Republic of the Philippines

Drug Information Classification Mechanism of Action Indication Contraindications Side Effects Nursing Responsibilities
Generic Name: Pharmacologic Pharmacodynamics or General Indication/s: Lactulose should not GI: Diarrhea, Before Drug Administration:
Classification: Mechanism of Action: be used in individuals abdominal cramps or
Lactulose Lactulose is indicated with the following discomfort and 1. Assessment:
Osmotic Arrives unchanged in the colon, for: • Before administering lactulose, assess the
Trade Name: known or suspected flatulence
laxative, where it breaks down into lactic patient's medical history, including any
1. The treatment of condition:
Lactoxx Ammonia acid and small amounts of formic Metabolic and allergies, current medications, and any
detoxicant (for and acetic acids, acidifying fecal constipation. 1. Galactosemia: Electrolyte conditions that may affect the use of the
Minimum Dose: hepatic contents. Acidification leads to 2. The prevention and Lactulose contains Imbalance: drug, such as diabetes.
encephalopathy) increased osmotic pressure in treatment of galactose, which Hypokalemia, • For patients with hepatic encephalopathy,
15 mL hepatic Dehydration and
the colon, which, in turn, individuals with the assess their mental status and symptoms
Therapeutic encephalopathy. irregular heartbeats.
Maximum Dose: increases stool water content rare genetic disorder to determine the severity of the condition.
Classification: 3. The prevention and
and softens stool. Also, lactulose known as 2. Patient Education:
60 mL treatment of Endocrine:
Laxative and makes intestinal contents more hepatic coma or galactosemia cannot Hyperglycemia in • Explain the purpose of lactulose to the
Patient’s Dose: Hepatic acidic than blood. This prevents precoma. metabolize. Diabetic patients. patient, including its role in treating
Encephalopathy ammonia diffusion from intestine constipation or managing hepatic
15 mL into blood, as occurs in hepatic 2.Intestinal
Patient’s Indication: Renal: Increased risk encephalopathy.
Obstruction:
Route: encephalopathy. The trapped for kidney stones • Provide clear instructions on the dosage,
ammonia is converted into Lactulose is used to Lactulose should not
administration route, and timing.
be used in individuals
PO ammonia ions and, by lactulose’s treat constipation. Respiratory: Emphasize the importance of following the
with a known or
cathartic effect, is expelled in Increased respiratory prescribed regimen.
suspected intestinal secretions

Certification Date: 1 February 2021

Recertification due date: 24 January 2024
SDF-CON-304-071-00
For verification of the certificate please
access www.gcl-intl.com (Certification Page 1 of 6
check and type the registration number)

Registration No. 52Q18778

 feces with other nitrogenous
wastes.
Frequency:
Pharmacokinetics:
QHS OD
Lactulose has unique
Availability/Form:
pharmacokinetic properties due
• Liquid 10g/ 15 to its non-absorbable nature,
mL per sachet which makes it an effective
• Powder 200g treatment for constipation and
hepatic encephalopathy.
• Syrup 120 and
200mL Peak: Lactulose does not have
suspension a traditional peak concentration
because it is not absorbed into
Contents:
the bloodstream to a significant
Lactulose Solution, degree. Its therapeutic effect is
USP 10 g/15 mL, primarily localized in the colon,
lactulose, galactose, where it draws water into the
lactose, sugar, FD & colon and softens stool.
C Blue No. 1, , FD &
Absorption: Lactulose is not
C Blue No. 6,
significantly absorbed in the
flavoring, sodium
small intestine. It passes through
hydroxide, and
the stomach and reaches the
purified water.
colon in its intact form. Its
mechanism of action is primarily
localized in the colon.
obstruction. It may • For patients with diabetes, educate them
worsen the condition about the sugar content in lactulose and
by increasing fluid and advise them to monitor their blood glucose
gas in the obstructed levels.
area.
During Drug Administration:
3.Perforated Bowel:
1. Medication Administration:
Lactulose is
contraindicated in
• Administer lactulose as prescribed by the
healthcare provider. The medication is
individuals with a
typically given orally, either as a syrup or a
perforated bowel crystalline powder that is dissolved in
because it can water.
exacerbate the • Ensure that the patient is comfortable and
problem by increasing able to swallow or take the medication,
pressure and fluid in providing assistance if necessary.
the abdominal cavity. 2. Monitoring:
• For patients with constipation, monitor their
4. Inflammatory response to lactulose. Evaluate whether the
BowelDisease medication is effectively relieving
(IBD): Lactulose constipation and improving bowel
should be used with movements.
caution in individuals • For patients with hepatic encephalopathy,
with active monitor their mental status and the
inflammatory bowel frequency of bowel movements to assess
disease, as it can the impact on ammonia levels and
potentiallyworsen symptom relief
.After Drug Administration:
Certification Date: 1 February 2021
Recertification due date: 24 January 2024

