Lactulose is used to treat chronic constipation.

Lactulose is sometimes used to treat or prevent certain conditions of the brain that are caused by liver failure. These conditions can lead to confusion, problems with memory or thinking, behavior changes, tremors, feeling irritable, sleep problems, loss of coordination, and loss of consciousness.

Lactulose may also be used for purposes not listed in this medication guide.

Use only as directed. Tell your doctor if you use other medicines or have other medical conditions or allergies.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

Mix lactulose powder with at least 4 ounces of water, milk, or fruit juice.

Measure liquid medicine with the supplied measuring device (not a kitchen spoon).

Lactulose should produce a bowel movement within 24 to 48 hours.

If you use lactulose long-term, you may need frequent medical tests.

Tell your doctor if you have a planned colonoscopy or proctoscopy procedure.

Store tightly closed at room temperature, away from moisture and heat. Avoid freezing.

The liquid may turn darker in color, but this will not affect the medicine. Do not use the medicine if it becomes very dark or gets thicker or thinner in texture.

Usual Adult Dose for Constipation -- Chronic:

15 mL orally once a day.

Usual Adult Dose for Constipation -- Acute:

Initial dose: 15 mL orally once a day. Therapy should be continued until normal bowel function resumes.

Usual Adult Dose for Hepatic Encephalopathy:

Initial dose: 30 mL orally 3 times a day or
300 mL in 700 mL water or normal saline as an enema retained for 30 to 60 minutes every 4 to 6 hours.
Maintenance dose: 30 to 45 mL orally 3 times a day.

Usual Pediatric Dose for Hepatic Encephalopathy:

Infants: 1.7 to 6.7 g/day (2.5 to 10 mL) orally daily divided in 3 to 4 doses. Adjust dosage to produce 2 to 3 soft stools per day.

Children: 26.7 to 60 g/day (40 to 90 mL) orally daily divided in 3 to 4 doses. Adjust dosage to produce 2 to 3 soft stools per day.

Usual Pediatric Dose for Constipation -- Chronic:

Children: 0.7 to 2 g/kg/day (1 to 3 mL/kg/day) orally in divided doses daily; generally recommended not to exceed the adult maximum of 40 g/day (60 mL/day).

You should not use lactulose if you are on a special diet low in galactose (milk sugar).

Tell your doctor if you have ever had:

• diabetes; or

• if you need to have any type of intestinal test using a scope (such as a colonoscopy).

Tell your doctor if you are pregnant or breastfeeding.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose may cause nausea, vomiting, diarrhea, and stomach cramps, or symptoms of low blood potassium or low blood sodium (confusion, weakness, constipation, irregular heartbeats, fluttering in your chest, increased thirst or urination, numbness or tingling, muscle weakness or limp feeling).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Ask your doctor before taking any other laxative or an antacid, and take only the type your doctor recommends.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using lactulose and call your doctor at once if you have severe or ongoing diarrhea.

Common side effects of lactulose may include:

• bloating, gas;

• stomach pain;

• diarrhea; or

• nausea, vomiting.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Other drugs may affect lactulose, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all other medicines you use.

Keep all appointments with your doctor.

To improve the taste of lactulose, mix your dose with one-half glass of water, milk, or fruit juice.

Do not let anyone else take your medicine. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.