Lactulose

Constipation (adults and children) and hepatic encephalopathy (where it reduces ammonia absorption in liver disease).

Lactulose isn’t absorbed from the gut. It draws water into the bowel by osmosis and is fermented by colonic bacteria to produce lactic acid and other organic acids, which stimulate bowel motility. In liver disease, it traps ammonia in the gut, preventing it from reaching the brain.

Adults and children of all ages. Safe in pregnancy. Very sweet taste - some people find it unpleasant. Can cause significant bloating and flatulence due to bacterial fermentation. Avoid in galactosaemia.

Order online and we review your request. A prescriber checks your consultation form for clinical appropriateness and contacts you if anything else is needed. Once approved, your medication is dispensed and delivered to your door.

Tracked: Tracked delivery, arrives in two working days - Free

When it arrives: Every order is sent tracked. Where this page says in post today, it goes out today. Where it says in post tomorrow, it goes out the next working day. On the rare occasions a medicine is unavailable, we will contact you to talk about timing and alternatives.

We dispense clinically equivalent generic medications where available. Prices shown are for the generic version. If you prefer the branded version, let us know in your order form and we will confirm any price difference.

Lactulose from £11.99 per bottle.

Lactulose: bloating, flatulence, abdominal cramps (usually improve with continued use). Macrogol: bloating, nausea, abdominal pain. Senna: abdominal cramps, prolonged use may cause melanosis coli. Docusate: generally well tolerated, occasional cramping.

Intestinal obstruction, paralytic ileus, acute inflammatory bowel conditions, severe dehydration.

Laxatives may affect absorption of other medicines - take other medications 1-2 hours before or after. Loperamide: opioid structure means interactions possible with CYP inhibitors at high doses.

Lactulose and macrogol: generally considered safe in pregnancy and breastfeeding. Senna: use with caution, short-term only. Loperamide: limited data - use only if clearly needed.

Take 15-30ml daily, adjusting to effect. Takes 1-2 days to work. Bloating and flatulence are common (the fermentation is how it works). Mix with water or juice if the taste is too sweet. Macrogol is often preferred as first-line because it causes less bloating. Senna (Senna 7.5mg-15mg) For Constipation Natural stimulant. Works overnight.