Lactulose: Difference between revisions
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==General== | ==General== | ||
*Type: osmotic laxative | *Type: osmotic [[laxative]] | ||
*Dosage Forms: 10g/ | *Dosage Forms: 10g/15mL solution | ||
*Routes of Administration: oral, NG, rectal | *Routes of Administration: oral, NG, rectal | ||
*Common Trade Names: Kristalose | *Common Trade Names: Kristalose | ||
| Line 8: | Line 8: | ||
===[[Hepatic encephalopathy]]=== | ===[[Hepatic encephalopathy]]=== | ||
*30-45mg PO TID or QID or (300mL in 700cc H2O retention enema x30min) | *30-45mg PO TID or QID or (300mL in 700cc H2O retention enema x30min) | ||
*titrate for 2-3 soft stools per day | |||
=== | ===[[Constipation]]=== | ||
*15-50mL PO Qday - BID | *15-50mL PO Qday - BID | ||
*max 60mL/day | |||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
===Portal systemic encephalopathy=== | |||
*infants | |||
**2.5-10ml/day PO divided TID-QID | |||
**titrate for 2-3 soft stools per day | |||
*children | |||
**40-90ml/day PO divided TID-QID | |||
**titrate for 2-3 soft stools per day | |||
===[[Constipation (peds)|Constipation]]=== | |||
*1ml/kg PO Qday - BID | |||
*max 60mL/day | |||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: B (no evidence of risk) | ||
*[[Lactation risk categories|Lactation risk]]: | *[[Lactation risk categories|Lactation risk]]: safety unknown | ||
*Renal Dosing | *Renal Dosing | ||
**Adult | **Adult: not defined | ||
**Pediatric | **Pediatric: not defined | ||
*Hepatic Dosing | *Hepatic Dosing | ||
**Adult | **Adult: not defined | ||
**Pediatric | **Pediatric: not defined | ||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*galactosemia | |||
*caution in DM | |||
*caution if colorectal electrocautery procedures | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*diarrhea, severe (excessive dose) | |||
*electrolyte disorders (excessive dose) | |||
*metabolic acidosis (excessive dose) | |||
===Common=== | ===Common=== | ||
*flatulence | |||
*intestinal cramping | |||
*abdominal distention | |||
*nausea/vomiting | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: unknown | ||
*Metabolism: | *Metabolism: colon, <3% systemic absorption | ||
*Excretion: | *Excretion: feces (100% unchanged), urine < 3% | ||
==Mechanism of Action== | |||
*Undigestible disaccharide consumed by large bowel bacteria and broken down to lactic acid | |||
*Acidification of colonic contents attracts ammonia from bloodstream leading to excretion in stool | |||
==Comments== | ==Comments== | ||
==See Also== | ==See Also== | ||
*[[Hepatic encephalopathy]] | |||
*[[Constipation]] | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category: | [[Category:Pharmacology]] | ||
[[Category:GI]] | |||
Latest revision as of 19:55, 10 February 2021
General
- Type: osmotic laxative
- Dosage Forms: 10g/15mL solution
- Routes of Administration: oral, NG, rectal
- Common Trade Names: Kristalose
Adult Dosing
Hepatic encephalopathy
- 30-45mg PO TID or QID or (300mL in 700cc H2O retention enema x30min)
- titrate for 2-3 soft stools per day
Constipation
- 15-50mL PO Qday - BID
- max 60mL/day
Pediatric Dosing
Portal systemic encephalopathy
- infants
- 2.5-10ml/day PO divided TID-QID
- titrate for 2-3 soft stools per day
- children
- 40-90ml/day PO divided TID-QID
- titrate for 2-3 soft stools per day
Constipation
- 1ml/kg PO Qday - BID
- max 60mL/day
Special Populations
- Pregnancy Rating: B (no evidence of risk)
- Lactation risk: safety unknown
- Renal Dosing
- Adult: not defined
- Pediatric: not defined
- Hepatic Dosing
- Adult: not defined
- Pediatric: not defined
Contraindications
- Allergy to class/drug
- galactosemia
- caution in DM
- caution if colorectal electrocautery procedures
Adverse Reactions
Serious
- diarrhea, severe (excessive dose)
- electrolyte disorders (excessive dose)
- metabolic acidosis (excessive dose)
Common
- flatulence
- intestinal cramping
- abdominal distention
- nausea/vomiting
Pharmacology
- Half-life: unknown
- Metabolism: colon, <3% systemic absorption
- Excretion: feces (100% unchanged), urine < 3%
Mechanism of Action
- Undigestible disaccharide consumed by large bowel bacteria and broken down to lactic acid
- Acidification of colonic contents attracts ammonia from bloodstream leading to excretion in stool