Cholac (Generic)

This drug is used by mouth or rectally to treat or prevent complications of liver disease (hepatic encephalopathy). It does not cure the problem, but may help to improve mental status. Lactulose is a colonic acidifier that works by decreasing the amount of ammonia in the blood. It is a man-made sugar solution.

If you are taking this medication by mouth for liver disease, take it usually 3-4 times a day or as directed by your doctor. To improve the taste, you may mix it into fruit juice, water, milk, or a soft dessert. The goal is to have 2-3 soft stools each day. Dosage is based on your medical condition and response to therapy (i.e., the number of soft stools each day).

If you are taking this medication by mouth for constipation, take it usually once daily or as directed by your doctor.

This medication can also be given rectally as an enema for liver disease. Mix the recommended amount of lactulose with 700 milliliters (24 ounces) of water or normal saline. Give the solution into the rectum and keep the liquid inside for 30-60 minutes as directed by your doctor. If you keep the enema inside for less than 30 minutes, repeat the dose unless directed otherwise.

Use this medication regularly in order to get the most benefit from it. Remember to use it at the same time each day.

When this drug is given rectally for liver disease, an improvement in your mental status may occur in as little as 2 hours, but if you are taking this medication by mouth, it may take up to 24 to 48 hours. If you are using this medication for constipation, it may take up to 48 hours to have a bowel movement. Inform your doctor if your condition persists or worsens.

Gas, bloating, burping, stomach rumbling/pain, nausea, and cramps may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if any of these unlikely but serious side effects occur: diarrhea, vomiting, muscle cramps/weakness, irregular heartbeat, mental/mood changes, seizures.

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before using lactulose, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: a low galactose diet (e.g., a diet that includes few or no milk products), certain other bowel problem (bowel obstruction).

Before using this medication, tell your doctor or pharmacist your medical history, especially of: diabetes.

Do not take any laxative medications while using this drug. Frequent use or overuse of laxatives can cause a severe loss of body water (dehydration). This is especially likely to occur in children or the elderly. Contact your doctor right away if you develop any of the following symptoms of dehydration: muscle weakness, muscle cramps, dizziness.

Before having surgery or other procedures (e.g., electrocautery), tell your doctor or surgeon that you are using this medication.

This medication contains different sugars. If you have diabetes, this medication may affect your blood sugar. Check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is not known whether this drug passes into breast milk. Consult your doctor before breast-feeding.

Store between 36-86 degrees F (2-30 degrees C) away from light and moisture. Do not freeze because this will make the medication too thick to pour. If it becomes frozen, warm it to room temperature until it is pourable again. A normal darkening of color may occur. If too much darkening occurs and you cannot swallow it, discard the medication and get a refill. Do not store in the bathroom. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Your healthcare professionals (such as your doctor or pharmacist) may already be aware of any possible drug interactions and may be monitoring you for it. Do not start, stop or change the dosage of any medicine before checking with them first.

Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: antacids containing aluminum and/or magnesium, other laxatives (e.g., cleansing enemas with soap suds).

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe stomach cramps, diarrhea.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

If you are using this medication for liver disease, your doctor may direct you to follow a low-protein diet. Follow any dietary guidelines recommended by your doctor or dietician.

Do not share this product with others.

If you use this product for an extended time, laboratory and/or medical tests (e.g., blood mineral levels) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.