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(Chenodeoxycholic acid)

Chenodiol (Chenix)
Chenodeoxycholic acid (Chenix)
(kee-noh- DYE-ohl)
Pregnancy Category: X Chenix (Rx)

Classification: Naturally occurring human bile acid

Action/Kinetics: By reducing hepatic synthesis of cholesterol and cholic acid, replaces both cholic and deoxycholic acids in the bile acid pool. This helps desaturation of biliary cholesterol and leads to dissolution of radiolucent cholesterol gallstones. Is ineffective on calcified gallstones or on radiolucent bile pigment stones. Fifty percent of clients have stone recurrence within 5 years. Also increases LDLs and inhibits absorption of fluid from the colon. Well absorbed following PO administration. Metabolized by bacteria in the colon to lithocholic acid, most of which is excreted in the feces.

Uses: In radiolucent cholesterol gallstones where surgery is a risk due to age or systemic disease. Ineffective in some. Best results in thin females with a serum cholesterol not higher than 227 mg/dL and who have a small number of radiolucent cholesterol gallstones.

Contraindications: Known hepatic dysfunction or bile ductal abnormalities. Colon cancer. Pregnancy or in those who may become pregnant.

Special Concerns: Safety and efficacy in lactation and in children have not been established.

Side Effects: Hepatotoxicity including increased ALT in one-third of clients, intrahepatic cholestasis. GI: Diarrhea (common), anorexia, constipation, dyspepsia, flatulence, heartburn, cramps, epigastric distress, N&V, abdominal pain. Hematologic: Decreased white cell count. Chenodiol may contribute to colon cancer in susceptible clients.

Drug Interactions: Antacids, aluminum / Chenodiol effect due to GI tract absorption Cholestyramine / See Antacids Clofibrate / Chenodiol effect due to biliary cholesterol secretion Colestipol / See Antacids Estrogens, oral contraceptives / Chenodiol effect due to biliary cholesterol secretion

How Supplied: Tablet: 250 mg

?Tablets Radiolucent cholesterol gallstones.
Adults, initial: 250 mg b.i.d. for 2 weeks; then, increase by 250 mg/week until maximum tolerated or recommended dose is reached (13-16 mg/kg/day in two divided doses morning and night with milk or food). NOTE: Doses less than 10 mg/kg are usually ineffective and may result in increased risk of cholecystectomy.

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