Laevolac Pflaumenaroma (Lactulose, Liquid)

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

• Constipation: softens stool and promotes regular bowel movements.
• Hepatic encephalopathy: lowers colonic ammonia production to improve neurological symptoms.
• Prevention of hepatic encephalopathy recurrence: maintains low ammonia levels to reduce the risk of episodic deterioration.

• Lactulose is a synthetic disaccharide that is not absorbed in the small intestine. In the colon, bacterial enzymes hydrolyze it to short‑chain acids, increasing osmotic pressure and drawing water into the lumen, which softens stool. The resulting acidic environment also converts ammonia to ammonium, reducing its absorption and helping to lower systemic ammonia levels.

Lactulose may cause a range of adverse reactions, most of which are related to its osmotic activity in the gut.

Common Side Effects

• Bloating: sensation of abdominal fullness.
• Flatulence: increased intestinal gas.
• Abdominal cramps: mild to moderate discomfort.
• Diarrhea: loose stools, especially at higher doses.
• Nausea: feeling of sickness.
• Electrolyte imbalance: mild disturbances in sodium or potassium.

Serious or Rare Side Effects

• Severe dehydration: excessive fluid loss requiring medical attention.
• Electrolyte disturbances: significant hyponatremia or hypokalemia.
• Allergic reaction: rash, itching, or swelling.
• Severe abdominal pain: persistent or worsening pain.
• Hypotension: low blood pressure due to fluid shifts.

Before initiating lactulose therapy, consider the following precautions.

• Renal function assessment: evaluate kidney status as fluid shifts may affect renal clearance.
• Electrolyte monitoring: check serum electrolytes, especially with prolonged use.
• Diabetes caution: monitor blood glucose as lactulose can affect carbohydrate metabolism.
• Avoid abrupt discontinuation: taper dose to prevent rebound constipation.
• Hepatic impairment dose adjustment: use the lowest effective dose in severe liver disease.
• Store at room temperature: keep in the original container, protect from moisture and direct sunlight.

Lactulose can interact with other medicines, influencing its efficacy or safety.

Major Interactions (Avoid)

• Antacids containing magnesium or aluminum: may reduce lactulose's osmotic effect.
• Oral antibiotics: can alter gut flora, affecting lactulose metabolism.
• Phosphate binders: may interfere with lactulose activity.

Moderate Interactions (Monitor Closely)

• Diabetes medications: monitor blood glucose as lactulose may affect glucose absorption.
• Loop diuretics: watch for electrolyte disturbances.
• Probiotics: may increase gas production and abdominal discomfort.