Composition:
Each 5 ml Sivolac concentrate oral solution contains Lactulose USP 3.40 gm.
Pharmacology:
Lactulose is a disaccharide, which is not hydrolyzed in the small intestine. Therefore it can not be absorbed and is transported to the colon with water to retain the osmotic balance. It provides a natural substrate for the saccharolytic bacterial flora in the colon. In the colon, several species of bacteria can hydrolyze Lactulose to the monosaccharides galactose and fructose. By encouraging this normal metabolic activity of the bacteria, the osmotic pressure of the colonic contents is doubled and more water is drawn into the bowel. Further metabolism of the monosaccharides leads to the production of
acetic acids and the subsequent lowering of colonic pH. This acidification of the colonic contents is considered to be the main reason for the effectiveness of Lactulose solution. In chronic portal systemic encephalopathy it may be associated with the decrease in the relative concentration of free ammonia, the major agent involved in the cerebral disturbance.