EVALAX

General

EVALAX contains lactulose solution. It belongs to the class of hyper-osmotic agent that has laxative action. It produces increased osmotic pressure within colon and acidifies its contents, resulting in increased stool water content and stool softening. It also causes migration of ammonia from blood into colon, where it is converted to ammonium ion and expelled through laxative action.

General Info

Generic Name:	Lactulose
Therapeutic Category:	Osmotic Laxatives
Pharmacological Class:	Colonic Acidifier
Composition:	Lactulose 100/200 ml Each 15 ml consists of Lactulose concentrate USP equivalent to Lactulose 10 gm
Composition:	B
Presentation:	Available in 100 ml and 200 ml bottles, each with a measuring cap
Mechanism of Action:	FOR CONSTIPATION Lactulose passes unabsorbed down to large intestine. Colonic bacteria convert lactulose to lactic acid, acetic and formic acid. Increases the osmotic effect in the intestinal lumen. Retains water and fluid. Increases bowel volume content. Thus, causes easy evacuation
FOR HEPATIC ENCEPHALOPATHY*:	Also, Lactulose causes a decrease in blood ammonia concentration and reduces the degree of portal-systemic encephalopathy. These actions are considered to be results of the following: Bacterial degradation of Lactulose in the colon acidifies the colonic contents. This acidification of colonic contents results in the retention of ammonia in the colon as the ammonium ion. Since the colonic contents are more acidic than the blood, ammonia can be expected to migrate from the blood into the colon to form the ammonium ion. The acid colonic contents convert (Ammonia) NH3 to the ammonium ion (NH4)+, trapping it and preventing its absorption.
Indications:	Constipation Prevention & treatment of portal -systemic encephalopathy Acidification of the colon contents attracts ammonia from the bloodstream, assisting stool excretion; helpful in liver failure when ammonia cannot be detoxified
Dosage:	Route of administration: Oral Constipation Adults: 15 to 30 mL (10 to 20 gm lactulose) daily; may increase to 60 mL/day. Adjust dosage to produce 2 to 3 soft stools/day. Hourly doses of 30 to 45 mL may be used for rapid laxation initially; reduce to recommended daily dose. Portal-systemic encephalopathy Adults: 30 to 45 ml, 3 to 4 times daily.
Pharmacokinetics:	Absorption: Poorly absorbed in gastrointestinal tract Metabolism and Excretion: Absorbed lactulose is excreted unchanged in the urine. Unabsorbed lactulose is metabolized by colonic bacteria to lactic, acetic, and formic acids. Half-life: 1.7 – 2 hours
Adverse Effects:	Belching* Gas Stomach cramp Distention Flatulence* Diarrhea
Contraindications:	EVALAX is contraindicated in the following populations and situations: Use in patients who require low-galactose diet.
Drug Interactions:	Anticoagulant effect of coumarins possibly enhanced by lactulose