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lactulose

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Brand names: Enulose, Kristalose

Osmotic Laxative Rx

Lactulose is a medicine that helps treat and prevent problems with your brain caused by liver disease. It works by reducing the amount of ammonia in your blood.

Drug Pricing (NADAC)

Generic Price

$0.01/unit

Generic Available

Yes (13 manufacturers)

Pricing data from NADAC (CMS), effective December 18, 2024. Compare all drug costs →

What it does

This medicine treats and prevents portal-systemic encephalopathy.

Common side effects

Gas, Bloating, Belching

Key warnings

If you need a low-galactose diet, you should not take this medicine.

How It Works

Lactulose is a sugar that is not digested in your body. It travels to your colon where it is broken down by bacteria. This process makes the colon more acidic, which helps to draw ammonia from the blood into the colon, where it is then removed from the body through bowel movements.

How to Take It

Take lactulose by mouth as directed by your doctor. The usual adult dose is 2 to 3 tablespoonfuls (30 to 45 ml) three or four times a day. You can adjust the dose every day or two to have 2 or 3 soft bowel movements daily. For a quick effect, you may take 30 to 45 ml every hour.

Pregnancy & Breastfeeding

Tell your doctor if you are pregnant or breastfeeding before taking this medicine. It is not known if lactulose can harm your unborn baby. It is also not known if lactulose passes into breast milk.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is close to your next dose, skip the missed dose and continue with your regular schedule.

Storage

Store lactulose solution between 36° to 86°F (2° to 30°C), and do not freeze it.

Side Effects (from patient reports)

Based on 20,474 FDA adverse event reports.

Feeling sick to your stomach
2,523
Having trouble passing stool
2,497
Accidentally losing your balance and hitting the ground
2,240
Throwing up
2,047
Feeling very tired
2,028
The end of life
1,939
Difficulty breathing
1,910
Loose, watery stools
1,892
An unpleasant physical sensation
1,711
Lung infection
1,687

FDA Adverse Event Report Analysis

Detailed analysis of 37,033 reports from the FDA Adverse Event Reporting System (FAERS). Reports span 1997–2025.

Total Reports

37,033

Death-Related Reports

6,511

Hospitalization Reports

20,384

Top Indication

Product Used For Unknown Indication

Gender Distribution

Female 17,910 (52%)
Male 16,684 (48%)

Age Distribution

0–17 1,079
18–44 2,918
45–64 9,655
65–74 6,936
75+ 7,565

Most Reported Adverse Reactions (FAERS)

# Reaction Reports
1 NAUSEA 2,524
2 CONSTIPATION 2,497
3 FALL 2,241
4 VOMITING 2,047
5 FATIGUE 2,027
6 DEATH 1,939
7 DYSPNOEA 1,910
8 DIARRHOEA 1,892
9 PAIN 1,711
10 PNEUMONIA 1,687
11 HYPOTENSION 1,536
12 OFF LABEL USE 1,533
13 CONFUSIONAL STATE 1,482
14 PYREXIA 1,394
15 ASTHENIA 1,326

Reactions in Death Reports

DEATH 1,932
PNEUMONIA 487
SEPSIS 377
DYSPNOEA 362
NAUSEA 342
ASTHENIA 312
VOMITING 298
HEPATIC FAILURE 291
CONSTIPATION 284
DIARRHOEA 269

Reactions in Hospitalization Reports

FALL 1,819
CONSTIPATION 1,698
NAUSEA 1,505
PNEUMONIA 1,422
VOMITING 1,368
HYPOTENSION 1,319
DYSPNOEA 1,288
PAIN 1,150
DIARRHOEA 1,050
CONFUSIONAL STATE 1,044

Source: FDA FAERS (Adverse Event Reporting System) FDA FAERS (Adverse Event Reporting System) Reports are voluntary and do not establish causation

Serious Warnings

If you need a low-galactose diet, you should not take this medicine. Lactulose solution contains galactose.

Common Questions

Can I take lactulose with other medicines?
Tell your doctor about all the medicines you take, including antacids and antibiotics. Some medicines can affect how lactulose works.
How long does it take for lactulose to work?
It may take 24 to 48 hours, or even longer, to see an improvement.
What should I do if I get diarrhea?
If you get diarrhea, lower your dose or stop taking lactulose and contact your doctor.
Can children take lactulose?
Yes, children can take lactulose. The dose will be different than for adults. Talk to your doctor about the right dose for your child.
Does the color change of the medicine mean it has gone bad?
A normal darkening of color may happen. This is normal for sugar solutions and does not affect how the medicine works. If it gets very dark or cloudy, don't use it.
What do I do if the medicine freezes?
Freezing may cause the medicine to become thick. If this happens, warm it to room temperature. It should return to normal.
Can I mix lactulose with other liquids?
You can mix lactulose with water or juice to make it easier to swallow.
How will I know if the lactulose is working?
You will likely have 2 to 3 soft bowel movements each day. Your mental state may also improve.
What if I still don't have a bowel movement?
Talk to your doctor if you do not have a bowel movement after a few days. They may need to adjust your dose.
Can I take lactulose if I am diabetic?
Lactulose contains small amounts of other sugars like lactose and fructose. Talk to your doctor before taking lactulose if you have diabetes.
What are the common side effects of lactulose?
The most commonly reported side effects of lactulose include Gas, Bloating, Belching, Abdominal discomfort, Cramping. Based on 20,474 FDA adverse event reports. Always consult your healthcare provider about potential side effects.
What drug class is lactulose?
lactulose belongs to the Osmotic Laxative drug class. It requires a prescription (Rx). This medicine treats and prevents portal-systemic encephalopathy.
Is lactulose safe during pregnancy?
Tell your doctor if you are pregnant or breastfeeding before taking this medicine. It is not known if lactulose can harm your unborn baby. Always consult your healthcare provider before using any medication during pregnancy or breastfeeding.

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What the FDA Data Shows for lactulose

The FDA label for lactulose (sold under brand names such as Enulose, Kristalose) classifies it as a prescription-only medication in the Osmotic Laxative class. This medicine treats and prevents portal-systemic encephalopathy. Official labeling lists 5 commonly reported side effects, including Gas, Bloating, Belching.

Post-market surveillance from the FDA Adverse Event Reporting System (FAERS) captures real-world experience. For this drug, FAERS contains 20,474 voluntary reports. Interaction data is drawn directly from FDA-approved prescribing information. NADAC pricing from CMS shows a generic unit cost of $0.01.

Report counts do not establish causation — a FAERS entry documents a temporal association, not proof that the drug produced the outcome. Widely prescribed medications naturally accumulate more reports than niche therapies, so raw totals must be interpreted alongside total exposure. Shortage status, recall history, and patent information further shape supply and switching decisions. This page summarizes public FDA data for educational purposes only and is not a substitute for professional medical advice — always consult a licensed healthcare provider before starting, stopping, or changing any medication.

Data Sources

Drug labeling: FDA Drug Labels (SPL/DailyMed). Adverse events: FDA Adverse Event Reporting System (FAERS). Pricing: CMS National Average Drug Acquisition Cost (NADAC).

FAERS reports are voluntary and do not establish causation. Drug interactions are derived from FDA labeling and clinical references. Always consult a healthcare professional before making medication decisions.

Last updated: June 1, 2022

All federal data sources used on this page