Lactulose may cause accumulation of hydrogen gas in significant concentrations, which in the presence of an electrical spark may theoretically result in an explosive reaction. Patients treated with lactulose who may be required to undergo electrocautery procedures during proctoscopy or colonoscopy should have a thorough bowel cleansing with a nonfermentable solution prior to these procedures.
Lactulose contains some free galactose and lactose. Diabetic patients and those with lactose intolerance should use lactulose with caution since blood glucose may be elevated, usually after extended use.
Patients should consult their physicians if any unusual diarrhea occurs.
Elderly or debilitated patients using lactulose for more than 6 months should have their serum electrolytes (i.e., potassium, chloride, carbon dioxide) periodically measured.
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