Lactitol, known as an "osmotic laxative" is a disaccharide derivative consisting of galactose and sorbitol. It is only minimally absorbed and is not hydrolysed by the disaccharidases of the GIT and thus reaches the colon unchanged. In the colon it is broken down to short chain low molecular weight organic acids by the intestinal flora, resulting in an increase in osmotic pressure in the colon. It thus causes an increase in the stool water content and stool volume which explains the laxative effect. Lactitol produces its effect in the lumen of the colon where it is virtually 100% bioavailable. It is absorbed only in minimal amounts. Up to 2% can be found unchanged in the urine.

Constipation
Acute and chronic portal systemic encephalopathy.
 

Lactitol can be mixed with hot or cold beverages, puddings etc. Dosage will require adjustment to obtain one daily bowel movement in constipated patients and two daily bowel movements in patients with portal systemic encephalopathy. For taking fraction doses (e.g. 2.5or 5 g) of presented 10g Lactitol, the whole 10g should be dissolved in water. Half of the solution for 5 g and one fourth for 2.5 g respectively should be taken. The rest of the solution should be discarded.
In constipation
Adult: The initial daily dosage should be 20 g taken in a single dose with the morning or evening meal and subsequently adjusted to produce 1 soft stool daily (dose of 10 g daily may be sufficient).
Children: The mean dosage is 0.25 g/kg body weight daily.
1 to 6 years: 2.5 to 5 g per day
6 to 12 years: 5 to 10 g per day
12 to 16 years: 10 to 20 g per day
For taking fraction doses (e.g.2.5 or 5 g) of presented 10g lactitol, the whole 10g should be dissolved in water. Half of the solution for 5 g and one fourth for 2.5g respectively should be taken. The rest of the solution should be discarded.
The effect of lactitol has been found mostly to occur within a few hours after intake. But in some cases the first laxative response may be delayed until the second or third day of administration. Therefore patients should be advised to maintain an adequate daily fluid intake.
In portal systemic encephalopathy
The dose should be adjusted according to the severity of the patient's disease and their individual response. The initial recommended dose is 0.5 to 0.7g/kg body weight daily, divided into three daily doses with meals and subsequently adjusted to produce 2 soft stools daily.
 

Elderly or debilitated patients receiving long-term treatment with lactitol should have their serum electrolytes monitored regularly.
As for all laxatives, pre-existing fluid or electrolyte imbalance should be corrected before starting treatment with lactitol.
Following treatment of lactitol, hydrogen may accumulate in the bowel. Patients who need to undergo electrocauterisation procedure should therefore have a thorough bowel cleansing with a non-fermentable solution.
Lactitol is not recommended in case of ileostomy or colostomy.
Prolonged use of laxatives without interruption should be avoided.
 

At the start of the treatment lactitol may produce abdominal discomforts such as flatulence, pain, cramps or sensation of fullness. Such effects tend to diminish or disappear after a few days of regular intake of lactitol. Occasionally, nausea or anal pruritus has been reported in some cases.
 

Antacids and neomycin should not be given simultaneously with lactitol to cirrhotic patients with portal systemic encephalopathy. Lactitol may increase potassium loss caused by other drugs e.g. thiazide diuretics, corticosteroids, carbenoxolone, amphotericin B and it may enhance the risk of toxic effects of glycosides in patients receiving concomitant therapy.
 

Store in a cool, dry place and away from light. Keep out of reach of children.
 

Laxitol : Box containing 10 sachets. Each sachet contains 10 g of lactitol monohydrate BP.



Manufactured by:
ESKAYEF BANGLADESH LTD
DHAKA, BANGLADESH
® REGD.TRADEMARK