Duphalac Fruit Syrup: A Comprehensive Guide to Understanding and Using This Laxative Medication

Constipation affects millions of people worldwide, impacting quality of life and causing significant discomfort. Among the various treatments available, Duphalac Fruit Syrup stands out as a widely prescribed and effective option for managing constipation symptoms. This oral solution, containing the active ingredient lactulose, works differently from many other laxatives by drawing water into the bowel to soften stools and promote regular bowel movements. Unlike stimulant laxatives that can cause dependency over time, Duphalac Fruit Syrup offers a gentler approach to constipation relief with a mechanism that works more naturally with the body's digestive processes.

Duphalac Fruit Syrup (667 mg/ml oral solution) comes in a pleasant-tasting plum-flavored formulation, making it more palatable than many alternative treatments. Available in multiple formats including bottles with measuring cups and convenient single-dose sachets, this medication has been designed with patient compliance and ease of use in mind. As we explore this medication in detail, we'll discover why it has become a trusted option for healthcare providers when recommending constipation treatments for various patient populations, from infants to the elderly, though always with appropriate medical supervision.

What is Duphalac Fruit Syrup? A Detailed Look at This Medication

The Science Behind Lactulose

Duphalac Fruit Syrup contains lactulose as its active ingredient, a synthetic disaccharide that is not naturally found in significant quantities in our diet. Chemically, lactulose consists of the sugars galactose and fructose linked together, but what makes it special is how our bodies interact with it. The human digestive system lacks the enzymes needed to break down lactulose in the small intestine, which means it passes through unchanged until it reaches the colon. Once in the large intestine, beneficial bacteria ferment the lactulose, producing organic acids and gases that create two important effects: they acidify the colonic contents and increase osmotic pressure, drawing water into the intestine.

This unique mechanism of action differentiates Duphalac from stimulant laxatives, which work by irritating the intestinal lining to provoke contractions. Instead, Duphalac works osmotically and through bacterial action, making it gentler on the digestive system while still effectively promoting bowel movements. The acidification of the colon also helps soften the stool by altering its pH, making passage easier and less painful—a particularly important feature for patients with conditions like hemorrhoids where straining can exacerbate symptoms.

Physical Characteristics and Available Forms

Duphalac Fruit Syrup presents as a clear, viscous solution that ranges from colorless to brownish-yellow in appearance. Its syrupy consistency is due to the high concentration of lactulose (667 mg/ml), which gives it a slightly sweet taste alongside the added plum flavoring that helps mask any unpleasant notes. The medication is specifically designed to be palatable while delivering an effective dose of the active ingredient.

Available in multiple formats to suit different needs and preferences, Duphalac Fruit Syrup comes in:

• Sachets: 15 ml single-dose packets, with 20 sachets per box, ideal for travel or precise dosing
• Bottles: Available in 200 ml, 300 ml, 500 ml, 800 ml, or 1000 ml sizes, with an included measuring cup graduated at 2.5 ml, 5 ml, 10 ml, 15 ml, 20 ml, 25 ml, and 30 ml for accurate dosing

This variety of packaging options helps ensure that patients can select the most convenient form for their lifestyle, potentially improving medication adherence and treatment success.

Therapeutic Uses: When and Why Duphalac Fruit Syrup is Prescribed

Primary Indications for Constipation

Duphalac Fruit Syrup is primarily indicated for the symptomatic treatment of constipation, addressing the uncomfortable and often painful symptoms associated with infrequent bowel movements and hard, dry stools. Constipation is typically defined as having fewer than three bowel movements per week, difficulty passing stools, or incomplete evacuation. While occasional constipation affects almost everyone at some point, chronic constipation can significantly impact quality of life and may be associated with various underlying conditions or lifestyle factors.

The efficacy of Duphalac in treating constipation stems from its ability to increase stool water content and volume, which stimulates peristalsis (the wave-like muscle contractions that move content through the digestive tract). By softening the stool and making it easier to pass, Duphalac can provide relief without the griping pain often associated with stimulant laxatives. This gentler approach makes it suitable for longer-term management of chronic constipation when used under appropriate medical supervision and within recommended timeframes.

Special Circumstances for Use

Beyond general constipation management, Duphalac Fruit Syrup is particularly beneficial in specific clinical scenarios:

1. Hemorrhoid Management: Patients with hemorrhoids often experience significant pain during bowel movements, especially when passing hard stools. Duphalac's stool-softening action can reduce straining during defecation, minimizing pain and preventing further irritation or bleeding of hemorrhoidal tissue. This makes it a valuable adjunct therapy for hemorrhoid management, often recommended alongside topical treatments.

