Lactitol

Identification

Name
Lactitol
Accession Number
DB12942
Description

Lactitol, also known as 4-β-D-galactopyranosyl-D-glucitol, is a sugar alcohol synthesized from lactose.3 It is used in food manufacturing as a nutritive sweetener and is approximately 35% as sweet as table sugar (i.e. sucrose).1 Clinically, lactitol has been investigated for use as an osmotic laxative and, along with other non-absorbable disaccharides such as lactulose, in the treatment of hepatic encephalopathy in patients with cirrhosis.2,3

Pizensy, an oral lactitol powder for solution, was approved by the FDA for use in chronic idiopathic constipation in February 2020.4

Type
Small Molecule
Groups
Approved, Investigational
Structure
Thumb
Weight
Average: 344.3124
Monoisotopic: 344.13186161
Chemical Formula
C12H24O11
Synonyms
  • Lactitol
  • Lactitolum
External IDs
  • E-966
  • INS NO.966
  • INS-966
  • NSC-231323

Pharmacology

Indication

Lactitol is indicated for the treatment of chronic idiopathic constipation in adults.4

Associated Conditions
Contraindications & Blackbox Warnings
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Pharmacodynamics

Lactitol helps to facilitate bowel movements by drawing water into the gastrointestinal tract.4 The oral administration of lactitol may reduce the absorption of concomitant medications - other oral medications should be administered at least 2 hours before or 2 hours after lactitol.4

Mechanism of action

Lactitol is an osmotic laxative - it exerts its pharmacologic effect by creating a hyperosmotic environment within the small intestine. The osmotic effect generated by lactitol draws water into the small intestine, which loosens stools and ultimately facilitates bowel movements.4

Absorption

In healthy subjects under fed conditions, oral administration of 20 grams of lactitol resulted in a mean Tmax of 3.6 ± 1.2 hours, Cmax of 776 ± 253 ng/mL, and a mean AUC of 6,019 ± 1,771 ng*hr/mL.4

Volume of distribution

Data regarding the volume of distribution of lactitol are unavailable.

Protein binding

As it undergoes little-to-no systemic absorption, lactitol is unlikely to be subject to protein binding.4

Metabolism

As it undergoes little-to-no systemic absorption, lactitol is unlikely to undergo any significant degree of metabolism.4

Route of elimination

Lactitol is not absorbed in the gastrointestinal tract to any significant extent. The vast majority of an ingested dose is likely degraded into organic acids in the colon and eliminated in the feces.4

Half-life

The average half-life of orally administered lactitol is 2.4 hours.4

Clearance

Data regarding the clearance of lactitol are unavailable.

Adverse Effects
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Toxicity

The LD50 is 23 g/kg in mice and >30 g/kg in rats.5

Experience with acute overdosage is limited, but is likely to involve significant gastrointestinal upset and diarrhea consistent with the pharmacologic profile of lactitol. Overdosage should be managed with symptomatic and supportive measures, where necessary.4

Affected organisms
  • Humans and other mammals
Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AcetazolamideThe risk or severity of adverse effects can be increased when Acetazolamide is combined with Lactitol.
AclidiniumThe therapeutic efficacy of Lactitol can be decreased when used in combination with Aclidinium.
AlfentanilThe therapeutic efficacy of Lactitol can be decreased when used in combination with Alfentanil.
AlloinThe risk or severity of adverse effects can be increased when Lactitol is combined with Alloin.
AlmasilateThe therapeutic efficacy of Lactitol can be decreased when used in combination with Almasilate.
AluminiumThe therapeutic efficacy of Lactitol can be decreased when used in combination with Aluminium.
Aluminium phosphateThe therapeutic efficacy of Lactitol can be decreased when used in combination with Aluminium phosphate.
Aluminum hydroxideThe therapeutic efficacy of Lactitol can be decreased when used in combination with Aluminum hydroxide.
AmantadineThe therapeutic efficacy of Lactitol can be decreased when used in combination with Amantadine.
AmilorideThe risk or severity of adverse effects can be increased when Amiloride is combined with Lactitol.
Additional Data Available
  • Extended Description
    Extended Description

    Extended description of the mechanism of action and particular properties of each drug interaction.

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  • Severity
    Severity

    A severity rating for each drug interaction, from minor to major.

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  • Evidence Level
    Evidence Level

    A rating for the strength of the evidence supporting each drug interaction.

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  • Action
    Action

    An effect category for each drug interaction. Know how this interaction affects the subject drug.

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Food Interactions
  • Take with food. The manufacturer recommends administration with meals.

Products

Product Ingredients
IngredientUNIICASInChI Key
Lactitol monohydrateUH2K6W1Y6481025-04-9LXMBXZRLTPSWCR-XBLONOLSSA-N
International/Other Brands
Importal
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
PizensyPowder, for solution1 g/1gOralBraintree Laboratories, Inc.2020-02-12Not applicableUS flag
Additional Data Available
  • Application Number
    Application Number

    A unique ID assigned by the FDA when a product is submitted for approval by the labeller.

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  • Product Code
    Product Code

    A governmentally-recognized ID which uniquely identifies the product within its regulatory market.

