Head-to-head clinical analysis & difference comparison: details on mechanism of action, dosing, half-life, interactions, and maternal-fetal safety.
CHOLAC vs ANDROID 5
Clinician-reviewed, head-to-head comparison of mechanism, dosing, pharmacokinetics, and safety profiles.
Last clinically reviewed: July 2026 · OpiCalc Medical Review Team
Lactulose is a synthetic disaccharide that is not absorbed in the small intestine. It is metabolized by colonic bacteria to short-chain fatty acids, primarily lactic acid and acetic acid, which lower the colonic p H. This acidification traps ammonia (NH3) as ammonium (NH4+) in the gut lumen, reducing serum ammonia levels. Additionally, the osmotic effect of lactulose draws water into the colon, producing a laxative effect.
Androgen receptor agonist; stimulates protein synthesis and growth of androgen-sensitive tissues.
Treatment of hepatic encephalopathy (portal-systemic encephalopathy) in patients with acute and chronic liver disease,Constipation (including chronic idiopathic constipation)
Testosterone replacement therapy for male hypogonadism,Off-label: delayed puberty in males
15-30 m L (10-20 g lactulose) orally once daily, titrated to produce 2-3 soft stools per day; maximum dose 60 m L/day. For hepatic encephalopathy: 30-45 m L (20-30 g) orally 3-4 times daily, titrated to 2-3 soft stools per day.
2.5-10 mg orally once daily in the morning for androgen replacement therapy in adult males.
0.5-1.5 hours for lactulose; active metabolites (e.g., acetic acid) have negligible systemic half-life due to rapid local metabolism.
Terminal elimination half-life is 3.5–5.5 hours; clinical effects may persist for several days due to active metabolites.
Not absorbed systemically. Metabolized by colonic bacteria (e.g., Lactobacillus, Bacteroides) to lactic acid, acetic acid, and other short-chain fatty acids.
Hepatic via CYP3A4 and CYP2B6; undergoes first-pass metabolism.
Primarily fecal (biliary excretion of unchanged drug and metabolites); minimal renal excretion (<5%).
Primarily renal: ~90% as glucuronide and sulfate conjugates, 6% as unchanged drug; ~5% fecal via bile.
Negligible (<1%); not significantly bound to plasma proteins.
98% bound to sex hormone-binding globulin (SHBG) and albumin.
Approximately 0.2 L/kg; indicates distribution primarily in extracellular fluid.
Vd approximately 1.0 L/kg; indicates extensive tissue distribution, especially to reproductive organs and bone marrow.
Oral: <2% systemic bioavailability due to extensive first-pass metabolism and local gut action; rectal: minimal systemic absorption.
Oral: 15–25% due to first-pass metabolism; buccal or transdermal: higher, but not commercially available for this formulation.
No dose adjustment required for renal impairment.
No specific dose adjustment required based on GFR; caution in severe impairment (Cr Cl <30 m L/min) due to potential fluid retention.
No specific Child-Pugh based adjustments. Use with caution in severe hepatic impairment due to risk of electrolyte disturbances; monitor serum electrolytes.
Contraindicated in Child-Pugh class B and C cirrhosis due to hepatotoxicity risk; in class A, use with caution and monitor liver function.
Infants: 2.5-10 m L/day in divided doses. Children: 40-90 mg/kg/day (as lactulose) divided 1-2 times daily, titrated to produce soft stools. For hepatic encephalopathy: 2.5-10 m L (1.7-6.7 g) orally 3-4 times daily, titrated to 2-3 soft stools per day.
Not recommended for use in children as it may cause premature epiphyseal closure and virilization; limited data.
Initiate at lower end of dosing range (15 m L once daily) and titrate slowly to avoid diarrhea and electrolyte imbalance; monitor renal function and electrolytes.
Increased risk of prostatic hyperplasia and carcinoma; use lowest effective dose with regular prostate monitoring.
No FDA black box warning.
Warning: Prolonged use may cause virilization in women, premature epiphyseal closure, and increased risk of prostatic hypertrophy/carcinoma.
