Lactulose

Lactulose
Clinical data

Haworth projection of lactulose (bottom)
Pronunciation	/ˈlæktjᵿloʊz/
Trade names	Cholac, Generlac, Consulose, Duphalac, others
AHFS/Drugs.com	Monograph
MedlinePlus	a682338
Pregnancy category	US: B (No risk in non-human studies)
Routes of administration	By mouth (oral solution)
ATC code	A06AD11 (WHO)
Legal status
Legal status	UK: Pharmacy medicines US: ℞-only
Pharmacokinetic data
Bioavailability	Poorly absorbed
Metabolism	100% in colon by enteric bacteria
Onset of action	8 to 48 hours
Biological half-life	1.7–2 hours
Excretion	Fecal
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	4618-18-2^Y
PubChem (CID)	11333
DrugBank	DB00581^Y
ChemSpider	10856^Y
UNII	9U7D5QH5AE^Y
KEGG	D00352^Y
ChEBI	CHEBI:6359^Y
ChEMBL	CHEMBL296306^Y
ECHA InfoCard	100.022.752
Chemical and physical data
Formula	C₁₂H₂₂O₁₁
Molar mass	342.296 g/mol
3D model (Jmol)	Interactive image
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

Lactulose is a non-absorbable sugar used in the treatment of constipation and hepatic encephalopathy. It is used by mouth for constipation and either by mouth or in the rectum for hepatic encephalopathy. It generally begins working after eight to twelve hours but may take up to two days to improve constipation.

Common side effects include abdominal bloating and cramps. There is the potential for electrolyte problems to occur as a result of diarrhea it produces. No evidence of harm to the baby has been found when used during pregnancy. It is generally regarded as safe during breastfeeding. It is classified as an osmotic laxative.

Lactulose was first made in 1929 and has been used medically since the 1950s. It is on the World Health Organization's List of Essential Medicines, the most effective and safe medicines needed in a health system. It is available as a generic medication. The wholesale price in the developing world is about US$0.18 per dose. In the United States 30 doses of the liquid is about US$20. It is made from the milk sugar lactose and is composed of two simple sugars, galactose and fructose.

Lactulose is used in the treatment of chronic constipation in patients of all ages as a long-term treatment. Lactulose is used for chronic idiopathic constipation, i.e. chronic constipation occurring without any identifiable cause. Lactulose may be used to counter the constipating effects of opioids, and in the symptomatic treatment of hemorrhoids as a stool softener.

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Wikipedia