Lactulose Medication Guide

Names of Medication

Lactulose is available under the brand name Kristalose (Lactulose) in the United States.

Pharmacologic category

Lactulose is classified as an osmotic laxative. Other medications in the same category include Polyethylene Glycol 3350 (MiraLAX), Magnesium Hydroxide (Milk of Magnesia), and Sodium Phosphates (Fleet Phospho-Soda).

Dosing

Remember, never adjust your medication dosage without discussing it with your healthcare provider first.

Chronic Constipation:

The typical starting dose is 15 mL (10 g lactulose) daily, which may be adjusted up to 60 mL daily depending on response. The dosage can be adjusted every 1 to 2 days to produce 2 to 3 soft stools daily.

Hepatic Encephalopathy:

The usual dose is 30 to 45 mL (20 to 30 g lactulose) three to four times daily, adjusted to produce 2 to 3 soft stools daily. This can also be titrated based on blood ammonia levels.

Dosage Forms and the strengths

Lactulose is available as a solution in two concentrations: 10 g/15 mL and 20 g/30 mL. It is also available as a powder for oral solution, where each packet of Kristalose contains 10 g or 20 g of lactulose.

Administration Instructions

Lactulose can be taken with or without food. The solution can be mixed with fruit juice, water, or milk to improve its taste. If you are using the powder form of this medication, dissolve it in half a glass of water, juice, or milk.

Adverse Reactions and Side Effects

The most common side effects of Lactulose include:

Diarrhea (Common):

As lactulose is a laxative, diarrhea can occur if the dose is too high. It results from an increased passage of stool through the intestines, facilitated by the osmotic effect of lactulose. If diarrhea persists, consult your healthcare provider, as your dosage may need adjusting.

Bloating and gas (Common):

These occur as lactulose is broken down by bacteria in the gut, producing gas. This can cause discomfort and a feeling of fullness. Drinking plenty of fluids and eating a diet rich in fiber can help alleviate these symptoms.

Nausea and vomiting (Less common):

Some people may experience nausea and vomiting, especially when starting lactulose. This is likely due to the increased activity in the gut.

Contraindications to taking Lactulose

A contraindication is a specific situation in which a drug, procedure, or surgery should not be used because it may be harmful to the person. The following are contraindications for lactulose:

Galactosemia:

This is a genetic disorder where the body can’t break down a simple sugar called galactose. Lactulose contains galactose and lactose, so it should not be used in people with this condition.

Bowel Obstruction:

Lactulose should not be used if there is a blockage in the digestive tract. This is because it increases the passage of stool, which could aggravate the blockage and lead to serious complications.

Drug to Drug Interactions

Lactulose may interact with certain medications, including:
Antacids containing aluminum, such as Maalox (Aluminum Hydroxide and Magnesium Hydroxide): Regular use of these antacids while taking lactulose can lead to increased levels of aluminum in the body, especially in people with kidney problems.
Other laxatives: Combining lactulose with other laxatives may increase the risk of diarrhea and electrolyte imbalance.

Lactulose in Pregnancy

Lactulose is generally considered safe to use during pregnancy. It does not cross the placenta and therefore, does not pose a risk to the developing fetus. However, as with any medication, it should be used under the supervision of a healthcare provider.

Lactulose while Breastfeeding

Lactulose is considered safe to use while breastfeeding. It is not absorbed systemically by the mother, so it does not pass into breast milk.

Estimated Cost of Medication

The estimated cost of a 30-day supply of lactulose solution (10 g/15 mL), assuming the patient doesn’t have insurance and is utilizing a GoodRx coupon, is around $20-$25. Remember, these are only estimates, and prices may vary depending on the pharmacy, location, and negotiated agreements between pharmacies and pharmaceuticals.

Brief Legal Disclaimer

This article is for informational purposes only and not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.
Brief Legal Disclaimer: This article is for informational purposes only and not intended as medical advice. Always consult a healthcare professional for diagnosis and treatment. Reliance on the information provided here is at your own risk.