Lactulose is a synthetic derivative of lactose. does not disintegrate in the stomach and small intestine due to the lack of appropriate enzymes and is practically not absorbed. in the large intestine, lactulose is split under the action of microflora into low molecular weight organic acids, as a result of which ph decreases and osmotic changes occur, which stimulate intestinal motility. the volume of feces also increases and their consistency normalizes, which contributes to the process of physiological defecation.
Due to the stimulation of the growth of bifidobacteria, the growth of pathological intestinal microflora is inhibited and, as a result, intoxication with the products of their metabolism is reduced. As a result, the preparation exhibits a laxative effect and normalizes bowel function.
In hepatic encephalopathy or hepatic coma (precoma), the effect of the preparation is achieved through the following mechanisms of action:
Normolact has the ability to inhibit the growth of Salmonella in the large intestine. Does not reduce the absorption of vitamins and does not cause addiction (weakening or lack of effect with prolonged or repeated use).
The preparation is practically not absorbed in the intestine and at a dose of 40–75 ml is completely metabolized by the bacterial flora. When used in higher doses, some of the lactulose may be excreted unchanged.
Constipation (including chronic); intestinal dysbiosis; intoxication of various origins; hypercholesterolemia; hepatic encephalopathy; liver failure; hepatic precoma and coma; cirrhosis of the liver with a tendency to hyperammonemia.
It is also prescribed for the syndrome of putrefactive dyspepsia in young children, pain syndrome after removal of hemorrhoids; for softening feces with hemorrhoids, if necessary, surgical intervention on the colon / anus.
It is taken internally. the dose is set individually depending on the patient's condition. treatment should be started with the maximum dose, which is reduced after 2-3 days or after the desired effect is achieved. if there is no effect within 2-3 days, the initial dose may be increased.
Recommended doses *
Age group | Initial daily dose | Maintenance daily dose |
| ml | ml | |
| Adults and children over 14 years old | 15–45 | 10-25 |
| Children 7-14 years old | fifteen | 5-10 |
| Children from 1 to 7 years old | 5-10 | 5-10 |
| Children under 1 year old | 2.5-5 | 2.5-5 |
* For children under 1 year old, the preparation is measured in accordance with the scale indicated on the supplied dosing device. For children over the age of 1 year and adults, for ease of use, the preparation can be dispensed with teaspoons (5 ml), dessert (10 ml), tablespoons (15 ml) spoons.
The entire daily dose is best taken in one dose in the morning with breakfast. Mixing with fruit and vegetable juices or food mixtures is possible. The effect can be observed after 1-2 days, which is due to the action of lactulose.
In hepatic encephalopathy, hepatic coma and precoma, the preparation is prescribed in an initial dose of 30-50 ml 3 times a day (90-150 ml / day). The maintenance dose is set depending on the individual response (you should achieve 2-3 soft bowel movements per day). The dose is set individually and only by a doctor.
Hypersensitivity to the preparation; galactosemia; intestinal obstruction.
Normolact is usually well tolerated, but sometimes during treatment (most often at the beginning): flatulence; nausea; diarrhea; headache; dizziness; increased fatigue; weakness; with long-term treatment in high doses - violation of water and electrolyte metabolism; very rarely - myalgia and arrhythmia.
Do not use the preparation for abdominal pain, nausea and vomiting. with the onset of diarrhea, treatment is discontinued.
It should be used with caution in patients with diabetes mellitus. With gastrocardiac syndrome, the dose should be increased gradually to avoid flatulence. With long-term treatment (6 months), the level of electrolytes in the blood plasma should be regularly monitored, especially in elderly and debilitated patients. Patients with lactase deficiency when using the preparation should monitor sugar intake.
Use during pregnancy and lactation. It is possible to use Normolact during pregnancy and lactation.
Children. Normolact is used in children.
The ability to influence the reaction rate when driving and working with other mechanisms. Taking Normolact does not affect the ability to drive vehicles and engage in other potentially hazardous activities that require increased concentration and visual acuity.
When taking normolact with enteric-soluble pH-dependent release preparations, it should be remembered that lactulose lowers the pH of the intestine.
With simultaneous use with broad-spectrum antibiotics or antacids, the therapeutic efficacy of lactulose may decrease.
It is not recommended to take Normolact within 2 hours after taking other medicines.
When taking the preparation in very high doses, abdominal pain and diarrhea may occur.
Treatment: dose reduction or discontinuation of the preparation.
In a dry, dark place at a temperature of 15-25 ° C.
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