How Do Ammonium Detoxicants Work?

Ammonium detoxicants (a man-made sugar solution) are a class of medications used to treat constipation and portal systemic encephalopathy. Portal systemic encephalopathy also known as “hepatic encephalopathy” is a neuropsychiatric disorder that occurs secondary to chronic liver disease. It is a chronic and disabling disorder that must be treated concurrently with liver disease. Ammonium detoxicants do not cure the problem but may help to improve the mental status. Ammonium detoxicant (lactulose) is a synthetic disaccharide derivative, a type of sugar that is broken down in the large intestine into mild acids that draw water into the colon, which helps soften the stools.

Ammonium detoxicant is administered in a solution form for oral or rectal (given as enema by a healthcare provider) administration. It is usually taken once a day for treatment of constipation and three or four times a day for liver disease.

Ammonium detoxicant works in the following ways:

• Lactulose belongs to a class of drugs called laxatives. It is broken down in the colon into products (mild acids) that draw water into the colon, which helps soften the stools.
• Lactulose elicits its laxative effects in enhancing stool amounts and softening stools.
• Lactulose is a colonic acidifier that works by decreasing the amount of ammonia in the blood of patients with liver disease. It works by drawing ammonia from the blood into the colon where it is removed from the body in the form of stools.

Consider the use of ammonium detoxicants in constipation, particularly when lifestyle and dietary modifications fail. Ammonium detoxicants can be used in conditions such as:

• Chronic constipation
• To treat and prevent complications of:
  • Portal systemic encephalopathy (a complication of liver disease)

Common side effects include:

• Dehydration
• Diarrhea
• Excessive bowel activity
• Hypernatremia (high blood sodium levels)
• Hypokalemia (low blood potassium levels)
• Nausea
• Vomiting
• Abdominal cramping
• Abdominal distention
• Belching (burping)
• Flatulence (gas)

Other rare side effects may include:

• Severe diarrhea/vomiting
• Irregular heartbeat
• Mood changes

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of ammonium detoxicants include:

• Constulose
• Enulose
• Generlac
• Kristalose
• Lactulose