Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
ANDROID 5 vs CEPHULAC
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Androgen receptor agonist; stimulates protein synthesis and growth of androgen-sensitive tissues.
Lactulose, a synthetic disaccharide, is not absorbed from the gastrointestinal tract. It is metabolized by colonic bacteria to form short-chain fatty acids (e.g., lactic, acetic, formic acids), which acidify the colonic contents. In hepatic encephalopathy, the acidic environment converts ammonia (NH3) to ammonium (NH4+), which is poorly absorbed and excreted in feces. Additionally, the osmotic effect of lactulose draws water into the colon, softening stools and increasing bowel movements.
Testosterone replacement therapy for male hypogonadism,Off-label: delayed puberty in males
Treatment of constipation,Hepatic encephalopathy (portal-systemic encephalopathy) including the prevention and treatment of coma
2.5-10 mg orally once daily in the morning for androgen replacement therapy in adult males.
30-45 m L (6.67-10 g lactulose) orally 3-4 times daily for constipation; for hepatic encephalopathy, 30-45 m L orally 3-4 times daily titrated to produce 2-3 soft stools per day, or 300 m L in 700 m L of water or saline as retention enema for 30-60 min every 4-6 hours.
Terminal elimination half-life is 3.5–5.5 hours; clinical effects may persist for several days due to active metabolites.
Terminal elimination half-life is 7-10 hours (renal impairment: prolonged); systemic absorption is minimal (<3%) after oral administration, so half-life reflects clearance of absorbed fraction.
Hepatic via CYP3A4 and CYP2B6; undergoes first-pass metabolism.
Not absorbed; metabolized by colonic bacteria (e.g., Lactobacillus, Bacteroides) to low molecular weight organic acids.
Primarily renal: ~90% as glucuronide and sulfate conjugates, 6% as unchanged drug; ~5% fecal via bile.
Primarily renal (20-30% as unchanged drug) and fecal (up to 70% as unmetabolized drug via biliary elimination; following gastric acid-mediated degradation, only 5-10% reaches urine as intact lactulose; hepatic metabolism is negligible).
98% bound to sex hormone-binding globulin (SHBG) and albumin.
Negligible (<5%): lactulose does not bind significantly to albumin or other plasma proteins due to its hydrophilic nature.
Vd approximately 1.0 L/kg; indicates extensive tissue distribution, especially to reproductive organs and bone marrow.
0.5-1.0 L/kg (estimated from systemic absorption studies; limited data due to minimal absorption; reflects distribution largely into extracellular water).
Oral: 15–25% due to first-pass metabolism; buccal or transdermal: higher, but not commercially available for this formulation.
Oral: <3% (due to poor absorption and extensive metabolism by colonic bacteria; most of the drug remains in the gut lumen). Rectal: similar to oral, as systemic absorption is minimal.
No specific dose adjustment required based on GFR; caution in severe impairment (Cr Cl <30 m L/min) due to potential fluid retention.
No dose adjustment required for renal impairment as lactulose is minimally absorbed and primarily acts locally in the colon.
Contraindicated in Child-Pugh class B and C cirrhosis due to hepatotoxicity risk; in class A, use with caution and monitor liver function.
Not specifically adjusted based on Child-Pugh score; dose is titrated to achieve desired stool frequency; caution in severe hepatic impairment due to risk of electrolyte disturbances.
Not recommended for use in children as it may cause premature epiphyseal closure and virilization; limited data.
Infants: 2.5-10 m L/day in divided doses; older children: 10-25 m L/day; adolescents: 15-30 m L/day; all for constipation; for hepatic encephalopathy, doses as low as 5-10 m L 3-4 times daily with dose adjusted to produce 2-3 soft stools per day.
Increased risk of prostatic hyperplasia and carcinoma; use lowest effective dose with regular prostate monitoring.
Initiate at lower end of dosing range (15-30 m L/day) due to increased risk of dehydration and electrolyte imbalance; monitor for diarrhea and adjust accordingly.
Warning: Prolonged use may cause virilization in women, premature epiphyseal closure, and increased risk of prostatic hypertrophy/carcinoma.
None
Monitor liver function, lipid profile, and prostate-specific antigen; risk of edema in patients with cardiac disease; avoid use in patients with sleep apnea.
Electrolyte imbalance with prolonged use, especially in debilitated patients,Diarrhea may cause fluid and electrolyte loss,Galactose intolerance (contraindicated in patients requiring low galactose diet due to lactose content in some preparations),Monitor serum electrolytes in patients receiving high doses for hepatic encephalopathy
Known or suspected prostate cancer; breast cancer in males; hypersensitivity to androgens; pregnancy and lactation.
Patients requiring a low-galactose diet (lactulose contains galactose and lactose),Intestinal obstruction,Suspected gastrointestinal obstruction or perforation
Avoid grapefruit and grapefruit juice as they may increase drug levels. Limit salt intake to reduce fluid retention. Alcohol may increase risk of liver toxicity.
