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Components:
Lactulose
Method of action:
Detoxifying, Hypoazotemic, Laxative, Ph-Lowering Of Intestinal Contents, Stimulating Peristalsis Of The Intestine
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Medically reviewed by Fedorchenko Olga Valeryevna, Pharmacy-Provisor. Last updated on 2019.12.15

Name of the medicinal product

Lacson

Qualitative and quantitative composition

Lactulose

Therapeutic indications

The information provided in Therapeutic indications of Lacson is based on data of another medicine with exactly the same composition as the Lacson of the medicine (Lactulose). Be careful and be sure to specify the information on the section Therapeutic indications in the instructions to the drug Lacson directly from the package or from the pharmacist at the pharmacy.
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- Symptomatic treatment of constipation

Laevolac is indicated in adults and in children and adolescents aged 7 to 18 years. For children below 7 years, other dosage forms are available.

Dosage (Posology) and method of administration

The information provided in Dosage (Posology) and method of administration of Lacson is based on data of another medicine with exactly the same composition as the Lacson of the medicine (Lactulose). Be careful and be sure to specify the information on the section Dosage (Posology) and method of administration in the instructions to the drug Lacson directly from the package or from the pharmacist at the pharmacy.
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Posology

Laevolac may be administered diluted or undiluted. The dose should be titrated according to the clinical response. Lacson may be given as a single daily dose or in two to three divided doses.

A single dose of Lacson 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. The starting dose can be adjusted after adequate treatment effect individually (maintenance dose). Several days (2-3 days) of treatment may be needed in some patients before adequate treatment effect occurs. In case of single daily dose, this should be taken at the same time of the day, e.g. during breakfast. During the therapy with laxatives it is recommended to drink sufficient amounts of fluids (1.5-2 l/day, equal to 6-8 glasses).

If diarrhoea occurs, the dosing regimen should be reduced.

The duration of treatment has to be adopted according to the symptoms.

Starting dose

Maintenance dose

Adults

15-45 ml daily

1-3 sachets, corresponding to 10-30 g Lacson

15-30 ml daily

1-2 sachets, corresponding to 10-20 g Lacson

Older people

In elderly patients no special dosage recommendations exist.

Patients with renal or hepatic impairment

In patients with renal or hepatic insufficiency no special dosage recommendations exist.

Paediatric population

Starting dose

Maintenance dose

Adolescents over 14 years

15-45 ml daily

1-3 sachets, corresponding to 10-30 g Lacson

15-30 ml daily

1-2 sachets, corresponding to 10-20 g Lacson

Children

(7-14 years)

15 ml daily

1 sachet, corresponding to 10 g Lacson

15 ml daily

1 sachet, corresponding to 10 g Lacson

For a precise dosing for infants, toddlers and children up to 6 years, Lacson is available in bottles.

Method of administration

Oral use.

Contraindications

The information provided in Contraindications of Lacson is based on data of another medicine with exactly the same composition as the Lacson of the medicine (Lactulose). Be careful and be sure to specify the information on the section Contraindications in the instructions to the drug Lacson directly from the package or from the pharmacist at the pharmacy.
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- Use in patients with galactosaemia.

- Acute inflammatory bowel disease (ulcerative colitis, Crohn's disease), gastrointestinal obstruction or subocclusive syndromes, digestive perforation or risk of digestive perforation, painful abdominal syndromes of undetermined cause.

Special warnings and precautions for use

The information provided in Special warnings and precautions for use of Lacson is based on data of another medicine with exactly the same composition as the Lacson of the medicine (Lactulose). Be careful and be sure to specify the information on the section Special warnings and precautions for use in the instructions to the drug Lacson directly from the package or from the pharmacist at the pharmacy.
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In case of insufficient therapeutic effect after several days consultation of a physician is advised.

From the route of synthesis Laevolac may contain small amounts of sugars

(Not more than 67 mg/ml lactose, 100 mg/ml galactose, 67 mg/ml epilactose, 27 mg/ml tagatose and 7 mg/ml fructose).

Patients with rare hereditary problems of galactose or fructose intolerance, the Lapp lactase deficiency or glucose-galactose mal-absorption should not take this medicine.

Lacson should be administered with care to patients who are intolerant to lactose.

Lacson may contain more than 5 g lactose/galactose/epilactose depending upon the dose taken. This should be taken into account in patients with diabetes mellitus.15 ml of Lacson contain 42.7 KJ (10.2 kcals) = 0.21 BU.

For patients with gastro-cardiac syndrome (Roemheld syndrome) Lacson should only be taken after consultation of a physician. If symptoms like meteorism or bloating occur in such patients after Lacson intake, the dose should be reduced or the treatment should be discontinued.

Chronic use of unadjusted doses and misuse can lead to diarrhoea and disturbance of the electrolyte balance.

For elderly patients or patients that are in bad general condition and take Lacson for a more than 6 months period, periodic control of electrolytes is indicated.

During the therapy with laxatives it is recommended to drink sufficient amounts of fluids (1.5-2 l/day, equal to 6-8 glasses).

Paediatric population

Use of laxatives in children should be exceptional and under medical supervision.

Lacson should be administrated with caution in infants and small children with autosomal recessive hereditary fructose intolerance.

