Actilax Solution 500ml (Lactulose)
Actilax Solution 500ml (Lactulose)
ACTILAX oral liquid is a clear, viscous liquid, colourless or pale brownish-yellow, which is miscible with water.
- Treatment of acute, and prevention and treatment of chronic Portal-Systemic Encephalopathy (PSE),
including the stages of hepatic precoma and coma. - Treatment of chronic and habitual constipation.
- Controlled clinical studies in patients with a history of chronic constipation have shown that lactulose therapy causes a significant increase in the number of bowel movements per day and the number of days on which bowel movements occur.
AUST R 43582
You can buy Actilax Solution 500ml (Lactulose) online in Australia from Chemist Direct
The lactulose solution may be administered diluted or undiluted. The dose should be titrated according to the clinical response. A single dose of lactulose should be swallowed in one and should not be kept in the mouth for an extended period of time.
Portal-Systemic Encephalopathy:
The safety and efficacy of lactulose use in children (newborn to 18 years of age) with PSE have not been established. No data are available.
Dosing in PSE (for adults only): The usual dosage is 30 to 45 mL three or four times daily. The dosage may be adjusted every day or two to produce two or three soft stools daily. Hourly doses of 30 to 45 mL of ACTILAX solution may be used to induce the rapid laxation indicated in the
initial phase of the therapy of PSE. When the laxative effect has been achieved, the dose of ACTILAX may then be reduced to the recommended daily dose. Improvement in the patient's condition may take 24 to 48 hours to occur. Continuous long-term therapy is indicated to lessen the severity and prevent the recurrence of PSE. The dose of ACTILAX for this purpose is the same as the recommended daily dose.
In the treatment of acute episodes of PSE, a rapid response is desirable. In such cases it is important to avoid underdosage, and 50 mL every 1 to 2 hours can be given if necessary until two loose bowel actions have occurred. Thereafter, doses may be reduced to usual doses (30 mL four times daily).
The administration of lactulose by retention enema is an alternative technique. This can be prepared by diluting lactulose solution, and is of considerable value especially in the unconscious patient. In such cases 300 mL of ACTILAX may be mixed with 700 mL of water or normal saline to be used as a retention enema; the enema is to be retained for 30 to 60 minutes, and repeated every 4 to 6 hours until the patient is able to take oral medication.
Chronic constipation:
Dosage is individualised and depends somewhat on the severity of the constipation.
In case of single daily dose, this should be taken at the same time, e.g. during breakfast.
Adults. The usual initial dose is 15 to 30 mL daily. The dose may be increased to 45 mL daily if necessary.
Since ACTILAX solution relieves constipation by producing a physiological change in the colon, it may take from 24 to 48 hours before normal defaecation occurs. After three days, the dose may be reduced to 10 to 25 mL daily for maintenance. More serious constipation and/or constipation such as that caused by chemotherapy agents may require higher dosages.
Children. It is recommended that if ACTILAX is given to infants and children, this should be done under medical supervision. The usual initial daily doses (for the first three days) are as follows:
7 to 14 years: 15 mL
1 to 6 years: 10 mL
Infants under 1 year: 5 mL
Maintenance daily doses are as follows:
7 to 14 years: 10 mL
1 to 6 years: 5 to 10 mL
Infants under 1 year: 3 to 5 mL
ACTILAX solution may be more acceptable when mixed with fruit juice, water or milk. When experiencing constipation patients should be advised to drink plenty of water, and increase the fibre content in their diet.
Lactulose solution is an aqueous solution of lactulose (4-O--D-galacto-pyranosyl-D-fructose) and other sugars including lactose, galactose, tagatose and epilactose.
Each 5 mL contains lactulose 3.3 g, and lesser amounts of other sugars including lactose, galactose, tagatose and epilactose.
Excipients with known effect: galactose, lactose, sugars and traces of sulfites.
Painful abdominal symptoms of undetermined cause should be evaluated to exclude undiagnosed perforation or obstruction or undiagnosed disease/condition that predisposes to either before the treatment is started.
In case of insufficient therapeutic effect after several days, consultation of a physician is recommended since the dose and/or additional measures should be reconsidered.
A theoretical hazard may exist for patients treated with lactulose solution who may be required to undergo electrocautery procedures during proctoscopy or colonoscopy. If sugars reach the colon and bacterial breakdown causes hydrogen production, accumulation of hydrogen gas in significant concentration in the presence of an electrical spark may result in an explosive reaction. Although this complication has not been reported with lactulose, patients on lactulose therapy undergoing such procedures should have a thorough bowel cleansing with non-fermentable solution.
ACTILAX solution contains galactose and lactose and it should be used with caution in diabetics as blood glucose levels may be elevated, usually after extended use.
Patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucosegalactose malabsorption should not take this medicine.
If used by lactose intolerant patients, the lactose content in the recommended dose should be taken into consideration.
Chronic misuse of laxatives may result in electrolyte imbalance, in particular serum potassium levels may be decreased. Elderly debilitated patients who receive ACTILAX solution for more than 6 months should have serum electrolytes measured periodically.
When administered as a retention enema, due to strong cathartic effect, faecal incontinence, bed soiling, and peri-anal irritation due to the acidic stool can be expected. The hydration status of the patient should be observed carefully.
The defaecation reflex may be altered during the treatment with lactulose (see Section 5 PHARMACOLOGICAL PROPERTIES). This alteration is considered to improve bowel habits during constipation and can be seen as a normalization of stool frequency.
In the overall management of portal-systemic encephalopathy, it should be recognised that there is a preexisting liver disease and efforts should be made to identify and treat the precipitating cause of hepatic coma. Thus, the overall management of hepatic encephalopathy should include dietary protein restriction, bowel cleansing and sterilisation, correction of electrolyte and fluid imbalance, provision of caloric and nutritional needs and treatment of underlying liver disease.
It is recommended that if ACTILAX solution is given to infants and children, this should be done under medical supervision.
