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Ursodex
A drug based on bile acid Ursodex belongs to the category of drugs that are prescribed for the treatment of liver diseases and biliary system.
Indications of the ursodex
It is possible to appoint Ursodex for the following therapeutic purposes:
- for softening of radiologically negative cholesteric bile stones, diameter no more than 1,5 cm (in patients with functional biliary system);
- for the therapy of inflammatory processes in the stomach with bile reflux;
- for the therapy of the primary form of biliary cirrhosis, provided there is no state of decompensation.
Release form
Ursodex is available in tablet form: the tablets are rounded, covered with a film of reddish color. On one of the surfaces of the Ursodex tablet there is a metering line.
The active ingredient is ursodeoxycholic acid.
Blister plate contains 10 pcs. Tablets. A cardboard box may contain one or five blister plates.
Pharmacodynamics
A small amount of the active ingredient Ursodex is normally contained in the bile secretion of a person. After the use of the drug Ursodex, the concentration in the bile of cholesterol decreases, the absorption of cholesterol in the small intestine decreases and its release into bile.
Apparently, with the distribution of cholesterol and the formation of liquid crystal structures, incomplete dissolution of cholesterol begins in the hepatobiliary system.
Given the latest edits of scientists, it is believed that the active ingredient Ursodex in diseases of the liver and bile duct system demonstrates the effect by the relative replacement of lipophilic toxic bile acids with hydrophilic nontoxic tertiary acid. Simultaneously, the producing property of liver cells improves, immunoregulatory processes are normalized.
Pharmacokinetics
After internal use, the active ingredient Ursodex is soon assimilated in the small intestine, in the upper segment of the ileum by passive transport and in the terminal segment of the ileum by active transport.
The absorption rate can usually be from 60 to 80%.
After completion of the assimilation process, bile acid undergoes almost absolute hepatic conjugation, with the participation of the amino acid complex taurine and glycine. After this, the acid is excreted with bile secretions.
The clearance rates for primary passage through the liver can be about 60%.
Contraindications
Do not prescribe Ursodex:
- with exacerbation of the inflammatory process in the bile excretory system;
- with obstruction of the bile ducts;
- in the process of carrying and feeding the child;
- in the presence of calcifications;
- with impaired contractility of the gallbladder;
- with regular attacks of biliary colic.
Side effects of the ursodex
Reception Ursodex in some cases can be accompanied by undesirable phenomena, for example:
- diarrhea, pain in the projection of the liver;
- formation of calcification in the biliary system;
- development of the stage of decompensation in the presence of cirrhosis;
- an allergic rash (according to the type of urticaria).
Dosing and administration
To soften cholesterol stones, take:
- weight less than 60 kg - three tablets of 150 mg;
- weight from 60 to 80 kg - from 4 to 5 tablets of 150 mg;
- weight from 80 to 100 kg - three tablets of 300 mg;
- weight more than 100 kg - from 3 to 4 tablets of 300 mg.
Ursodex should be taken once a day, at night. The duration of therapy can be ½-1 year. If after a year of receiving positive dynamics is not found, then Ursodex is canceled.
The quality of therapy is checked every six months of treatment, with the help of ultrasound or X-ray study. In addition, it is important to check the lack of calcification - otherwise the treatment is stopped.
- For the treatment of the inflammatory process in the stomach with bile reflux, one tablet of Ursodex is prescribed 300 mg daily for the night. Therapy in this case can last up to 2 weeks, which is decided in each case separately.
- To eliminate the symptoms of primary biliary cirrhosis, the dosage is determined taking into account the weight of the patient:
- weight from 47 to 62 kg - daily amount of Ursodex 12-16 mg / kg;
- weight from 63 to 78 kg - daily amount of Ursodex 13-16 mg / kg;
- weight from 79 to 93 kg - daily amount of Ursodex 13-16 mg / kg;
- weight from 94 to 109 kg - daily amount of Ursodex 14-16 mg / kg;
- weight from 110 kg - the daily amount of Ursodex is set individually.
During the first three months, Ursodex 300 mg is taken, dividing the daily amount by three times (in the morning, during the day and at night). When the working capacity of the liver improves, then you can switch to the reception schedule once a day at night.
At the beginning of treatment, patients can observe the aggravation of the clinical picture. If this happens, then the dosage is somewhat reduced, gradually increasing the daily amount of medication to the required according to the scheme.
Overdose
Most often, an overdose of Ursodex is accompanied by the appearance of diarrhea, although in general this phenomenon occurs only in a small number of patients. The fact is that large amounts of the drug are intensively removed from the feces, which in fact reduces to zero the likelihood of a toxic effect on the body.
If the patient has a diarrhea due to an overdose, then you need to reduce or stop taking Ursodex.
There is no need for any special measures in case of an overdose. In case of diarrhea, appropriate preparations are taken, paying attention to the stability of the water-electrolyte balance in the patient's body.
Interactions with other drugs
Do not use Ursodex in combination with medicines such as Cholestyramine, Cholestipol, antacids, which contain aluminum oxides or hydroxides. These drugs envelop the components of Ursodex in the intestinal cavity, which leads to a deterioration in absorption and a decrease in effectiveness. If you can not avoid such a combination, then you need to withstand 180 minutes between receiving the above funds.
Ursodex can increase the degree of absorption of cyclosporine. Therefore, in patients who are treated with cyclosporine, it is necessary to check the content of this drug in the blood, and, if necessary, adjust it.
In some patients, Ursodex can impair the absorption of ciprofloxacin.
The combination of Ursodex and drugs, metabolism of which takes place with the participation of cytochrome P450 3A4, should be observed and controlled (sometimes dosage adjustment may be required).