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Cholbam
Cholbam (cholic acid) is a bile acid replacement therapy used to treat bile acid synthesis disorders and peroxisomal disorders that cause liver disease in patients. These rare conditions lead to a deficiency of certain bile acids that are essential for fat digestion and absorption. Cholbam helps replace missing bile acids and improve liver function and fat absorption.
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Frequently Asked Questions
Can Cholbam be used in infants?
Yes, Cholbam is often used in pediatric patients, including infants, with bile acid synthesis disorders.
How long do I need to take Cholbam?
Cholbam is typically taken long-term, as it treats chronic bile acid deficiencies that require ongoing therapy.
Can I take Cholbam with other medications?
Cholbam may interact with bile acid sequestrants and other medications that affect bile acid metabolism. Discuss all medications with your healthcare provider.
Are there any dietary restrictions while taking Cholbam?
Cholbam should be taken with food, and patients may need to supplement with fat-soluble vitamins (A, D, E, K) due to impaired fat absorption.
What should I do if I experience diarrhea while taking Cholbam?
Contact your healthcare provider if diarrhea becomes severe or persistent, as the dose may need to be adjusted.
Comprehensive Drug Guide
How Does Cholbam Work?
Cholbam works by replacing cholic acid, a naturally occurring bile acid, in patients with bile acid synthesis disorders. This helps to improve digestion and absorption of fats and fat-soluble vitamins, while also reducing the buildup of toxic metabolites in the liver.
Common Dosages
- 50 mg and 250 mg oral capsules.
Typical Dosing
- The typical dose of Cholbam varies based on body weight. For pediatric patients and adults, the usual dose is 10 to 15 mg/kg/day, divided into two doses, and adjusted based on clinical response and tolerability.
Typical Dosing
FDA Approved Indications
- Bile acid synthesis disorders caused by single enzyme defects.
- Peroxisomal disorders (including Zellweger spectrum disorders) that cause impaired liver function and fat malabsorption.
Who Shouldn't Take Cholbam?
- Complete biliary obstruction.
- Known hypersensitivity to cholic acid or any component of the formulation.
Advice From The Pharmacist
- Cholbam should be taken with food to improve absorption and efficacy.
- Patients require regular monitoring of liver function tests while on Cholbam therapy to prevent potential liver toxicity.
- Ensure adequate intake of fat-soluble vitamins (A, D, E, K), as fat absorption is often impaired in patients with bile acid disorders.
Side Effects of Cholbam
Common Side Effects
- Diarrhea
- Abdominal pain
- Increased liver enzymes
Uncommon/Severe Side Effects
- Liver dysfunction
- Cholestasis (blockage of bile flow)
- Jaundice
Risks and Warnings of Cholbam
- Liver toxicity: Cholbam can cause elevations in liver enzymes and liver dysfunction. Regular liver function tests are necessary during treatment.
- Diarrhea: Cholbam can cause diarrhea, particularly at higher doses, and dose adjustments may be necessary.
Interactions with Cholbam
Common Drug Interactions
- Bile acid sequestrants (e.g., cholestyramine) may interfere with the absorption of Cholbam and reduce its efficacy.
- Cyclosporine: May increase the levels of Cholbam in the blood, leading to a higher risk of side effects.
Alternatives to Cholbam
- Ursodiol (Actigall): Another bile acid used to treat bile acid synthesis disorders and dissolve gallstones.
- Chenodiol (Chenodal): Used to treat gallstones and other bile acid-related conditions.
