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: Bowel cleansing products can increase the gastrointestinal transit rate. Oral medications administered within one hour of the start of administration of the bowel cleansing solution may be flushed from the gastrointestinal tract and not properly absorbed.

MANAGEMENT: Patients should be advised that absorption of oral medications may be impaired during bowel cleansing treatment. Oral medications (e.g., anticonvulsants, oral contraceptives, antidiabetic agents, antibiotics) should not be administered during and within one hour of starting bowel cleansing treatment whenever possible. However, if concomitant use cannot be avoided, monitoring for reduced therapeutic effects may be advisable.

The recommended maximum number of medicines in the 'osmotic laxatives' category to be taken concurrently is usually one. Your list includes two medicines belonging to the 'osmotic laxatives' category:

• Fleet Phospho Soda (sodium biphosphate / sodium phosphate)
• lactulose

Note: In certain circumstances, the benefits of taking this combination of drugs may outweigh any risks. Always consult your healthcare provider before making changes to your medications or dosage.