Lactulose

The active ingredient, lactulose, is derived from lactose. It is a sugar made from galactose and fructose.

In people with hepatic encephalopathy, lactulose decreases the amount of ammonia in the blood, which reduces the degree of encephalopathy.

Lactulose also increases the water content in stool, both softening the stool and increasing the movement of your bowel, resulting in more frequent bowel movements.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using lactulose. However, the following is a synopsis of the general guidelines for the use of lactulose:

The typical dosing for constipation is 15-30mL, up to 60mL, of lactulose solution daily. This can be divided into 1-3 doses.

Lactulose is an oral solution that can be diluted in water, fruit juice, or milk.

The most common side effects of lactulose seen in clinical trials as compared to placebo include:

-stomach pain, cramping, or discomfort

-Bloating

-Flatulence

Some individuals may experience serious side effects while using lactulose. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

-Swelling of the face, tongue, or throat, or trouble breathing. These may be signs of an allergic reaction.

These are not all of the possible side effects of lactulose. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting lactulose, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including if you have:

-A kidney problem or other conditions that could worsen electrolyte imbalances.

-Diabetes, or conditions that require a low galactose diet.

Lactulose is contraindicated in people who are allergic to the active or inactive ingredients of the formulation.

Do not take lactulose if you have nausea, vomiting, or fever, as these may be underlying signs of a more serious condition.

It may take 24-48 hours for relief of constipation.

When lactulose is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

-Other laxatives

-Antibiotics (for example neomycin)

-Antacids

Lactulose is available in a 667mg/mL oral solution dosage form.

Lactulose should be stored at room temperature, out of reach of children.

Many brand names and generic versions of lactulose are available including from manufacturers like Pharmascience Inc.

Yes, while many brand names of lactulose exist (Enulose, Constulose, Generlac, Cephulac, and Cholac), lactulose is also available in many generic versions.

Other laxative products are also available OTC to treat constipation. Ask your pharmacist about polyethylene glycol, Dulcolax, Senokot, or how to incorporate fiber into your diet.

Lactulose is not known to cause rebound constipation. You can stop taking lactulose when your bowel movements return to normal.

Lactulose is also indicated for the treatment of chronic constipation. Speak with your doctor if you intend to use lactulose long-term.

The use of lactulose in pregnancy has not been studied in humans. Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. They will know or recommend what is best for you.

It is unknown whether lactulose is excreted in breast milk. Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. They will know or recommend what is best for you.