Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Austria: Bifiteral, Duphalac, Lactulose, Laevolac, Medilet; Belgium: Bifiteral, Duphalac, Lactulose, Transitol; Bulgaria: Duphalac, Imoper, Lactulose, Lactus; Cyprus: Duphalac, Lipebin, Normolax; Czech Republic: Duphalac, Lactecon, Lactulosa, Lactulose; Denmark: Lactulose, Laktulose, Medilax; Estonia: Duphalac, Lactecon, Lactulose; Finland: Duphalac, Lactulos, Lactulose, Laktulos, Laxorin, Levolac; France: Duphalac, Lactulose, Lansoyl, Laxaron, Melaxose, Transulose; Germany: Bifiteral, Lactu-Saar, Lactuflor, Lactugel, Lactulade, Lactulose, Lactuverlan, Solaguttae Abführ, Tulotract; Greece: Duphalac; Hungary: Amivalex, Duphalac; Ireland: Duphalac, Lactecon, Lactugal, Lactulose, Laxose; Italy: Dia Colon, Duphalac, Epalfen, Laevolac, Lattulac, Lattulosio, Normase, Osmolac, Transitol, Verelait; Latvia: Duphalac; Lithuania: Tulose; Malta: Dia Colon, Duphalac, Lactulose; Netherlands: Duphalac, Lactecon, Lactulose; Luxembourg: Bifiteral, Duphalac, Lactocur, Lac Epalfen, Lactulose, Legendal, Sirupus Lactulosi; Poland: Duphalac, Lactecon, Lactulol, Lactulose, Lactulosum, Normalac, Normase; Portugal: Colsanac, Duphalac, Lactulose, Laevolac, Obstipar, Melaxose; Romania: Duphalac, Epalfen, Lactulak, Lactulose; Slovakia: Duphalac, Lactecon, Lactulosa, Lactulose, Laevolac; Slovenia: Lactecon, Portalak, Prorektal; Spain: Belmalax, Duphalac, Lactulosa; Sweden: Duphalac, Lactulose, Laktipex, Laktulos; UK: Duphalac, Lactugal, Lactulose.

North America

Canada: Euro-Lac, Lactulose; USA: Cholac, Constilac, Constulose, Enulose, Generlac, Lactulose.

Latin America

Argentina: Genocolan, Lactulon, Lafelax, Medixin, Tenualax; Brazil: Colonac, Farlac, Lactulona; Mexico: Duphalac, Lactulax, Quimtulac, Regulact.


Japan: Caloryl, Lactulose, Lagnos, Liforos, Monilac, Piarle.

Drug combinations


Lactulose: C~12~H~22~O~11~. Mw: 342.30. D-Fructose, 4-O-β-D-galactopyranosyl-. CAS-4618-18-2 (1965).

Pharmacologic Category

Ammonia Detoxicants. Cathartics and Laxatives; Hyperosmotic Laxatives. (ATC-Code: A06AD11).

Mechanism of action

Bacterial degradation of lactulose resulting in acidic pH, inhibits diffusion of NH~3~ into blood by causing conversion of NH~3~ to NH~4~^+^. Also enhances diffusion of NH~3~ from blood into gut where conversion to NH~4~^+^ occurs. Produces osmotic effect in colon with resultant distention promoting peristalsis.

Therapeutic use

Adjunct in prevention and treatment of portal-systemic encephalopathy. Treatment of chronic constipation.

Pregnancy and lactiation implications

Use with caution during pregnancy or lactation.

Unlabeled use


Hypersensitivity to lactulose or any component of the formulation. Galactosemia (or patients requiring low galactose diet).

Warnings and precautions

Administer with caution to patients who may require electrocautery procedures during proctoscopy or colonoscopy (risk of an explosive reaction). Serious underlying liver disease may produce complications such as electrolyte disturbances (e.g. hypokalemia). Use with caution in diabetes mellitus (solution contains galactose and lactose). Concomitant use with oral anti-infective might cause inadequate response to lactulose.



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