Distribution: Lactulose remains
primarily within the
gastrointestinal tract. It is not
distributed systemically in the
body because it is not absorbed
in significant quantities.
Therefore, it does not enter the
bloodstream to a great extent.
Metabolism: Lactulose
undergoes minimal metabolism
in the body. It is primarily broken
down by colonic bacteria in the
large intestine. Bacteria in the
colon ferment lactulose, leading
to the production of short-chain
fatty acids, carbon dioxide, and
hydrogen gas. This fermentation
process creates an osmotic
effect that draws water into the
colon and softens the stool,
promoting bowel movements.
Elimination: Lactulose is mainly
eliminated from the body through
fecal excretion. It remains non-
absorbable, so it continues to
work within the colon, softening
symptoms and • Advise patient to take lactulose with food
inflammation. or dilute with juice to reduce sweet taste.
• Direct patient not to use other laxatives
5. Appendicitis: while taking lactulose.
Lactulose is generally • Instruct patient to report abdominal
contraindicatedin distention or severe diarrhea.
individualswith • Advise diabetic patient to check blood
suspected or glucose level often and to report
confirmed hyperglycemia.
appendicitis. It may • Instruct patient to increase fluid intake if
cause an increase in frequent bowel movements occur.
pressure and • Teach patient with chronic constipation the
discomfort in the area. importance of exercising, increasing fiber
in diet, and increasing fluid intake.
6. Dehydration: In • Inform patient that because oral lactulose
individuals with must reach the colon to work, bowel
severe dehydration, movement may not occur for 24 to 48
usinglactulose hours after taking drug.
without proper
rehydration can be
dangerous due to its
potential to cause or
exacerbate fluid loss
through diarrhea.
7. Hypersensitivity
or Allergy: People who
have a known
stool and promoting regular hypersensitivity or
bowel movements. In the case of allergy to lactulose or
hepatic encephalopathy, any of its components
lactulose helps lower ammonia should avoid using the
levels in the body, which are then medication.
eliminated through the feces.
8. Elevated
Intracranial Pressure:
Lactulose should be
Half-Life: Lactulose also does used with caution in
not have a conventional half-life. individuals
It remains primarily within the with elevated
gastrointestinal tract, working intracranial pressure,
locally to alleviate constipation as it may lead to
and reduce ammonia levels in increased fluid shifts
cases of hepatic and exacerbate this
encephalopathy. condition.
9. Diabetic
Ketoacidosis:
Lactulose may affect
blood glucose levels,
so it should be used
cautiouslyin
individuals with
diabetic ketoacidosis
 10. Phenylketonuria
(PKU): Some
formulations of
lactulose may contain
phenylalanine, which
can be harmful to
individuals with PKU,
a metabolic disorder.

References (at least 2):

DailyMed - LACTULOSE SOLUTION- lactulose solution usp, 10 g/15 ml solution. (n.d.). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=d460b1a2-9091-2ac9
Elsevier, Inc. (n.d.). Lactulose solution (Constipation). Cleveland Clinic. https://my.clevelandclinic.org/health/drugs/19131-lactulose-solution-constipation
StackPath. (n.d.). https://www.mims.com/philippines/drug/search?q=Lactulose&mtype=brand