Laevolac (Lactulose, Liquid)

Laevolac (lactulose) is used as an osmotic laxative to manage conditions involving impaired bowel transit or elevated ammonia levels.

• Constipation: softens stool and promotes regular bowel movements.
• Chronic constipation: improves stool frequency and consistency in long‑term management.
• Hepatic encephalopathy: lowers blood ammonia by acidifying colonic contents, helping to control neuropsychiatric symptoms.

• Lactulose is a synthetic disaccharide that is not absorbed in the small intestine. In the colon it is metabolized by bacterial flora into short‑chain fatty acids, which increase osmotic pressure, draw water into the lumen, and soften feces. The resulting acidic environment also converts ammonia to ammonium, reducing its absorption and helping to control hepatic encephalopathy.

Lactulose is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Abdominal bloating: feeling of fullness or swelling.
• Flatulence: increased intestinal gas.
• Mild diarrhea: loose stools, especially at higher doses.
• Nausea: transient feeling of queasiness.
• Abdominal cramping: intermittent discomfort.
• Increased stool frequency: more bowel movements than usual.

Serious or Rare Side Effects

• Severe dehydration: excessive fluid loss requiring medical attention.
• Electrolyte imbalance: notably low potassium or sodium levels.
• Allergic reaction: rash, urticaria, or swelling.
• Hyperosmolar coma: extremely rare, associated with massive overdose.
• Severe abdominal pain: persistent or worsening pain.
• Hepatic decompensation: worsening liver function in susceptible patients.

Lactulose should be used with attention to patient‑specific factors and monitoring.

• Renal impairment: adjust dose and monitor renal function.
• Electrolyte monitoring: check potassium and sodium levels during prolonged therapy.
• Diabetes mellitus: observe blood glucose as lactulose may affect glycemic control.
• Pediatric use: dose must be individualized by a pediatric specialist.
• Bowel obstruction: avoid use if mechanical obstruction is suspected.
• Store at ambient temperature: keep below 25 °C, in the original container, protected from moisture and direct sunlight.

Lactulose may interact with other agents that affect fluid balance or gastrointestinal motility.

Major Interactions (Avoid)

• Antidiarrheal agents (e.g., loperamide): may counteract lactulose's laxative effect.
• Mineral oil: can interfere with lactulose's action and increase risk of fat malabsorption.
• High‑dose osmotic laxatives: concurrent use raises risk of severe dehydration and electrolyte loss.

Moderate Interactions (Monitor Closely)

• Diuretics: monitor for additive electrolyte disturbances.
• Oral hypoglycemic drugs: observe for potential changes in glucose control.
• Antibiotics altering gut flora: may modify lactulose metabolism and efficacy.