4618-18-2

Synonyms: MLS-50;4-0-beta-d-galactopyranosyl-d-fructose;4-o-beta-d-galactopyranosyl-d-fructos;4-o-beta-d-galattopiranosil-d-fruttofuranosio;4-O-D-Galactopyranosyl-D-fructose;4-O-β-D-Galactopyranosyl-D-fructose, 4-O-β-D-Galactopyranosyl-D-fructofuranose
Alpha: -47 º (C=5, H2O, 12HR)
Boiling point: 397.76°C (rough estimate)
Density: 1.32g/cm3
Refractive index: 1.45-1.47
Solubility: Freely soluble in water, sparingly soluble in methanol, practically insoluble in toluene.
Pka: 11.67±0.20
Optical activity: [α]20/D 48±2°, 24 hr, c = 1% in H2O
Water Solubility: 76.4 G/100 ML (30 ºC)

Pharmacological action: 
1. Lactulose is synthesized nonabsorbable disaccharide. It is not absorbed in the intestinal tract, and can be decomposed into lactic acid and acetic acid by colonic bacteria, and the pH value of intestinal tract is reduced to less than 6. It can block the absorption of ammonia, reduce the accumulation and absorption of endotoxin, restore the patient's blood ammonia to normal, making the patient turn from coma to sober.
2. Lactulose also has the osmotic activity of disaccharide, making water and electrolytes retained in the intestinal cavity to produce hypertonic effects. Therefore, it's also a kind of osmotic laxative. Without intestinal irritation, it can also be used to treat chronic functional constipation.
3. It has the effect of anti endotoxin.

Mechanism of action:
Lactulose is transformed into a low molecular weight organic acid by the digestive tract bacteria in the colon, which leads to a decrease in the pH value in the intestinal tract.The volume of the feces was increased by retaining the water. The above effects stimulate the peristalsis of the colon, keep the bowel smooth, relieve constipation, and restore the physiological rhythm of the colon. In hepatic encephalopathy (PSE), hepatic coma and pre coma, these effects promote the growth of intestinal acidophilic bacteria (such as lactobacillus), inhibit protein decomposing bacteria, and turn ammonia into ionic state. By reducing the contact pH value, play osmotic effect, and improve bacterial ammonia metabolism, it plays a laxative effect.

Indication:
This product is not digested and decomposed in the stomach and small intestine, and is almost not absorbed in the small intestine.  There are a variety of bacteria in the large intestine.  Some of the beneficial bacteria (such as lactobacillus bifidobacterium) use lactulose as nutrients.  This product in the colon is decomposed into low molecular weight organic acids such as lactic acid and acetic acid, so that intestinal pH decreases below 6, which is conducive to the growth of beneficial bacteria and has therapeutic action.  First is can cure constipation: the decomposition of this product can stimulate the peristalsis of the large intestine, while keeping more water in the large intestine, softening the feces and relieving constipation.  Second, its can lower the blood ammonia: a larger dose of this product can promote the reproduction of sugar decomposing bacteria, thus inhibiting the growth of proteolytic bacteria, reducing the production of ammonia and other endotoxins and the pH in the colon.  In this state, most of the ammonia is converted into an ammonium ion that is difficult to absorb, reducing the absorption of ammonia and reducing the blood ammonia.  This product is not digested and absorbed in the stomach and small intestine, and has little absorption.  It can play a role in the large intestine.  Therefore, the effect will be seen 24~48 hours after taking this product.  Metabolism takes place in the colon, less than 3% of the original medicine is excreted with urine, and a small amount is excreted with feces through bile.  It can be used in the adjuvant treatment of hepatic coma and pre coma in hepatic encephalopathy.  It is also used for the treatment of acute and chronic constipation and the adjuvant medication used as endotoxemia.

Uses: Lactulose is is a synthetic, non-digestible sugar used in the treatment of chronic constipation; laxative.