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Lactulose
Lactulose is a synthetic disaccharide commonly used as a laxative and for the treatment of hepatic encephalopathy. It helps to relieve constipation and reduce blood ammonia levels by promoting the excretion of ammonia in the stool.
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Frequently Asked Questions
How long does it take for lactulose to work?
Lactulose usually starts to produce effects within 24 to 48 hours of administration.
Can I take lactulose with other medications?
Always consult your healthcare provider before combining lactulose with other medications, especially other laxatives or antibiotics.
What should I do if I miss a dose of lactulose?
If you miss a dose, take it as soon as you remember. If it’s close to the time for your next scheduled dose, skip the missed dose and continue with your regular schedule.
Is it safe to use lactulose during pregnancy?
Lactulose is generally considered safe during pregnancy, but it is advisable to consult a healthcare provider before use.
Can lactulose cause weight gain?
Weight gain is not a common side effect of lactulose. Any significant changes in weight should be discussed with a healthcare provider.
Comprehensive Drug Guide
How Does Lactulose Work?
Lactulose works by drawing water into the colon through osmosis, which increases stool volume and frequency. In the context of hepatic encephalopathy, it alters gut flora, promoting the growth of beneficial bacteria that convert ammonia to less toxic substances, thereby lowering serum ammonia levels.
Common Dosages
- Liquid solution: Common dosages may include 15 mL to 30 mL taken once or twice daily for constipation.
Typical Dosing
- For constipation, the usual starting dose is 15 to 30 mL daily, adjusted based on response.
- For hepatic encephalopathy, the dose may start at 30 to 45 mL taken three times daily, adjusted to achieve 2 to 3 soft stools per day.
Typical Dosing
FDA Approved Indications
- Treatment of constipation.
- Management of hepatic encephalopathy in patients with liver disease.
Who Shouldn't Take Lactulose?
- Known hypersensitivity to lactulose or any components of the formulation
- Galactosemia (a rare genetic disorder)
Advice From The Pharmacist
- Patients should be advised to take lactulose as directed and to maintain adequate hydration.
- Encourage patients to monitor their bowel movements and adjust dosage if necessary.
- Discuss possible side effects, including bloating and gas.
Side Effects of Lactulose
Common Side Effects
- Bloating
- Abdominal cramping
- Diarrhea
- Flatulence
Uncommon/Severe Side Effects
- Severe dehydration
- Electrolyte imbalances (especially with excessive use)
Risks and Warnings of Lactulose
- Electrolyte Imbalance: Long-term use or excessive doses can lead to imbalances; regular monitoring is important.
- Irritation: Overuse may lead to excessive bowel activity; consult a healthcare provider if this occurs.
Interactions with Lactulose
Common Drug Interactions
- Other Laxatives: Caution is advised when combining lactulose with other laxatives to avoid excessive bowel activity.
- Antibiotics: Some antibiotics may alter gut flora and potentially affect the efficacy of lactulose.
Alternatives to Lactulose
- Other Laxatives: Such as polyethylene glycol (PEG) for constipation.
- Rifaximin: An antibiotic often used in conjunction with lactulose for hepatic encephalopathy management.
