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Enulose Lactulose 10 g/15mL Solution, 473 mL — NDC 45963-0438-64 package photo

Enulose Lactulose 10 g/15mL Solution, 473 mL

by Actavis Pharma, Inc. · 473 mL in 1 BOTTLE (45963-438-64)
NDC 45963-0438-64
🏷️ FDA NDC (as labeled) 45963-438-64 billing pads the product segment with a zero
Rx only Generic On market Non-controlled
🗂️ Data synced Jul 24, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →

🆔 Identity & classification

FDA NDC (as labeled) 45963-438-64
Product NDC 45963-438
11-digit billing NDC 45963043864
NCPDP billing unit ML — per mL (volume)
RxCUI 391937, 755470
UNII 9U7D5QH5AE
Application # ANDA090502
SPL Set ID 00c42c5c-d19e-4130-aa08-a8bbd47d3e5b
Established class (EPC) Osmotic Laxative
Mechanism of action Osmotic Activity; Acidifying Activity
Physiologic effect Stimulation Large Intestine Fluid/Electrolyte Secretion
DEA schedule Non-controlled
Marketing category ANDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2011-02-28
Route ORAL, RECTAL
Dosage form SOLUTION
Substance LACTULOSE
GPI-14 52400020002010
GPI class Enulose
GCN Seq No 003143
GCN 10160
HICL code 001396
Ingredient (HICL) Lactulose
HIC1 code D
Therapeutic class — broad (HIC1) Biliary System/Gastro-Intestinal System
HIC2 code D9
Therapeutic class — intermediate (HIC2) Ammonia Inhibitors
HIC3 code D9A
Therapeutic class — specific (HIC3) Ammonia Inhibitors
AHFS code 40:10.00.00
AHFS class Ammonia Detoxicants
FDB label name ENULOSE 10 GM/15 ML SOLUTION
FDB brand name Enulose
Legend status F — Federal legend — prescription drug or device
TE code (Orange Book) AA · RLD · RS
Why two NDCs? The FDA registers this code as 45963-438-64 — a 5-3-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the product segment → 45963-0438-64. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

🏷️ RxNorm drug class

This medicine belongs to the Osmotic Laxative class.

Pharmacologic class Osmotic Laxative
Drug family (ATC) Osmotically acting laxatives
How it works Osmotic Activity, Acidifying Activity
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

🏭 Manufacturer & labeler

LabelerActavis Pharma, Inc.
Application holderFRESENIUS KABI AUSTRIA GMBH
FDA applicationANDA090502 (ANDA)
Labeler code45963
First marketedFeb 2011
Product typeHuman Prescription Drug
Portfolio324 products on file
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

🩺 Clinical

Label name ENULOSE 10 GM/15 ML SOLUTION Ingredient Lactulose
📖 What it is MedlinePlus · NLM

Lactulose is a synthetic sugar used to treat constipation. It is broken down in the colon into products that pull water out from the body and into the colon. This water softens stools. Lactulose is also used to reduce the amount of ammonia in the blood of patients with liver disease. It works by drawing ammonia from the blood into the colon where it is removed from the body. This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.

Read the full MedlinePlus article ↗
📗 Our plain-language guide HelloPharmacist
  • Lactulose has two main uses. Some products — like Constulose and Kristalose — are prescribed specifically for constipation. Other products, like Enulose and Generlac, are used for...
  • For constipation, it usually takes 24 to 48 hours to produce a bowel movement, so don't be worried if nothing happens right away. For portal-systemic encephalopathy, improvement ma...
  • How long does it take lactulose to work?
  • The most common side effects are digestive — gas, bloating, belching, and mild stomach cramping. These are pretty typical, especially when you first start. The one to watch for is...
📖 Read our full Lactulose guide →
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

🧪 Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

💡 Tap an ingredient (hover on desktop) to see what it is and why it’s used.

  • UNII 6YSS42VSEV
    Fructose is a natural sugar derived from fruits and plants. It's used in medicines as a sweetener and filler to improve taste and add bulk to tablets or syrups.
  • UNII X2RN3Q8DNE
    Galactose is a simple sugar derived from milk or made through chemical processes. It acts as a filler and sweetener in medicines, helping create the proper tablet size and improving taste.
  • UNII J2B2A4N98G
    Lactose is a natural sugar derived from milk. In medications, it serves as a filler and binder to add bulk and help hold tablet or capsule ingredients together during manufacturing.

