Lactulose

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Update Date 08/05/2020 . 6 mins read
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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 a colonic acidifier that works by increasing stool water content and softening the stool. It is a man-made sugar solution.

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug, but may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if has been so prescribed by your health care professional.

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?

Lactulose is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store Lactulose in the bathroom or the freezer. There may be different brands of Lactulose that may have different storage needs. 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 Lactulose down the toilet or pour them into a drain unless instructed to do so. 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 taking lactulose,

  • Tell your doctor and pharmacist if you are allergic to lactulose or any other drugs.
  • Tell your doctor and pharmacist what prescription and nonprescription lactulose you are taking, especially antacids, antibiotics including neomycin (mycifradin), and other laxatives.
  • Tell your doctor if you have diabetes or require a low-lactose diet.
  • Tell your doctor if you have a history of lactose intolerance.
  • Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking lactulose, call your doctor.
  • If you are having surgery or tests on your colon or rectum, tell the doctor that you are taking lactulose.

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 Lactulose. Lactulose 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?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using lactulose and call your doctor at once if you have severe or ongoing diarrhea.

Less serious side effects may include: bloating, gas; stomach pain; diarrhea; or nausea, vomiting.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with lactulose?

Lactulose 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. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Some medications that may interact with lactulose include:

  • Oral anti-infectives (e.g. tetracyclines, neomycin) 
  • Glutamine
  • Antacids

Does food or alcohol interact with lactulose?

Lactulose 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?

Lactulose may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have, especially:

  • Appendicitis (or signs of);
  • Rectal bleeding of unknown cause—These conditions need immediate attention by a doctor;
  • Colostomy;
  • Intestinal blockage;
  • Ileostomy—The use of laxatives may create other problems if these conditions are present;
  • Type 2 diabetes mellitus—Diabetic patients should be careful since some laxatives contain large amounts of sugars, such as dextrose, galactose, and/or sucrose;
  • Heart disease;
  • High blood pressure—Some laxatives contain large amounts of sodium, which may make these conditions worse.
  • Kidney disease—Magnesium and potassium (contained in some laxatives) may build up in the body if kidney disease is present; a serious condition may develop.
  • Swallowing difficulty—Mineral oil should not be used since it may get into the lungs by accident and cause pneumonia; also, bulk-forming laxatives may get lodged in the esophagus of patients who have difficulty in swallowing.

Understand the dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using Lactulose.

What is the dose of Lactulose for an adult?

Usual Adult Dose for 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 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.

Usual Adult Dose for 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 of Lactulose for a child?

Usual Pediatric Dose for 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 your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Lactulose, 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.

 

Hello Health Group does not provide medical advice, diagnosis or treatment.

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