Drug Interaction Report

GENERALLY AVOID: In the treatment of portal-systemic encephalopathy, the loose stools produced by concomitant use of other laxatives may falsely suggest that adequate lactulose dosage has been achieved.

MANAGEMENT: The use of other laxatives should generally be avoided when lactulose is prescribed for portal-systemic encephalopathy, especially during the initial phase of therapy.

ADJUST DOSING INTERVAL: Bulk-forming laxatives such as guar gum, psyllium, polycarbophil, or methylcellulose may affect the bioavailability of concomitantly administered substances due to their effect on the rate of gastrointestinal transit and gastric emptying.

MANAGEMENT: In general, oral medications should be administered at least 2 hours before or 2 hours after dosing of the bulk-forming laxative.