Electrolyte disturbances (e.g., hypernatremia) may occur, especially with prolonged use or in patients with renal impairment,Diarrhea can lead to fluid and electrolyte loss; dosage should be adjusted to produce 2-3 soft stools per day,Galactose content: lactulose contains galactose and lactose; use with caution in patients with galactose intolerance, Lapp lactase deficiency, or glucose-galactose malabsorption,Risk of colonic perforation in patients with severe colonic ulceration, toxic megacolon, or gastrointestinal obstruction
Monitor liver function, lipid profile, and prostate-specific antigen; risk of edema in patients with cardiac disease; avoid use in patients with sleep apnea.
Patients with galactosemia (due to galactose content),Gastrointestinal obstruction (including ileus),Hypersensitivity to lactulose or any component of the formulation
Known or suspected prostate cancer; breast cancer in males; hypersensitivity to androgens; pregnancy and lactation.
No specific food restrictions. Mixing with fruit juice, water, or milk may improve taste. Avoid excessive intake of dairy products if lactose intolerant (lactulose may contain small amounts of lactose).
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.
Lactulose is not absorbed systemically; no teratogenic effects reported in animal studies or human case reports. FDA Pregnancy Category B. Trimester-specific risks: no known fetal harm in any trimester.
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.
Excretion into breast milk is negligible due to minimal systemic absorption. M/P ratio not determined. Considered compatible with breastfeeding.
Excretion into human milk is unknown. Due to potential for androgenic effects in nursing infants, breastfeeding is not recommended. No M/P ratio available.
No dose adjustment required during pregnancy; pharmacokinetics unchanged due to localized GI action.
Not applicable; contraindicated in pregnancy. No dose adjustment recommendations exist for pregnant patients.
Cholac (lactulose) is used for constipation and hepatic encephalopathy. Monitor for diarrhea and electrolyte imbalances. In hepatic encephalopathy, titrate dose to achieve 2-3 soft stools per day. Syrup can be mixed with fruit juice or water to improve palatability. Onset of action is 24-48 hours for constipation; for encephalopathy, effects may take several days.
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.
Take exactly as prescribed. Do not change dose without consulting your doctor.,For constipation, effects may take up to 48 hours. Do not use other laxatives unless advised.,For liver disease, it helps reduce ammonia levels. Aim for 2-3 soft bowel movements daily.,May cause gas, bloating, or stomach cramps, which usually decrease over time.,Contact doctor if you have severe diarrhea, vomiting, or signs of dehydration.,Store at room temperature, away from heat and direct light.
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.
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 CHOLAC vs ANDROID 5, answered by our medical review team.
CHOLAC is a Laxative that works by Lactulose is a synthetic disaccharide that is not absorbed in the small intestine. It is metabolized by colonic bacteria to short-chain fatty acids, primarily lactic acid and acetic acid, which lower the colonic p H. This acidification traps ammonia (NH3) as ammonium (NH4+) in the gut lumen, reducing serum ammonia levels. Additionally, the osmotic effect of lactulose draws water into the colon, producing a laxative effect.. ANDROID 5 is a Androgen that works by Androgen receptor agonist; stimulates protein synthesis and growth of androgen-sensitive tissues.. They differ in pharmacokinetic profiles, FDA-approved indications, and side effect profiles.
Potency comparisons between CHOLAC and ANDROID 5 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 CHOLAC is: 15-30 m L (10-20 g lactulose) orally once daily, titrated to produce 2-3 soft stools per day; maximum dose 60 m L/day. For hepatic encephalopathy: 30-45 m L (20-30 g) orally 3-4 times daily, titrated to 2-3 soft stools per day.. 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.. 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 CHOLAC and ANDROID 5 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. CHOLAC is classified as Category C. Lactulose is not absorbed systemically; no teratogenic effects reported in animal studies or human case reports. FDA Pregnancy Category B. Trimester-specific risks: no known fetal . 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. Always consult a maternal-fetal medicine specialist before taking either drug during pregnancy or lactation.