LACTECON Oral solution Ref.[50945] Active ingredients: Lactulose

Source: Health Products Regulatory Authority (IE)  Revision Year: 2022  Publisher: Mylan IRE Healthcare Limited, Unit 35/36, Grange Parade, Baldoyle Industrial Estate, Dublin 13, Ireland

4.3. Contraindications

  • Use in patients with galactosaemia.
  • Hypersensitivity to the active substance or lactose, galactose, fructose or sulphite (see section 4.4).
  • Gastrointestinal obstruction, perforation or risk of perforation.

4.4. Special warnings and precautions for use

Painful abdominal symptoms of undetermined cause should be evaluated to exclude undiagnosed perforation or obstruction or undiagnosed disease/condition that predisposes to either before the treatment is started.

In case of insufficient therapeutic effect after several days the dose and/or additional measures should be re-considered. Long term use of this product is inadvisable except under medical supervision.

The dose normally used in constipation should not pose a problem for diabetics.

The dose used in the treatment of hepatic encephalopathy is usually much higher and may need to be taken into consideration for diabetics.

As diarrhoea induced by lactulose may lead to electrolyte imbalance, use with caution in patients prone to developing electrolyte disorders (e.g. patients with renal or hepatic impairment, patients receiving concomitant diuretics).

It should be taken into account that the defaecation reflex could be disturbed during the treatment.

Information on residues from manufacturing with known effect

This product contains lactose, galactose and fructose from the route of production. Therefore, patients with the rare hereditary problem of galactose or fructose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.

Lactulose should be administered with care to patients who are intolerant to lactose.

This product contains sulphite from the route of production.

Paediatric population

Use of laxatives in children should be exceptional and under medical supervision.

4.5. Interaction with other medicinal products and other forms of interaction

No interaction studies have been performed.

4.6. Fertility, pregnancy and lactation

Pregnancy

No effects during pregnancy are anticipated, since systemic exposure to lactulose is negligible.

Lactecon can be used during pregnancy.

Lactation

No effects on the breastfed newborn/infant are anticipated, since the systemic exposure of the breast-feeding woman to lactulose is negligible.

Lactecon can be used during breast-feeding.

Fertility

No effects are to be expected, since systemic exposure to lactulose is negligible.

4.7. Effects on ability to drive and use machines

The product has no or negligible influence on the ability to drive and use machines.

4.8. Undesirable effects

Summary of the safety profile

Flatulence may occur during the first few days of treatment. As a rule, it disappears after a few days. When dosages higher than instructed are used, abdominal pain and diarrhoea may occur. In such a case, the dosage should be decreased (see section 4.9).

If high doses (normally only associated with hepatic encephalopathy, HE) are used for an extended period of time, the patient may experience an electrolyte imbalance due to diarrhoea.

Tabulated list of adverse reactions

The following undesirable effects have been experienced with the below indicated frequencies in lactulose-treated patients in placebo-controlled clinical trials [very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000 to <1/1,000); very rare (<1/10,000); Not known (cannot be estimated from the available data)].

MedDRA SOC Frequency category
Very
common
Common Uncommon Not known
Gastrointestinal
disorders
DiarrhoeaFlatulence,
abdominal
pain,
nausea,
vomiting
  
Investigations   Electrolyte
imbalance
due to
diarrhoea
 
Immune system disorders    Hypersensitivity
reactions*
Skin and subcutaneous tissue disorders    Rash*, pruritus*,
urticaria*

* Post-marketing experience

Paediatric population

The safety profile in children is expected to be similar as in adults.

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via HPRA Pharmacovigilance, Website: www.hpra.ie.

6.2. Incompatibilities

Not applicable.

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