Composition

Each 100 ml contains:

Lactulose ................................................................................ 67 g

Therapeutic Indications

Hyperammonaemia in liver diseases.

Hepatic coma.

Chronic constipation.

Dysbacteria eg. in Salmonella carriers or following antibiotic treatment.

Periodontal disease.

Dosage and Administration

In liver diseases: 2-3 tablespoonfuls three times daily.

In chronic constipation:

Adults:  1-3 tablespoonful daily.

Children:  2-4 teaspoonful daily.

In dysbacteria:

Adults:  1-2 tablespoonful daily.

Children: 2-4 teaspoonful daily.

In Periodontal disease: 

Adults: 1-2 tablespoonful daily.

Children: 2-4 teaspoonfuls daily.

LACTULOSE-HEK must never be taken on an empty stomach, but only after meals.

Contraindications

lleus, galactose intolerance, fructose intolerance.

Undesirable Effects

At the beginning of treatment, flatulence and diarrhoea may occur.

This can be avoided by giving initial small doses and gradually increasing them to produce the desired effect.

Pharmacological Properties

Lactulose-HEK is a synthetic disaccharide.

Taken orally it is not hydrolysed in the small intestine and therefore not absorbed. In the colon it is broken down by microorganismes, chiefly lactobacteria, into low molecular weight organic acids such as lactic acid. This leads to a shift in the pH to the acid region and at the same time alters the balance between toxic absorbable ammonia and the non-toxic bound and non-absorbable ammonium ion, bringing reduction in the pathologically elevated levels of ammonia in blood.

The change in the intestinal milieu promotes the growth of the non-ammonia producing lactobacteria whilst markedly suppressing growth of the ammonia and phenol producing micro-organisms, E. coli and Proteus vulgaris. This effect which on one hand restricts production of toxic break down products in the intestine and on the other hand inhibits their absorption, enables a reliable prophylaxis and treatment of the hyperammonemia seen in those hepatopathies which involve an increased production of ammonia.

Lactulose-HEK provides symptomatic improvement and some normalization of the EEG in about three fourth of patients with portal-systemic encephatopathy associated with chronic liver disease.

Concentrations of ammonia in the blood are reduced by 25%-50%.

Favourable effects are observed in 1-7 days after initiation of therapy.

Chronic medication reduces recurrences and may permit liberalization of protein intake.

The osmotic action of lactulose and the formation of lactic acid act as a very strong physiological stimulus to intestinal motility.

LACTULOSE-HEK is very effective in eradicating the excretion of Salmonella in carriers.

The acidification of the intestinal contents leads to a forced absorption of phosphates and calcium and to the normalization of the metabolism in the region of the Jaws.

Packaging

Lactulose-HEK Syrup:  Bottles of 120 ml and 300 ml each.