3 inactive ingredients listed in the exact product block matched to this NDC.

Where does this data come from?
Data sourced from official FDA Structured Product Labeling (SPL) via DailyMedingredient classCode="IACT" elements from the exact product block matched by this NDC. Label-section narrative from DailyMed / the openFDA label index is shown separately when available.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

💲 Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer mLPer package
Retail pharmacies payNADAC · weekly $0.013 $6.24 / 473 ml
Medicaid paysCMS SDUD · 12 mo $0.0227 $10.74 / 473 ml
Medicare drug plans payPart D · Q2 2026 $0.0302 $14.28 / 473 ml
NADAC price history (per mL) — tap or hover for the price & month
Dec 2021 Jul 2022 Dec 2025 Aug 2026 $0.015 $0.012
▼ Down 13% over the last 24 months.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

🔁 Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Lactulose Solution 10 g/15mL 81033-0241-32 Kesin 946 ml $0.013 AA Availability likely save 5%
Enulose 10 g/15mLthis 45963-0438-64 Actavis 473 ml $0.013 AA Availability likely
Generlac 10 g/15mL 62135-0892-47 Chartwell 473 ml $0.013 AA Availability likely
Lactulose 10 g/15mL 00116-4005-08 Xttrium 237 ml $0.020 AA Availability likely +50%
Constulose 10 g/15mL 45963-0439-63 Actavis 237 ml $0.020 AA Availability likely +50%
Lactulose 10 g/15mL 62135-0003-37 Chartwell 237 ml $0.020 AA Availability likely +50%
Lactulose 10 g/15mL 83745-0405-08 APOZEAL 237 ml $0.020 AA Availability likely +50%
Lactulose 10 g/15mL 51672-4243-09 Sun 1 bottle $0.022 AA Availability likely +70%
Lactulose 10 g/15mL 00121-0873-06 PAI 16 cups AA FDA listed
Lactulose 20 g/30mL 00121-1154-06 PAI 16 cups AA Discontinued
Lactulose 20 g/30mL 00121-1746-00 PAI 10 cups AA FDA listed
Lactulose 10 g/15mL 00121-4577-06 PAI 16 cups AA Discontinued
Lactulose 10 g/15mL 00527-5125-68 Lannett 237 ml AA FDA listed
Lactulose 10 g/15mL 17856-0874-03 Atlantic 50 cups AA FDA listed
Lactulose 10 g/15mL 18124-0002-16 Fresenius 473 ml AA FDA listed
Lactulose 20 g/30mL 55154-9448-05 Cardinal 5 cups AA FDA listed
Lactulose Solution 10 g/15mL 61037-0471-02 Bajaj 236 ml AA FDA listed
Lactulose 10 g/15mL 62135-0002-24 Chartwell 10 cups AA FDA listed
Lactulose 10 g/15mL 62135-0004-24 Chartwell 10 cups AA FDA listed
Enulose 10 g/15mL 63629-8800-01 Bryant 473 ml AA FDA listed
Lactulose Solution 10 g/15mL 64980-0592-12 Rising 118 ml AA FDA listed
Lactulose 10 g/15mL 68999-0002-24 Chartwell 10 cups AA FDA listed
Lactulose 20 g/30mL 68999-0004-24 Chartwell 10 cups AA FDA listed
Lactulose 10 g/15mL 82804-0107-47 Proficient 473 ml AA FDA listed
Lactulose 10 g/15mL 83745-0249-08 APOZEAL 237 ml AA FDA listed
About this product: this is a generic version of the medicine. FDA equivalence ratings are shown when available, and other versions are listed above, least expensive first.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

Availability & generic status

🏛️
2011
On the market since
Feb 2011
📍
2026
Currently FDA-listed
15 years listed
🔓
·
Generic on the market
this product is a generic
This is a generic drug

This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.

Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

🗺️ Medicaid utilization & spend

📍 This exact package only: Medicaid data is reported per full 11-digit NDC — labeler, product and pack size — so every number here is for 45963-0438-64, not the drug overall. Other pack sizes report separately.
💊 Pharmacy benefit only: These are Medicaid outpatient pharmacy claims, billed by NDC. They exclude the medical benefit — clinic- or hospital-administered drugs billed under HCPCS J-codes — so drugs used mostly that way (e.g. Avastin, Lucentis, Keytruda) can look low or missing here. That’s expected, not an error.
📅 Q1 2025 – Q4 2025 · 4 quarters of data
ⓘ The newest quarter is usually incomplete when first published; states restate recent quarters in later CMS releases, so the latest figures typically revise upward. State coverage-policy changes can also shift quarter-to-quarter totals.
Prescriptions last 4 qtrs
91.7K
Units reimbursed last 4 qtrs
69M
Gross reimbursed last 4 qtrs
$1.57M
Avg / prescription
$17.06
Avg / unit
$0.0227
Latest quarter Q4 2025
25KRx
Medicaid pays / mL
$0.0227
gross reimbursed
vs
NADAC / mL
$0.0132
acquisition cost
=
Spread
+$0.0095
+72% vs cost
What Medicaid paid per mL (before rebates; includes the pharmacy’s dispensing fee) compared with NADAC — the average price pharmacies pay to buy the drug. A positive spread means Medicaid reimbursed more than the purchase price, before manufacturer rebates.
Fee-for-service vs managed care
51% FFS 49% MCO
Fee-for-service · 46,794 Rx Managed care · 44,934 Rx
State Medicaid map
Alaska: 96,362 units · 13,146 per 100k residents AK Maine: 172,910 units · 12,395 per 100k residents ME Washington: 341,162 units · 4,367 per 100k residents WA Idaho: 252,044 units · 12,833 per 100k residents ID Montana: 234,331 units · 20,701 per 100k residents MT North Dakota: 322,126 units · 41,140 per 100k residents ND Minnesota: 537,240 units · 9,364 per 100k residents MN Wisconsin: 322,431 units · 5,456 per 100k residents WI Michigan: 2,346,926 units · 23,383 per 100k residents MI New York: 6,874,268 units · 35,125 per 100k residents NY Vermont: 96,989 units · 14,991 per 100k residents VT New Hampshire: 128,259 units · 9,148 per 100k residents NH Oregon: 1,202,013 units · 28,396 per 100k residents OR Nevada: 397,278 units · 12,438 per 100k residents NV Wyoming: no data reported WY South Dakota: 124,922 units · 13,593 per 100k residents SD Iowa: 394,257 units · 12,294 per 100k residents IA Illinois: 6,068,214 units · 48,356 per 100k residents IL Indiana: 1,480,944 units · 21,582 per 100k residents IN Ohio: 4,754,342 units · 40,342 per 100k residents OH Pennsylvania: 1,690,605 units · 13,044 per 100k residents PA New Jersey: 1,914,199 units · 20,605 per 100k residents NJ Massachusetts: 2,488,414 units · 35,544 per 100k residents MA California: 11,401,509 units · 29,261 per 100k residents CA Utah: 278,609 units · 8,154 per 100k residents UT Colorado: 464,709 units · 7,906 per 100k residents CO Nebraska: 139,189 units · 7,037 per 100k residents NE Missouri: 1,037,726 units · 16,748 per 100k residents MO Kentucky: 1,378,935 units · 30,467 per 100k residents KY West Virginia: 1,256,569 units · 70,993 per 100k residents WV Virginia: 2,047,925 units · 23,496 per 100k residents VA Maryland: 2,103,178 units · 34,032 per 100k residents MD Connecticut: 62,113 units · 1,717 per 100k residents CT Rhode Island: 567,492 units · 51,826 per 100k residents RI Arizona: 714,073 units · 9,609 per 100k residents AZ New Mexico: 450,852 units · 21,327 per 100k residents NM Kansas: 138,858 units · 4,723 per 100k residents KS Arkansas: 277,718 units · 9,055 per 100k residents AR Tennessee: 768,065 units · 10,778 per 100k residents TN North Carolina: 2,120,536 units · 19,571 per 100k residents NC South Carolina: 1,127,351 units · 20,982 per 100k residents SC Delaware: 225,374 units · 21,860 per 100k residents DE Oklahoma: 1,152,738 units · 28,442 per 100k residents OK Louisiana: 677,318 units · 14,808 per 100k residents LA Mississippi: 235,832 units · 8,021 per 100k residents MS Alabama: 496,647 units · 9,723 per 100k residents AL Georgia: 1,601,259 units · 14,519 per 100k residents GA D.C.: 409,307 units · 60,281 per 100k residents DC Hawaii: 125,077 units · 8,716 per 100k residents HI Texas: 5,260,673 units · 17,246 per 100k residents TX Florida: 216,388 units · 957 per 100k residents FL
Units reimbursed · per 100k residents
95770,993
gray = no data reported
Colors are per 100,000 residents, so big states don’t automatically dominate. Tap or hover a state for its actual totals.
Tap or hover a state
…for its Medicaid breakdown
🏆 Top states by units · per 100k residents
1 West Virginia 70,993 /100k
2 D.C. 60,281 /100k
3 Rhode Island 51,826 /100k
4 Illinois 48,356 /100k
5 North Dakota 41,140 /100k
6 Ohio 40,342 /100k
7 Massachusetts 35,544 /100k
8 New York 35,125 /100k
National units — by quarter
💵 About the dollar figures: “reimbursed” is what Medicaid paid pharmacies before confidential manufacturer rebates, so the program’s real net cost is lower than these numbers. Fee-for-service and managed-care claims are combined unless split above. Source: CMS State Drug Utilization Data; per-100k rates use 2023 Census population estimates.

