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Lactulose Coupon - Lactulose 10g/15ml oral solution

lactulose

Generic Enulose
Used for Constipation, Hepatic Encephalopathy
Used for Constipation, Hepatic Encephalopathy

Enulose (lactulose) is a liquid osmotic laxative. It's used in adults and children to treat and prevent symptoms of hepatic encephalopathy, a serious condition sometimes seen in people with liver problems. Enulose (lactulose) is a liquid solution. It's typically taken by mouth 3 to 4 times a day until you have 2 or 3 soft stools daily. But healthcare professionals (HCPs) can give it as a rectal enema to people who are in a coma caused by hepatic encephalopathy. Some common side effects of Enulose (lactulose) include stomach pain and passing gas. Keep in mind there are other lactulose products that are prescribed for constipation.

Reviewed by:
reviewer
Allison Gourley, PharmD
reviewer
Kristianne Hannemann, PharmD
Last reviewed on June 5, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsCostContraindicationsAlternativesLatest newsImagesReferencesPricesMedicare
basics-icon

What is Enulose (lactulose)?

What is Enulose (lactulose) used for?

How Enulose (lactulose) works

People who have liver problems sometimes experience a condition called hepatic encephalopathy. This happens because the liver isn't able to clear the toxins in the body, and so there's a build up of toxins in the blood. This can lead to brain-related problems, such as confusion or sleepiness.

One toxin that can build up is called ammonia. Enulose (lactulose) treats hepatic encephalopathy by lowering the amount of ammonia in your gut.

Are you looking for information on Kristalose (lactulose) powder packets for constipation or Constulose (lactulose) for constipation instead?

Drug Facts

Common BrandsEnulose, Generlac (brands no longer available)
Drug ClassOsmotic laxative
Controlled Substance ClassificationNot a controlled medication
Generic StatusLower-cost generic available
AvailabilityPrescription only
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What are the side effects of Enulose (lactulose)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Flatulence or passing gas (20%)
  • Burping (20%)
  • Stomach cramps (20%)

Other Side Effects

  • Nausea or vomiting
  • Diarrhea

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

For bulk-forming-containing

Difficulty in breathing

intestinal blockage

skin rash or itching

swallowing difficulty (feeling of lump in throat)

For hyperosmotic-containing

Confusion

dizziness or light-headedness

irregular heartbeat

muscle cramps

unusual tiredness or weakness

For stimulant-containing

Confusion

irregular heartbeat

muscle cramps

pink to red, red to violet, or red to brown coloration of alkaline urine (for cascara, danthron, and/or senna only)

skin rash

unusual tiredness or weakness

yellow to brown coloration of acid urine (for cascara, and/or senna only)

For stool softener (emollient)-containing

Skin rash

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

For hyperosmotic-containing

Bloating

cramping

diarrhea

nausea

gas

increased thirst

For lubricant-containing

Skin irritation surrounding rectal area

For stimulant-containing

Belching

cramping

diarrhea

nausea

For stool softener (emollient)-containing

Stomach and/or intestinal cramping

throat irritation (liquid forms only)

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Enulose (lactulose)

thumbs-up

Pros

Might improve symptoms, such as confusion, within 1-2 days

A option for children and infants, under guidance of HCP

Can be given as a rectal enema to people who can't take medications by mouth

thumbs-down

Cons

Not appropriate for people who need a low-galactose diet

Need to take multiple times throughout the day

Might not work well if taken with antacids, such as calcium carbonate (Tums)

pharmacist-tips

Pharmacist tips for Enulose (lactulose)

pharmacist

  • Talk with your healthcare team if you've questions about how Enulose (lactulose) might affect your blood sugar. Enulose (lactulose) does contain galactose and lactose, which are two types of sugars. But limited research shows that Enulose (lactulose) isn't likely to raise your blood sugar levels.

    • Make sure to tell your healthcare team if you're lactose intolerant. Enulose (lactulose) contains lactose, which might cause people with this condition to have bloating, cramping, and diarrhea.

      • If your Enulose (lactulose) solution didn't come with a measuring device, ask your local pharmacist for a device to use in order to measure out your doses. Don't use a household tablespoon because these can be inaccurate and cause you to take the wrong dose.

        • It's normal for Enulose (lactulose) solution to darken in color during storage at room temperature (between 36° to 86°F). This won't affect how well the medication works. But if you've stored Enulose (lactulose) at temperatures higher than 86°F for an extended period of time, then don't take it because it might not work as it should.

