Lactulose

Lactulose is a non-absorbable sugar used in the treatment of constipation and hepatic encephalopathy. It is administered orally for constipation, and either orally or rectally for hepatic encephalopathy. It generally begins working after 8–12 hours, but may take up to 2 days to improve constipation.

Lactulose
Clinical data
Pronunciation/ˈlæktjʊloʊs/
Trade namesCholac, Generlac, Consulose, others
Other names4-O-β-D-Galactosyl-D-fructose
AHFS/Drugs.comMonograph
MedlinePlusa682338
Routes of
administration		By mouth
ATC code
Legal status
Legal status
  • UK: General sales list (GSL, OTC)
  • US: ℞-only
  • In general: Over-the-counter (OTC)
Pharmacokinetic data
BioavailabilityPoorly absorbed
Metabolism100% in colon by enteric bacteria
Onset of action8 to 48 hours
Elimination half-life1.7–2 hours
ExcretionFecal
Identifiers
  • 4-O-β-D-Galactopyranosyl-β-D-fructofuranose
    OR
    (2S,3R,4S,5R,6R)-2-((2R,3S,4S,5R)-4,5-Dihydroxy-2,5-bis(hydroxymethyl)tetrahydrofuran-3-yloxy)-6-(hydroxymethyl)tetrahydro-2H-pyran-3,4,5-triol
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.022.752
Chemical and physical data
FormulaC12H22O11
Molar mass342.297 g·mol−1
3D model (JSmol)
SMILES
  • O[C@H]2[C@H](O[C@@H]1O[C@H](CO)[C@H](O)[C@H](O)[C@H]1O)[C@H](O[C@]2(O)CO)CO
  • InChI=1S/C12H22O11/c13-1-4-6(16)7(17)8(18)11(21-4)22-9-5(2-14)23-12(20,3-15)10(9)19/h4-11,13-20H,1-3H2/t4-,5-,6+,7+,8-,9-,10+,11+,12-/m1/s1 Y
  • Key:JCQLYHFGKNRPGE-FCVZTGTOSA-N Y
  (verify)

Common side effects include abdominal bloating and cramps. A potential exists for electrolyte problems as a result of the diarrhea it produces. No evidence of harm to the fetus has been found when used during pregnancy. It is generally regarded as safe during breastfeeding. It is classified as an osmotic laxative.

Lactulose was first made in 1929, and has been used medically since the 1950s. Lactulose is made from the milk sugar lactose, which is composed of two simple sugars, galactose and glucose. It is on the World Health Organization's List of Essential Medicines. It is available as a generic medication. In 2021, it was the 265th most commonly prescribed medication in the United States, with more than 1 million prescriptions.

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