Chenodeoxycholic acid
Mechanism :
Chenodeoxycholic acid is a bile acid. Chenodeoxycholic acid is synthetized in the liver from cholesterol.
Indication :
- Cerebrotendinous xanthomatosis
- Bile acid synthesis defects
- Smith -Lemli- Opitz Syndrome
Contraindications :
Peptic ulcer and inflammatory disease of small intestine and large intestine.
Dosing :
Cerebrotendinous xanthomatosis:
5 mg/kg/dose TDS.
Bile acid synthesis defects:
Initially 5 mg/kg/dose TDS, then 2.5 mg/kg TDS.
Others:
7 mg/kg/dose in single or divided doses.
Adverse Effect :
Diarrhea.
Interaction :
Cholestyramine: Binds bile acids.
Aluminium hydroxide: May interfere with the absorption of chenodeoxycholic acid.
Oestrogenic Hormones, Oestrogen-rich OCPs and certain Blood Cholesterol Lowering Agents: Increase cholesterol elimination in bile, should not be used concurrently with chenodeoxycholic acid.
Cyclosporine: Increases absorption of cyclosporine.
Hepatic Dose :
Contraindicated for use in presence of known hepatocyte dysfunction or bile duct abnormalities.