Lactulose brands and prices in Pakistan

About Lactulose

Lactulose is a laxative, a medicine that helps you pass stools (poo). It is a man-made sugar that comes as a sweet syrup or liquid to swallow. Very little of it is absorbed into the body. Instead, it is broken down in the bowel into substances that draw water in, which softens the stools and makes them easier to pass. This type is called an osmotic laxative. In people with severe liver disease, it also helps remove toxins such as ammonia from the blood through the bowel. It can be bought from pharmacies and is also prescribed by doctors.

Who should not take it, or should take care

• Do not take it if you are allergic to lactulose or any other ingredient.
• Do not take it if you have galactosaemia (a rare inherited condition where the body cannot handle galactose), or if you cannot tolerate galactose or fructose.
• Do not take it if you have a bowel blockage that is not caused by ordinary constipation, a hole (perforation) in the gut or a risk of one, or stomach pain with no known cause.
• Tell your doctor if you are lactose intolerant or have been told you cannot tolerate some sugars, as the medicine contains small amounts of other sugars.
• Tell your doctor if you have a bowel condition such as Crohn's disease, ulcerative colitis, diverticular disease or IBS. The Irish leaflet says not to take it during a flare of inflammatory bowel disease.
• Diabetes: normal amounts have little effect on blood sugar, but the higher amounts used for liver disease can affect it. Your doctor may need to adjust your diabetes medicine, and you may need to check your blood sugar more often.
• Children: in the UK, babies and children under 14 should only take it if a doctor prescribes it, and children should be watched by a doctor because it can affect their normal bowel habits.
• Long-term use or using too much can cause ongoing diarrhoea and upset the body's salts. Older or frail people who take it for a long time may need regular blood tests.
• Pregnancy: it can be used in pregnancy if needed. NHS advice says it is not harmful to the baby, but speak to a pharmacist or doctor first.
• Breastfeeding: it can be used. It does not pass into breast milk, so side effects in the baby are very unlikely. Tell your doctor or midwife if your baby has diarrhoea or is not feeding well.
• Tell the doctor if you are having bowel surgery or tests on your bowel while taking lactulose.

Medicines and drinks that can interact

• Antacids (indigestion medicines)
• Neomycin (an antibiotic)
• Other laxatives. People taking lactulose for liver disease should not use other laxatives unless their doctor advises it.
• Water tablets (thiazide diuretics), steroid medicines and amphotericin B, as lactulose can add to the potassium they make you lose
• Heart medicines such as digoxin (cardiac glycosides), whose effects can become stronger if potassium is low
• Medicines such as mesalazine (5-ASA) for bowel conditions, which may not work as well because lactulose makes the bowel more acidic
• Contraceptive pills are not affected by lactulose itself, but severe diarrhoea or vomiting can stop the pill from protecting you. Check the pill leaflet.
• Tell your doctor or pharmacist about all medicines, vitamins and herbal products you use.

Always tell your doctor and pharmacist about every medicine, supplement and herbal product you take.

Using it safely

• Take it exactly as your doctor, pharmacist or the leaflet says. Measure it with the spoon or cup that comes with it, and do not change the amount without advice.
• You can take it with or without food.
• If it tastes too sweet, mix it with water, fruit juice or milk.
• Swallow it straight away rather than holding it in your mouth, as the sugar can harm teeth over time.
• Drink plenty of fluids while taking it, especially if you get diarrhoea.
• If it causes bloating, try taking it between meals. If it makes you feel sick, try taking it with meals.
• For wind, cut down on foods such as beans, lentils, peas and onions, and eat smaller meals slowly.
• To help constipation, slowly add more fibre (fruit, vegetables, cereals, oats), drink plenty of water and stay active.
• If you forget a dose, take the next one at the usual time. Never take a double dose.
• See a doctor if your constipation does not get better or gets worse.
• Store it out of the sight and reach of children and use it within the time the label says after opening. Return unused medicine to a pharmacy.

Common questions

How long does lactulose take to work?
It usually takes a few days to work, not hours. Talk to a doctor if your constipation has not improved. When it is used for liver disease, you may not notice a change in how you feel, but it helps prevent some liver-related problems.

I have diabetes. Can I take lactulose?
Usually yes, but check with your doctor or pharmacist. Lactulose is not the same as lactose. Normal amounts have little effect on blood sugar, but the higher amounts used for liver disease can raise it, so you may need to check your sugar more often.

Can I drink alcohol while taking lactulose?
Yes, but NHS advice is to avoid drinking too much, as it may make diarrhoea more likely.

Can I take lactulose for a long time?
It is best used now and then for constipation. Using it for a long time can cause ongoing diarrhoea and upset the body's salts, which can lead to cramps, twitching or even fits. Some people, such as those with liver disease, do need it long term; their doctor will decide how much and for how long.

Will lactulose affect my driving?
No. Lactulose is not expected to affect your ability to drive, ride a bike or use machines.

Prepared from the sources listed by the MedInfoBase team. General information, not medical advice: it gives no doses. Your doctor or pharmacist decides the medicine and dose for you.