📊 Medicare Part D spend CMS · PART D · 2026 (Q1)

Medicare Part D (outpatient prescription) spending for Enulose — the program that covers self-administered drugs. 1 manufacturer.
⚠️ Drug-level data: CMS publishes Part D spending by drug, not by NDC — these figures combine every manufacturer, strength and package size sold under the name Enulose. That’s a different level of aggregation than the Medicaid card above, which is specific to this exact 11-digit NDC (pack size included), so the two aren’t directly comparable.
Period
Total Part D spend
$1.57M
Claims incl. refills
61.5K
Beneficiaries
31.4K
Spend / beneficiary
$50.06
Spend / claim
$25.55
Trend by period
💵 About the dollar figures: spending is what Part D plans paid before confidential manufacturer rebates, so the program’s real net cost is lower. A blank patient count means fewer than 11 people — CMS hides counts that small to protect privacy. Source: CMS Medicare Quarterly Part D Spending by Drug (data.cms.gov), updated quarterly.

🔬 Reported adverse events (FAERS)

Read carefully: FAERS reports are voluntary and unverified. Counts are not incidence, do not establish causation, are subject to reporting bias, and cannot be used to compare one drug to another. Shown for signal context only. Reports for Enulose (this brand).

Top reported reactions

Nausea2,540
Constipation2,502
Fall2,250
Vomiting2,093
Fatigue2,017
Death1,934
Dyspnoea1,915

Age at onset

Neonate27
Infant36
Child108
Adolescent56
Adult2,705
Elderly2,931

Reporter sex

37,105 reports
Male · 48%
Female · 52%
Unknown · 0%

Serious outcomes

Hospitalization20,555
Death6,524
Life-threatening2,967
Disabling1,225
Reports over time (by year) — tap or hover for the count & year
2019 2021 2023 2026 2,981 0
Most recent year is provisional (FAERS lags ~3 months).
Where does this data come from?
Adverse-event reports from the FDA Adverse Event Reporting System (FAERS) via openFDA. FAERS reports are voluntary and unverified — counts are not incidence and don’t establish causation.

📦 Packaging — all sizes for this product

Package NDCDescription Marketing startStatus
45963-0438-64 You're viewing this 473 mL in 1 BOTTLE (45963-438-64) 2011-02-28 Active

📄 Full prescribing information FDA SPL

The complete FDA label for this product — the official prescribing information, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
🎯 Indications and Usage 109 words

INDICATIONS AND USAGE For the prevention and treatment of portal-systemic encephalopathy, including the stages of hepatic pre-coma and coma. Controlled studies have shown that lactulose solution therapy reduces the blood ammonia levels by 25 to 50%; this is generally paralleled by an improvement in the patients' mental state and by an improvement in EEG patterns. The clinical response has been observed in about 75% of patients, which is at least as satisfactory as that resulting from neomycin therapy.

An increase in patients' protein tolerance is also frequently observed with lactulose therapy. In the treatment of chronic portal-systemic encephalopathy, Lactulose has been given for over 2 years in controlled studies.

