Lactulose: Difference between revisions

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<languages/>
<translate>
==General==
==General==
*Type: osmotic laxative
 
*Dosage Forms: 10g/15L solution
*Type: osmotic [[Special:MyLanguage/laxative|laxative]]
*Dosage Forms: 10g/15mL solution
*Routes of Administration: oral, NG, rectal
*Routes of Administration: oral, NG, rectal
*Common Trade Names: Kristalose
*Common Trade Names: Kristalose


==Adult Dosing==
==Adult Dosing==
===[[Hepatic encephalopathy]]===
 
 
===[[Special:MyLanguage/Hepatic encephalopathy|Hepatic encephalopathy]]===
 
*30-45mg PO TID or QID or (300mL in 700cc H2O retention enema x30min)
*30-45mg PO TID or QID or (300mL in 700cc H2O retention enema x30min)
**titrate for 2-3 soft stools per day
*titrate for 2-3 soft stools per day
 
 
===[[Special:MyLanguage/Constipation|Constipation]]===


===constipation===
*15-50mL PO Qday - BID
*15-50mL PO Qday - BID
**max 60mL/day
*max 60mL/day
 


==Pediatric Dosing==
==Pediatric Dosing==
===Portal systemic encephalopathy===
===Portal systemic encephalopathy===
*infants
*infants
**2.5-10ml/day PO divided TID-QID
**2.5-10ml/day PO divided TID-QID
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**titrate for 2-3 soft stools per day
**titrate for 2-3 soft stools per day


===[[Constipation (peds)|Constipation]]===
 
===[[Special:MyLanguage/Constipation (peds)|Constipation]]===
 
*1ml/kg PO Qday - BID
*1ml/kg PO Qday - BID
*max 60mL/day
*max 60mL/day


==Special Populations==
==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B (no evidence of risk)
 
*[[Lactation risk categories|Lactation risk]]: safety unknown
*[[Special:MyLanguage/Drug Ratings in Pregnancy|Pregnancy Rating]]: B (no evidence of risk)
*[[Special:MyLanguage/Lactation risk categories|Lactation risk]]: safety unknown
*Renal Dosing
*Renal Dosing
**Adult: not defined
**Adult: not defined
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**Adult: not defined
**Adult: not defined
**Pediatric: not defined
**Pediatric: not defined


==Contraindications==
==Contraindications==
*Allergy to class/drug
*Allergy to class/drug
*galactosemia
*galactosemia
*caution in DM
*caution in DM
*caution if colorectal electrocautery procedures
*caution if colorectal electrocautery procedures


==Adverse Reactions==
==Adverse Reactions==
===Serious===
===Serious===
*diarrhea, severe (excessive dose)
*diarrhea, severe (excessive dose)
*electrolyte disorders (excessive dose)
*electrolyte disorders (excessive dose)
*metabolic acidosis (excessive dose)
*metabolic acidosis (excessive dose)


===Common===
===Common===
*flatulence
*flatulence
*intestinal cramping
*intestinal cramping
*abdominal distention
*abdominal distention
*nausea/vomiting
*nausea/vomiting


==Pharmacology==
==Pharmacology==
*Half-life: unknown
*Half-life: unknown
*Metabolism: colon, <3% systemic absorption
*Metabolism: colon, <3% systemic absorption
*Excretion: feces (100% unchanged), urine < 3%
*Excretion: feces (100% unchanged), urine < 3%
*Mechanism of Action: increases stool water content, increases stool acidity trapping NH4 ions
 
 
==Mechanism of Action==
 
*Undigestible disaccharide consumed by large bowel bacteria and broken down to lactic acid
*Acidification of colonic contents attracts ammonia from bloodstream leading to excretion in stool
 


==Comments==
==Comments==


==See Also==
==See Also==
[[hepatic encephalopathy]]
 
*[[Special:MyLanguage/Hepatic encephalopathy|Hepatic encephalopathy]]
*[[Special:MyLanguage/Constipation|Constipation]]
 


==References==
==References==
<references/>
<references/>
[[Category:Drugs]]
[[Category:Pharmacology]]
[[Category:GI]]
</translate>

Latest revision as of 23:15, 4 January 2026


General

  • Type: osmotic laxative
  • Dosage Forms: 10g/15mL solution
  • Routes of Administration: oral, NG, rectal
  • Common Trade Names: Kristalose


Adult Dosing

Hepatic encephalopathy

  • 30-45mg PO TID or QID or (300mL in 700cc H2O retention enema x30min)
  • titrate for 2-3 soft stools per day


Constipation

  • 15-50mL PO Qday - BID
  • max 60mL/day


Pediatric Dosing

Portal systemic encephalopathy

  • infants
    • 2.5-10ml/day PO divided TID-QID
    • titrate for 2-3 soft stools per day
  • children
    • 40-90ml/day PO divided TID-QID
    • titrate for 2-3 soft stools per day


Constipation

  • 1ml/kg PO Qday - BID
  • max 60mL/day


Special Populations

  • Pregnancy Rating: B (no evidence of risk)
  • Lactation risk: safety unknown
  • Renal Dosing
    • Adult: not defined
    • Pediatric: not defined
  • Hepatic Dosing
    • Adult: not defined
    • Pediatric: not defined


Contraindications

  • Allergy to class/drug
  • galactosemia
  • caution in DM
  • caution if colorectal electrocautery procedures


Adverse Reactions

Serious

  • diarrhea, severe (excessive dose)
  • electrolyte disorders (excessive dose)
  • metabolic acidosis (excessive dose)


Common

  • flatulence
  • intestinal cramping
  • abdominal distention
  • nausea/vomiting


Pharmacology

  • Half-life: unknown
  • Metabolism: colon, <3% systemic absorption
  • Excretion: feces (100% unchanged), urine < 3%


Mechanism of Action

  • Undigestible disaccharide consumed by large bowel bacteria and broken down to lactic acid
  • Acidification of colonic contents attracts ammonia from bloodstream leading to excretion in stool


Comments

See Also


References