Re: Constipation

<sortofa cross between 'oops' and 'hmmmm'>

Mike Easter wrote:
OldGoat wrote:

The first thing that struck me when I first gave the label itself a
look over was the phrase "for oral or rectal administration". I told
myself it was a typo and ripped the Rx'ing info packet off the bottle.

If you had a laxative which was labeled oral or rectal, it wasn't
lactulose, but some other laxative, I don't know what.

Searching on lactulose + 'orally or rectally' I find^1 some product lines
so labeled. I think rectal admin of lactulose isn't a good choice of a
rectal agent.

Lactulose must be administered orally because of its mechanism of
action. It is an osmotic cathartic which requires intestinal transit to
achieve its effect, ie it won't work if administered rectally.

^1 http://www.77canadapharmacy.com/lactulose.php Lactulose MAY BE USED
ORALLY OR RECTALLY.

<but then the labeling directions provide no rectal administration
guidelines>

I /am/ finding some research studies in which lactulose was admin/ed
rectally to some hepatic encephalopathy patients as a treatment to achieve
pH change and ammonia trapping from the colon -- but that wasn't for its
laxative purposes.

http://app.kfshrc.edu.sa/annals/articles/24_5/03-052.pdf

I'm wondering if the labeling might be in error or at the very least a
'bad idea'.

"Lactulose is a colonic acidifier for treatment and prevention of
portal-systemic encephalopathy."

That is, lactulose could be sold as an oral laxative or a rectal/colonic
treatment for encephalopathy.

--
Mike Easter

.