2. Post-Surgical Constipation: Following surgery to the rectum or large bowel, patients frequently experience constipation due to several factors: anesthesia temporarily slowing gut motility, pain medications (particularly opioids) causing constipation as a side effect, and the physiological stress response to surgery. Additionally, patients may be reluctant to have bowel movements due to pain or fear of disrupting surgical sites. Duphalac provides a gentle solution that can help restore normal bowel function without putting undue strain on healing tissues.

3. Pediatric Constipation: While requiring careful medical supervision, Duphalac can be prescribed for children experiencing constipation that hasn't responded to dietary modifications. The dosage is carefully calculated based on age and weight, with the medication's relatively mild action making it suitable for pediatric use when properly monitored.

4. Elderly Patients: Older adults frequently experience constipation due to decreased mobility, medication side effects, and age-related changes in digestive function. Duphalac's mechanism of action and favorable safety profile make it appropriate for this population, though dose adjustments may be necessary depending on individual factors.

Dosage and Administration: Using Duphalac Fruit Syrup Correctly

General Administration Guidelines

For Duphalac Fruit Syrup to provide optimal therapeutic benefit, proper administration is crucial. The medication should be taken at a consistent time each day to establish a regular routine and maximize effectiveness. Many healthcare providers recommend taking it with breakfast to help establish a predictable pattern of bowel movements. When consuming the medication, it should be swallowed quickly rather than held in the mouth, as this prevents potential dental issues that could arise from prolonged exposure to the sugars it contains.

Duphalac offers flexibility in administration—it can be taken either undiluted for a quicker, more convenient dose or diluted in water or fruit juice if the patient finds the taste or consistency challenging. For patients using bottled Duphalac, the provided measuring cup ensures accurate dosing, while those using sachets can simply tear open the corner and consume the pre-measured 15 ml dose immediately. This versatility in administration helps improve compliance, particularly for patients who may have difficulty swallowing medications or who have sensitivities to taste or texture.

Dosage by Age Group

Appropriate dosing of Duphalac Fruit Syrup varies significantly by age and individual response. The following table outlines the recommended starting and maintenance doses for different age groups:

Age Group	Starting Dose	Maintenance Daily Dose
Adults and adolescents	15-45 ml (10-30 g lactulose)	15-30 ml (10-20 g lactulose)
Children (7-14 years)	15 ml (10 g lactulose)	10-15 ml (7-10 g lactulose)
Children (1-6 years)	5-10 ml (3-7 g lactulose)	5-10 ml (3-7 g lactulose)
Infants under 1 year	up to 5 ml (up to 3 g lactulose)	up to 5 ml (up to 3 g lactulose)

These dosages recognize the physiological differences between age groups and provide a framework for treatment. However, it's important to note that individual response varies, and the actual effective dose may differ from person to person. Healthcare providers typically recommend starting at the lower end of the dosage range and adjusting based on response, with the goal of achieving soft, formed stools without causing diarrhea.

For younger children and infants, Duphalac should only be used in exceptional circumstances and always under close medical supervision. The bottle format is preferred for children under 7 years to allow for more precise dosing than the pre-measured sachets can provide.

Timing and Duration Considerations

Patient should be aware that Duphalac Fruit Syrup does not provide immediate relief like some other laxatives. The full therapeutic effect typically takes 2-3 days to manifest, as the medication needs time to reach the colon and undergo bacterial fermentation. This delayed onset of action should be factored into treatment expectations to prevent unnecessary dose escalation or discontinuation due to perceived ineffectiveness.

The dosage may be taken either as a single daily dose or divided into two administrations, depending on patient preference and response. After the initial few days of treatment, the starting dose may be adjusted to a maintenance dose based on individual response. The goal is to find the minimum effective dose that produces soft, comfortable bowel movements without causing diarrhea or other unwanted effects.

An important consideration is that Duphalac Fruit Syrup should not be used for more than two weeks without consulting a healthcare provider. Prolonged self-treatment of constipation can mask underlying conditions that may require different management approaches. Additionally, extended use of any laxative without medical supervision can potentially disrupt normal bowel function and create dependency.

