Lactulose solution USP – the safest stool softener

Posted On September 30, 2020May 5, 2022

Lactulose solution USP

Today, I am going to review medicine – Lactulose solution USP.

You must have heard about lactulose. You may have used it many times. It is popular in the market in a brand –

Lactulose solution USP emty and Lactulose solution USP evict. 

Lactulose is the most commonly prescribed medication that is used in the treatment of constipation.

As you know, constipation is a widespread problem today. Everyone must have faced a constipation problem. It is an uncomfortable condition that makes you feel uneasy. 

Besides this, it slows the movement of your faeces (stool), leading to hard stool and difficulty while passing stool.  

Although, the cause of chronic constipation is unknown.  But acute constipation may be due to

• Dietary changes (junk foods, oily foods, etc.)
• Less water intake
• Lack of physical activity
• Bed-ridden
• Pregnancy
• Disease, e.g., hypothyroidism, diabetes, etc.
• Medications, e.g., Opioids (codeine, morphine), anticholinergic drugs (atropine, dicyclomine), calcium channel blocker (amlodipine, verapamil, diltiazem, nifedipine)
• Bowel obstruction

So, Lactulose solution is a wonderful medicine which relieves you from constipation problem. That’s why you need to know everything about lactulose. 

In this post, you will get essential information about lactulose. So, let’s get more details of this medicine – 

What is Lactulose and what is lactulose solution USP used for?

Lactulose is a synthetic disaccharide because it is made from lactose which is milk sugar. This lactose is composed of galactose and fructose.

Galactose and fructose (simple sugars)
↓
Lactose (milk sugar) – a disaccharide
↓
Lactulose

It is a non-absorbable sugar which helps to relief in constipation problem. Besides, lactulose solution USP has the potential to manage hepatic encephalopathy.

The letters “USP” on the label of your lactulose solution represents the United States Pharmacopoeia. It references the uniform preparation of medicine in terms of well-tested quality, potency and purity. 

How does lactulose solution work?

Lactulose is an osmotically active sugar or laxatives or purgatives.

Generally, It draws the water from the intestine and makes the stool soft so that it can easily pass through your anus.

Lactulose in constipation

It has a unique property; it does not absorb in your bloodstream.
When you take lactulose solution. Firstly, it goes to your intestine region. It is then broken down into low molecular organic acid in the colon (i.e., lactic acid) by the colonic bacterial flora.

It increases the feces’ acidic and water contents (stool) in the lumen by increasing osmotic pressure. Then it stimulates peristalsis of the colon. Consequently, it increases the consistency of the fecal matter.

Lactulose in hepatic encephalopathy

It also works in hepatic encephalopathy. Hepatic encephalopathy is a severe liver condition.

In this condition, your liver does not convert ammonia to urea, resulting in an increased level of ammonia (toxins) in the blood. Due to this, it crosses the blood-brain barrier and causes a neurological problem.

Lactulose helps to draw ammonia from the blood into the colon by acidification of colonic content. Eventually, It increases the content of acidophilic bacteria (lactobacillus) by suppressed proteolytic bacteria (pseudomonas).

How to use Lactulose and what is the best time to take Lactulose? 

Lactulose solution USP usage and dosage for constipation –

Your dosage will depend upon your age, the severity of the disease, and other medical condition. You must consult your doctor if you are giving to children. 

You may take lactulose syrup as per the below table – 

It is mostly available in syrup with a strength – lactulose solution USP 10g/15ml. Each 15 ml contains 10 g lactulose.

It is better to take a once-daily dose after dinner. You need to take a sufficient amount of water (1.5 to 2 litres/day) during lactulose therapy.

Dosage for hepatic encephalopathy –

You will require 10-15 ml three times daily for an adult.

Does lactulose have side effects?

Generally, it does not have life-threatening side effects. You may have flatulence (gas) problem while starting a few days of treatment.

Suppose you are taking a higher dose of lactulose. You may have diarrhea, nausea, vomiting, abdominal pain, and loss of electrolytes in that case.

If you get any other side effects, you may contact your doctor or pharmacist or nearest AMC (Adverse drug reaction monitoring centers).

Can a diabetic patient take Lactulose?

Since it is non-absorbable sugar that does not enter your bloodstream.

If you are diabetic and struggling with constipation, you do not need to bother about this. You may take lactulose in this condition as it won’t spike your blood sugar level.

A study suggests lactulose does not change blood glucose levels in healthy volunteers. Hence, it is safe and well-tolerated osmotic laxatives for diabetic patients.

Is Lactulose safe in pregnancy and breastfeeding?

Generally, many pregnant women feel constipation.

If you are pregnant, then you may have a constipation problem. It is a common complaint in pregnancy. Many factors contribute to causing constipation during pregnancy like –

• Taking iron supplements
• Hormonal changes
• Lack of physical inactivity
• Physical changes – growing baby may press your rectum

In a German study, lactulose was found the safest and effective in pregnancy and breastfeeding because its systemic exposure is negligible.

It comes in under Category – B.

Category – B drugs are considered safe to use in pregnancy. So, it is safe and well-tolerated. You can take this medicine, but it should be under medical supervision.

You must consult with your gynaecologist before taking lactulose if you are pregnant.

When should I avoid taking lactulose?

You should not consume lactulose, or you must consult your doctor if –

• You have an inflammation in your digestive tracts like  Crohn’s disease and  ulcerative colitis
• You have an intestinal obstruction
• You have lactose intolerance (unable to digest milk)
• You have hypersensitivity to the lactulose or any of the excipients of the product.
• You have severe diarrhoea

You should immediately stop taking lactulose during these conditions.

Conclusion

As shown above, we have reviewed – Lactulose solution USP. We found that lactulose has negligible side effects and it does not interact with other drugs.

Lactulose solution USP uses for constipation and hepatic encephalopathy. It can be used in children, adults, the elderly, diabetic, pregnancy, and breastfeeding. 

Therefore, It is a safe, effective, and well-tolerated medicine.

If you have a query regarding this post – Lactulose solution USP. Please mention this in the below comment box.

I hope you like this post. Please share this post on social media to spread knowledge.

References –

1. Mohamad Rasm Al Sibaeand Brendan M McGuire. Current trends in the treatment of hepatic encephalopathy. Ther Clin Risk Manag. 2009; 5: 617–626. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724191/

2. USP – quality matters

 https://qualitymatters.usp.org/what-letters-usp-mean-label-your-medicine

3. Samiran Mukherjee; Savio John, Lactulose. Stat pearls, july2020

https://www.ncbi.nlm.nih.gov/books/NBK536930/

4. Treatment of constipation in pregnant women. A multicenter study in a gynecological practice. Schweiz Med Wochenschr. 1995 Sep 9;125(36):1689-93.

https://pubmed.ncbi.nlm.nih.gov/7481624/

5. Duphalac. SmPC. EMC Aug, 2020.

https://www.medicines.org.uk/emc/product/5525/smpc

6. Jasmine steudle et al. Blood glucose response after oral intake of lactulose in healthy volunteers: A randomized, controlled, cross-over study. World J Gastrointest Pharmacol Ther. 2018 Aug 7;9(3):22-30.

https://pubmed.ncbi.nlm.nih.gov/30090645/

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