Lactulose is a synthetic sugar that functions as a laxative, primarily utilized to manage chronic constipation and to reduce elevated ammonia levels in individuals with liver disease, a condition known as hepatic encephalopathy. This medication works within the digestive system to facilitate softer bowel movements. It is not absorbed into the bloodstream in significant amounts, performing its actions directly in the colon.
General Timing Guidelines
For general constipation, the specific time of day lactulose is taken is less important than maintaining a consistent daily schedule. Many individuals find it convenient to take their dose once daily, either in the morning or the evening. This consistency helps the body adjust to the medication’s effects and promotes regularity.
Lactulose can be taken with or without food. Taking it with meals may help reduce the likelihood of stomach upset for some people.
Specific Timing for Different Conditions
For constipation, a single daily dose of lactulose is prescribed. Some individuals may choose to take it in the evening to encourage a morning bowel movement, aligning with their personal schedules.
For hepatic encephalopathy, the timing and frequency of lactulose administration are more precise and adjusted to achieve a specific outcome. Doses are taken multiple times a day, often three to four times, aiming for two to three soft bowel movements daily. This frequent dosing helps to continuously lower ammonia levels in the blood, which is crucial for managing the neurological symptoms associated with the condition. In acute episodes, hourly doses may be administered until a bowel movement occurs, after which the dosage is adjusted to maintain the target number of soft stools.
Administering Lactulose
Lactulose is available as a liquid solution and can be mixed with other liquids to improve its palatability. To make the sweet taste more tolerable, it can be diluted in half a glass of water, fruit juice, or milk. This helps ensure the full dose is consumed for effectiveness.
If a dose is missed, it should be taken as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped to avoid taking a double dose. Resuming the regular dosing schedule is important to maintain consistent treatment.
Lactulose should be stored at room temperature, between 59°F and 86°F (15°C and 30°C), and protected from excessive heat and moisture. Do not freeze the medication. While the liquid may darken over time, this is normal and does not affect its efficacy, though extremely dark or cloudy solutions should not be used.
What to Expect After Taking Lactulose
The effects of lactulose are not immediate; it takes 24 to 48 hours for a bowel movement to occur after the first dose. This delayed onset is due to the time it takes for the medication to reach the colon and begin its work. Continue taking the medication as prescribed during this initial period.
Common side effects include bloating, gas, and abdominal cramping, which result from the fermentation process in the colon. Diarrhea can also occur, particularly at higher doses, and may indicate that the dosage needs to be adjusted. Staying well-hydrated by drinking plenty of fluids, such as water, is important while taking lactulose to prevent dehydration, especially if diarrhea occurs.