Lactomax Special Precautions

Absorption of lactate from colonic metabolism of lactitol can potentially result in acid-base disturbance. Diarrhea induced by lactitol can be associated with hypokalemia and hypernatremia. Potassium deficiency may increase the risk of toxic effects of glycosides in patients receiving concomitant therapy.
Periodic monitoring of serum electrolytes, blood glucose and blood lactate is suggested. If watery stools are noticed, one of either reduce the quantity of administration or suspend administration. As with all laxatives, any pre-existing electrolyte or water balance abnormalities must be corrected. Blood electrolyte levels should be monitored regularly in elderly or debilitated patients on long term treatment.
Patients who has complaint of nausea should be advised to take lactitol with meal.
Lactitol is not recommended in case of ileostomy.
Fecal impaction should be treated by alternative methods prior to using lactitol.
Following treatment with lactitol, hydrogen may be accumulated in the bowel. Patients who need to undergo electrocauterisation procedures should therefore have a bowel cleaning with a non fermentable solution.
All cases of chronic constipation should first be treated by a fibre rich diet, intake of liquids or physical activity.
Prolonged use of laxatives without interruption should be avoided.
Typical symptoms of laxative overdose include abdominal pain, weakness, fatigue, thirst, vomiting, edema, bone pain (due to osteomalacia), fluid and electrolyte imbalance, hypoalbuminemia (due to protein losing gastroenteropathy) and syndromes that mimic colitis.
If presence of air is perceived in the intestine, it is advisable to begin in the treatment with the minimum dose, gradually increasing based on the therapeutic response. Should not be given to patients with galactosaemia or intestinal obstruction. It should not be used in patients on a low galactose diet and care should be taken in patients with lactose intolerance or in diabetic patients because of the presence of some free galactose.