The defecation reflex may be altered during the treatment with Lacson.

Effects on ability to drive and use machines

The information provided in Effects on ability to drive and use machines of Lacson is based on data of another medicine with exactly the same composition as the Lacson of the medicine (Lactulose). Be careful and be sure to specify the information on the section Effects on ability to drive and use machines in the instructions to the drug Lacson directly from the package or from the pharmacist at the pharmacy.
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Laevolac has no or negligible influence on the ability to drive and use machines.

Undesirable effects

The information provided in Undesirable effects of Lacson is based on data of another medicine with exactly the same composition as the Lacson of the medicine (Lactulose). Be careful and be sure to specify the information on the section Undesirable effects in the instructions to the drug Lacson directly from the package or from the pharmacist at the pharmacy.
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Very common

> 1/10

Common

>1/100 to < 1/10

Uncommon

>1/1,000 to <1/100

Rare

>1/10,000 to < 1/1,000

Very rare

< 1/10,000

Not known

cannot be estimated from the available data

Flatulence may occur during the first few days of treatment. As a rule it disappears after a couple of days. When dosages higher than instructed are used, abdominal pain and diarrhoea may occur. In such a case the dosage should be decreased.

Gastrointestinal disorders

Very common (> 1/10):

Flatulence, abdominal pain,

Common (> 1/100 < 1/10):

Nausea and vomiting; if dosed too high, diarrhoea (sometimes including electrolyte imbalance).

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard.

Overdose

The information provided in Overdose of Lacson is based on data of another medicine with exactly the same composition as the Lacson of the medicine (Lactulose). Be careful and be sure to specify the information on the section Overdose in the instructions to the drug Lacson directly from the package or from the pharmacist at the pharmacy.
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Symptoms:

If the dose is too high, the following may occur: diarrhoea and abdominal pain.

Management: cessation of treatment or dose reduction. Extensive fluid loss by diarrhoea or vomiting may require correction of electrolyte disturbances.

Pharmacodynamic properties

The information provided in Pharmacodynamic properties of Lacson is based on data of another medicine with exactly the same composition as the Lacson of the medicine (Lactulose). Be careful and be sure to specify the information on the section Pharmacodynamic properties in the instructions to the drug Lacson directly from the package or from the pharmacist at the pharmacy.
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Pharmacotherapeutic group: Drugs for constipation. Osmotically acting laxatives.

ATC code: A06A D11

Lacson is a synthetic disaccharide formed from D-galactose and fructose. Lacson as a prebiotic substance strengthens the growth of bifidobacteria and lactobacilli, whereas Clostridium and Escherichia coli may be suppressed.

In the colon Lacson is metabolised by bacterial enzymes to short chain fatty acids mainly lactic and acetic acid as well as methane and hydrogen. This effect leads to a decrease of the pH-value and an increase of the osmotic pressure in the colon. This causes stimulation of peristalsis and an increase of the water content of the faeces.

Pharmacokinetic properties

The information provided in Pharmacokinetic properties of Lacson is based on data of another medicine with exactly the same composition as the Lacson of the medicine (Lactulose). Be careful and be sure to specify the information on the section Pharmacokinetic properties in the instructions to the drug Lacson directly from the package or from the pharmacist at the pharmacy.
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Lacson is practically not absorbed, because in man there is no corresponding disaccharidase available in the upper intestinal tract. Not being absorbed as such, it reaches the colon unchanged. There it is metabolised by the colonic bacterial flora. Metabolism is complete at doses up to 25-50 g or 40-75 ml; at higher dosages, a proportion may be excreted unchanged.

Pharmacotherapeutic group

The information provided in Pharmacotherapeutic group of Lacson is based on data of another medicine with exactly the same composition as the Lacson of the medicine (Lactulose). Be careful and be sure to specify the information on the section Pharmacotherapeutic group in the instructions to the drug Lacson directly from the package or from the pharmacist at the pharmacy.
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Drugs for constipation. Osmotically acting laxatives.

Preclinical safety data

The information provided in Preclinical safety data of Lacson is based on data of another medicine with exactly the same composition as the Lacson of the medicine (Lactulose). Be careful and be sure to specify the information on the section Preclinical safety data in the instructions to the drug Lacson directly from the package or from the pharmacist at the pharmacy.
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Preclinical data based on studies of single and repeated dose toxicity reveal no special hazards for humans. A long-term animal study does not give reference to tumorigenic potential. Lacson was not teratogenic in mice, rats and rabbits. After oral administration systemic toxicity is not to be expected due to the pharmacological and pharmacokinetic properties of Lacson.

Incompatibilities

The information provided in Incompatibilities of Lacson is based on data of another medicine with exactly the same composition as the Lacson of the medicine (Lactulose). Be careful and be sure to specify the information on the section Incompatibilities in the instructions to the drug Lacson directly from the package or from the pharmacist at the pharmacy.
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Not applicable.

Special precautions for disposal and other handling

The information provided in Special precautions for disposal and other handling of Lacson is based on data of another medicine with exactly the same composition as the Lacson of the medicine (Lactulose). Be careful and be sure to specify the information on the section Special precautions for disposal and other handling in the instructions to the drug Lacson directly from the package or from the pharmacist at the pharmacy.
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No special requirements.

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