Common uses

Duphalac is used to treat chronic constipation. It can be taken by pregnant women. It works by increasing the amount of water and stool bulk in the bowel, promoting normal bowel activity.
Duphalac can also be used to treat portal-systemic encephalopathy (PSE), also known as hepatic encephalopathy (a disease of the brain that occurs when the liver is not working properly. Symptoms are caused by too much ammonia in the blood). It works by lowering the level of ammonia in the blood.

Before using

Tell your doctor or pharmacist if you have allergies to:
* any other medicines.
* any other substances, such as foods, preservatives or dyes.
Tell your doctor or pharmacist if you have or have had any medical conditions, especially the following:
* diabetes
* lactose intolerance.
Tell your doctor or pharmacist if you are breast-feeding or plan to breast-feed. Your doctor or pharmacist will discuss the possible risks and benefits of using DUPHALAC during breastfeeding. Do not give DUPHALAC to a child under the age of 14 years without medical supervision. If you have not told your doctor or pharmacist about any of the above, tell them before you start taking DUPHALAC.

Directions

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label. Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. The liquid form of lactulose may become slightly darken in color, but this is a harmless effect. However, do not use the medicine if it becomes very dark, or if it gets thicker or thinner in texture. Lactulose powder should be mixed with at least 4 ounces of water. You may also use fruit juice or milk to make the medication better. It may take up to 48 hours before you have a bowel movement after taking lactulose. If you use lactulose over a long period of time, your doctor may want you to have occasional blood tests. Do not miss any scheduled appointments. Store lactulose at room temperature away from moisture and heat.

The usual starting dose for constipation in adults is 15-30 ml daily, and may be increased to 45 ml daily. It may take 1-2 days for DUPHALAC to work fully. After 3 days, the dose may be reduced to 10-25 mL daily. DUPHALAC should be given to children and infants under medical
supervision. The usual doses are:
Children 7-14 years:
Initial dose (3 days) 15 ml
Maintenance 10 ml
Children 1-6 years:
Initial dose (3 days) 10 ml
Maintenance 5-10 ml
Infants under 1 year:
Initial dose (3 days) 5 ml
Maintenance 3-5 ml
The usual dose is 30-45 ml three to four times daily.


Cautions

People with an intolerance to lactose in the diet should use with caution.
Not to be used in
• People with a blockage in their gut (intestinal obstruction).
• Inherited inability to metabolise galactose in the diet (galactosaemia).
This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Possible side effects

Tell your doctor or pharmacist a soon as possible if you do not feel well while you are taking Duphalac. Duphalac helps most people with chronic constipation, but it may have unwanted side effects in a few people. All medicines can have side effects. Sometimes they are serious, most of the time they are not. You may need medical treatment if you get some of the side effects. Ask your doctor or pharmacist to answer any questions you may have. During the first few days of taking Duphalac, you may feel bloated as a result of increased wind and intestinal cramps. These effects are usually mild and disappear after a few days. At high doses you may suffer diarrhoea. If this happens, reduce the dose and/or tell your doctor or pharmacist.
Tell your doctor or pharmacist if you notice any of the following and they worry you:
* nausea
* vomiting
* loss of appetite
* increased thirst.
These side effects are uncommon.
Very rarely, infants given Duphalac may develop dehydration. Other side effects not listed above may occur in some patients. Tell your doctor or pharmacist if you notice anything that is making you feel unwell. Some of these side effects (for example, potassium levels in the blood) can only be found when your doctor orders blood tests.


If you take too much

Immediately telephone your doctor or pharmacist or the Poisons Information Centre (telephone 13 11 26), or go to Accident and Emergency at your neares hospital, if you think that you or anyone else may have taken too much Duphalac. Do this even if there are no signs of discomfort or poisoning. Symptoms of an overdose are likely to be diarrhoea and abdominal cramps.

Additional information

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.
This medicine is not known to be harmful if used during pregnancy or breastfeeding. However, as with all medicines, you should seek medical advice from your doctor before taking this medicine if you are pregnant or breastfeeding.

Drug interactions

There may be other drugs that can interact with lactulose. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.