Lactulose

Cosmetic ingredients (Lactulose) -> CIR (Cosmetic Ingredient Review)

Humectant; Skin conditioning

Soluble in cold water, hot water. Solubility in water: 76.4% @ 30 deg. C

764.0 mg/mL

Breast Feeding; Lactation; Milk, Human; Gastrointestinal Agents; Laxatives

FDA approved drugs -> Active ingredient

FDA approved drugs -> Active ingredient

Medicines for other common symptoms in palliative care

171.3 Ų [M+K]+ [CCS Type: TW; Method: calibrated with polyalanine and drug standards]

180.1 Ų [M+Na]+ [CCS Type: DT; Method: stepped-field]

This chemical does not meet GHS hazard criteria for 100% (9 of 9) of all reports.

Not Classified

Aggregated GHS information provided per 9 reports by companies from 2 notifications to the ECHA C&L Inventory.

Because lactulose has insignificant absorption by the gut and undergoes rapid excretion by the kidneys, its effects remain localized to the gut microenvironment. Side effects would include increased bowel sounds (borborygmi), increased flatus, and a sensation of bloating. Since lactulose's intended use is to soften the stool quantity and increase the stool amount, its most significant side effect remains diarrhea. The diarrhea is dose-dependent and decreases in severity with a reduction in the dose of lactulose.

Safe in the present practices of use and concentration. Ingredient, concentration, and use information are available in documents discoverable at https://cir-reports.cir-safety.org

Clinically, documentation on lactulose toxicity is lacking. Specific studies using rats inoculated with various concentrations of lactulose syrup ranging from 0.5% to 5% revealed no evidence of toxicity. However, there have been study results indicating the ability of lactulose to induce lithium toxicity in psychiatric patients. This effect is more broadly attributable to lactulose's ability to induce dehydration through its osmotic action, depletion of total body volume, and the resultant poor renal excretion of lithium. Although rare, documented allergic reactions to lactulose have been recorded in patients with milk allergies.

A06AD11

A - Alimentary tract and metabolism

QA - Alimentary tract and metabolism

A06AD11

Lactulose formulations are most commonly administered via the oral route or the rectal route. Consequently, because the substance experiences minimal absorption by the gut it typically remains localized in the gastrointestinal tract environment and ultimately demonstrates almost all of its pharmacologic effects within the gut. In particular, as lactulose elicits its laxative effects in enhancing stool amounts and softening stool, such biochemical and physiologic activities can cause increased bowel sounds (borborygmi), a feeling of bloatedness, belching, frequent flatus, and diarrhea.

Lactulose is a synthetic disaccharide derivative of lactose that consists of one molecule of galactose and one molecule of fructose. Saccharolytic bacteria present in the large intestine subsequently break the substance down into organic acids like lactic acid and small amounts of formic and acetic acids. Such resultant volatile fatty acid metabolites, in combination with hydrogen and methane that is also generated consequently enhance intraluminal gas formation, peristaltic gut motility, and elicit an osmotic effect that facilitates an increase in the water content of stool as well as associated stool softening. All of these actions ultimately assist in facilitating and increasing the frequency of bowel movements in patients experiencing constipation, although it may take 24 to 48 hours after using the medication for this laxative effect to become evident. At the same time, the formation of such acids via the metabolism of lactulose by colonic bacteria also acidifies the contents of the colon, thereby contributing to the treatment of portal-systemic encephalopathy (PSE). As one of the principal features of PSE involves the accumulation of nitrogenous waste products like ammonia in the systemic circulation, a state in which the colonic contents become more acidic than blood allows ammonia in the circulation to diffuse into the colon.. Furthermore, ammonia that diffuses into the acidic colon is ionized to ammonium ions that are incapable of being absorbed back into the blood. These effects, combined with the laxative action of lactulose facilitates the excretion of excess ammonia. And finally, it is also believed that an acidic colonic environment results in the elimination of urease-producing bacteria that contribute to the formation of ammonia while surviving colonic bacteria use up any trapped ammonia in the colon as a source of nitrogen for protein synthesis.