Lactulose question

@jodeej That's really a dilemma. I was retired already and most of the time I was able to go about my normal activities but sometimes the lactulose just got too intrusive on my life. It wasn't just the having to "go", it also causes really horrible smelling gas. I guess whether or not he could work would depend on how much tolerance his workplace has for bathroom trips. Once "titrated" it is manageable but I did have to monitor my doses constantly depending on results. I presume what you are eating must have some influence on it too. Have you spoken to a hepatologist who could possibly prescribe xifaxan instead of lactulose? That was what my hepatologist did for me. It was initially refused by my Medicare D so she wrote something to them to justify it and then they did pay a large part of it. The actual cost is something around $2400 a month but with insurance our portion was between $700 and $800 a month; a sacrifice for sure but my husband felt it was worth it. The xifaxan, alone, prevented HE episodes for almost a year. I understand you can appeal to the company for a less expensive cost on the medication too depending on your income level.
JK

@contentandwell we are in Rochester and have an appointment with his doctor on Tuesday. We are going to talk to him about it. Hubs was thinking about short-term disability, but would like to stay working as long as possible. That's why I'm asking about the lactulose. I don't know if he'd want to pay for the xifaxan.

@jodeej My doctors insisted on the lactulose as it helps both remove the toxins and clears the mind. It may be gassy but depends on when you take it. I have never found it to interrupt my day and keeps me regular even though I eat a healthy diet. I have for some reason though not able (wanting to) eat meat or fish. I buy all fresh fruit and vegetables and maintain a very low sodium intake. I hope you find something that balances your husband's work/home life.

@jodeej When I first got on xifaxan I asked my hepatologist if I could switch back and forth between lactulose and xifaxan, and she said I could. I was figuring that I would go with the xifaxan when I really did not want to bothered with the lactulose, as when on vacation. I got the prescription I think in June. When my husband saw the difference it made he said he thought we should just go with it so we did. As I said, it was a sacrifice, we are comfortable but not wealthy, but it did make my life, and his, much easier. He was worried constantly about the possibility of my having an HE episode and they were very tough on him so the xifaxan really did help him as much as it did me.
JK

@gaylea1 Are you saying that your doctor felt that lactulose is more helpful than xifaxan? I found just the opposite. I was able to be totally normal while taking xifaxan, no obstacles to living my normal life, driving, and going anywhere. For me it was a Godsend. Many people speak of "brain fog". I never experienced that.
JK

@jodeej
Sending Prayers on Tuesday..
Rosemary

@rosemarya thank you!

I have been on Rifaxin and Lactulose for 2 years. I have mild HE but have found that juggling the lactulose til you get it right works for me I take 1 big slug of it right out of the bottle...lol.. before bed and it works pretty good. PS I usually follow it up with s slug of lemonade...lol

@contententandwell I had been taking lactulose for a year and was just prescribed rifaximin a few months ago. I was instructed to take both. I have to agree that the rifaximin is doing a great job. I do skip the lactulose some days and seem fine. Sorry for the confusion.

@gaylea1 It sounds like you are doing as well as possible, that's great. I was very happy to be able to do without the lactulose for almost a year because for me it was really disrupting of my life.
JK