Safety Considerations: Important Information Before Taking Duphalac

Contraindications: When Not to Use Duphalac Fruit Syrup

Understanding when Duphalac Fruit Syrup should not be used is crucial for patient safety. The medication is contraindicated in several specific conditions where its use could potentially cause harm. Patients with known hypersensitivity or allergy to lactulose or any other ingredients in the formulation should avoid this medication entirely, as allergic reactions can range from mild skin irritations to potentially life-threatening anaphylaxis. Although rare, such allergic responses require immediate discontinuation and medical attention.

Several digestive system conditions absolutely prohibit the use of Duphalac. Patients with galactosaemia, a rare but serious genetic disorder where the body cannot metabolize the sugar galactose, should never use this medication as it contains galactose, which could lead to toxic accumulation. Similarly, Duphalac is contraindicated in cases of intestinal obstruction (aside from normal constipation) since the medication works by drawing water into the bowel—a mechanism that could worsen pressure behind an obstruction. Perhaps most seriously, patients with gastrointestinal perforation or risk of perforation, such as those with acute inflammatory bowel diseases like Crohn's disease or ulcerative colitis in active phases, should avoid Duphalac as the increased intestinal activity could potentially exacerbate these serious conditions.

Medical Conditions Requiring Caution

Beyond absolute contraindications, several medical conditions warrant special caution and consultation with a healthcare provider before initiating Duphalac therapy. Patients experiencing unexplained abdominal pain should have the underlying cause diagnosed before starting any laxative, including Duphalac, as symptom masking could delay important diagnoses or potentially worsen certain conditions. Those with Roemheld syndrome, a condition where gas accumulation in the gastrointestinal tract can trigger cardiac symptoms, should use Duphalac only under close medical supervision, as the fermentation process can produce additional gas that might exacerbate their condition.

People with lactose intolerance should be aware that Duphalac contains production residues of lactose, which could potentially trigger symptoms in sensitive individuals, although the quantities are typically small. Patients with diabetes mellitus should use Duphalac with caution and with their healthcare provider's knowledge, as the medication contains sugars that, while not significantly absorbed in most people, could theoretically affect blood glucose control in some cases. Additionally, those with sugar intolerances such as galactose or fructose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption should avoid Duphalac due to its sugar content and the potential for adverse reactions.

Drug Interactions

Duphalac Fruit Syrup can interact with several medications, potentially affecting their efficacy or safety profile. One significant interaction involves medications that can cause potassium depletion, such as thiazide diuretics, corticosteroids, and amphotericin B. When these medications are used concurrently with Duphalac, especially if Duphalac causes diarrhea, the risk of hypokalemia (low blood potassium) increases. This electrolyte imbalance can have serious consequences, particularly for cardiac function and muscle performance.

Of particular concern is the interaction between Duphalac and cardiac glycosides like digoxin, which are used to treat heart failure and certain arrhythmias. Potassium depletion can enhance the effect of these medications, potentially leading to digitalis toxicity characterized by nausea, vomiting, visual disturbances, and dangerous cardiac arrhythmias. Patients taking both medications should be monitored closely for signs of electrolyte imbalance and cardiac glycoside toxicity, with potential adjustments to dosage or more frequent laboratory monitoring.

While not directly related to drug interactions, it's worth noting that during treatment with Duphalac, adequate hydration is essential. Patients should consume sufficient fluids (approximately 2 liters or 6-8 glasses daily) to support the medication's osmotic action and prevent excessive fluid loss that could contribute to electrolyte imbalances.

Managing Treatment: What to Expect and How to Monitor

Expected Therapeutic Timeline

When beginning treatment with Duphalac Fruit Syrup, patients should understand the expected timeline for symptom improvement. Unlike stimulant laxatives that can work within hours, Duphalac typically requires 2-3 days before producing noticeable therapeutic effects. This delay occurs because the medication must reach the colon and undergo bacterial fermentation to generate its laxative action. Patients should be counseled to maintain consistent dosing during this initial period and resist the temptation to increase the dose prematurely out of frustration with seemingly slow results.

During the first few days of treatment, some patients may experience increased flatulence or abdominal discomfort as the gut bacteria adjust to fermenting the lactulose. This side effect is usually temporary and diminishes as treatment continues. The initial treatment phase aims to establish regular bowel movements with soft, formed stools rather than loose or watery stools. If diarrhea occurs, this indicates that the dose may be too high and should be reduced. Once the therapeutic effect begins, most patients notice a gradual improvement in stool consistency and defecation comfort, with reduced straining and a more predictable bowel pattern.

