Lactulose is an osmotic laxative but it is rarely used for this purpose. I discuss lactulose pharmacology in this episode.

Elevated ammonia levels are an issue in hepatic encephalopathy. Lactulose can help manage this issue.

Lactulose is dosed to 2-3 soft stools per day when used to reduce ammonia levels.

Lactulose can increase the effect of warfarin and raise INR; I discuss this further on this episode.

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