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Chenodal
Chenodal (chenodiol) is a bile acid used to dissolve gallstones in patients who are unable or unwilling to undergo surgery. It is also used to treat certain patients with cerebrotendinous xanthomatosis (CTX), a rare genetic condition affecting bile acid synthesis. Chenodal works by reducing the production of cholesterol in the liver and dissolving cholesterol in bile, which helps to dissolve gallstones.
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Frequently Asked Questions
How long does it take for Chenodal to dissolve gallstones?
Gallstone dissolution can take anywhere from 6 to 24 months, depending on the size and composition of the stones.
Can I take Chenodal if I am pregnant?
No, Chenodal should not be taken during pregnancy due to the risk of harm to the fetus.
What should I do if I miss a dose of Chenodal?
Take the missed dose as soon as you remember, but if it’s close to your next dose, skip the missed dose and continue with your regular dosing schedule.
Does Chenodal completely dissolve all gallstones?
Not always. Chenodal is most effective for cholesterol-based gallstones but may not dissolve calcified stones or other types.
Are there dietary restrictions while taking Chenodal?
Yes, it is recommended to avoid high-fat and high-cholesterol foods to help improve the medication's efficacy in dissolving gallstones.
Comprehensive Drug Guide
How Does Chenodal Work?
Chenodal works by suppressing cholesterol synthesis in the liver, which in turn reduces the cholesterol content in bile. This reduction helps dissolve cholesterol-based gallstones and is beneficial in patients with bile acid disorders like cerebrotendinous xanthomatosis.
Common Dosages
- 250 mg tablets.
Typical Dosing
- For gallstone dissolution: The typical starting dose is 13-16 mg/kg/day, divided into two doses. The treatment may last 6 to 24 months.
- For CTX: Dosing is individualized based on disease severity and patient weight, and it requires close monitoring.
Typical Dosing
FDA Approved Indications
- Dissolving radiolucent cholesterol gallstones in patients who require nonsurgical treatment.
- Cerebrotendinous xanthomatosis (CTX), a rare bile acid synthesis disorder.
Who Shouldn't Take Chenodal?
- Chronic liver disease or biliary obstruction.
- Pregnancy, as it may cause fetal harm.
- Known hypersensitivity to chenodiol or any components of the formulation.
Advice From The Pharmacist
- Chenodal requires regular liver function tests during treatment, as it can cause liver toxicity.
- Patients should avoid foods high in cholesterol and fats to improve the effectiveness of gallstone dissolution.
- Gallstones may not dissolve completely with Chenodal, and gallstone recurrence is possible after stopping treatment.
Side Effects of Chenodal
Common Side Effects
- Diarrhea
- Stomach pain
- Elevated liver enzymes
Uncommon/Severe Side Effects
- Liver toxicity
- Severe diarrhea
- Jaundice
Risks and Warnings of Chenodal
- Liver toxicity: Chenodal can cause elevations in liver enzymes and lead to liver damage. Regular liver function monitoring is required.
- Gallstone recurrence: Gallstones may recur after discontinuation of the drug, and complete dissolution is not guaranteed.
Interactions with Chenodal
Common Drug Interactions
- Cholestyramine or other bile acid sequestrants may reduce the effectiveness of Chenodal by preventing its absorption.
- Statins: Combining Chenodal with cholesterol-lowering medications may enhance its effects on gallstone dissolution.
Alternatives to Chenodal
- Ursodiol (Actigall): Another bile acid used to dissolve gallstones and treat bile acid disorders.
- Surgical removal of gallstones: Cholecystectomy is often the preferred treatment for symptomatic gallstones.
