normalac syrup - Lactulose (3.35gm/5ml) medicine

Laxopeg Syrup: Complete Guide to Uses, Dosage, and Safety

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🏭 Mankind Pharma Ltd 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 24, 2026
⚠️ Hepatotoxicity Risk 📋 Prescription Required 💊 Generic Available
Medically Reviewed
12 min read
Evidence: Well-established for constipation and hepatic encephalopathy.
Reviewed by
SaathiMed Expert Panel | Sep 24, 2026

When to Call Your Doctor IMMEDIATELY

  • Severe abdominal pain or cramping that does not go away
  • Persistent diarrhea lasting more than 24 hours
  • Signs of dehydration such as dry mouth, decreased urine output, or dizziness
  • Blood in stool or vomit
  • Allergic reactions like rash, itching, swelling of face, lips, or throat
  • Confusion or changes in mental status in patients with liver disease
  • Muscle weakness or irregular heartbeat (signs of electrolyte imbalance)

If experiencing severe symptoms, call emergency services immediately.

What is normalac syrup used for?

This medicine is a lactulose-based syrup used to treat chronic constipation and hepatic encephalopathy. It works by drawing water into the intestines to soften stools and by reducing ammonia levels in the blood. It is generally safe for long-term use but may cause bloating and gas initially.

  • Generic Name: Lactulose (3.35gm/5ml)
  • Manufacturer: Mankind Pharma Ltd
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 normalac syrup के बारे में (Hindi Summary)

उपयोग: यह दवा लैक्टुलोज़ आधारित सिरप है जिसका उपयोग कब्ज और लिवर से जुड़ी बीमारी (हेपेटिक एन्सेफेलोपैथी) के इलाज के लिए किया जाता है। यह आंतों में पानी खींचकर मल को नरम करती है और आंतों की गति को बढ़ाती है। यह दवा खून में अमोनिया के स्तर को कम करने में भी मदद करती है। यह आमतौर पर सुरक्षित मानी जाती है और इससे लत नहीं लगती।

साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में पेट फूलना, गैस, पेट में ऐंठन और मतली शामिल हैं। ये लक्षण आमतौर पर हल्के होते हैं और कुछ दिनों में ठीक हो जाते हैं। अगर दस्त लगातार बना रहे या गंभीर हो, तो तुरंत डॉक्टर से संपर्क करें। कभी-कभी एलर्जी की प्रतिक्रिया हो सकती है जैसे चकत्ते, खुजली या सूजन।

सुरक्षा सलाह: इस दवा को डॉक्टर के बताए अनुसार ही लें। खुद से मात्रा न बढ़ाएं या घटाएं। दिनभर पर्याप्त पानी पिएं। अगर आपको मधुमेह है तो ब्लड शुगर की निगरानी करें। गर्भावस्था या स्तनपान के दौरान डॉक्टर से सलाह लें। दवा को ठंडी और सूखी जगह पर रखें। बच्चों की पहुंच से दूर रखें। अगर कब्ज कई दिनों तक ठीक न हो तो डॉक्टर से मिलें।

💡 Did You Know? The Indian pharmaceutical market is expected to reach $130 billion by 2030.

💊 normalac syrup Uses & Benefits

  • [{"condition":"Chronic constipation","description":"This medicine is used to treat chronic constipation by softening stools and promoting regular bowel movements.
  • It is effective in both adults and children.","evidence":"Well-established"},{"condition":"Hepatic encephalopathy","description":"This medicine helps reduce blood ammonia levels in patients with liver disease, thereby improving mental status and preventing episodes of hepatic encephalopathy.","evidence":"Well-established"},{"condition":"Portosystemic encephalopathy","description":"This medicine is used to manage portosystemic encephalopathy by lowering ammonia production in the gut.","evidence":"Well-established"},{"condition":"Constipation in pregnancy","description":"This medicine is often recommended for constipation during pregnancy because it is not significantly absorbed and is considered safe.","evidence":"Moderate"},{"condition":"Constipation in elderly","description":"This medicine is commonly used in elderly patients to relieve constipation, as it is gentle and does not cause dependency.","evidence":"Well-established"}]

