Introduction About LIVOLUK SOLUTION

LIVOLUK SOLUTION contains Lactulose which belongs to the group of medicines called Laxatives. It is used to manage constipation (infrequent bowel movements, hard and dry stools) and hepatic encephalopathy. Hepatic encephalopathy is a decline in brain function due to liver disease that causes symptoms like confusion, tremor and decreased level of consciousness, also it can lead to hepatic coma.

LIVOLUK SOLUTION is not recommended for use in patients with serious genetic disorder where you cannot digest galactose (galactosaemia), acute inflammatory bowel disease, blockage in bowels (apart from normal constipation), gastro-intestinal perforation or risk of perforation or stomach pain due to unknown cause.  During management with LIVOLUK SOLUTION, you should drink enough fluids (about 6 - 8 glasses).

Before taking LIVOLUK SOLUTION, inform your doctor if you are lactose intolerant or have diabetes or roemheld syndrome. LIVOLUK SOLUTION should be used with caution in pregnant and breastfeeding women only if clearly advised by the doctor. LIVOLUK SOLUTION is usually not recommended for use in infants and smaller children but your child’s doctor may prescribe in certain circumstances.

It should be used with caution in elderly patients (aged 65 years and above) and your doctor may check your blood electrolytes when this medicine is taken for more than 6 months period or patients with bad general condition. The most common side effects of taking LIVOLUK SOLUTION are flatulence, stomach pain, nausea, vomiting, or diarrhea. Consult your doctor if any of the side effects worsen.

Uses Of LIVOLUK SOLUTION

Manage:

• constipation
• hepatic encephalopathy

How LIVOLUK SOLUTION Works

LIVOLUK SOLUTION works by making the stool softer and easier to pass, by drawing more water into the bowel. It also reduces the amount of ammonia in the blood by removing the toxin from the bloodstream which helps to improve cognitive functions.

How to use LIVOLUK SOLUTION

Take LIVOLUK SOLUTION as advised by your physician. Shake well before use. Use a measuring cup or spoon and swallow the medicine immediately, do not keep it in your mouth for long. You can mix this medicine with fruit juice or water. It is recommended that you drink plenty of fluids (6-8 glasses). Your doctor will decide the correct dose and duration for you according to your age, body weight and disease condition.

Side Effects Of LIVOLUK SOLUTION

How To Manage Side Effects

Bloating

Eat smaller and frequent meals and exercise regularly (like walking). Limit the intake of carbonated drinks. Avoid eating foods such as beans, lentils. If the symptom does not show improvement, consult your doctor. 

Diarrhea

Drink lot of fluids such as water to keep yourself hydrated. Avoid eating high-fat or spicy foods. Do not take any medicine on your own to manage diarrhea without consulting your doctor. 

Nausea And Vomiting

Take LIVOLUK SOLUTION with or just after meals. Stick to simple meals. Avoid eating oily, fried or spicy foods. Do not lie down or sleep immediately after eating. Consult your doctor if the symptom does not improve.

Stomach Pain

Try to rest and relax. Eat and drink slowly or try to eat smaller meals more frequently. Keep a heat pad on your stomach. If the stomach pain does not improve, consult your doctor.

Warning & Precautions

Pregnancy

Monitoring required

LIVOLUK SOLUTION should be used with caution in pregnant women only if considered clearly necessary. Consult your doctor before taking it. 

Breastfeeding

Monitoring required

LIVOLUK SOLUTION should be used with caution in breastfeeding women only if considered clearly necessary. Consult your doctor before taking it. 

Driving and Using Machines

Use with Caution

LIVOLUK SOLUTION will not affect your ability to drive or use machines.

Allergy

Contraindicated

Do not take LIVOLUK SOLUTION if you are allergic to Lactulose or any other ingredients of this medicine.

Use In Pediatrics

Use with Caution

LIVOLUK SOLUTION should be used with caution in infant, baby or child (under 1 year of age to 18 years of age) only under the supervision of your doctor to manage constipation. Your child’s doctor may adjust the dose depending upon age. Consult child’s doctor for advice before administering LIVOLUK SOLUTION to your child.