          • Keep Enulose (lactulose) stored at room temperature. If it happens to get too cold or frozen, the solution can become solid-like. If this happens, leave the solution out at room temperature and it will return back to normal.

            • There aren't enough studies about whether Enulose (lactulose) is safe during pregnancy. But Enulose (lactulose) might not be appropriate to take during pregnancy because it can cause nausea and bloating, which can be very uncomfortable. If you have plans to get pregnant, ask your healthcare team about safer options to treat your condition.

              faqs

              Frequently asked questions about Enulose (lactulose)

              How does Enulose (lactulose) help with hepatic encephalopathy?
              Hepatic encephalopathy is a condition sometimes seen in people with liver damage. When your liver isn't working as it should, it isn't able to remove toxins, such as ammonia, from your body. When ammonia builds up in the blood, you might have a more difficult time thinking clearly. You might also feel more tired or confused. Enulose (lactulose) helps with hepatic encephalopathy by removing ammonia out of the body.
              How does Enulose (lactulose) decrease ammonia levels?
              Enulose (lactulose) lowers ammonia levels in a few different ways. One way it does so is by making the gut environment more acidic. In an acidic environment, ammonia moves out of the blood and into the gut, then is removed from the body when you have a bowel movement. Enulose (lactulose) also causes your gut to not make as much ammonia in the first place by removing ammonia-producing bacteria. With this in mind, it's important to take Enulose (lactulose) as prescribed so that it'll work well to remove ammonia and treat your symptoms.
              How long does Enulose (lactulose) take to work?
              The amount of time it will take for Enulose (lactulose) to work might depend on how serious your (or your loved one's) condition is. Some symptoms of hepatic encephalopathy might start to get better within a day, but it can take two or more days to see a more noticeable improvement. Your healthcare team will adjust your dose of Enulose (lactulose) until you're able to have 2 or 3 soft stools a day. This helps ensure that you're clearing ammonia and toxins from your system, which will help improve symptoms of encephalopathy.
              When to stop Enulose (lactulose) for hepatic encephalopathy?
              You'll likely need to continue taking Enulose (lactulose) as long as it's working to treat and prevent your hepatic encephalopathy. If you stop taking Enulose (lactulose) sooner than recommended by your HCP, your symptoms might return. Have a discussion with your liver specialist about how long you need to take this medication.
              How to give Enulose (lactulose) enema?
              If you or your loved one isn't unable to take Enulose (lactulose) by mouth, a trained healthcare professional (HCP) might give Enulose (lactulose) as a rectal enema using a rectal balloon catheter. For example, the rectal enema might be needed when a person is in a coma from hepatic encephalopathy. In order to give the enema, the HCP will mix Enulose (lactulose) with water or saline, and then insert the mixture into the rectum. The solution will be held in the rectum for 30 to 60 minutes, then released. If needed, the HCP will repeat the rectal enema every 4 to 6 hours until the person is no longer in a coma and can start to take Enulose (lactulose) by mouth.
              Is Enulose (lactulose) still available?
              Brand name Enulose is no longer available. Generic lactulose is still available and is FDA-approved to relieve constipation. If appropriate, your liver specialist will prescribe generic lactulose to help treat hepatic encephalopathy.
              Is Enulose and Generlac the same as lactulose?
              Both Enulose and Generlac are discontinued brand names of lactulose that were approved for hepatic encephalopathy. Generic lactulose is still available. If needed, your liver specialist might prescribe generic lactulose to prevent and treat encephalopathy.
              Is Enulose (lactulose) over-the-counter (OTC)?
              No, Enulose (lactulose) is only available with a prescription from your healthcare professional (HCP). There are many OTC medications available to help you have a bowel movement, but they won't work to clear ammonia and toxins from your system like Enulose (lactulose) does.
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              What are the risks and warnings for Enulose (lactulose)?

              Enulose (lactulose) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

              risk-warning

              Loss of fluids

              • Risk factors: Taking Enulose (lactulose) for more than 6 months | Age 65 years and older | Taking medications that cause electrolyte imbalances

                Enulose (lactulose) can make you dehydrated which can affect your body's mineral levels. Electrolytes (minerals), such as sodium, potassium, and calcium, have many important functions in the body. Your healthcare professional (HCP) might want to check these regularly while you're taking Enulose (lactulose), especially if you’re older in age or have been taking Enulose (lactulose) for a long period of time. Call your HCP right away if you feel extremely thirsty, tired, or confused because these are signs that Enulose (lactulose) might be making you dehydrated and affecting your electrolyte levels.