Monitoring Treatment Effectiveness

Effective monitoring of Duphalac therapy involves tracking both symptomatic improvements and potential side effects. Patients should maintain a simple bowel diary during treatment, noting the frequency, consistency, and ease of bowel movements. The Bristol Stool Form Scale, a medical tool for classifying stool consistency, can be helpful in this regard:

• Type 1-2: Hard, lumpy stools (constipation)
• Type 3-4: Normal, formed stools
• Type 5-7: Soft to watery stools (approaching diarrhea)

The goal of Duphalac therapy is to achieve Type 3-4 stools, indicating normal consistency without excessive softening that could lead to fecal incontinence or urgency. Patients should also monitor for signs of proper hydration, as Duphalac's osmotic action works best when fluid intake is adequate. Dark yellow urine or feelings of thirst can indicate insufficient fluid intake, which should be addressed to optimize treatment effectiveness.

Any persistent or worsening abdominal pain, bloating that doesn't improve after the initial adaptation period, or changes in stool characteristics (such as blood in the stool) should prompt immediate medical consultation, as these could indicate either adverse reactions to the medication or underlying conditions requiring different management approaches.

When to Adjust or Discontinue Treatment

After the initial treatment period, most patients will find an effective maintenance dose that produces comfortable bowel movements without side effects. However, several scenarios may warrant dose adjustment or treatment discontinuation. If constipation symptoms persist despite several days at the maximum recommended dose, patients should consult their healthcare provider rather than continuing to increase the dose independently. Persistent constipation despite adequate laxative therapy may indicate an underlying condition requiring further investigation.

Conversely, if treatment leads to diarrhea or excessive bowel movements (more than 2-3 soft stools per day), the dose should be reduced to prevent electrolyte imbalances and dehydration. Finding the optimal dose often involves some trial and error, with gradual adjustments based on individual response. In patients with Roemheld syndrome, the development of significant flatulence or bloating should prompt discontinuation and medical consultation, as these symptoms could potentially trigger cardiac complaints in this vulnerable population.

Most importantly, Duphalac Fruit Syrup should not be used for more than two weeks without medical supervision, regardless of the response. Prolonged self-treatment of constipation carries several risks: it may mask underlying conditions requiring specific treatment, potentially disrupt normal bowel reflexes, and in some cases, lead to laxative dependency where the bowel becomes less responsive to normal stimuli. If constipation persists beyond this two-week window, a comprehensive medical evaluation is warranted to identify and address the root cause.

Understanding Side Effects: What Patients Should Know

Common Side Effects

Like all medications, Duphalac Fruit Syrup can cause side effects, though many patients tolerate it well at appropriate doses. The most common side effect, affecting more than 1 in 10 users, is diarrhea. This typically occurs when the dosage is too high for the individual and can be managed by reducing the dose. Diarrhea is not just an inconvenience but can lead to dehydration and electrolyte imbalances if persistent, so patients should not dismiss this as a normal part of treatment.

Other common side effects, occurring in up to 1 in 10 patients, include flatulence (excessive gas), nausea, vomiting, and abdominal pain. Flatulence is particularly common during the first few days of treatment as the gut bacteria adapt to fermenting the increased lactulose. This side effect often diminishes with continued use as the gut microbiome adjusts. The abdominal discomfort and bloating some patients experience is directly related to this gas production and generally follows the same pattern of initial appearance followed by gradual resolution. However, if these symptoms persist or are severe, they warrant medical attention as they could indicate an intolerance to the medication or an underlying condition.

Less Common and Serious Side Effects

Less commonly, occurring in up to 1 in 100 patients, Duphalac may cause electrolyte imbalances, particularly if it causes prolonged or severe diarrhea. Potassium, sodium, and other electrolytes play crucial roles in numerous bodily functions, including heart rhythm, muscle contraction, and nerve signaling. Signs of electrolyte imbalance may include unusual fatigue, muscle weakness or cramps, irregular heartbeat, and confusion. These symptoms require prompt medical evaluation, especially in elderly patients or those with pre-existing cardiac or renal conditions.

