Constulose (lactulose)
Laxatives Oral Solution, Oral
Last reviewed · Source: First Databank (FDB) drug data
Overview
Lactulose, a synthetic derivative of lactose, is an ammonia detoxicant.
USES: This medication is a laxative used to treat constipation. It may help to increase the number of bowel movements per day and the number of days you have a bowel movement. Lactulose is a colonic acidifier that works by increasing stool water content and softening the stool.
It is a man-made sugar solution.
Generic name: lactulose
Pronunciation: (LACK-tew-lohss)
Drug class: Laxatives
Therapeutic class: Gastrointestinal Therapy Agents
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Constulose
Indications
The following indications are listed for Constulose:
- Constipation
- Hepatic Encephalopathy
- Hyperammonemia
Also known as: Abnormally Elevated Blood Ammonia, Ammonemia, Portal Systemic Encephalopathy.
Dosing
Each 15 mL of commercially available lactulose solution provides approximately 10 g of the drug; corresponding doses provided by 2.5, 5, 7.5, 10, 30, 40, 45, 90, 150, and 300 mL of the commercial solution are approximately 1.67, 3.3, 5, 6.67, 20, 27, 30, 60, 100, and 200 g, respectively. Following reconstitution of the oral powder as directed, a 10 or 20 g dose is provided by the total volume.
No dosing information is available for this tab.
| Drug label | Dosing type | Instructions |
|---|---|---|
| Constulose 10 Gm/15 Ml Soln | Maintenance | Take 15 milliliters (10 gram) by oral route once daily. |
| Drug label | Dosing type | Instructions |
|---|---|---|
| Lactulose 10 Gm/15 Ml Solution | Maintenance | Take 15 milliliters (10 gram) by oral route once daily. |
| Lactulose 20 Gm/30 Ml Soln Cup | Maintenance | Take 15 milliliters (10 gram) by oral route once daily. |
| Lactulose 10 Gm/15 Ml Soln Cup | Maintenance | Take 15 milliliters (10 gram) by oral route once daily. |
Drug interactions
There is no enhanced messaging for this drug.
There are no contraindication interactions for this drug.
Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
Laxatives/Trofinetide
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Trofinetide commonly causes diarrhea of mild to moderate severity. Laxatives may increase the incidence or severity of diarrhea.(1)
CLINICAL EFFECTS: Concurrent use of laxatives with trofinetide may increase the risk of severe diarrhea.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: Patients should stop laxatives before starting trofinetide. If diarrhea occurs, consider anti-diarrheal treatment and monitor hydration status. If severe diarrhea or dehydration occurs, interrupt, reduce dose, or discontinue trofinetide.(1)
DISCUSSION: In clinical trials, 85% of patients on trofinetide developed diarrhea. Concurrent use of laxatives may increase this risk.(1)
Laxatives; Stool Softeners/Tenapanor
SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction.
MECHANISM OF ACTION: Tenapanor commonly causes diarrhea of mild to moderate severity. Laxatives and stool softeners may increase the incidence or severity of diarrhea.(1)
CLINICAL EFFECTS: Concurrent use of laxatives or stool softeners with tenapanor may increase the risk of severe diarrhea.(1)
PREDISPOSING FACTORS: None determined.
PATIENT MANAGEMENT: The US manufacturer of tenapanor states that patients should be instructed to avoid stool softeners and laxatives with tenapanor. If severe diarrhea occurs, tenapanor should be discontinued.(1)
DISCUSSION: In clinical trials, 43-53% of CKD patients on dialysis treated with tenapanor developed diarrhea. Diarrhea usually occurred soon after treatment initiation and was severe in 5% of patients.(1)
There are no moderate interactions for this drug.
Contraindications
There is no enhanced messaging for this drug.
- Appendicitis
- Galactosemia
- Gastrointestinal obstruction
- Glucose-galactose malabsorption
There are no severe contraindications for this drug.
- Diabetes mellitus
Adverse reactions
There is no enhanced messaging for this drug.
There are no severe adverse reactions for this drug.
Less Frequent
- Abdominal pain with cramps
- Diarrhea
- Flatulence
- Polydipsia
Precautions
No enhanced messaging available.
No enhanced messaging available.
Use of lactulose during pregnancy has not been studied in humans. Reproduction studies in rats, mice, and rabbits receiving oral lactulose doses up to 6 times the usual human oral dose have not revealed evidence of harm to the fetus. Lactulose should be used during pregnancy only when clearly needed.
It is not known if lactulose is distributed into milk. The drug should be used with caution in nursing women.
No enhanced messaging available.
ICD codes
| Code | Type | Description |
|---|---|---|
| Constipation | ||
| K59.0 | ICD10CM | Constipation |
| K59.00 | ICD10CM | Constipation, unspecified |
| K59.01 | ICD10CM | Slow transit constipation |
| K59.03 | ICD10CM | Drug induced constipation |
| K59.04 | ICD10CM | Chronic idiopathic constipation |
| K59.09 | ICD10CM | Other constipation |
| Hepatic encephalopathy | ||
| B15.0 | ICD10CM | Hepatitis A with hepatic coma |
| B16.0 | ICD10CM | Acute hepatitis B with delta-agent with hepatic coma |
| B16.2 | ICD10CM | Acute hepatitis B without delta-agent with hepatic coma |
| B17.11 | ICD10CM | Acute hepatitis C with hepatic coma |
| B19.0 | ICD10CM | Unspecified viral hepatitis with hepatic coma |
| B19.11 | ICD10CM | Unspecified viral hepatitis B with hepatic coma |
| B19.21 | ICD10CM | Unspecified viral hepatitis C with hepatic coma |
| K70.41 | ICD10CM | Alcoholic hepatic failure with coma |
| K71.11 | ICD10CM | Toxic liver disease with hepatic necrosis, with coma |
| K72.01 | ICD10CM | Acute and subacute hepatic failure with coma |
| K72.11 | ICD10CM | Chronic hepatic failure with coma |
| K72.90 | ICD10CM | Hepatic failure, unspecified without coma |
| K72.91 | ICD10CM | Hepatic failure, unspecified with coma |
| K76.82 | ICD10CM | Hepatic encephalopathy |
| Hyperammonemia | ||
| B15.0 | ICD10CM | Hepatitis A with hepatic coma |
| B16.0 | ICD10CM | Acute hepatitis B with delta-agent with hepatic coma |
| B16.2 | ICD10CM | Acute hepatitis B without delta-agent with hepatic coma |
| B17.11 | ICD10CM | Acute hepatitis C with hepatic coma |
| B19.0 | ICD10CM | Unspecified viral hepatitis with hepatic coma |
| B19.11 | ICD10CM | Unspecified viral hepatitis B with hepatic coma |
| B19.21 | ICD10CM | Unspecified viral hepatitis C with hepatic coma |
| D81.810 | ICD10CM | Biotinidase deficiency |
| E71.110 | ICD10CM | Isovaleric acidemia |
| E71.121 | ICD10CM | Propionic acidemia |
| E72.20 | ICD10CM | Disorder of urea cycle metabolism, unspecified |
| E72.21 | ICD10CM | Argininemia |
| E72.22 | ICD10CM | Arginosuccinic aciduria |
| E72.23 | ICD10CM | Citrullinemia |
| E72.29 | ICD10CM | Other disorders of urea cycle metabolism |
| E72.4 | ICD10CM | Disorders of ornithine metabolism |
| K72.91 | ICD10CM | Hepatic failure, unspecified with coma |
| P74.6 | ICD10CM | Transitory hyperammonemia of newborn |
ICD code information from First Databank (FDB).
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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