From the Guidelines
Lactulose is considered safe for use in adults and children of all ages, including infants, when prescribed by a healthcare provider. The safety profile of lactulose is well-established, although dosing should be carefully adjusted based on weight and clinical response, especially in infants and young children 1. In adults, the typical starting dose is 10–20 g (15–30 mL or 1–2 packets) daily, which may be increased to 40 g (60 mL or 2–4 packets) daily if needed 1. Lactulose works by drawing water into the intestines and softening stool, making it particularly useful for treating constipation. However, common side effects may include bloating, gas, and abdominal cramping, especially when treatment begins 1.
Key Considerations
- Lactulose is not absorbed systemically, which contributes to its safety profile across age groups.
- Patients with diabetes should use lactulose with caution as it contains galactose and lactose.
- Always consult a healthcare provider before starting lactulose, particularly for infants, young children, or patients with underlying medical conditions.
- The use of lactulose in mildly constipated, noninsulin-dependent patients with diabetes mellitus type 2 may not lead to an increase in blood sugar levels 1.
Recommendations
- Lactulose can be considered if symptoms of chronic idiopathic constipation (CIC) have failed to improve with fiber and OTC laxatives, and individuals do not experience significant bloating or abdominal pain with lactulose use 1.
- A trial of fiber supplement can be considered for mild constipation before lactulose use or in combination with lactulose 1.
From the Research
Lactulose Safety in Children
- Lactulose is considered safe for use in children, with studies indicating its effectiveness and safety in infants and children of various ages 2, 3.
- According to a study published in 2016, lactulose-based medications are authorized and effective for children under 6 months of age 2.
- Another study from 2010 found that small doses of lactulose appeared to be safe in premature infants and did not cause diarrhea 3.
- A 2019 study compared the efficacy and tolerance of polyethylene glycol 3350 (PEG) and lactulose in children with functional constipation, finding that both treatments were effective but PEG had fewer side effects 4.
- Other studies have also investigated the use of lactulose in children, including a 2008 study that compared lactulose to a dietary fiber mixture in the treatment of childhood constipation, finding comparable results between the two treatments 5.
- Additionally, a 2005 study found that Lactobacillus GG was not an effective adjunct to lactulose for treating constipation in children 6.
Age-Specific Safety
- The exact age at which lactulose is considered safe for use is not universally agreed upon, but studies suggest it can be used in infants as young as a few months old 2, 3.
- For children under 6 months of age, lactulose-based medications are considered authorized and effective 2.
- In premature infants, small doses of lactulose have been found to be safe and effective 3.