Off-label uses: [{"condition":"Small intestinal bacterial overgrowth (SIBO)","description":"This medicine may be used as a substrate in breath tests for diagnosing SIBO, but treatment use is not standard.","evidence":"Limited"},{"condition":"Calcium stone prevention","description":"Some studies suggest lactulose may help reduce urinary calcium oxalate stones, but evidence is insufficient.","evidence":"Limited"}]

Primary treatment for: Chronic constipation

Also treats: Hepatic encephalopathy, Portosystemic encephalopathy

📋 Drug Information

Generic Name(s)Lactulose (3.35gm/5ml)
Brand Namenormalac syrup
ManufacturerMankind Pharma Ltd
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassGASTRO INTESTINAL
Action ClassOsmotic laxatives/Purgative
Route of AdministrationOral
StorageStore at room temperature (15-30°C). Protect from direct sunlight and moisture. Do not freeze. Keep the bottle tightly closed when not in use.
Shelf Life24 months from the date of manufacture.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Take this medicine at the same time each day to establish a routine and improve compliance.
2
Increase your water intake to enhance the laxative effect and prevent dehydration.
3
If you experience bloating or gas, it usually subsides within a few days; if not, consult your doctor.
4
For hepatic encephalopathy, the dose is adjusted to achieve 2-3 soft stools per day; report any changes in stool frequency.
5
Do not take other laxatives without consulting your doctor, as this may cause severe diarrhea.
6
Monitor your blood sugar if you have diabetes, as this medicine contains sugars.
7
If you are scheduled for a breath test, inform your doctor about this medicine as it may affect results.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

Chronic constipation
This medicine is commonly prescribed for this.
Likely Use
Hepatic encephalopathy
This medicine is used to reduce ammonia levels in liver disease.
Likely Use
Fever
This medicine is not a fever reducer.
Not Primary
Acute diarrhea
This medicine is not used to treat diarrhea; it may cause diarrhea as a side effect.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionLactulose is poorly absorbed from the gastrointestinal tract. Only about 0.4% to 2% of an oral dose is absorbed unchanged. The majority reaches the colon where it exerts its effects.
DistributionAbsorbed lactulose is distributed minimally in the body. It does not bind to plasma proteins significantly and does not cross the blood-brain barrier to any appreciable extent.
Protein BindingNot established from the available information.
MetabolismLactulose is not metabolized by human enzymes. It is metabolized by colonic bacteria into short-chain fatty acids, which are then partially absorbed and metabolized by the liver.
Half-LifeNot established from the available information.
ExcretionUnabsorbed lactulose and its metabolites are primarily excreted in the feces. A small amount of absorbed lactulose is excreted unchanged in the urine.
BioavailabilityThe oral bioavailability of lactulose is very low, approximately 0.4% to 2%.
Onset of ActionThis medicine typically takes 24 to 48 hours to produce a bowel movement. For hepatic encephalopathy, the effect on ammonia levels may take 24 to 48 hours as well.
Peak Plasma TimeNot established from the available information.
Duration of ActionThe laxative effect of this medicine lasts until the lactulose is fully fermented and expelled, usually within 24 to 48 hours after a dose.

How It Works

This medicine works primarily as an osmotic laxative and a prebiotic. Lactulose is a synthetic disaccharide composed of galactose and fructose. It is poorly absorbed in the small intestine and reaches the colon unchanged. There, colonic bacteria ferment lactulose into short-chain fatty acids, mainly lactic acid, acetic acid, and formic acid. This fermentation lowers the colonic pH, which stimulates peristalsis and increases water and electrolyte retention in the colon. The increased water content softens the stool and promotes bowel movements. In hepatic encephalopathy, the acidification of the colon converts ammonia (NH3) to ammonium (NH4+), which is poorly absorbed and is excreted in the feces. This reduces blood ammonia levels. Additionally, lactulose promotes the growth of beneficial bacteria such as Lactobacillus and Bifidobacterium, which further contributes to gut health.