Use In Geriatrics

Use with Caution

LIVOLUK SOLUTION should be used with caution in elderly patients (aged 65 years and above). Your doctor may check your blood electrolytes when this medicine is taken for more than 6 months period. Consult your doctor before taking LIVOLUK SOLUTION

Interactions

A. Drug-Drug interactions:

Before taking LIVOLUK SOLUTION, inform your doctor if you are taking any of the following medicines:

• medicines used to manage fluid retention (Ex. chlorthalidone, hydrochlorothiazide)
• medicines used to manage inflammatory conditions (Ex. hydrocortisone, prednisolone)
• amphotericin B (used to manage serious fungal infections)
• medicines used to manage heart insufficiency (Ex. digitalis, digoxin)
• 5-aminosalicylic acid (5-ASA) such as mesalamine (used to manage inflammatory bowel disease such as crohn’s disease)

Overdosage:

If you or anyone else accidentally take too much of LIVOLUK SOLUTION, consult your doctor immediately or visit the nearby hospital. Overdosage symptoms of LIVOLUK SOLUTION are diarrhea, loss of electrolytes and abdominal pain.

Synopsis

More Information

• Keep LIVOLUK SOLUTION out of reach of children
• Store at room temperature

FAQs About LIVOLUK SOLUTION

Q: Can LIVOLUK SOLUTION be given to infants?

A: LIVOLUK SOLUTION is usually not recommended for use in infants and smaller children as it can disturb the normal reflexes for passing stools. Your child’s doctor will decide the correct dose or select a suitable alternative management for your child. In special situation, your doctor may prescribe it for your baby, where they will supervise the management closely.

Q: Can LIVOLUK SOLUTION cause diarrhea?

A: LIVOLUK SOLUTION may cause diarrhea when you take higher than recommended dose of it. In such case, drink lot of fluids, such as water to keep yourself hydrated. Do not take any medicine on your own to manage diarrhea without consulting your doctor. If diarrhea does not improve, consult your doctor immediately.

Q: Can LIVOLUK SOLUTION be used during pregnancy?

A: LIVOLUK SOLUTION should be used with caution in pregnant women only if clearly advised by your doctor. Consult your doctor before taking LIVOLUK SOLUTION if you are pregnant or planning to get pregnant.

Q: What if I forget to take a dose of LIVOLUK SOLUTION?

A: If you forget to take a dose of LIVOLUK SOLUTION, take it as soon as you remember. However, omit the missed dose if it is almost time for your next dose. Do not take LIVOLUK SOLUTION twice to make up for the forgotten dose.

Q: Can I stop taking LIVOLUK SOLUTION on my own?

A: Continue taking LIVOLUK SOLUTION until your doctor tells you to stop, unless you experience any unwanted effects, worsening of your condition or any new symptoms. In such case, contact your doctor right away. If you stopped taking it suddenly, the expected benefit of the management may not be achieved.

References

1. KD. Tripathi. Drugs for Constipation and Diarrhea. Essentials of Medical Pharmacology. Seventh edition. 2013. Page – 676.

2. Wesselius-De Casparis, A., Braadbaart, S., Bergh-Bohlken, G. E., and Mimica, M. Treatment of chronic constipation with lactulose syrup: results of a double-blind study. NIH National Library of Medicine, National center for biotechnology information. PubMed Central. February 1968. [Accessed on 20th July 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1552607/pdf/gut00703-0098.pdf

3. Institute of Liver and Biliary Sciences, India. To Compare Efficacy and Safety of Lactulose Versus Polyethylene Glycol for Treatment of Overt Hepatic Encephalopathy in Cirrhotics. NIH U.S. National Library of Medicine ClinicalTrials.gov. [Revised in February 2018] [Accessed on 20th July 2022] https://clinicaltrials.gov/ct2/show/NCT03448770

4. Abbott Biologicals B.V. Electronic Medicines Compendium (EMC). [Revised in April 2022] [Accessed on 20th July 2022] https://www.medicines.org.uk/emc/files/pil.5525.pdf

5. Braintree Laboratories, Inc. U.S. Food & Drug Administration. [Revised in February 2020] [Accessed on 20th July 2022] https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/211281s000lbl.pdf

6. Fresenius Kabi Austria GmbH. Health Products Regulatory Authority (HPRA). [Revised in May 2022] [Accessed on 20th July 2022] https://www.hpra.ie/img/uploaded/swedocuments/34c1e172-9c2b-4d3e-a53d-e021122ee5f9.pdf

Useful Diagnostic Tests

• MRI defecography
• CT scan
• Electroencephalogram (EEG)