Lactulose Pharmacology


About Lactulose
A synthetic Disaccharide, Osmotic Laxative, Ammonium Detoxicant.
Mechanism of Action of Lactulose
Laxative: Lactulose is a synthetic disaccharide of galactose and fructose that resist intestinal disaccharidase activity. The sugars are joined by a beta glycosidic linkage and are resistant to hydrolysis by human digestive enzymes. Lactulose is fermented by a limited number of colonic bacteria. This can lead to changes in the colonic ecosystem in favor of some bacteria, such as lactobacilli and bifidobacteria, which may confer some health benefits. The products of fermentation include lactic acid and small-chain fatty acids. Degradation to short chain fatty acids also increases the osmotic pressure in the intestinal lumen. It also cause an increase in fecal volume due to intraluminal water retention and stimulate colonic propulsive motility result in increased fecal bulk and stimulation of peristalsis.
Hepatic encephalopathy: Patients with severe hepatic impairment are unable to detoxify ammonia (produced by bacterial metabolism of fecal urea) coming from colon. Lactulose broken down and acidifies the colon and convert ammonia (NH3) to polar ammonium (NH4+) and is excreted in the stool.

Pharmacokinets of Lactulose
Absorption: Lactulose is absorbed minimally
Distribution: It is distributed locally, mainly in the colon
Metabolism: Lactulose undergoes metabolism by colonic bacteria
Excretion: Unabsorbed part is excreted through faeces and absorbed part in the urine.
Onset of Action for Lactulose
24 - 48 hours
Duration of Action for Lactulose
Half Life of Lactulose
1.7-2 hours
Side Effects of Lactulose
Contra-indications of Lactulose
1. Patient on low galactose diet
Special Precautions while taking Lactulose
1.Diabetes mellitus
2.Patient require electrocautery procedures during protoscopy and colonoscopy
3.Along with other laxatives
4.Long term use
5 Those who develop gastrointestinal symptoms (flatus, bloating, diarrhea) with the use of dietary fiber
6.Those with lactose intolerance
Pregnancy Related Information
Use with caution
Old Age Related Information
May be used
Breast Feeding Related Information
Use with caution
Children Related Information
May be used
NEONATES: contraindicated
Indications for Lactulose
2.Hepatic encephalopathy
3.After barium examination
4.To restore bowel movement after haemorrhoidectomy
Interactions for Lactulose
Typical Dosage for Lactulose
Constipation: Doses of 10 to 20 grams daily and if needed dose can be increased to 40 grams/ day
Hepatic encephalopathy: 60 - 120 grams daily.

Syrup: 7.5 - 15 ml to be taken 3 - 4 times daily (Syrup corresponding to 5 to 10 grams of Lactulose) if needed dose can be increased to 30 to 45 ml 3 - 4 times daily

Schedule of Lactulose
Storage Requirements for Lactulose
Store at 15 - 30 degree C. Avoid freezing
Effects of Missed Dosage of Lactulose
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose.Continue the regular schedule.Do not double the dose.
Effects of Overdose of Lactulose
Not reported.

Home Delivery for Lactulose in Your City

Medicine India is just a publishing medium for medicine related information and does not provide services or sales of medicines including lactulose.

However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for lactulose and other medicines and health products. Home delivery services for lactulose may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.

Please be aware that you should take lactulose only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for lactulose before they complete the sale. You can get this information while placing the order for lactulose with the pharmacy.

Lactulose is a generic medicine name and there are several brands available for it. Some of the brands for lactulose might be better known than lactulose itself. If the pharmacy that's willing to deliver medicines to your home doesn't have lactulose in stock, you can ask for one of the branded alternatives for lactulose.