Lactulose For Liver Disease – Side Effects and Safety During Pregnancy
Lactulose is a medication used to treat liver disease. Before you start using lactulose for liver disease, you should know its side effects and how it interacts with other medications. You should also know about the safety of this drug if you are pregnant. You can read more information in this article.
Treatment of hepatic encephalopathy with lactulose
The objective of hepatic encephalopathy (HE) treatment is to reduce blood toxins. Unlike liver failure, hepatic encephalopathy is not a life-threatening illness. Fortunately, there are several available treatments. These include antibiotics and lactulose, a man-made synthetic sugar.
One study found that lactulose can treat minimal HE in 66% of patients. However, it is not recommended as primary prophylaxis against HE. Lactulose is administered through a nasogastric tube. There are a variety of adverse effects associated with lactulose therapy, including gastrointestinal side effects, hyperkalemia, and hyponatility.
Lactulose is used in treatment of HE to decrease ammonia. It does not directly inhibit urea degradation, but it reduces the rate at which it accumulates in the body. In addition to lactulose, dietary fiber and nonabsorbable saccharides also have similar effects. However, antibiotics neomycin may produce additive effects with lactulose.
Lactulose has a long history of use for treating hepatic encephalopathy. The drug eliminates toxic metabolites in the liver, thus alleviating symptoms of hepatic encephalopathy. However, lactulose has serious side effects, and a third of patients do not respond to this standard therapy. For this reason, newer drugs have been introduced that have fewer side effects.
Despite these limitations, lactulose is considered a first-line therapy for episodic HE. It is recommended to combine rifaximin with the drug to further improve patient outcomes. In addition, the drug should be continued for patients after the episode of HE has ended.
Interactions with other drugs
One of the potential side effects of lactulose is hepatic encephalopathy, a neuropsychiatric complication of liver cirrhosis. This condition often manifests as obtundation, mild confusion, or sleep disturbance. Despite advances in medication, more than a third of patients with hepatic encephalopathy do not respond to standard treatment. Therefore, it is important to discuss lactulose’s interactions with your healthcare provider before starting treatment. In addition, avoid taking any other medications at the same time.
Lactulose is a synthetic sugar that is used to treat patients with liver disease or liver failure. It reduces ammonia in the blood and helps the gastrointestinal tract to flush out waste. Lactulose also serves as a laxative and prevents chronic constipation. While it is not a cure for liver disease, it does improve mental state and reduce the risk of other complications of liver disease. Lactulose is a man-made sugar solution that is absorbed into the gastrointestinal tract and decreases intestinal ammonia levels.
The typical dosage of lactulose is 10g per day, but this can be increased to 40g per day or decreased to seven to ten grams per day. Patients can take lactulose as a liquid (15-50 mL three times a day) or in granules (6g thrice daily). Lactulose is available as a whole pill, granules, and as a nasogastric sachet.
Patients with cirrhosis should consult their physician about the use of lactulose because lactulose is not absorbed systemically. Patients should be monitored for blood glucose levels and serum electrolytes during and after treatment. Lactulose may also cause abdominal pain, flatulence, or bloating, so it is important to monitor these conditions.
In the study, patients with MHE were randomly assigned in a 1:1 ratio to receive either lactulose or a placebo. Randomization was performed using tables of random numbers with sequences kept secret until enrollment. Patients were followed monthly to determine compliance. In the MHE-L group, patients were given 30-60 ml of lactulose in 2 or three divided doses daily. The dose of lactulose was adjusted until the patients were able to pass two or three semi-soft stools a day.
Patients taking lactulose should tell their doctors about any other medications they are taking. They should also notify their doctor if they are on a low lactose diet, pregnant, or breastfeeding.
Safety during pregnancy
The safety of lactulose for liver disease during gestation depends on the dosage and condition. The usual dosage range is 20 to 30 g four times daily. If the condition is chronic, the dose may be decreased to two or three g a day. Patients with acute liver disease may require more aggressive therapy.
Lactulose was first synthesized from lactose in 1929. It is a form of lactose that has a galactosyl b-(1-4)-fructose moiety. It was approved by the Institutional Review Boards at the University of Texas Southwestern Medical Center and the Parkland Health and Hospital System. Informed consent was obtained from all patients and legal representatives.
The study included 186 patients who had liver disease and were screened for safety. Of these, fifty were eligible for treatment. The main reasons for exclusion were a history of more than one dose of lactulose in the emergency department prior to consent. In addition, the majority of patients had cirrhosis and a male predominance.
While lactulose is safe to take during pregnancy, it should be taken with caution. It is recommended to consult your doctor or health care provider if you experience any serious side effects, including bleeding, nausea, and diarrhea. The usual adult dosage ranges from two to three tablespoons (30 to 45 mL) three or four times a day.
Lactulose is often used as an oral laxative for people with liver failure. It can also help treat brain conditions caused by liver failure. These can cause confusion, memory problems, and loss of coordination. In addition to improving stool characteristics, lactulose also has few adverse effects. The drug is safe for breastfeeding and does not affect fetal development. It is also not absorbed into the blood.
