Substitutions Can Be Sticky

Republished July 31, 2024

When a middle-aged man arrived at a pharmacy to pick up a refill for lactulose (a prescription medicine commonly used as a laxative), he was told that he needed a new prescription from his doctor. There were no refills left on his previous prescription. The pharmacist suggested that the man could use KARO corn syrup as a substitute for lactulose until he visited his doctor for his next check-up.

Karo corn syrup is a food syrup. However, it was also thought to be useful in treating constipation in children and adults. But the man was taking lactulose to treat a liver problem (hepatic encephalopathy), not constipation. Luckily, the patient called his doctor about the suggestion and was told not to use the substitute. He was given a new prescription for lactulose.

Hepatic encephalopathy is when the liver does not work well enough to remove toxins from the body. The risk of substituting the prescription medicine with Karo corn syrup could have been very serious because this untreated liver problem could sometimes lead to increased confusion, behavioral changes, and not being able to care for yourself. If a totally different medicine or product is suggested, you may want to first check with your doctor before making the switch. Also ask your doctor to write the reason you are taking a medicine on the prescription. This way, the pharmacist will be able to make more accurate suggestions. The suggestion to use Karo syrup would not have been wrong if the man had been using lactulose to treat constipation.

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