Posology : מינונים

4.2 Posology and method of administration
The lactulose solution may be administered diluted or undiluted. The dose should be titrated according to the clinical response. Lactulose may be given as a single daily dose or up to three divided daily doses, using the measuring cup.
A single dose of lactulose should be swallowed in one and should not be kept in the mouth for an extended period of time.
The posology should be adjusted according to the individual needs of the patient. The starting dose can be adjusted after adequate treatment effect individually (maintenance dose). Several days (2-3 days) of treatment may be needed in some patients before adequate treatment effect occurs. In case of single daily dose, this should be taken at the same time of the day, e.g.
during breakfast. During the therapy with laxatives, it is recommended to drink sufficient amounts of fluids (1.5-2 l/day, equal to 6-8 glasses).

Constipation

After a few days the starting dosage may be adjusted to the maintenance dose based upon treatment response. Several days (2-3 days) of treatment may be needed before treatment effect occurs.
Starting dose          Maintenance dose
Adults and              15 - 30 ml             15 - 30 ml adolescents
Children                15 ml                  10 - 15 ml
(7 - 14 years)
Children                5 - 10 ml              5 - 10 ml
(1 - 6 years) infants under 1 year    Up to 5 ml             Up to 5 ml

If diarrhoea occurs, the dosing regimen should be reduced.


Treatment of portal systemic encephalopathy - for adults only:

Beginning with 30 - 50 ml 3 times daily (corresponding to 60 - 100 g Lactulose).
The dosage has to be adopted to get 2-3 soft stools daily, pH of the stools should be between 5.0 to 5.5.

Children:
The safety and efficacy in children aged 0 - 18 years has not been established. No data are available.

In elderly patients and patients with renal or hepatic insufficiency no special dosage recommendations exist.

Duration of treatment

The duration of treatment has to be adopted according to the symptoms.