Mechanism Steps

1
Ingestion and passage through the small intestine: Lactulose is swallowed and passes through the stomach and small intestine largely unchanged because human digestive enzymes cannot break it down.
2
Fermentation by colonic bacteria: In the colon, bacteria such as Lactobacillus and Bifidobacterium ferment lactulose into short-chain fatty acids, including lactic acid and acetic acid.
3
Lowering of colonic pH: The production of organic acids lowers the pH of the colon, which inhibits the growth of harmful bacteria and promotes the growth of beneficial bacteria.
4
Osmotic effect and water retention: The acidic environment draws water into the colon, increasing stool water content and softening the stool.
5
Increased peristalsis and bowel movement: The increased volume and softened stool stimulate colonic peristalsis, leading to bowel movements.
6
Reduction of ammonia absorption: In patients with liver disease, the acidic colon converts ammonia to ammonium, which is poorly absorbed and is excreted in the stool, lowering blood ammonia levels.

💡 How to Take normalac syrup

Strength: Lactulose 3.35 grams per 5 milliliters oral syrup.

1Shake the bottle well before each use.
2Measure the prescribed dose using the provided measuring cup or spoon.
3Take the medicine orally, with or without food.
4Drink a full glass of water after taking the dose.
5Follow with adequate fluid intake throughout the day.
6Wash the measuring cup after each use.
7Close the bottle tightly after use.

Dosage Information

Adult DosageThe usual adult dose for constipation is 15 to 30 milliliters (containing 10 to 20 grams of lactulose) once daily, preferably at the same time each day. For hepatic encephalopathy, the dose is typically 30 to 45 milliliters (20 to 30 grams) three to four times daily, adjusted to produce two to three soft stools per day. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function. Do not exceed the prescribed dose without medical advice.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician for appropriate dosing in children.
Elderly DosageElderly patients may require lower initial doses due to increased sensitivity to electrolyte imbalances. Start with 15 milliliters once daily and adjust as needed. Dose must be individualized by a qualified clinician based on renal and hepatic function.
Renal ImpairmentNo specific dose adjustment is established for renal impairment. However, use with caution and monitor electrolytes closely. Consult your doctor for individualized dosing.
Hepatic ImpairmentNo specific dose adjustment is established for hepatic impairment. This medicine is used in hepatic encephalopathy; dosing is based on clinical response and ammonia levels. Consult your doctor for individualized dosing.
Maximum Daily DoseFor constipation, the maximum recommended daily dose is 60 milliliters (40 grams). For hepatic encephalopathy, doses up to 120 milliliters (80 grams) daily may be used under medical supervision. Do not exceed the prescribed dose.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

With or without food
Can be taken with or without food
Food does not significantly affect the absorption or efficacy of this medicine.
Water
Drink plenty
Adequate hydration enhances the osmotic effect and prevents dehydration.

⏰ What to Do If You Miss a Dose

📌 Less than half the dosing interval has passed
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than half the dosing interval has passed
→ Skip the missed dose.
💡 Do not double dose to catch up.

⚠️ Side Effects of normalac syrup

✅ Common Side Effects

Flatulence (Common (10-20%))
Usually resolves after a few days. If persistent, consult your doctor.
Abdominal bloating (Common (10-20%))
Take with plenty of water. If bloating is severe, contact your doctor.
Abdominal cramps (Common (5-10%))
Usually subsides with continued use. If severe, consult your doctor.
Nausea (Common (5-10%))
Take with food or after meals to reduce nausea.
Diarrhea (Common (5-10%))
Reduce dose if diarrhea occurs. Consult your doctor if it persists.