⏱️ Dosage and Administration ~2 min read

DOSAGE AND ADMINISTRATION Oral Adult: The usual adult, oral dosage is 2 to 3 tablespoonfuls (30 to 45 ml, containing 20 g to 30 g of lactulose) three or four times daily. The dosage may be adjusted every day or two to produce 2 or 3 soft stools daily. Hourly doses of 30 to 45 ml of Lactulose may be used to induce the rapid laxation indicated in the initial phase of the therapy of portal-systemic encephalopathy.

When the laxative effect has been achieved, the dose of lactulose may then be reduced to the recommended daily dose. Improvement in the patient's condition may occur within 24 hours but may not begin before 48 hours or even later. Continuous long-term therapy is indicated to lessen the severity and prevent the recurrence of portal-systemic encephalopathy.

The dose of lactulose for this purpose is the same as the recommended daily dose. Pediatric Very little information on the use of lactulose in young children and adolescents has been recorded. As with adults, the subjective goal in proper treatment is to produce 2 to 3 soft stools daily.

On the basis of information available, the recommended initial daily oral dose in infants is 2.5 to 10 ml in divided doses. For older children and adolescents, the total daily dose is 40 to 90 ml. If the initial dose causes diarrhea, the dose should be reduced immediately.

If diarrhea persists, lactulose should be discontinued. Rectal When the adult patient is in the impending coma or coma stage of portal-systemic encephalopathy and the danger of aspiration exists, or when the necessary endoscopic or intubation procedures physically interfere with the administration of the recommended oral doses, lactulose solution may be given as a retention enema via a rectal balloon catheter. Cleansing enemas containing soapsuds or other alkaline agents should not be used.

Three hundred ml of lactulose solution should be mixed with 700 mL of water or physiologic saline and retained for 30 to 60 minutes. Lactulose enema may be repeated every 4 to 6 hours. If the enema is inadvertently evacuated too promptly, it may be repeated immediately.

The goal of treatment is reversal of the coma stage in order that the patient may be able to take oral medication. Reversal of coma may take place within 2 hours of the first enema in some patients. Lactulose, given orally in the recommended doses, should be started before Lactulose by enema is stopped entirely.

Contraindications 22 words

CONTRAINDICATIONS Since lactulose solution contains galactose (less than 1.6 g/15 mL), it is contraindicated in patients who require a low galactose diet.

⚠️ Warnings 91 words

WARNINGS A theoretical hazard may exist for patients being treated with lactulose solution who may be required to undergo electrocautery procedures during proctoscopy or colonoscopy. Accumulation of H 2 gas in significant concentration in the presence of an electrical spark may result in an explosive reaction. Although this complication has not been reported with lactulose, patients on lactulose therapy undergoing such procedures should have a thorough bowel cleansing with a non-fermentable solution.

Insufflation of CO 2 as an additional safeguard may be pursued but is considered to be a redundant measure.

🤒 Adverse Reactions 69 words

ADVERSE REACTIONS Precise frequency data are not available. Lactulose may produce gaseous distention with flatulence or belching and abdominal discomfort such as cramping in about 20% of patients. Excessive dosage can lead to diarrhea with potential complications such as loss of fluids, hypokalemia, and hypernatremia.

Nausea and vomiting have been reported. To report SUSPECTED ADVERSE EVENTS, contact the FDA at 1-800-FDA-1088 or http://www.fda.gov/ for voluntary reporting of adverse reactions.

🔄 Drug Interactions 146 words

Drug Interactions There have been conflicting reports about the concomitant use of neomycin and lactulose solution. Theoretically, the elimination of certain colonic bacteria by neomycin and possibly other anti-infective agents may interfere with the desired degradation of lactulose and thus prevent the acidification of colonic contents. Thus the status of the lactulose-treated patient should be closely monitored in the event of concomitant oral anti-infective therapy.

Results of preliminary studies in humans and rats suggest that nonabsorbable antacids given concurrently with lactulose may inhibit the desired lactulose-induced drop in colonic pH. Therefore, a possible lack of desired effect of treatment should be taken into consideration before such drugs are given concomitantly with lactulose. Other laxatives should not be used, especially during the initial phase of therapy for portal-systemic encephalopathy, because the loose stools resulting from their use may falsely suggest that adequate lactulose dosage has been achieved.

