Hepatic encephalopathy:
Indications for: Lactulose solution
Prevention and treatment of portal-systemic encephalopathy, including the stages of hepatic pre-coma and coma.
Adult Dosage:
Oral: 30–45mL 3–4 times daily; may adjust dose every day or two to produce 2–3 soft stools daily. Hourly doses of 30–45mL may be used to induce rapid laxation initially; when laxative effect has been achieved, reduce dose to recommended daily dose. Maintenance: continue recommended daily dose. Rectal: may be given as a retention enema via a rectal balloon catheter. Mix 300mL of lactulose solution with 700mL of water or physologic saline, retain for 30–60 minutes. May repeat every 4–6 hours; if evacuated too promptly, may be repeated immediately. Start oral route before stopping enema entirely.
Children Dosage:
Oral: Individualize dose to produce 2–3 soft stools daily. Infants: initially 2.5–10mL in divided doses. Older children and adolescents: 40–90mL/daily. If initial dose causes diarrhea, reduce dose immediately; discontinue if diarrhea persists.
Lactulose solution Contraindications:
Patients who require a low galactose diet.
Lactulose solution Warnings/Precautions:
Perform thorough bowel cleansing with non-fermentable solution prior to electrocautery procedures during proctoscopy or colonoscopy. Diabetes. Pregnancy (Cat.B). Nursing mothers.
Lactulose solution Classification:
Colonic acidifier.
Lactulose solution Interactions:
Avoid concomitant laxatives. Caution with concomitant oral anti-infectives (eg, neomycin); monitor closely. May be antagonized by non-absorbable antacids.
Adverse Reactions:
Gas, cramping, diarrhea, nausea, vomiting; infants: also hyponatremia, dehydration.
Note:
Formerly known under the brand names Cephulac, Chronulac, Evalose.
How Supplied:
Contact supplier.
