Нормолакт

General characteristics. Structure:

Active ingredient: lactulose.
1 ml of drug contains not less than 0,62 g of lactulose. Transparent viscous liquid, colourless or slightly yellowish-brown color. Saturated solution of drug may contain crystals which disappear when heating.

Pharmacological properties:

Lactulose – synthetic derivative lactoses. Does not break up in a stomach and a small intestine due to the lack of the corresponding enzymes and it is practically not soaked up. In a large intestine lactulose is split under the influence of intestinal microflora on low-molecular organic acids owing to what pH decreases and there are osmotic changes which stimulate an intestines peristaltics. Also the volume of fecal masses increases and there is a normalization of their consistence that promotes process of physiological defecation.
Thanks to stimulation of growth of bifidobacteria there is an oppression of growth of pathological intestinal microflora and, as a result, reduction of intoxication products of their metabolism. As a result drug shows laxative effect and normalizes work of intestines.
At hepatic encephalopathy or a hepatic coma (prekoma) the effect of drug is reached at the expense of the following mechanisms of action:
- suppression of proteolytic bacteria;
- increase in quantity of acidophilic bacteria (for example, lactobacilli);
- purgation thanks to a low indicator of pH;
- osmotic effect;
- reduction of nitrogen-containing toxic substances by stimulation of the bacteria connecting ammonia in the course of proteinaceous synthesis;
- fermentation of lactulose in a large intestine under the influence of bacteria leads normoflor to acidulation of contents of intestines that interferes with ammonia absorption by a large intestine;
- in the presence of lactulose of a bacterium of a large intestine do not use amino acid as an energy source that sharply reduces accumulation of toxic products of metabolism of proteins.
     Нормолакт has property to oppress growth of salmonellas in a large intestine. Does not reduce absorption (absorption) of vitamins and does not cause accustoming (easing or lack of effect at prolonged or repeated use).
     Drug is practically not soaked up in intestines and in a dose of 40-75 ml is completely metabolized by a bacterial flora. At use of higher doses a part of lactulose can be removed in an invariable look.

Indications to use:

• Locks (including chronic);
• intestinal dysbiosis;
• intoxications of various genesis;
• hypercholesterolemia;
• hepatic encephalopathy;
• liver failure;
• hepatic prekoma and coma;
• cirrhosis with a tendency to a giperammoniyemiya.
It is appointed also at a syndrome of putrefactive dyspepsia at children of early age, a pain syndrome after removal of hemorrhoidal nodes; for a softening of fecal masses at hemorrhoids, in need of a surgical operative measure on a thick gut / anus.

Route of administration and doses:

Accept inside. The daily dose is established individually depending on a condition of the patient. Treatment should be begun with the highest dose which is reduced in 2-3 days or after achievement of necessary effect. In case of lack of effect within 2-3 days, the initial dose can be increased.
The recommended doses:

Age group	Initial daily dose	The supporting daily dose
	ml	ml
Adults and children are more senior than 14 years	15-45	10-25
Children of 7-14 years	15	5-10
Children from 1 year to 7 years	5-10	5-10
Children till 1 year	2,5-5	2,5-5

* For children till 1 year drug is measured according to the scale designated on the portioning device which is applied. For children 1 years and adults, for convenience of use are more senior, it is possible to dose drug tea (5 ml), dessert (10 ml), dining rooms (15 ml) spoons.

It is better to accept all daily dose in one step in the morning during a breakfast. Mixing with fruit and vegetable juice or food mixes is possible. The effect can be observed in 1-2 days that is caused by effect of lactulose.
 At hepatic encephalopathy, a hepatic coma and a prekoma drug 3 times a day appoint in an initial dose 30-50 ml (90-150 ml a day). The maintenance dose is established depending on individual reaction (it is necessary to achieve 2-3 soft excrements a day). The dose is established individually and only by the doctor.

Features of use:

Before an initiation of treatment Normolaktom it is necessary to consult to the doctor as the doctor has to decide on a drug dosing and duration of treatment.
It is not necessary to use drug at an abdominal pain, nausea and vomiting. With the advent of diarrhea treatment is stopped.
With care it is necessary to apply at patients with a diabetes mellitus. At a gastrocardial syndrome it is necessary to raise a dose gradually to avoid a meteorism. At prolonged treatment (more than 6 months) it is regularly necessary to control the level of electrolytes in a blood plasma, especially at the elderly and weakened patients. Patients with insufficiency of lactase at use of drug need to monitor sugar consumption.
If symptoms of a disease do not begin to disappear or, on the contrary, the state of health will worsen, or there will be undesirable phenomena, it is necessary to suspend administration of drug and to see behind consultation a doctor of rather further use.

Use during pregnancy or feeding by a breast.
Normolakt's use during pregnancy or feeding by a breast is possible.

Ability to influence speed of response at control of motor transport or other mechanisms.
Normolakt's reception does not exert impact on ability to manage motor transport and to be engaged in other potentially dangerous types of activity demanding the increased concentration of attention and visual acuity.

Children.
Нормолакт it is applied at children.

Side effects:

Нормолакт it is usually well transferred, but sometimes during treatment  (most often in the beginning) can arise:
• meteorism;
• nausea;
• diarrhea;
• headache;
• dizziness;
• increased fatigue;
• weakness;
• at prolonged treatment in high doses - disturbance of water and electrolytic exchange; very seldom – a mialgiya and arrhythmia.
In case of any negative reactions surely consult to the doctor of rather further use of drug!

Interaction with other medicines:

If you accept any other medicines, surely report about it to the doctor!
At Normolakt's reception with kishechnorastvorimy drugs of rn-dependent release it is necessary to remember that lactulose reduces рН intestines.
At simultaneous use with antibiotics of a broad spectrum of activity or antacids decrease in a therapeutic effectiveness of lactulose is possible.
It is not recommended to accept Normolakt within 2 hours after reception of other drugs.

Contraindications:

• Hypersensitivity to drug;
• galactosemia;
• intestinal impassability

Overdose:

At reception of very high doses there can be pains in a stomach, diarrhea. Treatment: reduction of a dose or termination of administration of drug.
If symptoms of overdose do not disappear, it is necessary to ask for medical care immediately!

Storage conditions:

To store in the unavailable to children, dry, protected from light place at a temperature from 15ºС to 25ºС.Не it is necessary to use drug after the termination of the period of validity specified on packaging.

Period of validity - 2 years.

Issue conditions:

Without recipe

Packaging:

On 100 ml in bank polymeric and a pack together with the portioning device. On 100 ml or 200 ml in a polymeric bottle and a pack together with the portioning device.