Possible Interaction: Lactulose and Neomycin

“As neomycin antagonises the effect of lactulose in the colon, its concurrent use may be less effective in the treatment of hepatic encephalopathy.”

“There is some evidence that neomycin can be given with lactulose to cause an additive effect in the treatment of hepatic encephalopathy.”

“There is some evidence that neomycin can be given with lactulose to cause an additive effect in the treatment of hepatic encephalopathy.”

“The beneficial effect of disaccharides, lactulose and lactitol, in prevention and treatment of hepatic encephalopathy is well established but their use in combination with neomycin is still controversial.”

“The beneficial effect of disaccharides, lactulose and lactitol, in prevention and treatment of hepatic encephalopathy is well established but their use in combination with neomycin is still controversial.”

“When lactulose was supplemented with neomycin , the nitrogen content of the bacterial fraction decreased by 28%.”

“The decreased stool pH induced by sorbitol would have diminished the antibacterial effect of the neomycin, thus likely making it seem less effective than it would if used alone while, reciprocally, increasing the apparent effectiveness of lactulose together with neomycin.”

“ Lactulose and neomycin , when administered together, had an additive effect in reducing gut ammonia production in cirrhotic subjects.”

“The addition of neomycin to a lactulose regimen caused a 17% reduction in the urea production rate that was quantitatively accounted for by a 70% reduction in the urea degradation rate.”

“These results demonstrate that neomycin inhibited bacterial ureolysis when administered with lactulose while lactulose itself was metabolized and its individual effect on nitrogen metabolism persisted.”

“ Neomycin intensified nonsignificantly the integrated (0-6 hours) breath hydrogen response to lactulose (+43 %) and the maximal H2-concentration by 29.8 %, probably because it interferes with intestinal bacteria which are important for H2-consumption.”

“Because long-term treatment with neomycin reduces also the physiological intestinal bacteria combination with lactulose (70-100 gm daily) is better.”