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Evalose Syrup (Generic Lactulose)

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Why is this medication prescribed?

Lactulose is a synthetic sugar used primarily as a laxative to treat constipation. It works by drawing water into the bowel, softening stools, and increasing the frequency of bowel movements. Additionally, lactulose is sometimes used to treat or prevent hepatic encephalopathy, a serious complication of liver disease, by reducing the amount of ammonia in the body.

When prescribed as a laxative, lactulose is typically taken orally in liquid form. The dosage and frequency of administration depend on the individual’s age, condition, and response to treatment. It’s important to follow the instructions provided by the healthcare provider or pharmacist.

How should this medicine be used?

Here are general guidelines for using lactulose:

  • Measure the dose carefully using a medication cup or spoon.
  • Mix the prescribed amount of lactulose with water, fruit juice, or milk to mask the taste, if desired.
  • Take lactulose orally, usually once or twice daily.
  • Ensure adequate fluid intake while using lactulose to prevent dehydration.
  • It may take a few days for lactulose to produce the desired effect, so continue taking it as directed even if you do not see immediate results.
  • Do not increase the dosage without consulting a healthcare professional.
  • If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule.
  • Store lactulose at room temperature away from moisture and heat.

It’s important to discuss any concerns or questions about lactulose usage with a healthcare provider, especially if you experience severe or persistent side effects.

Other uses for this medicine

  • Prevention of Portal-Systemic Encephalopathy: Lactulose may be used to prevent the recurrence of portal-systemic encephalopathy in patients with a history of hepatic coma.
  • Treatment of Hyperammonemia: In some cases of hyperammonemia not associated with hepatic encephalopathy, lactulose may be used to reduce ammonia levels in the blood.
  • Prebiotic: Lactulose is also sometimes used as a prebiotic to promote the growth of beneficial bacteria in the gut.

What special precautions should I follow?

As for special precautions to follow when using lactulose:

  • Medical History: Before taking lactulose, inform your healthcare provider about any medical conditions you have, especially diabetes or galactose intolerance, as lactulose contains galactose.
  • Allergies: If you have allergies to lactulose or any other medications, foods, or substances, make sure to inform your doctor.
  • Pregnancy and Breastfeeding: It’s important to consult with a healthcare professional before using lactulose if you are pregnant or breastfeeding.
  • Monitoring: If you’re using lactulose for hepatic encephalopathy, your healthcare provider may monitor your blood ammonia levels and adjust your dosage accordingly.
  • Hydration: Make sure to drink plenty of fluids while taking lactulose to prevent dehydration.
  • Other Medications: Lactulose may interact with other medications. Inform your healthcare provider about all the medications, vitamins, and supplements you are taking before starting lactulose.
  • Side Effects: Be aware of potential side effects such as bloating, gas, abdominal discomfort, and diarrhea. If you experience severe or persistent side effects, contact your healthcare provider.
  • Dosage: Take lactulose exactly as prescribed by your healthcare provider. Do not take more or less than the prescribed dose without consulting them.

Always follow your healthcare provider’s instructions and recommendations regarding the use of lactulose, and consult them if you have any questions or concerns.

What special dietary instructions should I follow?

Special dietary instructions for lactulose:

  • Fiber: Eating a diet rich in fiber can help complement the effects of lactulose in treating constipation.
  • Fluids: Increase your intake of fluids, especially water, to prevent dehydration while taking lactulose.
  • Avoid Certain Foods: If you have specific dietary restrictions due to other medical conditions, consult your healthcare provider for guidance on any necessary adjustments while taking lactulose.

What should I do if I forget a dose?

  • Take it as soon as you remember: If you miss a dose, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.
  • Notify your healthcare provider: If you frequently forget doses or have trouble remembering to take your medication, inform your healthcare provider. They may provide strategies or reminders to help you stay on track with your medication schedule.
  • Follow-up: If you’re unsure about what to do if you miss a dose or have any concerns, contact your healthcare provider for guidance. They can provide personalized advice based on your specific situation.

What side effects can this medication cause?

Lactulose is generally well-tolerated, but like any medication, it can cause side effects in some individuals. Common side effects of lactulose may include:

  • Abdominal discomfort: This can include bloating, cramping, or abdominal pain.
  • Flatulence (gas): Increased gas production is a common side effect of lactulose.
  • Diarrhea: Lactulose can sometimes lead to loose stools or diarrhea, especially when taken in high doses.
  • Nausea or vomiting: Some people may experience nausea or vomiting, although this is less common.
  • Electrolyte imbalance: In rare cases, prolonged use of lactulose may lead to electrolyte imbalances, such as low potassium levels, particularly if diarrhea occurs.
  • Dehydration: Lactulose works by drawing water into the bowel, so it’s important to drink plenty of fluids to prevent dehydration, especially if you experience diarrhea.
  • Hypoglycemia: Lactulose contains galactose and lactose, which can be broken down into sugars. In rare cases, this can lead to hypoglycemia (low blood sugar), particularly in individuals with diabetes.
  • Rectal irritation: Some individuals may experience irritation or discomfort in the rectal area, especially if they are using enemas containing lactulose.

It’s important to note that not everyone will experience these side effects, and many people tolerate lactulose well. If you experience severe or persistent side effects, or if you have any concerns about your medication, be sure to contact your healthcare provider for further guidance and advice.

What should I know about storage and disposal of this medication?

Storage and disposal of lactulose:


  • Store lactulose at room temperature away from moisture and heat.
  • Keep the medication tightly closed in its original container to protect it from light and moisture.
  • Do not freeze lactulose.


  • Dispose of unused or expired lactulose according to the instructions provided by your pharmacist or healthcare provider.
  • Do not flush medications down the toilet unless instructed to do so. Properly discard this product when it is expired or no longer needed.

In case of emergency/overdose

  • In case of an overdose of lactulose, seek emergency medical attention or contact a poison control center immediately.
  • Symptoms of overdose may include severe diarrhea, dehydration, electrolyte imbalances, and gastrointestinal disturbances.
  • If possible, provide the healthcare provider with information such as the amount of lactulose taken, the time of ingestion, and any symptoms experienced.

What other information should I know?

  • Keep all appointments with your healthcare provider and laboratory while taking lactulose. Your doctor may want to monitor your response to the medication and adjust your dosage as needed.
  • Inform all healthcare providers involved in your care that you are taking lactulose, especially if you undergo any medical procedures or surgery.
  • Follow the dietary instructions provided by your healthcare provider, including increasing fiber intake and fluid consumption.
  • Lactulose may take several days to produce its full effect. Continue taking it as directed even if you do not notice immediate improvement in your symptoms.
  • Do not stop taking lactulose suddenly without consulting your healthcare provider, as this may lead to a recurrence of symptoms or complications.
  • If you have any questions or concerns about lactulose or its use, do not hesitate to contact your pharmacist or healthcare provider for clarification.

Always follow the instructions provided by your healthcare provider and pharmacist regarding the use, storage, and disposal of lactulose, and seek medical attention in case of emergencies or overdose.

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