Orally, can be mixed with water, fruit juice, or milk to improve palatability. Should be taken at the same time each day. For constipation, it may be taken as a single daily dose or divided into two doses. For hepatic encephalopathy, doses are typically divided throughout the day.

Lactulose is a non-absorbable disaccharide that reaches the colon unchanged. In the colon, it is metabolized by colonic bacteria into low molecular weight organic acids, which increase osmotic pressure, leading to water retention in the colon. This softens the stool and stimulates peristalsis. In hepatic encephalopathy, it reduces blood ammonia levels by promoting ammonia diffusion from blood to gut lumen, converting ammonia to ammonium ions (which are non-absorbable), and inhibiting ammonia-producing bacteria.

• •Galactosemia
• •Bowel obstruction or perforation
• •Acute abdominal pain of unknown cause
• •Hypersensitivity to lactulose or any component of the solution

Store at room temperature (below 30°C). Do not refrigerate or freeze. Keep tightly closed and out of reach of children.

Symptoms include abdominal pain, diarrhea, and electrolyte disturbances (especially hypokalemia and hyponatremia). Treatment is symptomatic and supportive, including correction of fluid and electrolyte imbalances.

Generally considered safe during pregnancy and lactation as it is minimally absorbed. Consult a doctor before use.