Lactulose

Lactulose
Clinical data
Pronunciation/ˈlæktjʊloʊs/
Trade namesCholac, Generlac, Constulose, others
Other names4-O-β-D-Galactosyl-D-fructose
AHFS/Drugs.comMonograph
MedlinePlusa682338
Routes of
administration		By mouth
ATC code
Legal status
Legal status
Pharmacokinetic data
BioavailabilityPoorly absorbed
Onset of action8 to 48 hours[1][2]
Identifiers
IUPAC name
  • 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
  • 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)

Lactulose is a non-absorbable sugar used in the treatment of constipation and hepatic encephalopathy.[3][4] It is administered orally for constipation, and either orally or rectally for hepatic encephalopathy.[3] It generally begins working after 8–12 hours, but may take up to 2 days to improve constipation.[1][2]

Common side effects include abdominal bloating and cramps.[3] A potential exists for electrolyte problems as a result of the diarrhea it produces.[3] No evidence of harm to the fetus has been found when used during pregnancy.[3] It is generally regarded as safe during breastfeeding.[5] It is classified as an osmotic laxative.[6]

Lactulose was first made in 1929, and has been used medically since the 1950s.[7][8] Lactulose is made from the milk sugar lactose, which is composed of two simple sugars, galactose and glucose.[9][3] It is on the World Health Organization's List of Essential Medicines.[10] It is available as a generic medication.[4] In 2022, it was the 267th most commonly prescribed medication in the United States, with more than 900,000 prescriptions.[11][12]

  1. ^ a b Karwacki MW (2006). "Gastrointestinal Symptoms". In Goldman A, Hain R, Liben S (eds.). Oxford textbook of palliative care for children (2nd ed.). Oxford: Oxford University Press. p. 352. ISBN 9780198526537. Archived from the original on 8 September 2017.
  2. ^ a b Hogue VW, McKoy-Beach YB (2006). "Constipation and diarrhea". In Helms RA (ed.). Textbook of therapeutics : drug and disease management (8th ed.). Philadelphia, Pa. [u.a.]: Lippincott Williams & Wilkins. p. 1310. ISBN 9780781757348. Archived from the original on 8 September 2017.
  3. ^ a b c d e f "Lactulose". The American Society of Health-System Pharmacists. Archived from the original on 4 September 2017. Retrieved 11 August 2015.
  4. ^ a b Hamilton RJ (2013). "Gastroenterology". Tarascon pocket pharmacopoeia : 2013 classic shirt-pocket edition (27th ed.). Burlington, Ma.: Jones & Bartlett Learning. p. 111. ISBN 9781449665869. Archived from the original on 8 September 2017.
  5. ^ Jones W (2013). Breastfeeding and Medication. Routledge. p. 127. ISBN 9781136178153. Archived from the original on 8 September 2017.
  6. ^ Papaconstantinou HT (2009). "Operative and Nonoperative Therapy for Chronic Constipation". In Whitlow CB, Beck DE, Margolin DA, Hicks TC (eds.). Improved Outcomes in Colon and Rectal Surgery. New York: Informa Healthcare. p. 366. doi:10.3109/9781420071535-36. ISBN 9781420071535. Archived from the original on 8 September 2017.
  7. ^ O'Brien J (2009). "Non-Enzymatic Degradation Pathways of Lactose and Their Significance in Dairy Products". In McSweeney PL, Fox PF (eds.). Advanced dairy chemistry (3rd ed.). New York: Springer-Verlag. p. 236. ISBN 9780387848655. Archived from the original on 8 September 2017.
  8. ^ Schumann C (November 2002). "Medical, nutritional and technological properties of lactulose. An update". European Journal of Nutrition. 41 (Suppl 1): I17 – I25. doi:10.1007/s00394-002-1103-6. PMID 12420112. S2CID 20487660.
  9. ^ Kuntz HD (2008). Hepatology textbook and atlas : history, morphology, biochemistry, diagnostics, clinic, therapy (3rd ed.). Heidelberg: Springer. p. 887. ISBN 9783540768395. Archived from the original on 8 September 2017.
  10. ^ World Health Organization (2023). The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023). Geneva: World Health Organization. hdl:10665/371090. WHO/MHP/HPS/EML/2023.02.
  11. ^ "The Top 300 of 2022". ClinCalc. Archived from the original on 30 August 2024. Retrieved 30 August 2024.
  12. ^ "Lactulose Drug Usage Statistics, United States, 2013 - 2022". ClinCalc. Retrieved 30 August 2024.
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