Laevolac Plum (Lactulose, Liquid)

Laevolac Plum (lactulose) is used as an osmotic laxative to manage conditions related to impaired bowel function and ammonia metabolism.

• Constipation: softens stool and increases bowel frequency, facilitating regular evacuation.
• Hepatic encephalopathy: lowers intestinal ammonia production, helping improve neurological symptoms in patients with liver disease.
• Prevention of hepatic encephalopathy recurrence: maintains low ammonia levels to reduce the risk of episodic mental status changes.

• Lactulose is a synthetic disaccharide that is minimally absorbed in the small intestine. When it reaches the colon, resident bacteria hydrolyze it to short‑chain fatty acids such as lactic and acetic acid, lowering colonic pH. The resulting osmotic gradient draws water into the lumen, softening feces and stimulating peristalsis. In hepatic encephalopathy, the acidic environment converts ammonia to ammonium, which is less readily absorbed, thereby decreasing systemic ammonia levels.

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

Common Side Effects

• Abdominal cramping: discomfort or pain in the lower abdomen.
• Flatulence: increased intestinal gas production.
• Diarrhea: loose, watery stools occurring more frequently.
• Nausea: feeling of unease or urge to vomit.
• Bloating: sensation of fullness or swelling in the abdomen.
• Thirst: increased desire for fluids.

Serious or Rare Side Effects

• Severe electrolyte imbalance: abnormal levels of sodium, potassium or other minerals.
• Dehydration: excessive loss of body fluids leading to weakness.
• Allergic reaction: rash, urticaria or swelling indicating hypersensitivity.
• Severe abdominal pain: intense, persistent pain requiring medical attention.
• Hypernatremia: elevated blood sodium concentration in rare cases.

When using Laevolac Plum, certain precautions should be observed to ensure safety and effectiveness.

• Dose titration: adjust the amount according to stool frequency and clinical response.
• Renal impairment: monitor kidney function and electrolytes closely.
• Diabetes monitoring: observe blood glucose as lactulose may affect glycemic control.
• Electrolyte disturbances: watch for signs of hyponatremia or hypokalemia, especially with high‑dose therapy.
• Pregnancy: consult a healthcare professional before use, as safety data are limited.
• Store at ambient temperature: keep in the original container, protect from moisture and light.

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

Major Interactions (Avoid)

• Broad‑spectrum antibiotics: may reduce lactulose's effectiveness by altering gut flora.
• Stimulant laxatives: combined use can cause severe diarrhea and dehydration.
• Mineral oil: may interfere with the action of lactulose and affect absorption.

Moderate Interactions (Monitor Closely)

• Diabetes medications: monitor glucose levels as lactulose can affect carbohydrate metabolism.
• Electrolyte supplements: concurrent use may exacerbate electrolyte imbalances.
• Probiotics: may modify colonic fermentation and alter lactulose's osmotic effect.