Lactulose is a synthetic disaccharide derivative of lactose that is most commonly used as a laxative agent despite also being formally indicated to serve as an adjunct therapy in treating portal-systemic encephalopathy (PSE).[FDA Label,L6199,L6202] Despite being first synthesized in 1929[A178081], investigations regarding its possible use as a laxative for the treatment of chronic constipation did not occur until the 1960s and its first clinical use for treating PSE was not until 1966.[L6202] Nevertheless, although lactulose received formal FDA approval in 1977 and has since become a readily available generic and brand-name non-prescription medication listed on the World Health Organization's List of Essential Medicines as one of the most effective and safe medicines employed in a health system[L6205], data regarding its optimal place in therapy is often ambiguous.[L6202] Especially considering the use of lactulose as a laxative is typically only considered after lifestyle and dietary modifications fail and the fact that lactulose therapy cannot be ethically withheld from patients diagnosed with PSE in a placebo study, the substance may just be one of many options available for treating constipation and its efficacy in managing PSE may never be formally confirmed or refuted via clinical investigation.[L6202]
Synonyms
4-O-beta-D-Galactopyranosyl-D-fructose
Lactulose
4-O-beta-D-Galactopyranosyl-D-fructofuranose
Lactulosa
Lactulosum
Brand Names
Pro-lactulose - 667
Woodward's Laxative Syrup
Lactulose Solution USP - Liq 667mg/ml
Duphalac Dry
Jamp-lactulose
PHL-lactulose Soln 667mg/ml
Cephulac Syr 667mg/ml
Comalose R Sirop 10gm/15ml
Orb-lactulose
Enulose
Generlac
Pharma-lactulose
PMS-lactulose Syr 667mg/ml
M-lactulose
Lactulax Sirop 10gm/15ml
Duphalac
Lactulose Syrup
Kristalose
Chronulac Syr 667mg/ml
Lactulose Solution
Lactulose Solution, USP 667mg/ml
Chronulac Syr
Constulose
Gen-lac - Liq 667mg/ml
Lactulose Solution USP
Ratio-lactulose
PMS-lactulose-pharma
Lactulose
Teva-lactulose
Indication
Lactulose is indicated for use as a laxative in the treatment of chronic constipation in adults and geriatric patients.[FDA Label,L6199,L6202] Additionally, lactulose is also employed as an adjunct to protein restriction and supportive therapy for the prevention and treatment of portal-systemic encephalopathy (PSE), including both the hepatic pre-coma and coma variations.[FDA Label,L6199,L6202] In particular, lactulose solution has been effective at managing PSE resulting from surgical portacaval shunts or from chronic hepatic diseases like cirrhosis.[L6199] Moreover, there have also been studies demonstrating the capacity for lactulose to minimize the formation of gallstones and even some investigations regarding the experimental use of the agent in developing novel anticancer agents owing to its ability to bind galactin carbohydrates involved in various tumor progressions [L6202].
Categories
Acidifying Activity
Alimentary Tract and Metabolism
Ammonia Detoxicants
Carbohydrates
Disaccharides
Drugs for Constipation
Gastrointestinal Agents
Laxatives
Osmotic Activity
Osmotic Laxatives
Stimulation Large Intestine Fluid/Electrolyte Secretion
Drug Info/Drug Targets: DrugBank 3.0: a comprehensive resource for 'omics' research on drugs. Knox C, Law V, Jewison
T, Liu P, Ly S, Frolkis A, Pon A, Banco K, Mak C, Neveu V, Djoumbou Y, Eisner R, Guo AC, Wishart DS.
Nucleic Acids Res. 2011 Jan; 39 (Database issue):D1035-41. | PMID:21059682
