Duphalac 667gm/l syrup 200 ml

Osmotic laxative and ammonium detoxifying agent used in the treatment of constipation and used also in the treatment and prevention of hepatic encephalopathy.

Constipation Adults: 15–30 mL once daily, may be adjusted to 10–45 mL/day Children: Dose adjusted according to age and response Effect usually occurs within 6–12 hours (may take up to 24–48 hours) Hepatic Encephalopathy Adults: 30–45 mL 3–4 times daily Titrate dose to produce 2–3 soft stools per day May be taken with or without food Can be mixed with water, juice, or milk to improve taste

Abdominal cramp Nausea and vomiting Diarrhoea Local irritation if suppository preparation is used Tolerance

Contraindications Hypersensitivity to lactulose Galactosemia Intestinal obstruction Precautions Use cautiously in diabetes mellitus (contains sugars) Avoid prolonged excessive use (risk of electrolyte imbalance) If diarrhea occurs, reduce dose Adequate fluid intake recommended

Laxatives and antidiarrhoeals should be kept in a cool and dry place. Unless specified on the label, medicines should not be stored in refrigerators. Furthermore, drugs should be kept properly in places unreachable by children to prevent accidental ingestion.

Antibiotics (e.g., neomycin) → may reduce lactulose efficacy Antacids → may reduce colonic acidification Other laxatives → increased risk of diarrhea and electrolyte imbalance

Pregnancy: Considered safe Lactation: Safe; not significantly absorbed systemically

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