Inolac Oral Solution contains Lactulose 3.35 g per 5 ml, a synthetic disaccharide sugar widely used for its osmotic laxative properties. It is primarily indicated for the treatment of constipation and for the management of hepatic encephalopathy, a serious complication of liver disease. Lactulose is not absorbed in the small intestine; instead, it reaches the colon where it is metabolized by colonic bacteria into organic acids, which help soften stools and increase bowel movements.

This solution is designed for oral administration, making it suitable for children, adults, and elderly patients who require a convenient and effective treatment for constipation or ammonia reduction.

রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Therapeutic Class

• Osmotic Laxatives

• Gastrointestinal Agents

Pharmacology / Mode of Action

Lactulose is a non-absorbable sugar. Its primary actions include:

1. Osmotic Laxative Effect:

   • Lactulose increases water content in the colon, softening the stool and stimulating bowel movements.

   • This action helps relieve chronic constipation and prevents straining during defecation.

2. Reduction of Ammonia Levels (Hepatic Encephalopathy):

   • In the colon, lactulose is metabolized into lactic acid and acetic acid by bacteria.

   • These acids acidify the colonic contents, converting ammonia (NH₃) into ammonium ions (NH₄⁺), which are not absorbed into the bloodstream.

   • This reduces systemic ammonia levels, improving symptoms such as confusion, lethargy, and cognitive impairment associated with liver failure.

Indications

1. Constipation:

   • Chronic or occasional constipation in adults and children.

   • Useful in patients where stool softening and safe bowel evacuation are required.

2. Hepatic Encephalopathy:

   • Adjunct therapy to reduce hyperammonemia in patients with liver disease.

   • Helps prevent recurrent episodes of hepatic encephalopathy.

3. Other Uses:

   • May be used pre- or post-operatively to prevent straining in certain conditions.

   • Pediatric constipation under medical supervision.

Dosage & Administration

Constipation:

• Adults: 15–30 ml once daily initially, may be adjusted to achieve 1–2 soft stools per day.

• Children: 5–15 ml daily, adjusted according to age and response.

Hepatic Encephalopathy:

• Adults: 30–45 ml 2–4 times daily, titrated to produce 2–3 soft bowel movements per day.

• Pediatric dosing varies by age and clinical condition, under physician supervision.

Administration Notes:

• Can be taken with water, milk, or juice to improve taste.

• Effects usually appear within 24–48 hours for constipation relief.

Interactions

• Lactulose may affect absorption of certain antibiotics or mineral supplements if taken simultaneously.

• Use with caution in patients on diuretics due to potential electrolyte changes.

  রেজিস্টার্ড চিকিৎসকের পরামর্শ অনুযায়ী ঔষধ সেবন করুন

Contraindications

• Known hypersensitivity to lactulose or any component of the solution.

• Galactosemia (due to metabolism to galactose).

• Intestinal obstruction or acute surgical abdomen.

Side Effects

• Gastrointestinal: bloating, flatulence, abdominal cramps, diarrhea.

• Rare: electrolyte imbalance if overused, especially in elderly patients.

Precautions & Warnings

• Monitor electrolytes in patients receiving prolonged therapy.

• Adjust dose gradually to avoid excessive diarrhea.

• Use with caution in diabetic patients, as lactulose contains sugar.

• Not suitable for patients with galactose intolerance.

Pregnancy & Lactation

• Generally considered safe in pregnancy, as it is minimally absorbed.

• Compatible with breastfeeding.

Storage

• Store in a cool, dry place below 25°C, protected from light.

• Keep out of reach of children.

• Shake well before use.