Rarer side effects with undetermined frequency include allergic reactions manifesting as rash, itching, or hives. While uncommon, these hypersensitivity reactions can occur with any medication and should not be ignored. In extremely rare cases, more severe allergic reactions could develop, potentially including angioedema (swelling of deeper skin layers, often around the face) or anaphylaxis (a severe, potentially life-threatening allergic reaction). Any signs of allergic reaction should prompt immediate discontinuation of the medication and appropriate medical attention based on the severity of symptoms.

Managing and Minimizing Side Effects

Several strategies can help manage and minimize the side effects associated with Duphalac Fruit Syrup. Starting with a lower dose and gradually increasing it allows the digestive system to adapt more gently to the medication, potentially reducing initial flatulence and abdominal discomfort. Taking the medication with meals rather than on an empty stomach may also help mitigate digestive symptoms for some patients.

Maintaining adequate hydration is particularly important, not only for the medication's effectiveness but also for preventing complications from diarrhea if it occurs. The recommended fluid intake of approximately 2 liters (6-8 glasses) daily supports both the medication's osmotic action and general digestive health. For patients experiencing significant flatulence, temporary dietary modifications might help, such as reducing consumption of other fermentable foods like beans, certain vegetables, and high-fiber foods until the body adjusts to the medication.

If troublesome side effects persist despite these measures, patients should consult their healthcare provider before discontinuing treatment. Often, a simple dose adjustment can resolve many side effects while maintaining therapeutic benefit. However, severe or persistent symptoms, particularly diarrhea leading to signs of dehydration (excessive thirst, dry mouth, reduced urination, dizziness) should prompt immediate medical attention regardless of the duration of treatment.

Special Populations: Considerations for Different Patient Groups

Duphalac Use During Pregnancy and Breastfeeding

Duphalac Fruit Syrup is generally considered safe for use during pregnancy and breastfeeding, providing relief for constipation that commonly occurs during these periods due to hormonal changes, reduced physical activity, and the physical pressure of the growing uterus on the intestines. Unlike stimulant laxatives that might potentially affect uterine contractility, Duphalac works locally in the intestine with minimal systemic absorption, making it a preferred option when dietary changes and increased fluid intake prove insufficient for constipation management during pregnancy.

For breastfeeding mothers, the safety profile remains favorable as lactulose is not significantly absorbed into the bloodstream and therefore has minimal potential for transfer into breast milk. However, as with any medication during pregnancy or lactation, the principle of using the lowest effective dose for the shortest necessary duration applies. While formal studies specifically designed to assess safety in pregnancy are limited due to ethical constraints, extensive clinical experience has not identified concerns, and major obstetric guidelines generally list osmotic laxatives like lactulose among the safer options when medication becomes necessary for constipation during pregnancy or breastfeeding.

Pediatric Use: Important Considerations

The use of Duphalac in pediatric populations requires special attention and should only occur under medical supervision. While the medication is approved for use in children and even infants in certain circumstances, laxatives should generally be considered only after dietary modifications, increased fluid intake, and behavioral approaches have failed to resolve constipation. Children often develop constipation during toilet training, dietary transitions, or as a result of withholding behavior due to previous painful bowel movements, and addressing these underlying factors is crucial alongside any medication.

For accurate dosing in younger children and infants, the bottled form of Duphalac with its graduated measuring cup is strongly preferred over sachets to allow for precise administration of the smaller volumes required. Parents should be cautioned that the medication contains propylene glycol (E1520) at a concentration of 0.96 mg/ml, which requires special consideration in infants younger than 4 weeks, particularly if they are receiving other medications containing propylene glycol or alcohol. The dosage schedule must be strictly followed for pediatric patients, with close monitoring for side effects and regular reassessment of the need for continued treatment.

Elderly Patients and Those with Compromised Organ Function

While there are no specific dosage recommendations for elderly patients or those with renal or hepatic insufficiency, certain considerations apply to these populations. Older adults often have multiple factors contributing to constipation, including reduced mobility, multiple medications with constipating side effects, decreased fluid intake, and age-related changes in gastrointestinal function. They may also be more susceptible to electrolyte disturbances and dehydration if Duphalac causes diarrhea, warranting careful dose titration and monitoring.

For patients with renal insufficiency, the minimal systemic absorption of lactulose means that dose adjustments are generally not required based on kidney function alone. However, these patients may already have challenges with fluid and electrolyte balance that could be exacerbated by diarrhea, suggesting a more cautious approach to dosing. Similarly, patients with hepatic impairment don't typically require specific dose adjustments for Duphalac based on liver function, though those with advanced liver disease may have altered gut motility and microbiome function that could affect response to the medication. In all these special populations, starting at the lower end of the dosing range and adjusting based on individual response remains the prudent approach.

