Absorption: Less than 3% absorbed after oral administration.
Metabolism and Excretion: Absorbed lactulose is excreted unchanged in the urine. Unabsorbed lactulose is metabolized by colonic bacteria to lactic, acetic, and formic acids.
TIME/ACTION PROFILE (relief of constipation)
Use Cautiously in:
GI: belching, cramps, distention, flatulence, diarrhea
Endo: hyperglycemia (diabetic patients)
* CAPITALS indicate life-threatening.
Underline indicate most frequent.
PO (Adults): 15–30 mL/day up to 60 mL/day as liquid or 10–20 g as powder for oral solution (up to 40 g/day has been used).
PO Children: 7.5 mL daily after breakfast (unlabeled).
PO (Adults): 30–45 mL 3–4 times/day; may be given every 1–2 hr initially to induce laxation.
PO Infants: 2.5–10 mL daily in 3–4 divided doses (unlabeled).
PO (Children and Adolescents): 40–90 mL daily in 3–4 divided doses (unlabeled).
Rect: (Adults): 300 mL diluted and administered as a retention enema every 4–6 hr.
Oral solution: 10 g lactulose/15 mL
Rectal solution: 10 g lactulose/15 mL
Single-use packets (Kristalose): 10 g (equal to 15 mL liquid lactulose), 20 g (equal to 30 mL liquid lactulose)
Assess patient for abdominal distention, presence of bowel sounds, and normal pattern of bowel function.
Lab Test Considerations:
↓ blood ammonia concentrations by 25–50%.
When used in hepatic encephalopathy, adjust dose until patient averages 2–3 soft bowel movements per day. During initial therapy, 30–45 mL may be given hourly to induce rapid laxation.
Mix with fruit juice, water, milk, or carbonated citrus beverage to improve flavor. Administer with a full glass (240 mL) of water or juice. May be administered on an empty stomach for more rapid results.
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