Lactitol

Products

Lacitol is commercially available as a powder in sachets and as a syrup (Importal). It has been approved in many countries since 1985.

Structure and properties

Lactitol is present in drugs as lactitol monohydrate (C12H24O11 – H2O, Mr = 362.3 g/mol). Lactitol monohydrate is a white crystalline powder that is very soluble in water. Structurally, it is a sugar alcohol composed of galactose and sorbitol.

Effects

Lactitol (ATC A06AD12) has laxative properties. The effects are due to bacterial metabolization of the drug in the colon to various acids. The low pH results in retention of ammonia.

Indications

For symptomatic treatment of constipation and chronic or acute portal-systemic encephalopathy. Lactitol is also used as a prebiotic.

Dosage

According to the professional information leaflet.

Contraindications

  • Hypersensitivity
  • Organic dysfunction of the digestive tract
  • Artificial anus
  • Abdominal pain of unclear cause
  • Rectal bleeding
  • Intestinal obstruction
  • Galactosemia

Full precautions can be found in the drug label.

Interactions

Lactitol can potentially cause hypokalemia with regular use, which may be further exacerbated by other drugs. Digoxin may induce cardiac arrhythmias in the presence of hypokalemia. During encephalopathy treatment, antacids and neomycin should not be administered concomitantly because they increase fecal pH.

Adverse effects

Possible adverse effects include flatulence, diarrhea, lower abdominal discomfort, cramps, nausea, stomach rumbling, and anal itching.