Lactulose is generic laxative drug. It works as a colonic acidifier that increases water in stools, resulting in softer stools. Chemically, it is derived from lactose, a sugar found in milk products.
Know the basics
What is lactulose used for?
Lactulose is a laxative used to treat constipation. It may help to increase the number of bowel movements per day and the number of days you have a bowel movement.
Lactulose is also used to treat or prevent complications of liver disease (hepatic encephalopathy).
How should I take lactulose?
Take Lactulose by mouth, usually once daily for constipation, or as directed by your doctor. If you are taking the solution, to improve the taste, you may mix it into fruit juice, water, milk, or a soft dessert. If you are using the crystals in packets, dissolve the contents of the packet in half a glass of water (4 ounces or 120 milliliters), or as directed by your doctor.
Use Lactulose regularly in order to get the most benefit from it. Remember to take it at the same time each day. Dosage is based on your medical condition and response to therapy.
It may take up to 48 hours to have a bowel movement. Inform your doctor if your condition persists or worsens.
How do I store lactulose?
This product is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store it in the bathroom or the freezer.
There may be different brands of this drug that may have different storage needs. So, it is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.
You should not flush this product down the toilet or pour them into a drain unless instructed to do so. Additionally, it is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.
Know the precautions & warnings
What should I know before using lactulose?
Before using this drug, tell your doctor if you are/have:
- Pregnant or breastfeeding.
- Taking any other medicines. This includes any prescription, OTC, and herbal remedies.
- An allergy to any of the ingredients of this product.
- Any other illnesses, disorders, or medical conditions, especially:
- Diabetes
- Lactose intolerance
- Undergoing bowel surgery or procedures
Is it safe to take lactulose during pregnancy or breast-feeding?
There are no adequate studies in women for determining risk when using Lactulose during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking any medication.
This medication is pregnancy risk category B according to the US Food and Drug Administration (FDA).
FDA pregnancy risk category reference below:
- A=No risk
- B=No risk in some studies
- C=There may be some risk
- D=Positive evidence of risk
- X=Contraindicated
- N=Unknown
Know the side effects
What are the side effects of lactulose?
Like all drugs, this product may have side effects. If they occur, side effects are generally mild and resolve once treatment is finished or the dose is lowered. Some reported side effects include:
- Bloating, gas
- Stomach pain
- Diarrhea
- Nausea
- Vomiting
- Allergic reaction
However, not everyone experiences these side effects. In addition, some people may experience other side effects. So, if you have any concerns about a side effect, please consult your doctor or pharmacist.
Know the interactions
What drugs may interact with lactulose?
This medication may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects.
To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist.
Drugs with known interactions:
- Oral anti-infectives (e.g. tetracyclines, neomycin)
- Glutamine
- Antacids
If you experience an adverse drug interaction, stop taking this drug and continue taking your other medication. Inform your doctor immediately to reevaluate your treatment plan. Approaches include dose adjustment, drug substitution, or ending therapy.
Does food or alcohol interact with lactulose?
This drug may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.
What health conditions may interact with lactulose?
This drug may interact with underlying conditions. This interaction may worsen your health condition or alter the way the drug works. Therefore, it is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:
- Appendicitis
- Rectal bleeding
- Colostomy
- Intestinal blockage
- Ileostomy
- Type 2 diabetes mellitus
- Heart disease
- High blood pressure
- Kidney disease
- Dysphagia
Understand the dosage
The information provided is not a substitute for any medical advice. Therefore, you should always consult with your doctor or pharmacist before using any medication.
What is the dose for an adult?
Constipation
As 3.335 g/5 mL solution or 10 g/15 mL single dose solution sachet: Initially, 15-45 mL (10-30 g or 1-3 sachets) daily, may be adjusted according to clinical response.
Maintenance dose: 15-30 mL (10-20 g or 1-2 sachets) daily.
All doses of Lactulose may be given as single daily dose or in 2 divided doses.
Therapeutic effect may occur after 2-3 days of treatment. As powder for solution: 10-20 g daily, may increase to 40 g daily if necessary.
Hepatic Encephalopathy
- Oral: As 3.335 g/5 mL solution:
- Initially, 30-45 mL 3-4 times daily, may be adjusted as necessary to achieve 2 or 3 soft stools daily.
What is the dose for a child?
Hepatic Encephalopathy
- Infants: 1.7 to 6.7 g/day (2.5 to 10 mL) orally daily divided in 3 to 4 doses. Adjust dosage to produce 2 to 3 soft stools per day.
- Children: 26.7 to 60 g/day (40 to 90 mL) orally daily divided in 3 to 4 doses. Adjust dosage to produce 2 to 3 soft stools per day.
Usual Pediatric Dose for Constipation
<1 year As 3.335 g/5 mL solution:
Initially, up to 5 mL daily. Maintenance dose: Up to 5 mL daily.
1-6 years As 3.335 g/5 mL solution:
Initially, 5-10 mL daily. Maintenance dose: 5-10 mL daily.
7-14 years As 3.335 g/5 mL solution or 10 g/15 mL single dose solution sachet:
Initially, 15 mL (10 g or 1 sachet) daily, may be adjusted according to clinical response. Maintenance dose: 10-15 mL (10 g or 1 sachet) daily.
>14 years Same as adult dose. All doses may be given as a single daily dose or in 2 divided doses.
How is Lactulose available?
Lactulose is available in the following dosage form and strength:
Syrup, oral: 3.3 g/5 mL
What should I do in case of an emergency or overdose?
In case of an emergency or an overdose, call your local emergency services or go to the nearest emergency room.
What should I do if I miss a dose?
If you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.
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