Laevolac Lactulose Solution

Laevolac general information

What is Laevolac used for?

Laevolac solution is an oral liquid used to treat chronic constipation and acts as a laxative to soften stools, making them easy to pass.  Laevolac solution is also used for conditions where a soft stool is important to prevent discomfort of pain, such as haemorrhoids or post colonic/anal surgery.  It usually takes two to three days to be effective and relieve the blockage caused by constipation.  Laevolac solution is also used to treat hepatic encephalopathy (portal systemic encephalopathy), which is a condition caused by failure of the liver to remove toxins from the blood and results in serious symptoms including, confusion and coma.  Toxic substances that are normally removed by the liver accumulate in the blood, cross the blood/brain barrier and can cause impaired brain function, which can be fatal.  Laevolac solution uses the same mechanism of action to relieve constipation and to remove toxic substances from the blood to prevent and treat hepatic encephalopathy.   

How does Laevolac work?

Laevolac solution is an oral liquid that contains lactulose, which is a synthetic disaccharide (complex sugar molecule) and is used as an osmotic laxative to treat constipation.  Lactulose in Laevolac solution passes through the intestines unchanged until it reaches the colon (large intestine), where it is broken down by a particular bacteria that metabolises sugars (sacchrolytic bacteria).  The products of this bacterial metabolism are smaller molecules like organic acids, mainly lactic acid, which makes the contents of the colon more acidic and changes the osmotic pressure in the colon, so that water is drawn into the colon by osmosis.  The increase in water content of the stools makes them softer and this increases the peristaltic activity of the colon, making the stools easier to pass.  Hepatic encephalopathy a complication of liver disease is usually caused by a build up of substances like ammonia to levels that are toxic to the brain.  Ammonia is a by-product of protein metabolism by bacteria in the intestines and is usually eliminated by the liver.  As Lactulose in Laevolac solution is metabolised, the acidity of the colon is increased, which supports the growth of bacteria that causes ammonia to be retained, and the trapped excess ammonia is excreted in the stools, which is helped by the laxative effect of lactulose.  This results in a synergistic mechanism to remove ammonia, since the stools are not so readily available to the ammonia producing bacteria.  These actions of Lactulose in Laevolac solution help to prevent the build-up of ammonia, thereby reducing the amount of ammonia that enters the blood, which relieves symptoms of hepatic encephalopathy. 

What does Laevolac contain?

Laevolac solution contains the active ingredient lactulose (3.35mg/5ml), an osmotic laxative, in a clear syrup that is used to treat constipation and also treat and prevent hepatic encephalopathy.  It also contains lactose and galactose. 

Treating constipation with Laevolac

Laevolac solution is an oral liquid that contains lactulose, an osmotic laxative used to treat chronic constipation.  Lactulose in Laevolac solution passes through the intestines unchanged until it reaches the colon (large intestine), where it is broken down by a particular bacteria that metabolises sugars (sacchrolytic bacteria) and this produces smaller molecules like organic acids, mainly lactic acid.  Metabolism of lactulose makes the contents of the colon more acidic and changes the osmotic pressure in the colon, so that water is drawn into the colon by osmosis.  This increases the water content of the stools and makes them softer, which increases the peristaltic activity of the colon, making the stools easier to pass.  It usually takes two to three days to be effective and relieve the blockage caused by constipation.  

Laevolac for hepatic encephalopathy

Laevolac solution is an oral liquid containing lactulose, an osmotic laxative that is also used to treat hepatic (portal-systemic) encephalopathy, a complication of liver disease that is usually caused by a build up of substances like ammonia to levels that are toxic to the brain.  Ammonia is a by-product of protein metabolism by bacteria in the intestines and is usually eliminated by the liver.  As a result of liver failure ammonia is not eliminated and serious symptoms of ammonia toxicity include confusion and coma, which can be fatal.  Lactulose in Laevolac solution passes through the intestines unchanged until it reaches the colon (large intestine), where it is broken down by a particular bacteria that metabolises sugars (sacchrolytic bacteria) and this produces smaller molecules like organic acids, mainly lactic acid, which makes the contents of the colon more acidic.  Ammonia is retained in the colon and the trapped excess ammonia is excreted in the stools.  This action helps to prevent the build-up of ammonia, thereby reducing the amount of ammonia that enters the blood, which relieves symptoms of hepatic encephalopathy. 

What are the side effects of Laevolac?

The most commonly reported side effects when taking Laevolac solution include: abdominal discomfort or pain, flatulence (build up of wind), abdominal cramps, nausea, vomiting, diarrhoea.

When should Laevolac not be used?

You should not use Laevolac solution if you:

• are allergic to lactulose or any ingredients in Laevolac
• have galactosaemia a metabolic disorder caused by to inability to metabolise galactose in the diet
• have disaccharide deficiency
• are on a low galactose diets or a galactose and/or lactose free diet
• have any form of bowel obstruction other than constipation
• have kidney or liver disease
• are taking medicines that interact with Laevolac, including the antibiotic neomycin

How should Laevolac be taken?

You should take your Laevolac solution as a single dose for relief of constipation, usually after breakfast.  The amount you take depends on your condition and should be as recommended by your doctor.  Once your constipation has been relieved your dose may be reduced.  For treatment of hepatic encephalopathy you should take your Laevolac solution with or without food, 3-4 times daily, or as recommended by your doctor, and your dose may be reduced.  If you require a rapid laxative effect for treatment of hepatic encephalopathy your doctor may suggest hourly dosing initially, then reduced to 3-4 times daily.  You should continue to take your Laevolac solution for as long as recommended by your doctor, which may be for long-term treatment. 

How long should you take Laevolac?

You should continue to take your Laevolac solution for as long as recommended by your doctor, which may be for long-term treatment.   

Missed dose of Laevolac

If you miss a dose of Laevolac solution take it as soon as you remember, unless it is time to take the next dose, then skip the missed dose.  Do not take a double dose.

How should Laevolac be stored?

You should store your Laevolac solution above 25°C do not refrigerate or freeze.