The liver is one of the most important organs in our body. Sometimes, when the liver functions poorly, it is unable to properly filter out harmful toxins from the blood. These toxins can go directly to the brain and cause problems such as memory loss, behavioral changes, and cognitive impairment. This is what we medically call hepatic encephalopathy. In such cases, a very important medicine that doctors often prescribe is a liquid called lactulose. Let us learn more about this today.
What is this lactulose?
Simply put, lactulose is a type of artificially made sugar. However, it is not absorbed by the body like the sugar we usually eat. Its main function is to reduce toxins from the blood, especially things like ammonia, that the liver has not been able to remove, as mentioned earlier.
Imagine, when this medicine goes to the intestines, the beneficial bacteria there use it to acidify the environment. Because of this acidic environment, the harmful ammonia in the blood is drawn back into the intestines. Then it is excreted from the body with feces. Through this, this medicine reduces the effect on the brain and controls the symptoms.
Some people also know it as a medicine for constipation. Yes, it is used for that too. But in the case of hepatic encephalopathy, its action is more complex.
Things you need to tell your doctor before taking this medicine
Before your doctor prescribes this medication for you, it is very important to give him a complete description of your health condition. Be sure to mention the following points in particular:
- If a doctor has advised you to follow a diet that does not contain a type of sugar called galactose.
- If you have scheduled a surgery in the future.
- If you have ever had an allergic reaction to lactulose or any other sugar, medicine, food, or food coloring.
- If you are pregnant or are expecting to become pregnant soon.
- If you are a breastfeeding mother.
Based on this information, the doctor will decide whether this medication is suitable for you or not and the dosage to be given.
How exactly do you use this medicine?
This medicine is usually given as a liquid to take by mouth. Try to take the dose your doctor tells you to take, at the same time every day, and at the same time every day.
Most importantly: Do not use household teaspoons or tablespoons to measure the dose of medicine. They cannot measure the exact amount of milliliters (ml). Use a special syringe, cup, or spoon marked in milliliters (ml) that comes with the medicine or is provided by the pharmacy.
In some severe cases, your doctor may also advise you to give this medicine rectally as an enema. If so, you will be given special instructions from the hospital. Follow those instructions exactly.
What to do if you overdose?
If you think you have taken an overdose, do not panic and immediately go to the nearest hospital Emergency Department (ETU). Or call the National Poisons Information Centre at the Colombo National Hospital for advice.
What if I miss a dose?
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 take your next dose at the scheduled time. Never take two doses at once (double up) to make up for a missed dose.
What are the possible side effects?
Like any medication, lactulose can cause some side effects. While most of these are not dangerous, there are some things to be aware of.
| Side effect | Description and what to do |
|---|---|
| Serious side effects that require immediate medical attention | |
| Severe Allergic Reactions | Skin rash, itching, swelling of the face, lips, tongue or throat, difficulty breathing. If any of these occur, go to the ETU immediately. |
| Side effects that are usually not dangerous, but should be reported to the doctor if they persist | |
| Diarrhea | This is normal when you first start taking the medicine. But if it is severe or lasts for several days, tell your doctor. Your dose may need to be adjusted. |
| Gas | This is also common in the early stages and will subside after a few days. |
| Nausea & Stomach Cramping | This can be reduced by taking the medicine with food. If it persists, inform your doctor. |
| Vomiting | May occur rarely. If it persists, seek medical advice. |
How to store and care for the medicine?
- Storage: Keep out of reach of children and pets. Store at room temperature (between 20-25 degrees Celsius). Never freeze.
- Color change: Since this is a sugar solution, the color of the liquid in the bottle may turn a slightly dark brown over time. This is normal and does not affect the quality of the medicine. However , if the color has become very dark and has turned almost black, ask your doctor before using it.
- Other medications: Tell your doctor if you are taking antacids for gastritis, certain antibiotics such as Neomycin, and other laxatives while taking lactulose. They may affect the way lactulose works.
- Drink water: Drink plenty of water every time you take your medicine.
- Expiration: If you need to get rid of expired or no longer needed medications, consult your doctor or pharmacist. Do not flush them down the toilet or simply throw them in the trash for any reason.
Take-Home Message
- Lactulose is a very important medication used to control hepatic encephalopathy, a condition that affects the brain due to liver disease.
- Take the dose prescribed by your doctor, using a proper measuring device, at the proper time. Do not use household spoons.
- Inform your doctor about all other medications, vitamins, and traditional medicines you are taking.
- Although side effects such as stomach upset are common, seek medical advice immediately if severe allergic symptoms occur.
- Do not stop taking the medication without your doctor's advice. It is important to continue taking it to control symptoms.
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