lactulose

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.

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.

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.

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.

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.

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.

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.