Lactulose

Generic Details

Generic Name

Lactulose

Other Names

  • Cephulac
  • Constulose
  • Enulose
  • Generlac
  • Kristalose

Drug Class

  • Osmotic Laxative

Chemical Formula

C12H22O11

Molecular Weight

342.30 g/mol

Mechanism of Action

  • Lactulose is a synthetic disaccharide that is not absorbed in the small intestine but broken down into organic acids by colonic bacteria. This creates an osmotic effect, drawing water into the colon and increasing stool bulk, which helps to soften the stool and promote bowel movements.

Indications

  • Constipation
  • Hepatic encephalopathy

Common Dosage Forms

  • Oral solution
  • Powder for oral administration

Typical Dosage

  • For constipation: 15-30 mL once daily, can be adjusted based on response
  • For hepatic encephalopathy: 30-45 mL three to four times daily, adjusted as needed to achieve 2-3 soft stools per day

Pediatric Dosage

  • Consult pediatric gastroenterologist for appropriate dosing

Geriatric Dosage

  • Dose adjustments may be needed based on renal function

Side Effects

  • Flatulence
  • Abdominal cramps
  • Diarrhea
  • Electrolyte disturbances (with prolonged use)

Contraindications

  • Galactose or fructose intolerance
  • Gastrointestinal obstruction

Pregnancy Category

  • Category B - No proven risk in humans

Lactation Safety

  • Considered compatible with breastfeeding

Drug Interactions

  • Limited systemic absorption reduces the risk of significant drug interactions

Overdose Symptoms

  • Severe diarrhea
  • Abdominal cramps
  • Fluid and electrolyte imbalances

Antidote for Overdose

  • Supportive care, monitor and correct fluid and electrolyte imbalances

Storage Conditions

  • Store at room temperature away from moisture and heat

Pharmacokinetics

  • Absorption: Minimal absorption in the small intestine, undergoes bacterial fermentation in the colon
  • Distribution: Not well characterized
  • Metabolism: Metabolized to organic acids by colonic bacteria
  • Excretion: Excreted in the feces

Precautions

  • Monitor for electrolyte imbalances in patients with renal impairment or prolonged use

Warnings

  • Avoid sudden discontinuation in patients with hepatic encephalopathy as it may lead to a rebound effect and worsening symptoms

Others

  • Lactulose may take 24-48 hours to produce a bowel movement, adequate fluid intake is recommended during use.