Lactulose

Aka: Lactulose

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II. Mechanism

  1. Converts Ammonia to unabsorbed Ammonium
  2. Produces Diarrhea
  3. Alters bowel flora

III. Indications

  1. Hepatic Encephalopathy (in Cirrhosis)
  2. Constipation

IV. Advantages

  1. Poorly absorbed (may be used in Renal Failure)

V. Disadvantages: Constipation

  1. Not as effective or well tolerated as Miralax

VI. Dosages

  1. Constipation
    1. Lactulose (Chronulac)
      1. Consider Sorbitol 70% as alternative agent
      2. Adults: 30 ml PO qhs
      3. Children (10 mg/15 ml) 1-3 cc/kg/day divided qd-bid
        1. Easier to administer to young children
      4. May cause abdominal cramping and Flatus
    2. Lactitol
      1. As effective as Lactulose with less pain and Flatus
      2. Pitzalis (1995) Pediatr Med Chir 17(3):223-6 [PubMed]
  2. Hepatic Encephalopathy
    1. Initial: 30-50 ml PO qh until Diarrhea
    2. Next: 15-30 ml PO tid-qid prn 2-3 stools/day
  3. Hepatic Coma
    1. Lactulose 300 ml in 700 ml water retention enema

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Cost: Medications

lactulose (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
LACTULOSE 10 GM/15 ML SOLUTION Generic $0.02 per ml
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Related Topics in Pharmacology

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