1. About lactulose

    Lactulose is a laxative taken to treat constipation (difficulty pooing). It is also taken to help a severe liver disease called hepatic encephalopathy.

    Lactulose comes as a sweet syrup that you swallow.

    It's available on prescription and to buy from pharmacies.

    Do not give lactulose to children under 6 unless recommended by a doctor.

  2. Key facts

    • Lactulose relieves constipation by drawing water into the bowel to make poo softer.
    • The most common side effects are diarrhoea, bloating and wind. These are usually mild and short-lived.
    • Lactulose takes at least 48 hours to work.
    • If you find the taste of lactulose too sweet, you can dilute it with fruit juice or water.
    • Lactulose is also called by the brand names Duphalac and Lactugal.
  3. Who can and can't take lactulose

    Lactulose can be taken by adults including pregnant and breastfeeding women.

    Lactulose can be taken by children aged 6 and older. Don't give lactulose to a child under 6 unless your doctor has said so.

    Lactulose isn't suitable for some people. To make sure lactulose is safe for you, tell your doctor or pharmacist if you:

    • have ever had an allergic reaction to lactulose or any other medicine in the past
    • have lactose intolerance (where your body can't digest the sugar, lactose)
    • have galactosaemia (a rare health problem where the body cannot process a sugar called galactose)
    • have diabetes (as lactulose may affect your blood sugar levels)
  4. How and when to take it

    Take lactulose once or twice a day. You can take it with or without food.

    How much to take

    The normal dose for constipation in:

    • adults and children aged 14 and over is between 15mls and 45mls once or twice a day - this dose can be reduced to between 15mls and 30mls once or twice a day after it starts working
    • children aged 7 to 14 is 15mls once or twice a day - this dose can be reduced to between 10mls and 15mls once or twice a day after it starts working
    • children aged 1 to 6 (only under medical supervision) is between 5mls and 10mls once or twice a day
    • babies under 1 year old (only under medical supervision) is up to 5mls once or twice a day

    For adults with hepatic encephalopathy, the normal dose is between 30mls and 45mls taken 3 to 4 times a day.

    How to take it

    The medicine comes with a plastic cup or spoon to measure your dose. Do not use a kitchen spoon as it will not give the right amount. If you don't have a cup or spoon, ask your pharmacist for one.

    Some people don't like the sweet taste of lactulose. To improve the taste, you can mix your dose with half a glass or water or fruit juice.

    Aim to drink 6 to 8 glasses of fluid during the day while you are taking lactulose or your constipation may get worse.

    What if I forget to take it?

    If you forget a dose of lactulose, don't worry, just take the next dose at the usual time.

    Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

    If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

    What if I take too much?

    Taking an extra dose of lactulose by accident is unlikely to harm you. You may get diarrhoea and stomach pain but this should ease off within a day or two.

    If you're worried, talk to your doctor or pharmacist for advice.

  5. Side effects

    Like all medicines, lactulose may cause side effects in some people, but many people have no side effects or only minor ones.

    Common side effects

    A very common side effect, particularly at high doses, is diarrhoea. This happens in more than 1 in 10 people.

    Other common side effects, which happen in more than 1 in 100 people, are:

    • bloating
    • wind (farting and burping)
    • feeling sick
    • vomiting
    • stomach pain

    These side effects are mild and usually go away after a couple of days. Talk to your doctor or pharmacist if the side effects bother you or don’t go away.

    Serious side effects

    Tell your doctor straight away if these unlikely but serious side effects happen to you:

    • severe diarrhoea or vomiting
    • muscle cramps or weakness
    • irregular heartbeat

    Serious allergic reaction

    In rare cases, it’s possible to have a serious allergic reaction to lactulose.

    A serious allergic reaction is an emergency. Contact a doctor straight away if you think you or someone around you is having a serious allergic reaction.

    The warning signs of a serious allergic reaction are:

    • getting a skin rash that may include itchy, red, swollen, blistered or peeling skin
    • wheezing
    • tightness in the chest or throat
    • having trouble breathing or talking
    • swelling of the mouth, face, lips, tongue, or throat

    These are not all the side effects of lactulose. For a full list see the leaflet inside your medicines packet.

    You can report any suspected side effect to the UK safety scheme.

  6. How to cope with side effects

    What to do about:

    • bloating - take lactulose between meals instead of before or after them
    • wind - steer clear of foods that cause wind like pulses, lentils, beans and onions. It might also help to eat smaller and more frequent meals, eat and drink slowly, and exercise regularly. Some pharmacy remedies help wind, such as charcoal tablets or simethicone.
    • feeling sick - try taking lactulose with meals, or mixing your dose with some water or fruit juice
    • vomiting - drink plenty of water or other fluids. It may also help to take oral rehydration solutions which you can buy from a pharmacy to prevent dehydration. Don't take any other medicines to treat vomiting without speaking to a pharmacist or doctor
  7. Pregnancy and breastfeeding

    Lactulose is generally safe to take during pregnancy and while breastfeeding.

    Constipation is common at the end of pregnancy and just after having a baby.

    If you're pregnant or breastfeeding, it's always better to try to safely treat constipation without taking a medicine.

    Your doctor or midwife will first advise you to eat more fibre and drink plenty of fluids. You'll also be encouraged to do gentle exercise.

    If dietary and lifestyle changes don't work, you may be recommended a laxative such as lactulose.

    For safety, tell your pharmacist or doctor if you're trying to get pregnant, are already pregnant or if you're breastfeeding.

  8. Cautions with other medicines

    There are no known problems mixing lactulose with other medicines, herbal remedies or supplements.

    However, for safety, tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.

  9. Common questions