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Lactulose (Generlac)
Virtual visit

Lactulose (Generlac)

With our quick and easy online prescription process, you can manage your health effortlessly — whether you need a first-time prescription for Lactulose (Generlac) or a refill of an existing one.

Licensed providers in all 50 states

Expert-guided, evidence-based treatments

Skip the trip to the doctor's office

Visit options

Costs shown are for the visit only. You'll pay for medication at your preferred pharmacy.

Video Visit

$25

Est. or $100 w/o insurance

Chat Visit

$30

w/o insurance

Most insurance accepted

Board-certified

No hidden fees

Available nationwide

What is Lactulose (Generlac)?

Lactulose is a synthetic sugar used as a laxative for chronic constipation and, at higher doses, to treat and prevent hepatic encephalopathy—the confusion and cognitive decline caused by ammonia buildup in liver disease. It's not absorbed into the bloodstream; instead it works entirely within the colon. For constipation, it draws water into the colon to soften stool. For hepatic encephalopathy, it acidifies the colon environment, trapping ammonia and promoting its excretion. It's taken orally as a syrup, and doses are adjusted based on the number of soft bowel movements per day.

Osmotic laxative action

Lactulose is not digested or absorbed and draws water into the colon osmotically, softening stool and stimulating bowel movements—providing gentle, predictable relief for chronic constipation without systemic effects.

Ammonia trapping for hepatic encephalopathy

Gut bacteria ferment Lactulose into organic acids that lower colonic pH, converting ammonia (NH3) to ammonium (NH4+) which cannot be absorbed—trapping it in the colon for excretion and reducing the blood ammonia levels that drive encephalopathy.

Entirely gut-local mechanism

Because Lactulose is not absorbed into the bloodstream, its entire therapeutic effect occurs within the gastrointestinal tract—making it safe for long-term use in patients with liver disease who cannot metabolize many systemic medications.

Virtual visit with clinician

Ongoing support, always available.

You’ll be supported by experienced clinicians who care for a wide range of health needs, from everyday concerns to more complex conditions.

Our clinicians track your progress over time and adjust your care as needed. If medication is prescribed, we’ll manage dosing and monitor for side effects. If lab testing is recommended, we review results and refine your plan accordingly. You’re never left to navigate care on your own.

All your care in one place. That’s the General Medicine difference.

We help you understand your options, connect you to the right clinicians, manage prescriptions, coordinate any needed evaluations, and keep an eye on your overall health along the way. It’s comprehensive care that looks at the full picture — your goals, your history, your lifestyle — and makes it simple to move forward with confidence.

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What our customers have to say

“I feel like I’m finally on the right path to improving my health with the right support now! It’s so refreshing and reassuring.”

Emerald

“My experience with General Medicine was amazing. The understanding and care that was taken to figure out what is exactly going on with me. I feel like a weight has been lifted off of me.”

Kaylee

“I couldn’t be happier with my experience with General Medicine! They are fast, responsive, kind and knowledgeable. It is much easier, more affordable and faster.”

Nika

Get the care you need, without the wait.

Frequently Asked Questions

What are the two different uses for lactulose?

At lower doses, lactulose treats constipation by drawing water into the colon. At higher doses, it treats hepatic encephalopathy — the confusion caused by ammonia buildup in liver disease — by trapping ammonia in the gut for excretion.

How quickly does lactulose work for constipation?

Most people experience a bowel movement within 24–48 hours of the first dose. The dose may need adjustment to achieve the target of 2–3 soft bowel movements per day without excessive diarrhea.

How do I know if my lactulose dose is correct for hepatic encephalopathy?

For hepatic encephalopathy, the goal is 2–3 soft bowel movements per day — enough to excrete ammonia-containing stool without causing dehydration. Your clinician will adjust the dose to achieve this target.

What side effects might I experience?

Gas, bloating, cramping, and diarrhea are the most common effects — particularly when starting or at higher doses. Excessive use can cause dehydration and electrolyte imbalance. These are managed by dose adjustment.

Does lactulose interact with other medications?

Lactulose's colon-acidifying effect can reduce the activity of certain antibiotics used for hepatic encephalopathy (like neomycin). It may also affect the absorption of other oral medications — discuss your full medication list with your clinician.
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