No specific food interactions. Avoid concurrent use with other laxatives unless directed. High-fiber foods may enhance effect; ensure adequate fluid intake.
Pregnancy Category X. ANDROID 5 (oxandrolone) is contraindicated in pregnancy due to teratogenic effects including masculinization of female fetus, clitoral enlargement, and labial fusion. Risk is highest during first trimester but applies throughout gestation.
Lactulose (CEPHULAC) is not absorbed systemically; therefore, fetal exposure is negligible. Animal studies have not shown teratogenic effects. In clinical practice, no fetal risks have been identified in any trimester.
Excretion into human milk is unknown. Due to potential for androgenic effects in nursing infants, breastfeeding is not recommended. No M/P ratio available.
Lactulose is not excreted into breast milk due to minimal systemic absorption. It is considered compatible with breastfeeding. M/P ratio: Not applicable (negligible absorption).
Not applicable; contraindicated in pregnancy. No dose adjustment recommendations exist for pregnant patients.
No dose adjustment required. Pharmacokinetics are unchanged in pregnancy due to lack of systemic absorption. Standard dosing of 15-30 m L (10-20 g) once daily, up to 60 m L/day in divided doses, is appropriate.
Android 5 (methyltestosterone) is an androgenic anabolic steroid used for hypogonadism and delayed puberty. Monitor liver function due to hepatotoxicity. Use with caution in elderly due to increased risk of prostatic hypertrophy and carcinoma. Can cause fluid retention in patients with cardiac, renal, or hepatic disease. Avoid in patients with breast cancer or known or suspected prostate cancer.
Cephulac (lactulose) is a non-absorbable disaccharide used for constipation and hepatic encephalopathy. In hepatic encephalopathy, titrate to produce 2-3 soft stools per day. Monitor serum electrolytes, especially in elderly or renal impairment. Onset of action for constipation may be 24-48 hours. Do not confuse with other lactose-containing products.
Take exactly as prescribed; do not increase dose or frequency without consulting your doctor.,Report any signs of liver problems: yellowing of skin or eyes, dark urine, severe stomach pain.,Women should report any signs of virilization: hoarseness, acne, menstrual changes, growth of facial hair.,Men should report any breast enlargement, changes in urination, or priapism.,Avoid driving or operating machinery if you experience dizziness or drowsiness.,Do not use if you are pregnant or planning to become pregnant.
Take exactly as prescribed; may take 24-48 hours to produce a bowel movement.,For hepatic encephalopathy, maintain 2-3 soft stools daily; do not skip doses.,May cause bloating, gas, or cramping initially; usually resolves.,Do not take other laxatives without consulting your doctor.,Report severe diarrhea, vomiting, or muscle cramps to your healthcare provider.
No interactions on record
No interactions on record
Explore head-to-head clinical comparisons of other medications in the same therapeutic classes.
Common clinical questions about ANDROID 5 vs CEPHULAC, answered by our medical review team.
ANDROID 5 is a Androgen that works by Androgen receptor agonist; stimulates protein synthesis and growth of androgen-sensitive tissues.. CEPHULAC is a Laxative that works by Lactulose, a synthetic disaccharide, is not absorbed from the gastrointestinal tract. It is metabolized by colonic bacteria to form short-chain fatty acids (e.g., lactic, acetic, formic acids), which acidify the colonic contents. In hepatic encephalopathy, the acidic environment converts ammonia (NH3) to ammonium (NH4+), which is poorly absorbed and excreted in feces. Additionally, the osmotic effect of lactulose draws water into the colon, softening stools and increasing bowel movements.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between ANDROID 5 and CEPHULAC depend on the specific clinical indication. These are agents from distinct pharmacological classes and are not directly interchangeable by dose. A physician or clinical pharmacist should guide any therapeutic switching decisions.
The standard adult dose of ANDROID 5 is: 2.5-10 mg orally once daily in the morning for androgen replacement therapy in adult males.. The standard adult dose of CEPHULAC is: 30-45 m L (6.67-10 g lactulose) orally 3-4 times daily for constipation; for hepatic encephalopathy, 30-45 m L orally 3-4 times daily titrated to produce 2-3 soft stools per day, or 300 m L in 700 m L of water or saline as retention enema for 30-60 min every 4-6 hours.. Dosing should always be individualized based on indication, renal and hepatic function, age, and other patient factors.
No direct drug-drug interaction has been formally documented between ANDROID 5 and CEPHULAC in current clinical databases. However, individual patient risk factors including other medications, organ function, and comorbidities should always be evaluated by a qualified healthcare provider.
The maternal-fetal safety profiles differ. ANDROID 5 is classified as Category C. Pregnancy Category X. ANDROID 5 (oxandrolone) is contraindicated in pregnancy due to teratogenic effects including masculinization of female fetus, clitoral enlargement, and labial. CEPHULAC is classified as Category C. Lactulose (CEPHULAC) is not absorbed systemically; therefore, fetal exposure is negligible. Animal studies have not shown teratogenic effects. In clinical practice, no fetal risks . Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.