Lactulose Teva (Lactulose, Liquid)

• Lactulose is used as an osmotic laxative and as a therapy for hepatic encephalopathy.
• Constipation: Relieves chronic or acute constipation by softening stools and increasing bowel movements.
• Hepatic encephalopathy: Reduces blood ammonia levels, helping to prevent or treat episodes of hepatic encephalopathy in patients with liver disease.
• Portal‑systemic encephalopathy: Assists in managing ammonia accumulation in patients with portal hypertension.
• Prevention of ammonia buildup: Helps maintain low ammonia concentrations in chronic liver disease.

• 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, lowering colonic pH. The resulting osmotic gradient draws water into the lumen, softening stool and stimulating peristalsis. The acidic environment also converts ammonia (NH₃) to ammonium (NH₄⁺), which is trapped and eliminated, thereby decreasing systemic ammonia levels.

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

Common Side Effects

• Flatulence: Increased gas production in the intestine.
• Abdominal cramping: Stomach discomfort or cramps.
• Diarrhea: Loose, watery stools.
• Nausea: Feeling of sickness.

Serious or Rare Side Effects

• Electrolyte imbalance: Significant loss of potassium or sodium leading to cardiac issues.
• Severe dehydration: Excessive fluid loss requiring medical attention.
• Allergic reaction: Rash, itching, swelling, or difficulty breathing.

• When prescribing lactulose, consider the following precautions to ensure safe use.
• Renal impairment: Adjust dose and monitor kidney function.
• Diabetes mellitus: Be aware of the sugar content and monitor blood glucose.
• Electrolyte monitoring: Check serum electrolytes during prolonged therapy.
• Abrupt discontinuation: Taper the dose to avoid rebound constipation.
• Store at ambient temperature: Keep below 25 °C, in the original container, protected from moisture.

Lactulose can interact with other medicines, affecting their efficacy or safety.

Major Interactions (Avoid)

• Antacids containing aluminum or magnesium: May reduce lactulose’s laxative effect.
• Neomycin: Combined use can diminish the ammonia‑lowering benefit of lactulose.

Moderate Interactions (Monitor Closely)

• Oral phosphate binders: May interfere with lactulose absorption.
• Diuretics: Increased risk of electrolyte disturbances.
• Probiotic supplements: May alter colonic flora and affect lactulose metabolism.