Description
What It Is
Lactulac is an osmotic laxative oral solution containing lactulose (10 g per 15 ml), available in a 200 ml bottle format. It softens stools by drawing water into the colon, making it effective for relieving chronic constipation and for managing hepatic (portosystemic) encephalopathy.
How It Works
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Lactulose, a synthetic disaccharide, is not absorbed from the intestine. It is metabolized by gut bacteria into short-chain fatty acids, which lower colon pH and increase osmotic pressure.
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The result is enhanced fluid retention and peristalsis, leading to softer stool and easier bowel movements.
Indications
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Chronic constipation—standard use for adults and children.
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Hepatic encephalopathy—relieves neurotoxic effects by reducing ammonia levels via colonic acidification.
Dosage Guidelines
| Indication | Age Group | Typical Dosage |
|---|---|---|
| Constipation | Adults | 15–30 ml once or twice daily; up to 60 ml/day as needed (adjust to produce 2–3 soft stools/day) |
| Children (5–17 yrs) | 5–20 ml twice daily | |
| Children (1–4 yrs) | 2.5–10 ml twice daily | |
| Infants (1–11 months) | ~2.5 ml twice daily | |
| Hepatic Encephalopathy | Adults | 30–50 ml three times daily |
Onset of Action
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Typically takes 24–48 hours to produce relief in constipation.
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For hepatic encephalopathy, higher doses are used to achieve more frequent bowel movements.
Side Effects & Precautions
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Common: Bloating, gas, stomach cramps, nausea, belching. These tend to ease within days.
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Less common: Diarrhea with excessive dosage—lower dose if this occurs.
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Cautions:
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Avoid in galactosemia, intestinal obstruction, or patients on strict low-galactose diets.
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Use carefully in diabetics due to sugar content; monitor electrolytes with prolonged use.
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Safe during pregnancy and breastfeeding when appropriately supervised.
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