Practical Advice: Maximizing Treatment Success

Lifestyle Modifications to Support Treatment

While Duphalac Fruit Syrup provides effective relief for constipation, combining medication with appropriate lifestyle modifications can enhance outcomes and potentially reduce the needed dosage. Dietary fiber plays a crucial role in maintaining bowel regularity, and patients should be encouraged to gradually increase their intake of fruits, vegetables, whole grains, and legumes. A sudden increase in fiber can initially worsen bloating and gas, so a gradual approach is recommended, starting with an additional serving or two of high-fiber foods daily and increasing over several weeks until reaching the recommended 25-30 grams daily for adults.

Hydration supports Duphalac's mechanism of action and promotes overall digestive health. The often-cited recommendation of 8 glasses (approximately 2 liters) of fluid daily provides a reasonable target for most adults, though individual needs may vary based on activity level, climate, and certain medical conditions. Water is the ideal choice, though other non-caffeinated, non-alcoholic beverages can contribute to fluid intake. Caffeinated and alcoholic beverages may actually contribute to dehydration and should be limited.

Physical activity stimulates intestinal contractions and can significantly improve constipation. Even modest activity—such as a 20-30 minute walk daily—can help maintain regular bowel function. For those with mobility limitations, appropriate seated exercises or physical therapy may provide similar benefits. Additionally, establishing a regular toileting routine, ideally after meals when the gastrocolic reflex naturally stimulates bowel activity, can help train the body to establish more regular patterns. Patients should be encouraged to respond promptly to the urge to defecate rather than suppressing it, as repeated suppression can lead to diminished sensation and worsening constipation over time.

Tips for Medication Administration

Maximizing the palatability and convenience of Duphalac can improve treatment adherence. For patients who find the sweet taste or syrupy consistency challenging, diluting the medication in water, fruit juice, or mixing it with yogurt can make it more acceptable without reducing efficacy. Using cold rather than room temperature liquid for dilution can also help mask the sweetness that some patients find cloying. For those using the bottled form, transferring a daily or weekly supply to a smaller container can make it more portable for work or travel.

The timing of administration can affect both efficacy and side effect profile. Taking Duphalac with breakfast allows it to work throughout the day when the patient is active, potentially enhancing its effect. This timing also means that any increased gas production is less likely to disturb sleep. However, some patients may prefer evening dosing if they find that the laxative effect typically occurs predictably several hours after administration, allowing them to plan bathroom access accordingly.

For patients who experience significant initial flatulence, gradually increasing the dose over several days can allow the gut microbiome to adapt more comfortably. Starting at the lower end of the recommended range—perhaps half the usual starting dose—and increasing every 2-3 days until reaching effective relief can minimize this common side effect while still achieving therapeutic benefit. This approach is particularly helpful for patients with irritable bowel syndrome or those who have previously experienced bloating with fiber supplements or other treatments.

When to Seek Further Medical Advice

While Duphalac is generally safe when used as directed, certain situations warrant prompt medical attention. Persistent constipation despite maximal recommended dosing for several days suggests either an inadequate treatment approach or an underlying condition requiring further evaluation. Diagnostic workup might include blood tests, imaging studies, or specialized testing of colorectal and anorectal function to identify conditions ranging from hypothyroidism to pelvic floor dyssynergia that might be contributing to refractory symptoms.

The development of new or changing symptoms during treatment should always prompt medical consultation. This includes new abdominal pain, blood in the stool, unintentional weight loss, persistent nausea or vomiting, or fever. These could indicate conditions unrelated to the constipation itself that require specific diagnosis and management. Similarly, signs of significant electrolyte imbalance such as unusual fatigue, muscle weakness or cramping, heart palpitations, or confusion should trigger immediate medical evaluation, particularly in elderly patients or those with cardiac or renal conditions.

For patients with recurrent constipation requiring repeated courses of treatment, a more comprehensive evaluation of potential underlying causes is appropriate. This might include medication review to identify constipating agents, screening for metabolic disorders like hypothyroidism or diabetes, assessment for structural abnormalities of the gastrointestinal tract, and evaluation of pelvic floor function. Identifying and addressing these root causes can reduce reliance on laxative therapy and provide more sustainable symptom management. Remember that while over-the-counter availability makes Duphalac accessible, proper medical oversight ensures its appropriate use within a comprehensive treatment approach.

