Lattulosio Teva (Lactulose)

Lactulose acts as an osmotic agent to relieve bowel stasis and to lower blood ammonia levels in liver disease.

• Constipation: softens stools and promotes bowel movements.
• Hepatic encephalopathy: reduces ammonia absorption, helping to improve mental status.
• Pediatric constipation: provides a safe, non‑stimulant option for children with functional constipation.

• Lactulose is metabolized by colonic bacteria into short‑chain fatty acids, primarily lactic and acetic acid. This creates an osmotic gradient that retains water in the intestinal lumen, increasing stool volume and promoting peristalsis. In the colon, the acidic environment traps ammonia as ammonium ions, reducing its absorption into the bloodstream and lowering systemic ammonia levels.

Lactulose may cause a range of adverse reactions, most of which are mild and transient.

Common Side Effects

• Abdominal cramping: discomfort due to increased intestinal activity.
• Flatulence: excess gas production from bacterial fermentation.
• Diarrhea: loose stools from osmotic water retention.
• Nausea: mild stomach upset.
• Bloating: sensation of fullness.
• Thirst: increased fluid loss.

Serious or Rare Side Effects

• Severe dehydration: excessive fluid loss requiring medical attention.
• Electrolyte imbalance: particularly low potassium or sodium levels.
• Allergic reaction: rash, itching, or swelling.
• Hepatic decompensation: worsening liver function in susceptible patients.

When prescribing lactulose, clinicians should consider several safety aspects.

• Assess renal function: impaired kidneys may affect drug clearance.
• Monitor electrolytes: risk of hyponatremia or hypokalemia.
• Use caution in diabetes: monitor blood glucose as lactulose can affect carbohydrate metabolism.
• Avoid in intestinal obstruction: risk of perforation.
• Store at ambient temperature: keep in the original container, protect from moisture.

Lactulose can interact with other medicines, altering efficacy or safety.

Major Interactions (Avoid)

• Antibiotics (e.g., rifaximin): may reduce lactulose's ammonia‑lowering effect.
• Other laxatives (e.g., senna): additive laxative action can cause severe diarrhea.

Moderate Interactions (Monitor Closely)

• Antidiabetic agents: monitor glucose as lactulose may affect glycemic control.
• Mineral supplements (e.g., calcium, magnesium): may interfere with absorption.
• Diuretics: watch for electrolyte disturbances.
• Oral hypoglycemics: adjust dose if needed.
• Proton pump inhibitors: may alter gut flora and lactulose metabolism.