Lactulose Relonchem (Lactulose)

Lactulose is an osmotic laxative that acts on the gastrointestinal tract to facilitate bowel movements and lower systemic ammonia.

• Constipation: softens stool and promotes regular bowel movements.
• Hepatic encephalopathy: lowers blood ammonia concentrations, helping to improve neurological symptoms.

• Lactulose is a synthetic disaccharide that is not absorbed in the small intestine. In the colon it is metabolized by bacterial flora into lactic and acetic acids, which increase osmotic pressure, draw water into the lumen, and acidify colonic contents, thereby stimulating peristalsis and reducing ammonia absorption.

Lactulose may cause a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Abdominal bloating: sensation of fullness or swelling in the abdomen.
• Flatulence: increased intestinal gas.
• Diarrhea: loose, watery stools.
• Nausea: feeling of sickness.
• Stomach cramps: intermittent abdominal pain.
• Thirst: increased desire for fluids.

Serious or Rare Side Effects

• Severe electrolyte imbalance: abnormal levels of sodium, potassium, or magnesium.
• Dehydration: excessive loss of body fluids.
• Allergic reaction: rash, itching, swelling, or difficulty breathing.
• Severe abdominal pain: intense, persistent pain requiring medical attention.

When prescribing lactulose, clinicians should consider patient‑specific factors and monitor for potential complications.

• Dose adjustment: renal impairment may require dose modification.
• Electrolyte monitoring: prolonged use can affect sodium and potassium levels.
• Diabetes caution: lactulose contains sugars that may influence glucose control.
• Galactosemia avoidance: patients with this metabolic disorder should not use lactulose.
• Storage: Store at ambient temperature: keep in the original container, protect from moisture.

Lactulose can interact with other medications, influencing efficacy or safety.

Major Interactions (Avoid)

• Other osmotic laxatives: combined use may cause severe diarrhea and fluid loss.
• Mineral oil: may reduce the effectiveness of lactulose.

Moderate Interactions (Monitor Closely)

• Diuretics: monitor electrolytes for additive fluid loss.
• Antidiabetic agents: observe blood glucose as lactulose may affect sugar levels.
• Antibiotics: alteration of gut flora may diminish lactulose’s ammonia‑lowering effect.