Can be taken orally, either undiluted or diluted with water, fruit juice, or milk. For constipation, usually taken once daily, often in the morning. For hepatic encephalopathy, doses are spread throughout the day.

Lactulose is poorly absorbed from the gastrointestinal tract. In the colon, it is metabolized by bacterial flora into low molecular weight organic acids, which increases osmotic pressure, drawing water into the colon and softening the stool. In hepatic encephalopathy, these acids also lower the pH of the colon, which traps ammonia (NH3) as ammonium (NH4+) ions, preventing its absorption into the bloodstream and facilitating its excretion.

• •Hypersensitivity to lactulose or any component of the formulation
• •Galactosemia
• •Intestinal obstruction (e.g., paralytic ileus, colon obstruction)
• •Acute abdominal pain of unknown cause

Store below 30°C, away from light and moisture. Do not refrigerate or freeze.

Symptoms of overdose include abdominal pain, diarrhea, electrolyte imbalance (especially hypokalemia). Treatment involves discontinuing the drug, correcting fluid and electrolyte imbalances.

Pregnancy Category B. Generally considered safe during pregnancy and lactation as it is minimally absorbed. Consult a doctor.