnancy and lactation must be made by registered physician.