Portalac, syrup 250 ml

Portalac is a hypoazotemic, stimulating intestinal peristalsis laxative.

Pharmacodynamics

It has hyperosmotic, laxative effect, stimulates intestinal peristalsis, improves absorption of phosphates and Ca2+ salts, promotes excretion of ammonium ions.

Lactulose causes multiplication of Lactobacillus acidophilus, Lactobacillus bifidus in the intestine, which in its turn lowers pH in the lumen of the large intestine and activates its peristalsis. At the same time, the volume increases and softening of stools occurs. The drug has a laxative effect without affecting directly the mucosa and smooth muscles of the large intestine.

Lactulose decreases formation of nitrogen-containing toxic substances in the proximal colon and their absorption into the systemic blood flow.

The concentration of ammonium ions in the blood is reduced by 25-50%; it reduces the severity of hepatic encephalopathy, improves mental state and normalizes the EEG.

The drug has the ability to inhibit the growth of Salmonella in the large intestine.

The action of the drug occurs 24-48 hours after oral administration as the drug passes through the gastrointestinal tract.

Pharmacokinetics

Lactulose is practically not absorbed from the gastrointestinal tract (absorption is less than 3% of the dose taken), it does not reduce absorption of vitamins and is not addictive.

Indications

Active ingredient

Composition

100 ml of the syrup contains:

The active ingredient:

Lactulose concentrate66.7 g;

Auxiliary substances:

Purified water.

How to take, the dosage

Portalac is taken orally, in the morning during or after a meal, once or divided into 2 doses, with water or other liquids. The dose of Portalac is adjusted individually. The starting dose (3 days) is:

Children under 1 year, 5 ml (1 tsp.);

Children 1 to 6 years old, 5-10 ml (1-2 tsp.

Children from 6 to 14 years old take 15 ml (1 tablespoon);

Adults take 15-45 ml.

Interaction

When using therapeutic doses of lactulose, no clinically reliable interaction with other medicinal products has been observed. However, it is not recommended to take Portalac® within 2 hours after taking another drug.

In concomitant administration lactulose may interfere with the action of the drugs which have an unfavorable environment for release in the large intestine (e.g., drugs containing mesalazine).

Antibiotics (neomycin) and antacids reduce the effect.

Special Instructions

If constipation does not resolve within a few days of taking the drug, and if constipation resumes after discontinuation of the drug, a physician should be consulted.

With regard to the presence of small amounts of sugars in the syrup (15 ml syrup contains up to 1.7 g of galactose and up to 1 g of lactose) caution should be exercised when prescribing with patients with diabetes or lactose intolerance.

Patients with gastrocardia syndrome are treated with caution: treatment starts with low doses and increases them gradually to avoid the occurrence of flatulence.

When treating hepatic encephalopathy, especially in the initial phase of therapy, other laxatives should not be used, because increased bowel emptying may lead to the erroneous conclusion that an adequate dose for encephalopathy therapy has been achieved.

The effect on the ability to drive or perform work requiring increased speed of physical and mental reactions. In the recommended doses, the drug has no effect on the ability to drive and operate vehicles and mechanisms.

Contraindications

Cautiously prescribes the drug in patients with gastrocardia syndrome: treatment starts with low doses and increases them gradually to avoid the occurrence of flatulence.

Because of the small amount of sugars in the syrup (15 ml of the syrup contains up to 1.7 g of galactose and up to 1 g of lactose), caution should be exercised when prescribing in patients with diabetes and lactose intolerance.

Side effects

The side effects are usually mild and reversible and are caused by exceeding the dose.

Spasms, abdominal discomfort or pain, and diarrhea may be resolved by lowering the dose. Meteorism, which appears at the beginning of treatment, usually goes away after 1-2 days.

There have been cases of skin reactions (rash).

In case of prolonged therapy and administration of high doses of lactulose during treatment of hepatic encephalopathy disruptions of water-electrolyte balance may occur, and as a consequence, convulsions, nausea, headache, dizziness, arrhythmia, myalgia, increased fatigue and weakness.

Overdose

Pregnancy use

Lactulose can be used safely in pregnant and nursing women.

Similarities