🚨 Serious Side Effects

Severe diarrhea leading to dehydration and electrolyte imbalance (Uncommon (0.1-1%))
Seek immediate medical attention if you experience persistent diarrhea, dizziness, or muscle weakness.
Allergic reactions (rash, itching, swelling of face, lips, or throat) (Rare (<0.1%))
Stop the medicine and seek emergency medical help immediately.
Pneumatosis intestinalis (in patients with liver disease) (Rare (<0.1%))
Report severe abdominal pain, bloating, or blood in stool to your doctor immediately.

⚠️ Rare Side Effects

Hypernatremia
Monitor electrolyte levels if on long-term therapy. Consult doctor if symptoms like excessive thirst or confusion occur.
Hypokalemia
Report muscle weakness, cramps, or palpitations to your doctor.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
Other laxatives Major
Antacids Moderate
Diuretics Moderate
Corticosteroids Moderate
Oral medications Minor

🚨 Major Interactions

  • Other laxatives (e.g., stimulant laxatives)
  • Antacids (non-absorbable)

⚡ Moderate Interactions

  • Diuretics
  • Corticosteroids

🍷 Alcohol Interaction

Alcohol may worsen dehydration and electrolyte imbalance caused by diarrhea. It is advisable to avoid alcohol while taking this medicine, especially if you experience diarrhea.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Galactosemia","Bowel obstruction or suspected bowel obstruction","Gastrointestinal perforation","Severe inflammatory bowel disease (e.g., ulcerative colitis, Crohn's disease) during acute flares","Low-galactose diet","Hypersensitivity to lactulose or any component of the formulation"]

⚠️ Warnings & Precautions

["Use with caution in patients with diabetes mellitus as this medicine contains galactose and lactose.","Do not use in patients with galactosemia.","Prolonged use of high doses may cause electrolyte imbalance; monitor electrolytes.","If diarrhea occurs, reduce dose or discontinue and consult your doctor.","Use with caution in patients with renal impairment; monitor renal function.","Elderly patients may be more susceptible to electrolyte imbalances.","This medicine may interfere with breath tests for lactose intolerance or SIBO; inform your doctor.","Do not use for more than 2 weeks without medical advice unless prescribed for hepatic encephalopathy.","Keep out of reach of children.","Inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding."]

🤱 Lactation Safety

Lactulose is considered safe during breastfeeding as it is poorly absorbed and unlikely to affect the nursing infant. Consult your doctor for guidance.

💊 Overdose Management

Overdose of this medicine may cause severe diarrhea, abdominal cramps, dehydration, and electrolyte imbalance. If you suspect an overdose, seek immediate medical attention. Treatment is supportive and may include intravenous fluids and electrolyte replacement. Do not induce vomiting unless instructed by a healthcare professional.

⏰ Missed Dose

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double the dose to catch up.

Additional Safety Advice

General Safety

Take this medicine exactly as prescribed by your doctor. Do not increase or decrease the dose without consulting your healthcare provider. Drink plenty of water throughout the day to help soften your stool and prevent dehydration. This medicine may take 24 to 48 hours to produce a bowel movement, so do not expect immediate results. Avoid taking other laxatives unless your doctor approves. If you have diabetes, monitor your blood sugar levels regularly because this medicine contains sugars. Do not use this medicine if you have a bowel obstruction, galactosemia, or if you are on a galactose-free diet. Inform your doctor if you are pregnant, planning to become pregnant, or breastfeeding. Keep this medicine out of reach of children. Store it at room temperature and protect it from direct sunlight. Do not use this medicine after the expiry date. If you miss a dose, take it as soon as you remember, but skip it if it is almost time for your next dose. Do not double the dose. If your constipation does not improve after several days of treatment, consult your doctor. This medicine is generally safe for long-term use, but regular follow-up with your doctor is recommended to monitor for any electrolyte imbalances or other complications.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients may be more sensitive to the effects of this medicine, particularly electrolyte imbalances and dehydration. Start with a lower dose and monitor closely. Ensure adequate fluid intake and regular monitoring of renal function and electrolytes.