                risk-warning

                Possible risk of high blood sugar

                • Risk factors: Diabetes

                  Be mindful that Enulose (lactulose) contains galactose and lactose, which are both forms of sugar. If you have high blood sugar, you’ll want to make sure that you are checking your blood sugars while taking Enulose (lactulose). Limited research shows that Enulose (lactulose) doesn't seem to cause a spike in blood sugar, but you're still recommended to check your blood sugar levels just in case.

                  risk-warning

                  Problems during colonoscopy

                  If you're planning to have a colonoscopy or a rectal exam, let your healthcare team know you're taking Enulose (lactulose). Your HCP might have you take different medications to clean out your gut before your exam.

                  dosage

                  Enulose (lactulose) dosage forms

                  The average cost for 473 ml of 10g/15ml of Enulose (lactulose) is $12.32 with a free GoodRx coupon. This is 60.04% off the average retail price of $30.83.
                  ml of oral solution
                  Ml of oral solution
                  DosageQuantityPrice as low asPrice per unit
                  10g/15ml473 ml$12.32$0.03

                  Typical dosing for Enulose (lactulose)

                  Each 15 mL of Enulose (lactulose) contains 10 grams of lactulose.

                  • Adults: The typical dose is 30 mL to 45 mL by mouth 3 or 4 times daily. Your healthcare team might adjust your dose every day or two until you're able to have 2 or 3 soft stools daily.

                  • Children: The typical dose for an infant is 2.5 mL to 10 mL, divided into multiple doses and taken throughout the day. In general, your child's pediatrician will give enough Enulose (lactulose) so that your child is able to have 2 or 3 soft stools daily.

                  Enulose (lactulose) is sometimes given as a rectal enema by a trained healthcare professional (HCP) every 4 to 6 hours to adults who are in a coma from hepatic encephalopathy.

                  interactions

                  Interactions between Enulose (lactulose) and other drugs

                  Enulose (lactulose) may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Enulose (lactulose). Please note that only the generic name of each medication is listed below.

                  Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking any of these medicines, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

                  Using medicines in this class with any of the following medicines is not recommended. Your doctor may decide not to treat you with a medication in this class or change some of the other medicines you take.

                  Using medicines in this class with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

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                  contraindications-icon

                  Enulose (lactulose) contraindications

                  Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Enulose (lactulose) will not be safe for you to take.

                  • People on a low-galactose diet

                  alternatives

                  What are alternatives to Enulose (lactulose)?

                  There are a number of medications that your doctor can prescribe in place of Enulose (lactulose). Compare a few possible alternatives below.
                  Enulose (lactulose)
                  Used for:
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                  Xifaxan (rifaximin)
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                  Enulose (lactulose) images

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                  This medicine is Yellow And Brown Oral Solution.yellow and brown - Lactulose 10g / 15mL Solution
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                  This medicine is Colorless Oral Solution.
                  This medicine is Colorless Oral Solution.
                  This medicine is Colorless Oral Solution.

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                  References

                  Best studies we found

                  Actavis Pharma, Inc. (2022). Enulose- lactulose solution [package insert]. DailyMed.

                  Bloom, P. P., et al. (2023). Lactulose in cirrhosis: Current understanding of efficacy, mechanism, and practical considerations. Hepatology Communications.

                  Bosch, A. M. (2011). Classic galactosemia: Dietary dilemmas. Journal of Inherited Metabolic Disease.

                  View All References (10)

                  Butterworth, R. F. (2003). Hepatic encephalopathy. Alcohol Research & Health.

                  Ferenci, P. (2017). Hepatic encephalopathy. Gastroenterology Report.

                  Fresenius Kabi Austria GmbH. (2022). Lactulose- lactulose solution [package insert]. DailyMed.

                  Longo, S. A., et al. (2010). Gastrointestinal conditions during pregnancy. Clinics in Colon and Rectal Surgery.

                  MedlinePlus. (2023). Ammonia levels.

                  Mukherjee, S., et al. (2024). Lactulose. StatPearls.

                  National Center for Emerging and Zoonotic Infectious Disease (U.S.). (2018). Spoons are for soup / Milliliters (mL) are for medicine.

                  National Organization for Rare Disorders. (2011). Hepatic encephalopathy.

                  Pieber, T. R., et al. (2021). Blood glucose response after oral lactulose intake in type 2 diabetic individuals. World Journal of Diabetes.

                  Steudle, J., et al. (2018). Blood glucose response after oral intake of lactulose in healthy volunteers: A randomized, controlled, cross-over study. World Journal of Gastrointestinal Pharmacology and Therapeutics.

                  GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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