Duphalac contains a sugar called lactulose- an unabsorbable liquid which is used for constipation and hepatic encephalopathy (liver disease causing brain damage).It is used by mouth for constipation and either by mouth or in the rectum for hepatic encephalopathy.Other common brands in Kenya include:Lactulac,lactulin,osmol among others.Costipation is characterized by the following features:

  • infrequent bowel movements
  • have to strain yourself when discharging stool
  • stools are hard and lumpy
  • blocking feeling around the anus
  • pain while passing stool

Constipation can lead to abdominal discomfort, appetite loss, piles (haemorrhoid), bleeding stools and even low back pain. The reason for constipation includes poor eating habit (e.g. inadequate fibrous food and water intake), poor exercise habit, and habitually delaying the urge to toilet. Besides, constipation can also be caused by emotions, medications, and underlying medical condition.

  • Lactulose relieves constipation by drawing water into the bowel to make stool softer
  • Lactulose takes at least 48 hours to work when taken by mouth.
  • If you find the taste of lactulose too sweet, you can dilute it with fruit juice or water.


For constipation in:

  • adults – the starting dose is usually 15ml taken twice a day
  • children aged 5 to 17 years – the usual dose is 5ml to 20ml twice a day
  • children aged 1 to 4 years – the usual dose is 2.5ml to 10ml twice a day
  • babies aged 1 to 11 months – the usual dose is 2.5ml twice a day

For adults with hepatic encephalopathy, the usual dose is between 30ml and 50ml taken 3 times a day.


Only give lactulose to children under 14 years if their doctor recommends it.


Most common side effects include gas, bloating, burping, stomach rumbling/pain, nausea, and cramps. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.

Tell your doctor or pharmacist right away if any of these unlikely but serious side effects occur: diarrhea, vomiting, muscle cramps/weakness, irregular heartbeat, mental/mood changes, seizures.

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

How to use Lactulose

If you are taking this medication by mouth for constipation, take it usually once daily or as directed by your doctor.

If you are taking this medication by mouth for liver disease, take it usually 3-4 times a day or as directed by your doctor. To improve the taste, you may mix it into fruit juice, water, milk, or a soft dessert. The goal is to have 2-3 soft stools each day. Dosage is based on your medical condition and response to therapy (i.e., the number of soft stools each day).

Who can and can’t take lactulose

Lactulose can be taken by adults including pregnant and breastfeeding women. It can also be taken by children aged 14 years and over.

Babies and children can take lactulose if their doctor recommends it. Do not give lactulose to a child under the age of 14 years unless your doctor has said so.

Lactulose isn’t suitable for some people. To make sure lactulose is safe for you, tell your doctor or pharmacist if you:

  • have ever had an allergic reaction to lactulose or any other medicine in the past
  • can’t digest a sugar called lactose (lactose intolerance)
  • have a rare health problem where the body cannot process a sugar called galactose (galactosemia)
  • have diabetes (as lactulose may affect your blood sugar levels)
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