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Categories

ATC Codes
A06AD12 — Lactitol
Drug Categories
Chemical TaxonomyProvided by Classyfire
Description
This compound belongs to the class of organic compounds known as fatty acyl glycosides of mono- and disaccharides. These are compounds composed of a mono- or disaccharide moiety linked to one hydroxyl group of a fatty alcohol or of a phosphorylated alcohol (phosphoprenols), a hydroxy fatty acid or to one carboxyl group of a fatty acid (ester linkage) or to an amino alcohol.
Kingdom
Organic compounds
Super Class
Lipids and lipid-like molecules
Class
Fatty Acyls
Sub Class
Fatty acyl glycosides
Direct Parent
Fatty acyl glycosides of mono- and disaccharides
Alternative Parents
Alkyl glycosides / O-glycosyl compounds / Disaccharides / Fatty alcohols / Sugar alcohols / Oxanes / Secondary alcohols / Polyols / Oxacyclic compounds / Acetals
show 2 more
Substituents
Acetal / Alcohol / Aliphatic heteromonocyclic compound / Alkyl glycoside / Disaccharide / Fatty acyl glycoside of mono- or disaccharide / Fatty alcohol / Glycosyl compound / Hydrocarbon derivative / O-glycosyl compound
show 9 more
Molecular Framework
Aliphatic heteromonocyclic compounds
External Descriptors
disaccharide (CHEBI:75323)

Chemical Identifiers

UNII
L2B0WJF7ZY
CAS number
585-86-4
InChI Key
VQHSOMBJVWLPSR-JVCRWLNRSA-N
InChI
InChI=1S/C12H24O11/c13-1-4(16)7(18)11(5(17)2-14)23-12-10(21)9(20)8(19)6(3-15)22-12/h4-21H,1-3H2/t4-,5+,6+,7+,8-,9-,10+,11+,12-/m0/s1
IUPAC Name
(2S,3R,4R,5R)-4-{[(2S,3R,4S,5R,6R)-3,4,5-trihydroxy-6-(hydroxymethyl)oxan-2-yl]oxy}hexane-1,2,3,5,6-pentol
SMILES

References

Synthesis Reference

冯建鹏, 孙田江, 张玉斌, 张虎跃, 朱年青, 杨俊, 赵文镜, 陆宏国, 霍浩刚, 高力虎. "Preparation of lactitol ." Chinese Patent CN101481395B, issued August 2011.

General References
  1. Mooradian AD, Smith M, Tokuda M: The role of artificial and natural sweeteners in reducing the consumption of table sugar: A narrative review. Clin Nutr ESPEN. 2017 Apr;18:1-8. doi: 10.1016/j.clnesp.2017.01.004. Epub 2017 Feb 4. [PubMed:29132732]
  2. Gluud LL, Vilstrup H, Morgan MY: Non-absorbable disaccharides versus placebo/no intervention and lactulose versus lactitol for the prevention and treatment of hepatic encephalopathy in people with cirrhosis. Cochrane Database Syst Rev. 2016 May 6;(5):CD003044. doi: 10.1002/14651858.CD003044.pub4. [PubMed:27153247]
  3. Finney M, Smullen J, Foster HA, Brokx S, Storey DM: Effects of low doses of lactitol on faecal microflora, pH, short chain fatty acids and gastrointestinal symptomology. Eur J Nutr. 2007 Sep;46(6):307-14. doi: 10.1007/s00394-007-0666-7. Epub 2007 Jul 11. [PubMed:17623227]
  4. FDA Approved Drug Products: Pizensy (lactitol) oral solution [Link]
  5. MOLBASE: Lactitol monohydrate MSDS [Link]
KEGG Drug
D08266
PubChem Compound
157355
PubChem Substance
347829086
ChemSpider
138481
BindingDB
50240023
RxNav
28395
ChEBI
75323
ChEMBL
CHEMBL1661
ZINC
ZINC000005225520
Wikipedia
Lactitol
FDA label
Download (265 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
2Unknown StatusTreatmentBacterial Colonization1
Not AvailableRecruitingNot AvailableBladder Dysfunction / Bowel Dysfunction / Fecal Impaction / Lower Urinary Tract Disorder1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
Powder, for solutionOral1 g/1g
Prices
Not Available
Patents
Not Available

Properties

State
Solid
Experimental Properties
Not Available
Predicted Properties
PropertyValueSource
Water Solubility377.0 mg/mLALOGPS
logP-3.2ALOGPS
logP-5.5ChemAxon
logS0.04ALOGPS
pKa (Strongest Acidic)12.1ChemAxon
pKa (Strongest Basic)-3ChemAxon
Physiological Charge0ChemAxon
Hydrogen Acceptor Count11ChemAxon
Hydrogen Donor Count9ChemAxon
Polar Surface Area200.53 Å2ChemAxon
Rotatable Bond Count8ChemAxon
Refractivity70.82 m3·mol-1ChemAxon
Polarizability31.98 Å3ChemAxon
Number of Rings1ChemAxon
Bioavailability0ChemAxon
Rule of FiveNoChemAxon
Ghose FilterNoChemAxon
Veber's RuleNoChemAxon
MDDR-like RuleNoChemAxon
Predicted ADMET Features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
GC-MS Spectrum - GC-MS (9 TMS)GC-MSsplash10-0uxr-0793000000-953bf1e924fdd8f3400c
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSNot Available
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSNot Available

Drug created on October 20, 2016 19:30 / Updated on June 12, 2020 10:53

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