Lactulose Orifarm (Lactulose)

Lactulose is an osmotic laxative used to manage conditions related to bowel motility and hepatic ammonia accumulation.

• Constipation: softens stools and promotes regular bowel movements.
• Hepatic encephalopathy: lowers intestinal ammonia levels, helping improve mental status in patients with liver disease.
• Prevention of hepatic encephalopathy recurrence: maintains low ammonia levels during long‑term therapy.

• Lactulose is a synthetic disaccharide that is not absorbed in the small intestine. In the colon, bacterial enzymes hydrolyze it to short‑chain fatty acids, which increase the osmotic pressure within the lumen, drawing water into the bowel and softening stool. The resulting acidic environment also traps ammonia as ammonium ions, reducing its absorption and lowering systemic ammonia levels.

Lactulose may cause several adverse reactions, ranging from mild to serious.

Common Side Effects

• Abdominal bloating: feeling of fullness or swelling in the abdomen.
• Flatulence: increased intestinal gas.
• Diarrhea: loose, watery stools.
• Nausea: sensation of wanting to vomit.
• Abdominal cramps: painful muscle contractions in the stomach area.
• Thirst: increased desire to drink fluids.

Serious or Rare Side Effects

• Severe electrolyte imbalance: abnormal levels of sodium, potassium, or other minerals.
• Dehydration: excessive loss of body fluids.
• Allergic reaction: rash, itching, swelling, or difficulty breathing.
• Severe abdominal pain: intense, persistent pain in the abdomen.
• Hypernatremia: elevated blood sodium concentration.

Before initiating Lactulose therapy, consider the following safety measures.

• Renal function assessment: evaluate kidney health to adjust dosing if needed.
• Electrolyte monitoring: check serum electrolytes regularly during treatment.
• Diabetes caution: monitor blood glucose as lactulose may affect sugar levels.
• Discontinuation guidance: avoid abrupt cessation to prevent rebound constipation.
• Hepatic impairment adjustment: use lower doses in patients with severe liver disease.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Lactulose can influence the absorption or effect of other medications.

Major Interactions (Avoid)

• Oral phosphate binders: may reduce lactulose efficacy.
• Metformin: increased risk of gastrointestinal side effects.
• Loop diuretics: heightened potential for electrolyte disturbances.

Moderate Interactions (Monitor Closely)

• Probiotics: may alter gut flora and affect lactulose action.
• Iron supplements: can increase constipation risk.
• Antacids containing magnesium: may lessen lactulose's osmotic effect.