Lactulose Plus

Lactitol (10gm) + Fructo Oligosaccharide (2gm)
Price: ₹280 - ₹330 for 10 sachets
Mfr: Cipla Ltd. | Form: Powder in sachet

📋 Clinical Overview

A combination of two osmotic laxative prebiotics used for the treatment of chronic constipation and hepatic encephalopathy. Lactitol is a synthetic disaccharide sugar alcohol, while Fructo-oligosaccharide (FOS) is a naturally occurring prebiotic fiber. This combination works synergistically to increase stool water content, promote peristalsis, and modulate gut microbiota, making it a first-line therapy for functional constipation in the Indian population.

💊 Dosage & Administration

Adult: One sachet (containing Lactitol 10gm + FOS 2gm) once daily, preferably with a meal or at bedtime. Can be adjusted to twice daily (morning and evening) based on response. Dissolve the granules in a glass of water (approx. 200 ml) and consume immediately.

Note: Granules must be dissolved in a full glass of water or other cold beverage (not hot) and consumed immediately. Follow with an additional glass of water. Do not take in dry form. Administer with or without food. Consistent daily intake is crucial for prebiotic effect.

⚠️ Contraindications

  • Known hypersensitivity to lactitol, fructo-oligosaccharide, or any component.
  • Galactosemia (due to lactitol's galactose component).
  • Intestinal obstruction, ileus, or acute abdominal conditions (e.g., appendicitis, inflammatory bowel disease flare).

🔬 Mechanism of Action

The combination exerts a dual osmotic and prebiotic action. 1) Osmotic Laxation: As non-absorbable carbohydrates, they draw water into the intestinal lumen by osmosis, increasing stool volume and softening consistency. 2) Prebiotic Effect: They serve as selective substrates for beneficial colonic bacteria (e.g., Bifidobacteria, Lactobacilli), promoting their growth. Bacterial fermentation produces short-chain fatty acids (SCFAs), which lower colonic pH, inhibit pathogenic bacteria, and directly stimulate colonic peristalsis (motility).

🤕 Side Effects

  • Flatulence
  • Abdominal distension/bloating
  • Borborygmi (stomach rumbling)
  • Mild abdominal cramps or discomfort

🤰 Special Populations

Pregnancy: Category B (US FDA). No well-controlled studies in pregnant women. Animal studies show no risk. Use only if clearly needed, as systemic absorption is negligible. Beneficial for pregnancy-related constipation.

Driving: No effect on ability to drive or operate machinery.

🔄 Drug Interactions

Oral Medications (e.g., Antiepileptics, Anticoagulants, Cardiac glycosides)The increased gastrointestinal transit time may reduce the absorption and efficacy of concurrently administered oral drugs. Maintain a 2-hour gap.Moderate
Non-Absorbable Antacids (e.g., Aluminum Hydroxide)May reduce the acidifying effect of SCFAs in the colon, potentially diminishing efficacy in hepatic encephalopathy.Mild
Insulin or Oral HypoglycemicsTheoretically, fermentation products may influence glucose metabolism. Monitor blood glucose in diabetics.Mild

🔁 Alternatives to Lactulose Plus

Same composition (Lactitol (10gm) + Fructo Oligosaccharide (2gm)), different brands:

Laxigrow Lactifiber Lactihep