Lactil

Indications

Lactitol is a laxative used to treat constipation in adults. It is also used, as prescribed, to help prevent and treat hepatic encephalopathy, a confusion caused by toxins building up when the liver is badly damaged.

How It Works

Lactitol is a sugar alcohol that is not absorbed in the small intestine. In the large bowel, normal gut bacteria break it down into acids. These draw water into the bowel, making stools softer and easier to pass. The acidity also reduces the amount of ammonia (a toxin linked to liver confusion) absorbed from the gut.

Dosage and Administration

For constipation in adults the usual starting dose is 20 g once a day, then adjusted to 10 g to 20 g a day to get one soft stool daily, or as directed on the label. Dissolve the granules or powder in a glass of water, juice or milk, or mix with food, and take with a meal, usually in the morning or evening. Drink 1 to 2 litres of fluid a day. It may take 1 to 2 days to work. For hepatic encephalopathy, use as prescribed by your doctor.

Interactions

Antacids and some antibiotics such as Neomycin may reduce its effect. Taking it with diuretics or steroids may increase the risk of low potassium if diarrhoea occurs. Leave about 2 hours between Lactitol and other medicines, because faster bowel movement can reduce their absorption.

Contraindications

• Bowel blockage, bowel perforation or risk of these.
• Unexplained abdominal pain or rectal bleeding.
• Galactosaemia (an inherited sugar disorder).
• Allergy to Lactitol.

Side Effects

Wind, bloating, rumbling, abdominal discomfort and loose stools are common, especially at the start, and usually ease after a few days or with a lower dose. Itching around the anus may occur.

Get urgent medical help if you have severe abdominal pain, ongoing diarrhoea with weakness, dizziness or muscle cramps (signs of losing too much fluid and salts), or bleeding from the back passage.

Pregnancy and Lactation

Very little Lactitol is absorbed, so it is not expected to harm the baby. It can be used in pregnancy and breastfeeding if a doctor or pharmacist advises it.

Precautions and Warnings

If constipation lasts more than 2 weeks, or there is a change in bowel habit, weight loss or blood in the stool, see a doctor. Long term daily use should be supervised. People with diabetes should note it contains a small amount of sugars. Older or weak people with long term diarrhoea should have their salts checked. It is not usually given to children without medical advice.

Overdose

Too much can cause diarrhoea and abdominal pain. Stop taking it and drink plenty of fluids; seek medical help if diarrhoea is severe.

Therapeutic Class

Osmotic laxative.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Keep sachets or containers closed to protect from moisture.