Lactulosum Aflofarm (Lactulose, Liquid)

Lactulose is used as an osmotic laxative and ammonia‑lowering agent in the following conditions:

• Constipation: softens stool and promotes regular bowel movements.
• Hepatic encephalopathy: lowers intestinal ammonia absorption, helping improve mental status.
• Prevention of hepatic encephalopathy recurrence: maintains low ammonia levels to reduce the risk of episodic neurocognitive decline.

• Lactulose is a synthetic disaccharide that is not absorbed in the small intestine. In the colon it is metabolised by bacterial flora into short‑chain fatty acids, which increase the osmotic pressure within the lumen. This draws water into the colon, softening stool and stimulating peristalsis, while also converting ammonia to ammonium, reducing its systemic absorption and aiding patients with hepatic encephalopathy.

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 production.
• Diarrhoea: loose, watery stools, especially at higher doses.
• Nausea: feeling of sickness or urge to vomit.
• Abdominal cramping: painful muscle contractions in the gut.
• Thirst: increased desire for fluids.

Serious or Rare Side Effects

• Severe electrolyte imbalance: notably low potassium or sodium levels.
• Dehydration: excessive fluid loss leading to dizziness or low blood pressure.
• Allergic reaction: rash, itching, swelling, or difficulty breathing.
• Severe abdominal pain: persistent, intense pain requiring medical evaluation.

Before initiating Lactulosum Aflofarm, consider the following safety measures:

• Renal function assessment: evaluate kidney status to avoid accumulation.
• Electrolyte monitoring: check serum potassium and sodium periodically.
• Diabetes caution: monitor blood glucose as lactulose can affect carbohydrate metabolism.
• Intestinal obstruction avoidance: do not use in patients with known blockage.
• Hepatic impairment dose adjustment: consider lower doses in severe liver disease.
• Store at ambient temperature: keep in the original container, protect from moisture and direct sunlight.

Lactulose can interact with other medicines; awareness of the interaction level helps manage risk.

Major Interactions (Avoid)

• Antidiarrhoeal agents (e.g., loperamide): may counteract lactulose’s laxative effect.
• Concurrent strong laxatives: increase risk of severe electrolyte disturbances.

Moderate Interactions (Monitor Closely)

• Diabetes medications: lactulose may alter glucose control; monitor blood sugar.
• Mineral supplements (e.g., magnesium): additive osmotic effect may enhance diarrhoea.
• Oral antibiotics: may modify gut flora, potentially affecting lactulose metabolism.