🤰 Pregnancy Planning (TTC)

This medicine is considered safe for use during pregnancy and while trying to conceive. It is not absorbed systemically to a significant extent. However, consult your doctor before use to confirm it is appropriate for your situation.

🏥 Post-Surgery Considerations

This medicine may be used after surgery to prevent constipation, especially if you are taking pain medications that slow bowel movements. Consult your surgeon before use, as it may be contraindicated in certain abdominal surgeries.

🦷 Dental Procedures

This medicine does not interact with dental anesthetics or procedures. However, inform your dentist about all medications you are taking, including this one, before any dental work.

💚 Lifestyle Tips for Better Results

🏃
Maintain a high-fiber diet rich in fruits, vegetables, and whole grains to support bowel regularity.
🥗
Drink plenty of water throughout the day to enhance the laxative effect and prevent dehydration.
😴
Engage in regular physical activity, such as walking or yoga, to stimulate bowel movements.
💧
Establish a regular toilet routine, preferably after breakfast, to train your bowels.
🧘
Avoid processed foods and excessive caffeine, which can worsen constipation.
🌞
Manage stress through relaxation techniques, as stress can affect digestion.
🚭
Get adequate sleep to support overall digestive health.

🏋️ Exercise Considerations

This medicine does not usually restrict exercise. However, if you experience diarrhea or dehydration, avoid strenuous exercise until you are rehydrated. Listen to your body and consult your doctor if you have concerns.

🥗 Diet Recommendations

Include high-fiber foods like oats, beans, lentils, and prunes.
Drink at least 8-10 glasses of water daily.
Limit intake of refined sugars and processed foods.
Include probiotic-rich foods like yogurt to support gut health.
Avoid excessive caffeine and alcohol, which can dehydrate you.

💼 Impact on Daily Work & Life

This medicine generally does not affect your ability to work or drive. However, if you experience dizziness or severe diarrhea, avoid driving or operating heavy machinery until you feel better. It is advisable to stay near a restroom when you first start taking this medicine, as it may cause urgent bowel movements.

🛑 When to Stop This Medicine

Do not stop taking this medicine without consulting your doctor, especially if you are being treated for hepatic encephalopathy. For constipation, you may stop if your symptoms resolve, but consult your doctor for a gradual tapering plan. If you experience severe side effects, stop the medicine and seek medical attention immediately.

📅 Long-Term Use Effects

Long-term use of this medicine is generally safe, but it may lead to electrolyte imbalances, particularly low potassium and sodium levels, especially with high doses. Regular monitoring of electrolytes is recommended for patients on prolonged therapy. In patients with hepatic encephalopathy, long-term use is often necessary and beneficial. It is important to have regular follow-ups with your doctor to adjust the dose and monitor for any complications. This medicine does not cause dependency or tolerance.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Dietary fiber supplementation

Increasing dietary fiber can help relieve constipation naturally.

Evidence: Well-established
Probiotics

Probiotics can improve gut health and regularity, but evidence for constipation is mixed.

Evidence: Moderate
Biofeedback therapy

For chronic constipation due to pelvic floor dysfunction, biofeedback can be effective.

Evidence: Well-established

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

This medicine does not interact with vaccines. There are no specific vaccination considerations while taking this medicine. However, maintain your regular vaccination schedule as advised by your doctor.

📦 Storage Guide

✅ DO

Store at room temperature (15-30°C)

