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ALIMENTARY TRACT AND METABOLISM › DRUGS FOR CONSTIPATION › DRUGS FOR CONSTIPATION › Osmotically acting laxatives
lactulose
A06AD11
Forms & Strengths
- Oral solution: 10g/15mL
- Powder for oral solution: 1 dose = 10g
- Capsules: 3.34g
Adult Dosing
- Constipation: 1-2 tablespoons (15-30 mL, 10-20g) orally once daily
- Hepatic encephalopathy: 30-50 mL (20-33g) orally 3-4 times daily
- Adjust dose to achieve 2-3 soft stools per day
Pediatric Dosing
- Infants <1 year: 1/4 to 1/2 teaspoon (1.25-2.5 mL, 0.625-1.25g) orally daily
- Children 1-6 years: 1-2 teaspoons (5-10 mL, 2.5-5g) orally daily
- Children 7-14 years: 1-2 tablespoons (15-30 mL, 10-20g) orally daily
Indications
- Constipation
- Hepatic encephalopathy
- Portal systemic encephalopathy
Mechanism of Action
- Non-digestible sugar that draws water into colon
- Fermented by colonic bacteria to produce short-chain fatty acids
- Increases osmotic pressure, softening stool and stimulating bowel movements
Contraindications
- Galactosemia
- Intestinal obstruction
Adverse Reactions
- Diarrhea
- Flatus
- Abdominal cramping
- Bloating
Drug Interactions
- Charcoal: may decrease lactulose efficacy
- Antacids: may decrease lactulose absorption
- Other laxatives: may enhance GI effects
Curated Content: Needs Vetting Before Put to Clinical Use