Lactulose

Mechanism :

Lactulose is poorly absorbed from the gastrointestinal tract and no enzyme capable of hydrolysis of this disaccharide is present in human gastrointestinal tissue. As a result, oral doses of lactulose reach the colon virtually unchanged. In the colon, lactulose is broken down primarily to lactic acid by the action of colonic bacteria, which results in an increase in osmotic pressure and slight acidification of the colonic contents. This in turn causes an increase in stool water content and softens the stool.

Indication :

• Constipation
• Hepatic encephalopathy

Contraindications :

Contraindicated in patients who require a low galactose diet viz. Galactosemia, and in gastrointestinal obstruction.

Dosing :

Adverse Effect :

Adverse reactions seen initially are nausea and vomiting, flatulence and intestinal cramps, which are usually transient. Excessive dosage can lead to diarrhea with potential complications such as loss of fluids, hypokalemia, and hypernatremia.

Interaction :

Nonabsorbable Antacids: May inhibit the desired lactulose-induced drop in colonic pH. Therefore, a possible lack of desired effect of treatment should be taken into consideration before such drugs are given concomitantly with lactulose.

Renal Dose :

Hepatic Dose :