Summary: Lactulose is an osmotic laxative but it is rarely used for this purpose. I discuss lactulose pharmacology in this episode. <br> <br> <br> <br> Elevated ammonia levels are an issue in hepatic encephalopathy. Lactulose can help manage this issue. <br> <br> <br> <br> Lactulose is dosed to 2-3 soft stools per day when used to reduce ammonia levels. <br> <br> <br> <br> Lactulose can increase the effect of warfarin and raise INR; I discuss this further on this episode.
