Beyond Lactulose

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New Member

Date Joined Apr 2009
Total Posts : 1
   Posted 4/10/2009 3:34 PM (GMT -7)   
Hi everyone - My lovely 67 year old mother has non-alcoholic cirhosis of the liver.  Ammonia levels were well over 200.   She is now on lactulose three times a day with a dosage that ranges from 45ml to 60ml (three tablespoons to four tablespoons) depending on her symptoms (confusion, being very very cold, no energy, muscle weakness, etc).  While on lactulose, she is going to her commode every hour during the day with extreme diarrhea.  While I am very grateful for the lactulose, we know that finding the right dosage is tricky.  It is also very hard on her to have her life center around a commode (as well as going through 10-12 Depends each day).   We have heard that there are some new medicines that may be taken in conjunction with or instead of lactulos.   I have heard about the use of antibitoics such as rifaximin 2 to help reduce ammonia levels?  Anyone know more about the success of this or any other medications beyond lactulos?

Pink Grandma
Veteran Member

Date Joined Nov 2006
Total Posts : 2445
   Posted 4/10/2009 5:16 PM (GMT -7)   
Hello gabriellewings and welcome to HealingWell.

Yes rifaximin is an antibiotic that it used in conjuction with Lactulose to fight the encephalopathy in some patients. Liver disease patients tend to get infections quite easily as their immune system is compromised.

The rifaximin fights the infections which make it a lot harder for the Lactulose to work to keep the ammonia levels under control. My husband was on both and they worked together great for him. He had the MRSA staph infection. As far as I know there is no other drug for ammonia levels than Lactulose or it's generics.

Ask her Hepatologist or GI about it .

Take care............thoughts and prayers..........
Pink Grandma
Forum moderator-Hepatitis

When the going gets tough....the tough get going! Don't always know where I going but I get there anyways.

Regular Member

Date Joined Dec 2008
Total Posts : 302
   Posted 4/10/2009 7:47 PM (GMT -7)   


Hi Gabriel,


Welcome to the forum.  Xifaxin (rifaximin) is an antibiotic that works within the intestines to control the bacteria that produce ammonia.  It is expensive, but it does help. 


If your Mother is having extreme diarrhea, her doctor needs to be notified immediately.  This is not normal.  She could become dehydrated quickly.  Lactulose is intended to produce 3-4 bowel movements a day, not extreme diarrhea.


I’m sorry she is having to suffer from the side effects of ESLD.  Good luck to you and your Mother. 



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