Hepatic encephalopathy

Prescribing Notes:

• Lactulose is included for specialist recommendation in hepatic encephalopathy. Doses for hepatic encephalopathy are often higher than for constipation.
• Rifaximin recommended by specialist for prophylaxis of hepatic encephalopathy, should be continued by primary care in the absence of side effects, efficacy will be reviewed by specialist team. If there is no improvement in encephalopathy, then rifaximin will be stopped by the specialist hospital team. If there is an improvement in symptoms, then rifaximin supply from primary care should continue long term with ongoing review from specialist hospital team.