Hepalac Drug Interactions

Laxatives: Additional laxatives should not be administered with lactulose solution, especially when lactulose therapy is initiated, because the loose stools produced may be falsely interpreted as an indication that adequate dosage of lactulose has been achieved.
Anti-infective agents: Theoretically, orally administered neomycin and possibly other anti-infective agents, when administered concurrently with lactulose could eliminate colonic bacteria that are necessary to metabolize lactulose and thereby prevent acidification of the contents of the colon. Limited data obtained from experiments in healthy individuals tend to support the theoretical incompatibility of these agents. There is, however, evidence that lactulose remains active when administered with neomycin to patients with portal-systemic encephalopathy. In addition, there have been reports that concomitant therapy with lactulose and neomycin may be more effective than either drug alone in the treatment of portal-systemic encephalopathy. Therefore, until there is conclusive evidence that concurrent administration of lactulose and neomycin or other oral anti-infective agents is efficacious, patients receiving lactulose and an oral anti-infective agents should be closely monitored for possible inadequate response to lactulose.
Antacids: Results of limited studies in rats and humans suggest that nonabsorbable antacid administered concomitantly with lactulose may inhibit the desired decrease in fecal pH in the colon. The potential lack of desired effect of lactulose should be considered before a nonabsorbable antacid is administered concomitantly with lactulose.