Duphalac

Duphalac (lactulose) is a first-line osmotic laxative prescribed for the management of chronic constipation. It works by drawing water into the bowel, softening the stool and stimulating natural peristalsis for predictable and gentle relief. Its primary active ingredient, lactulose, is a synthetic disaccharide that is not absorbed in the small intestine, making it a non-systemic treatment option. Clinically proven and trusted for decades, Duphalac offers a reliable solution for restoring regular bowel function and improving patient quality of life.

Features

• Active Ingredient: Lactulose
• Drug Class: Osmotic laxative
• Presentation: Oral solution or syrup
• Mechanism of Action: Non-absorbable disaccharide fermented by colonic bacteria into organic acids
• Onset of Action: May take 24-48 hours for full effect
• Prescription Status: Available both by prescription and over-the-counter in various regions

Benefits

• Provides predictable and gentle relief from constipation without causing harsh cramping.
• Works locally in the colon with minimal systemic absorption, offering a favorable safety profile.
• Helps restore and maintain the colon’s natural rhythm with regular use.
• Softens stool, making defecation easier and reducing strain, which is particularly beneficial for patients with hemorrhoids or anal fissures.
• Can be used for long-term management of chronic constipation under medical supervision.
• The syrup formulation allows for easy dose titration to achieve the desired clinical effect.

Common use

Duphalac is primarily indicated for the treatment of chronic constipation in adults, adolescents, and children. It is especially useful in patient populations where stool softening and easy passage are critical, such as in post-operative patients, the elderly, and those with certain neurological conditions. It is also used in hepatic encephalopathy to reduce blood ammonia levels by acidifying colonic contents and promoting the excretion of nitrogenous waste.

Dosage and direction

Dosage must be individualized based on patient response. It is typically administered orally, once daily, preferably at the same time each day (e.g., with breakfast).

• Adults and Adolescents: The usual starting dose is 15-30 ml (10-20 g of lactulose) daily. The dose may be adjusted to produce 1-2 soft stools per day. Maintenance doses typically range from 10-45 ml daily.
• Children: For children over 14 years, adult doses can be used. For children 7-14 years, 15 ml daily is recommended. For children 1-6 years, 5-10 ml daily is recommended. For infants under 1 year, 5 ml daily is recommended. Dosing for children should be under direct medical supervision.
• Administration: Can be taken undiluted or diluted in water, juice, or milk. Use the measuring cup or spoon provided for accuracy. Adequate fluid intake is recommended during treatment.

Precautions

• A diagnostic evaluation should be performed to rule out organic disorders before initiating treatment for chronic constipation.
• Use with caution in patients with diabetes mellitus, as the syrup contains galactose and lactose.
• Electrolyte levels should be monitored during prolonged use, especially in debilitated patients.
• If abdominal pain, nausea, or vomiting occurs, discontinue use and consult a physician to rule out intestinal obstruction.
• Patients with lactose intolerance should be cautious, as the product contains lactose.

Contraindications

Duphalac is contraindicated in patients with:

• Known hypersensitivity to lactulose or any of the excipients.
• Galactosemia.
• Conditions where a reduction in gut motility is dangerous, such as intestinal obstruction, acute inflammatory bowel disease, or undiagnosed abdominal pain.

Possible side effect

Most side effects are dose-dependent and often subside with continued use or dose adjustment.

• Very Common (≥1/10): Flatulence, abdominal distension, and discomfort.
• Common (≥1/100 to <1/10): Nausea, vomiting, diarrhea, and abdominal cramps.
• Uncommon (≥1/1,000 to <1/100): Electrolyte imbalance due to diarrhea.
• Excessive diarrhea can lead to hypokalemia and hypernatremia.

Drug interaction

• Antacids: Concomitant use with non-absorbable antacids may reduce the desired acidifying effect of Duphalac in the colon.
• Other Laxatives: The use of other laxatives concurrently may potentiate the effect and increase the risk of diarrhea and electrolyte imbalance.
• Oral Medications: Due to potential accelerated transit time, the absorption of other orally administered drugs may be affected. It is advised to take other medications at least 2 hours apart from Duphalac.

Missed dose

If a dose is missed, it should be taken as soon as remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped. Do not double the dose to make up for a missed one.

Overdose

Symptoms of overdose are primarily those of excessive diarrhea and abdominal cramping, which can lead to dehydration and electrolyte disturbances (hypokalemia, hypernatremia). Treatment is supportive and includes discontinuation of the drug, correction of fluid and electrolyte imbalances, and symptomatic relief.

Storage

• Store below 25°C (77°F). Do not freeze.
• Keep the bottle tightly closed to protect from light and moisture.
• Keep out of the sight and reach of children.
• Do not use after the expiration date printed on the packaging.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any new treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here.

Reviews

“After years of struggling with irregularity and trying various stimulant laxatives that caused significant cramping, my gastroenterologist recommended Duphalac. The initial adjustment period involved some bloating, but after a week, my system regulated itself. I now have a predictable, gentle bowel movement every morning without any pain. It has significantly improved my daily comfort.” – Maria K., 58

“As a pediatrician, I frequently recommend Duphalac for children with functional constipation. Its safety profile and gentle action make it an excellent first-choice treatment. The ability to titrate the dose precisely with the syrup formulation is a major advantage in pediatric care.” – Dr. A. Evans, MD

“Prescribed post-surgery, I was concerned about straining. Duphalac worked effectively within two days, producing a soft stool that was easy to pass without any pressure on my incision site. It was a crucial part of my comfortable recovery.” – James L., 45