Frequently Asked Questions (FAQs) about Duphalac Fruit

1. What is Duphalac Fruit and what is it used for?

Duphalac Fruit is an oral solution medicine containing a laxative called lactulose. Its main purpose is to treat the symptoms of constipation, which includes infrequent bowel movements or hard, dry stools. It works by softening the stools, making them easier to pass naturally. It's also used to help produce soft stools if you have conditions like haemorrhoids or have had recent surgery on your rectum or large bowel.

2. How does Duphalac Fruit work to relieve constipation?

The active ingredient in Duphalac Fruit, lactulose, isn't absorbed into your body when you take it. Instead, it travels to your bowel where it works by drawing water into the intestinal area. This added water helps to soften stools that are hard and dry. Softening the stools makes them easier and more comfortable to pass, relieving constipation symptoms.

3. How long does it take for Duphalac Fruit to start working?

After starting Duphalac Fruit, it may take a few days for the medicine to show its therapeutic effect. Typically, you might need to take the treatment for two to three days before you notice an improvement in your bowel movements. Consistency in taking the dose as recommended is important for achieving the desired results. If you don't feel better after several days, consult your doctor.

4. How should I take Duphalac Fruit and what is the typical dose?

You should always take Duphalac Fruit exactly as described in the leaflet or as told by your doctor or pharmacist. Take your dose at the same time each day, swallowing it quickly without keeping it in your mouth. You can take the solution undiluted or mix it with some liquid. The dose varies by age:

• Adults/Adolescents: Start with 15-45 ml daily, adjusting to 15-30 ml for maintenance.
• Children (7-14 yrs): Start with 15 ml daily, adjusting to 10-15 ml for maintenance.
• Children (1-6 yrs): Take 5-10 ml daily for both starting and maintenance.
• Infants (<1 yr): Take up to 5 ml daily for both starting and maintenance.

5. Can I use Duphalac Fruit if I am pregnant or breastfeeding?

Yes, based on the information provided, Duphalac Fruit can be used if you are pregnant or breastfeeding. There are no expected effects on fertility associated with its use. However, it is always advisable to consult with your doctor or pharmacist before starting any new medicine during pregnancy or while breastfeeding to ensure it is appropriate for you.

6. What are the possible side effects of Duphalac Fruit?

Like all medicines, Duphalac Fruit can cause side effects, though not everyone experiences them. The most common side effect reported is diarrhoea. Other common side effects include flatulence (wind), nausea (feeling sick), vomiting, and abdominal pain. Less commonly, diarrhoea might lead to an electrolyte imbalance. If you experience side effects, especially if they are bothersome, talk to your doctor or pharmacist.

7. Are there any people who should not take Duphalac Fruit?

Yes, you should not take Duphalac Fruit if you are allergic to lactulose or any other ingredients listed in the medicine. It's also not suitable if you have certain conditions:

• Galactosaemia (a severe genetic disorder).
• An obstruction in your digestive tract (besides normal constipation).
• A perforation (hole) in your digestive tract or are at risk of one (e.g., due to severe inflammatory bowel disease like Crohn's or ulcerative colitis). Always check with your doctor or pharmacist if you are unsure.

8. Can children take Duphalac Fruit?

Duphalac Fruit can be given to children, babies, and infants, but typically only in special cases prescribed by a doctor who will carefully supervise the treatment. Laxatives should generally only be used in children under medical supervision. Do not give Duphalac Fruit to children under 14 years old without consulting a doctor for guidance and close supervision. For accurate dosing in younger children (up to 7 years), using the bottled form with the measuring cup is recommended.

9. How long should I use Duphalac Fruit?

You should not use Duphalac Fruit for more than two weeks without consulting your doctor. Prolonged use, especially with incorrect doses (leading to more than 2-3 soft stools daily) or misuse, can cause issues like diarrhoea and electrolyte imbalances. If your constipation symptoms do not improve or get worse after several days of use, it is important to seek medical advice from your doctor.

10. What should I do if I miss a dose of Duphalac Fruit?

If you forget to take a dose of Duphalac Fruit, don't worry about it. Simply take your next scheduled dose at the usual time as planned. It is important not to take a double dose to try and make up for the one you missed. Just continue with your regular dosing schedule.