Usage
Lactase is prescribed for lactose intolerance. Its pharmacological classification is as a digestive enzyme. Lactase works by breaking down lactose, a sugar found in milk products, into simpler sugars (glucose and galactose) that can be easily absorbed by the small intestine. This prevents the symptoms of lactose intolerance, such as diarrhea, gas, and bloating.
Alternate Names
Lactase is also known as lactase enzyme. Some popular brand names include Lactaid, Lactaid Fast Act, SureLac, and Lac-Dose. Colief Infant Drops is a brand specifically for infants.
How It Works
Pharmacodynamics: Lactase supplements act locally in the small intestine, where they hydrolyze lactose into glucose and galactose. These simpler sugars are then absorbed into the bloodstream.
Pharmacokinetics: Lactase enzyme supplements are not absorbed into the bloodstream. They work directly in the digestive tract. The enzyme itself is likely digested like other proteins. As the enzyme is not systemically absorbed, hepatic or renal elimination pathways are not applicable.
Mode of Action: Lactase is an enzyme that catalyzes the hydrolysis of lactose into glucose and galactose. This occurs at the brush border of the small intestine. The enzyme is not absorbed but works directly in the gut lumen. There is no receptor binding, enzyme inhibition, or neurotransmitter modulation involved in the action of lactase supplements.
Dosage
Standard Dosage
Adults:
The typical dose ranges from 3,000 to 9,000 IU taken with the first bite of food containing lactose. For higher lactose content, higher doses might be required. Dosing can be repeated if dairy is consumed later in the meal.
Children:
Dosing for children over 4 years of age is generally the same as for adults, starting with a low dose and increasing based on symptoms and lactose intake. For children under 4, consult a pediatrician for appropriate dosing guidance (Colief Infant Drops are available for infants).
Special Cases:
- Elderly Patients: No specific dosage adjustments are typically needed. However, consider starting with a lower dose and titrating up based on tolerance.
- Patients with Renal Impairment: No specific dosage adjustments are required.
- Patients with Hepatic Dysfunction: No specific dosage adjustments are required.
- Patients with Comorbid Conditions: For patients with diabetes, consider the sugar content of certain lactase products and adjust diabetes medications if necessary.
Clinical Use Cases
Lactase is not typically used in clinical settings like intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations. Its use is primarily limited to managing dietary lactose intake.
Dosage Adjustments
Dosage should be adjusted based on individual response and the amount of lactose being consumed. Start with a low dose and gradually increase until symptoms are controlled.
Side Effects
Common Side Effects
Lactase is generally well-tolerated. In rare instances, some individuals may experience mild gastrointestinal discomfort, such as gas, bloating, or cramps.
Rare but Serious Side Effects
Allergic reactions (including anaphylaxis) are rare but possible.
Long-Term Effects
No long-term adverse effects are known to be associated with lactase use.
Adverse Drug Reactions (ADR)
Anaphylaxis is a rare but serious ADR that requires immediate medical attention.
Contraindications
Lactase is contraindicated in individuals with a known hypersensitivity to lactase or any component of the formulation. Those with galactosemia should also avoid lactase.
Drug Interactions
No significant drug interactions are known with lactase.
Pregnancy and Breastfeeding
Lactase is generally considered safe to use during pregnancy and breastfeeding.
Drug Profile Summary
- Mechanism of Action: Hydrolyzes lactose to glucose and galactose in the small intestine.
- Side Effects: Generally well-tolerated; rarely, gas, bloating, cramps, or allergic reactions.
- Contraindications: Hypersensitivity to lactase, galactosemia.
- Drug Interactions: None known.
- Pregnancy & Breastfeeding: Generally safe.
- Dosage: 3,000–9,000 IU with meals containing dairy. Adjust according to individual needs and lactose intake.
- Monitoring Parameters: Monitor for symptom relief and resolution of lactose intolerance symptoms.
Popular Combinations
Lactase is often combined with other digestive enzymes like amylase and protease to promote overall digestive health and relieve symptoms associated with several food intolerances, however, its use is primarily limited to addressing lactose intolerance. There are no specific medical guidelines for such combinations, and their efficacy remains largely unstudied.
Precautions
- General Precautions: Evaluate for true lactose intolerance. Rule out other conditions with similar symptoms.
- Specific Populations: No specific precautions apart from general recommendations.
- Lifestyle Considerations: No specific lifestyle restrictions.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Lactase?
A: The recommended dose is 3,000-9,000 IU taken at the beginning of a meal or snack containing lactose. Dosage should be individualized based on the amount of lactose consumed and individual tolerance.
Q2: How does lactase work?
A: Lactase is an enzyme that breaks down lactose (milk sugar) into glucose and galactose, which are easier to digest.
Q3: What are the side effects of lactase?
A: Lactase is generally well-tolerated. Rare side effects may include gas, bloating, abdominal cramps, and allergic reactions.
Q4: Who should not take lactase?
A: Individuals with a known allergy to lactase or those with galactosemia should not take lactase.
Q5: Can I take lactase if I am pregnant or breastfeeding?
A: Lactase is generally considered safe during pregnancy and breastfeeding. Consult your doctor before use.
Q6: How long does it take for lactase to work?
A: Lactase typically starts working within 30-45 minutes of ingestion.
Q7: Can lactase cure lactose intolerance?
A: No, lactase does not cure lactose intolerance. It is used to manage symptoms by aiding in the digestion of lactose.
Q8: Are there any drug interactions with lactase?
A: No significant drug interactions with lactase are known.
Q9: What should I do if I miss a dose of lactase?
A: Take the missed dose as soon as you remember, at the beginning of the next meal containing dairy. Do not double the dose.
Q10: Can children take lactase?
A: Yes, children can take lactase. The dosage may vary depending on age and should be determined in consultation with a pediatrician. Products like Colief Infant Drops are specifically designed for infants.