❌ DON'T

Do not refrigerate unless specified

✅ DO

Keep in original container

❌ DON'T

Do not transfer to unmarked containers

✅ DO

Keep away from direct sunlight

❌ DON'T

Do not store in bathroom cabinet

✅ DO

Keep the bottle tightly closed

❌ DON'T

Do not use after expiry date

✈️ Traveling with This Medicine

When traveling, carry this medicine in its original packaging with the prescription label intact. Bring a copy of your prescription in case of customs checks. Store it in a cool, dry place away from direct sunlight. If traveling across time zones, maintain your dosing schedule as closely as possible; for hepatic encephalopathy, consult your doctor for specific timing adjustments. Keep the bottle tightly closed and upright to prevent leakage. If you are flying, pack it in your carry-on luggage to avoid temperature extremes in checked baggage.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 60-year-old man with chronic constipation
Rajesh had been struggling with constipation for years. His doctor prescribed this medicine, and after two days, he noticed a significant improvement in his bowel movements. He initially experienced some bloating, but it subsided within a week. He now takes it every morning with a glass of water and has regular, comfortable bowel movements.
💡 Lesson: This medicine is effective for chronic constipation but may cause temporary bloating. Consistency and adequate hydration are key.
👤 A 55-year-old woman with liver cirrhosis and hepatic encephalopathy
Sunita was diagnosed with hepatic encephalopathy and was started on this medicine. Her ammonia levels were high, causing confusion. After a week of treatment, her mental status improved significantly, and her ammonia levels dropped. She now takes it three times a day and monitors her stool frequency.
💡 Lesson: This medicine is life-changing for patients with hepatic encephalopathy. Adherence to the prescribed dose and regular monitoring are crucial.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: This medicine typically takes 24 to 48 hours to produce a bowel movement. For hepatic encephalopathy, it may take a similar time to reduce ammonia levels.

Q: Can I take this medicine every day?

A: Yes, this medicine is safe for daily use under medical supervision. It does not cause dependency.

Q: Is this medicine safe during pregnancy?

A: This medicine is considered safe during pregnancy (FDA category B). However, consult your doctor before use.

Q: What are the side effects of this medicine?

A: Common side effects include bloating, gas, abdominal cramps, and nausea. These usually subside with continued use.

Q: Can I take this medicine with other laxatives?

A: Do not take other laxatives without consulting your doctor, as it may cause severe diarrhea and electrolyte imbalance.

Q: Does this medicine cause dependency?

A: No, this medicine is an osmotic laxative and does not cause dependency.

Q: How should I store this medicine?

A: Store at room temperature (15-30°C) away from direct sunlight and moisture. Keep the bottle tightly closed.

Q: What should I do if I miss a dose?

A: Take the missed dose as soon as you remember. If it is almost time for your next dose, skip it and continue with your regular schedule. Do not double the dose.

Q: Can diabetics take this medicine?

A: This medicine contains galactose and lactose, so diabetics should use it with caution and monitor blood sugar levels.

Q: Is this medicine safe for children?

A: Pediatric dosing is not established from available information. Consult a pediatrician for appropriate use in children.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my kidney function?
  • Can I drive after taking this medicine?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while taking this?
  • Is it safe for diabetics?
  • Can I take it during pregnancy?

🔄 Substitutes for normalac syrup

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: This medicine is a stimulant laxative and can cause dependency.
    Fact: This medicine is an osmotic laxative and does not cause dependency. It works by drawing water into the colon.
  • Myth: This medicine works immediately after taking it.
    Fact: This medicine takes 24 to 48 hours to produce a bowel movement. It is not a rapid-acting laxative.
  • Myth: This medicine is only for constipation.
    Fact: This medicine is also used to treat hepatic encephalopathy by reducing blood ammonia levels.
  • Myth: This medicine is unsafe for long-term use.
    Fact: This medicine is safe for long-term use under medical supervision, but monitoring for electrolyte imbalances is recommended.

🔄 Alternative Options

Generic Alternatives

  • Lactulose solution

Brand Alternatives

  • Laxopeg Syrup

📊 Comparison with Similar Medicines

[{"medicine":"Lactulose","class":"Osmotic laxative","main_use":"Constipation, hepatic encephalopathy","onset":"24-48 hours"},{"medicine":"Polyethylene glycol","class":"Osmotic laxative","main_use":"Constipation","onset":"24-48 hours"},{"medicine":"Lactitol","class":"Osmotic laxative","main_use":"Constipation, hepatic encephalopathy","onset":"24-48 hours"}]

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