🤰 Pregnancy 79 words

Pregnancy Teratogenic Effects Pregnancy category B . Reproduction studies have been performed in mice, rats, and rabbits at doses up to 2 or 4 times the usual human oral dose and have revealed no evidence of impaired fertility or harm to the fetus due to lactulose. There are, however, no adequate and well-controlled studies in pregnant women.

Because animal reproduction studies are not always predictive of human response, this drug should be used during pregnancy only if clearly needed.

🧒 Pediatric Use 21 words

Pediatric Use Very little information on the use of lactulose in pediatric patients has been recorded (see DOSAGE AND ADMINISTRATION ).

🆘 Overdosage 79 words

OVERDOSAGE Signs and Symptoms There have been no reports of accidental overdosage. In the event of overdosage, it is expected that diarrhea and abdominal cramps would be the major symptoms. Medication should be terminated.

Oral LD 50 : The acute oral LD 50 of the drug is 48.8 mL/kg in mice and greater than 30 mL/kg in rats. Dialysis: Dialysis data are not available for lactulose. Its molecular similarity to sucrose, however, would suggest that it should be dialyzable.

🧬 Clinical Pharmacology 215 words

CLINICAL PHARMACOLOGY Lactulose causes a decrease in blood ammonia concentration and reduces the degree of portalsystemic encephalopathy. These actions are considered to be results of the following: Bacterial degradation of lactulose in the colon acidifies the colonic contents. This acidification of colonic contents results in the retention of ammonia in the colon as the ammonium ion.

Since the colonic contents are then more acid than the blood, ammonia can be expected to migrate from the blood into the colon to form the ammonium ion. The acid colonic contents convert NH 3 to the ammonium ion (NH 4 )+, trapping it and preventing its absorption. The laxative action of the metabolites of lactulose then expels the trapped ammonium ion from the colon.

Experimental data indicate that lactulose is poorly absorbed. Lactulose given orally to man and experimental animals resulted in only small amounts reaching the blood. Urinary excretion has been determined to be 3% or less and is essentially complete within 24 hours.

When incubated with extracts of human small intestinal mucosa, lactulose was not hydrolyzed during a 24-hour period and did not inhibit the activity of these extracts on lactose. Lactulose reaches the colon essentially unchanged. There it is metabolized by bacteria with the formation of low molecular weight acids that acidify the colon contents.

📦 How Supplied / Storage and Handling 162 words

HOW SUPPLIED Lactulose Solution USP, 10 g/15 ml, is a natural colored and an unflavored solution supplied in one pint (473 ml) bottles. Lactulose solution, USP contains lactulose 670 mg/mL (10 g/15 mL). Store between 36° to 86°F (2° to 30°C).

Do not freeze. Under recommended storage conditions, a normal darkening of color may occur. Such darkening is characteristic of sugar solutions and does not affect therapeutic action.

Prolonged exposure to temperatures above 86°F (30°C) or to direct light may cause extreme darkening and turbidity which may be pharmaceutically objectionable. If this condition develops, do not use. Prolonged exposure to freezing temperatures may cause change to a semi-solid, too viscous to pour.

Viscosity will return to normal upon warming to room temperature. Dispense in a tight, light-resistant container as defined in the USP, with a child-resistant closure. Manufactured and packaged by: Fresenius Kabi Austria GmbH Estermannstraße 17 4020 Linz, Austria Manufactured for: Teva Pharmaceuticals Parsippany, NJ 07054 USA Revised – June 2022

📋 Description 82 words

DESCRIPTION Lactulose is a synthetic disaccharide in solution form for oral or rectal administration. Each 15 mL of lactulose solution, USP contains: 10 g lactulose (and less than 1.6 g galactose, less than 1.2 g lactose, and 0.1 g or less of fructose). Lactulose is a colonic acidifier for treatment and prevention of portal-systemic encephalopathy.

The chemical name for lactulose is 4-O- β -D-galactopyranosyl-D-fructofuranose. It has the following structural formula: The molecular weight is 342.30. It is freely soluble in water.

867ede97-figure-01

Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗
For educational and professional reference only — not medical advice. Pricing reflects published NADAC and CMS ASP (free public data) and may differ from your acquisition cost; always verify before billing or dispensing.