Gudlak

General characteristics. Structure:

Active agent: liquid lactulose (in terms of lactulose) 667 mg.
excipients: potassium sorbate (E202), fragrance caramel 12788, the water purified.

Description: transparent viscous liquid from light yellow till brownish-yellow color with a caramel smell.

Pharmacological properties:

Pharmacodynamics. Has hyperosmotic, laxative effect, stimulates an intestines peristaltics, improves absorption of phosphates and Sa2+ salts, promotes removal of ions of ammonium.

Under the influence of drug there is a reproduction of Lactobacillus acidophilus, Lactobacillus bifidus in intestines under the influence of which lactulose is split with lactification (generally) and partially ant and acetic acids. At the same time osmotic pressure increases and decreases рН in a gleam of a large intestine that leads to migration of ammonia from blood in intestines, to its ionization and deduction, and also to increase in volume of fecal masses and strengthening of a vermicular movement of intestines. Removal of the connected ions of ammonium is carried out at development of laxative effect.

Oppresses education and absorption of nitrogen-containing toxins in proximal department of a large intestine.

Reduces reproduction of salmonellas.

Action comes in 24-48 h after reception that is caused by duration of passing of drug through digestive tract.

Pharmacokinetics. After intake lactulose is soaked up in insignificant degree. It reaches distal departments of intestines in not changed look where is exposed to intensive biotransformation under the influence of a bacterial flora. At reception of 40 - 75 ml, the quantity is completely metabolized. Removal by kidneys - 3%. Higher doses can be removed completely in not changed look.

Indications to use:

• a lock, including chronic, at pregnancy, hemorrhoids;
• after surgical interventions on a large intestine and / илй in an anus, for preparation for surgical interventions on a large intestine;
• for a chair softening (defecation simplification) at a pain syndrome after removal of hemorrhoidal nodes;
• hepatic encephalopathy, hepatic prekoma and coma.

Route of administration and doses:

The daily dose is accepted once in the morning during food.

Daily doses define according to individual requirement and the answer. Because of the specific mechanism of effect of drug the clinical effect occurs in 1-2 days.

In the absence of effect after the first two days of administration of drug, the dose can be increased.

The recommended daily doses:
Lock and clinical need of simplification of defecation 
                Initial dose (first 3 days)      Maintenance dose
Adult    10-45                                      ml 10-25 ml
Children             of 7-14 years                                     of 15 ml 10-15 ml
Children             of 1 - 6 years                                      of 5-10 ml 5-10 ml
Children             <1 years                                     of 5 ml 5 ml

Hepatic prekoma, coma and encephalopathy
 Initial daily dose - 3 times on 30-50 ml. The daily dose can make 90-190 ml. The supporting daily dose is selected individually so that "the soft chair" was 2-3 times a day. From calculation that the indicator рН a calla was within 5,0-5,5.

Features of use:

In case of lack of clinical effect within several days or when resuming a lock after the termination of treatment it is necessary to consult with the doctor.

It is possible to appoint the recommended daily doses for treatment of a lock and simplification of defecation also a sick diabetes mellitus. It is necessary to appoint higher doses applied to treatment of a hepatic prekoma and a coma with the increased care in the presence of a diabetes mellitus.

Drug contains a galactose in this connection its reception is not recommended to patients with a lactose intolerance, deficit of lactase, glyukozo-galaktozny malabsorption.

At long reception (more than 6 months) control of indicators of potassium ions, chlorine and carbon dioxide in plasma is necessary.

At a gastrocardial syndrome it is necessary to increase gradually doses to avoid a meteorism (which disappears independently for 2-3 day of treatment). At the elderly and weakened patients accepting lactulose more than 6 months it is recommended to measure concentration of electrolytes in blood serum periodically.

At emergence of diarrhea treatment is cancelled.

Influence on ability of driving and to work with mechanisms.

Drug Gudlak does not exert impact on driving of the car and work with the equipment.

Side effects:

In the first days of reception emergence of a meteorism is possible. Usually this symptom gradually decreases and passes. At reception of the doses exceeding recommended pains in a stomach and diarrhea can be observed that demands dose adjustment.

At use of high doses of drug for a long time for prevention and treatment of a hepatic prekoma and a coma diarrhea and disturbance of water and electrolytic exchange can develop.

Display of spasms, nausea, a headache, dizziness, arrhythmia, a mialgiya, increased fatigue, weakness is in rare instances possible. Emergence of allergic reactions is possible.

Interaction with other medicines:

Antibiotics (Neomycinum) and antacids reduce effect of lactulose.

It is not recommended to accept lactulose during 2 h after reception of other medicines.

Lactulose should not be accepted along with medicines, absorption or which allocation from an organism depends on value рН in intestines. Administration of drug leads to decrease in value рН intestines environments that changes rn-dependent release of kishechnorastvorimy medicines.

Contraindications:

• hypersensitivity to active ingredient or to auxiliary components;
• rectal bleedings
• kolo-, ileostoma
• suspicion of appendicitis
• galactosemia
• the patient with a lactose intolerance, deficit of lactase, glyukozo-galaktozny malabsorption.
• impassability of intestines.

With care: diabetes mellitus.

Use during pregnancy and feeding by a breast

Drug Gudlak can be used during pregnancy and feeding by a breast in the recommended doses and duration of a course of treatment.

Overdose:

There are no data on drug overdose. Reception of high doses can cause pains in a stomach, diarrhea and loss of electrolytes. In these cases administration of drug should be stopped.

Storage conditions:

At a temperature not above 25 °C. Not to freeze! To store in the place, unavailable to children! Period of validity 2 years. A period of validity after packaging opening - 28 days. Not to use after the period of validity specified on packaging.

Issue conditions:

Without recipe

Packaging:

Syrup of 667 mg/ml. On 200 ml of syrup in a bottle of dark glass. The bottle together with a measured cup with a capacity of 20 ml and the application instruction is placed in a cardboard pack.