Recently, ursodeoxycholic acid has been increasingly used to treat various liver lesions. Instructions for use of this chemical compound indicate its effectiveness in many serious diseases. What is this substance? What is ursodeoxycholic acid used for? What products does it contain?
Description
Ursodeoxycholic acid, the use of which is based on its origin and properties, is a white-yellow crystalline powder. It has a bitter taste. This substance in a normally functioning human body is produced in small quantities. Its specific gravity is approximately 5% of the total mass of bile acids. It is hydrophilic and has no cytotoxicity. This chemical compound is soluble in alcohol and acetic glacial acid, slightly soluble in chloroform and practically insoluble in water. Ursodeoxycholic acid is not contained in the products. It was found in the gallbladder of a brown bear.
Ursodeoxycholic acid(UDCA) is an epimer of chenodeoxycholic acid. Initially, it began to be used for the treatment of reflux gastritis and the splitting of gallstones. Over time, it began to be used for many other diseases. UDCA is considered the safest bile acid.
The action of ursodeoxycholic acid
Today, the use of UDCA is the standard of care for various cholestatic liver diseases with an autoimmune component. The mechanism of action of this remedy is to stabilize the cells of this organ. Its molecules can be embedded in the membranes of liver cells - hepatocytes. Thanks to this, they are able to make them more resistant to aggressive factors. This hepatoprotective agent has a choleretic effect. UDCA reduces the synthesis of cholesterol in the liver and prevents its absorption in the intestine. This drug reduces the lithogenicity of bile and increases its acid content. It improves lipase activity, pancreatic and gastric secretion. Ursodeoxycholic acid also has a hypoglycemic effect, stimulates the formation and separation of bile, and lowers cholesterol levels in it.
This drug favors the partial or complete breakdown of cholesterol stones. That is why it is being used more and more. By combining with cholesterol, it increases the solubility of its crystals, which acts destructively on gallstones. UDCA has an immunomodulatory effect, which consists in increasing the activity of lymphocytes, reducesexpression of various antigens on hepatocyte membranes. It affects the number of T-lymphocytes, reduces the number of eosinophils.
UDKH reduces the concentration of cholesterol in bile by its dispersion and the transition of this substance into the liquid crystal phase. It affects the enterohepatic circulation of bile s alts. As a result, the reabsorption of endogenous hydrophobic and toxic compounds in the intestine decreases. This medicine has a direct hepatoprotective and choleretic effect. Ursodeoxycholic acid, which reviews from experts in the field of hepatology indicate its effectiveness, is able to reduce liver fibrosis in its fatty degeneration.
Application
Ursodeoxycholic acid, the use of which is carried out under the supervision of the attending physician, is prescribed for the following pathological conditions:
• the presence of cholesterol stones located in the gallbladder or common duct;
• impossibility of endoscopic or surgical treatment;
• chronic, atypical, acute and autoimmune hepatitis;
• presence of cholesterol stones after mechanical and extracorporeal lithotripsy;
• toxic (drug, alcohol) liver damage;
• sclerosing cholangitis;
• primary biliary cirrhosis without signs of decompensation;
• biliary atresia;
• cystic fibrosis;
• chronic active hepatitis;
• cholestasis with parenteral nutrition;
• dyskinesiabiliary tract;
• biliary dyspeptic syndrome with biliary dyskinesia and cholecystopathy;
• chronic opisthorchiasis;
• congenital atresia of bile ducts;
• biliary reflux esophagitis and reflux gastritis.
Ursodeoxycholic acid (UDCA) is also used to prevent liver damage caused by cytostatics and hormonal contraceptives. It is also prescribed for other diseases caused by stagnation of bile. UDCA is also prescribed for auxiliary treatment in liver or other organ transplantation.
Contraindications
Ursodeoxycholic acid, reviews of which are mostly positive, has serious contraindications. These include:
• inflammatory diseases of the gallbladder, intestines and bile ducts in the acute phase;
• X-ray high calcium gallstones;
• biliary obstruction;
• hypersensitivity;
• cirrhosis of the liver during decompensation;
• Crohn's disease;
• pronounced disorders in the functioning of the pancreas, liver and kidneys.
Use restrictions
Ursodeoxycholic acid, the instructions for use of which clearly indicate the absence of strict restrictions on its use, is not prescribed for babies under 3 years of age in the form of capsules. For their treatment, suspensions containing this medicinal substance are used. So far, there have been no relevant studies carried outaimed at determining the cholelitholytic effect of this substance, depending on the age of the child. At the same time, studies conducted on children with bile duct atresia and some liver diseases have not shown specific pediatric problems.
Preparations containing ursodeoxycholic acid are prescribed to pregnant women only when the expected effect of therapy with this drug outweighs the potential risk to the unborn child. At the same time, one should not forget that no one has conducted full-fledged scientific studies of the safety of this substance for this category of patients. Since it is not known for certain whether UDCA passes into breast milk, caution is required in prescribing this drug to lactating women.
Side effects
Ursodeoxycholic acid, the instructions for use of which indicate not only limitations in its use, but also possible side effects, can lead to such pathological phenomena as:
• constipation, diarrhea;
• nausea;
• increased transaminase activity;
• pain in the right hypochondrium and epigastric region;
• allergic skin reactions (itching, rash);
• calcination of stones.
Treatment of primary biliary cirrhosis with this drug sometimes results in the patient experiencing transient decompensation that disappears when the drug is stopped.
Precautions
For successful litholysischolesterol stones using UDCA, the following conditions must be considered:
• their size does not exceed 2 cm;
• they do not cast a shadow on the radiograph;
• gallbladder functions normally;
• ducts remain open;
• less than half full of stones;
• The common bile duct does not contain stones.
What other restrictions does ursodeoxycholic acid have? The instruction for this medication indicates that with prolonged treatment that exceeds 1 month, it is necessary to regularly (1 time in 30 days) monitor hepatic transaminases, phosphatase, bilirubin, blood gamma-glutamyltransferase. Conducting such tests is especially important in the initial 3 months of therapy using UDCA. The effectiveness of the treatment is confirmed every six months by x-ray and ultrasound examination of the bile ducts. To prevent attacks of recurrence of cholelithiasis, treatment is continued after complete dissolution of the stones. It can last many months.
Women of childbearing age are advised to use reliable methods of contraception during treatment with UDCA. These can be non-hormonal drugs or contraceptives with a small amount of estrogens.
Form of release and dosage
Ursodeoxycholic acid, the instructions for use of which gives a detailed description of the schemes for its administration, is available in the following dosage forms:
• 150 and 250 mg capsules and tablets;
• suspension for children.
Ursodeoxycholic acid dosageset strictly individually. It depends on the severity of the person's condition and his body weight. Most often, it is prescribed at 10-20 mg / kg per day. This dose is taken at one time, in the evening. The duration of therapy depends on the indications. This drug is absorbed in the small intestine, and after 3 hours its highest concentration is noted in the blood plasma. The constant intake of medications containing ursodeoxycholic acid makes it the main bile acid in the human body. This substance undergoes a number of transformations and is ultimately excreted as metabolites in feces and urine.
The duration of therapy is determined by the attending physician. It may vary depending on the type of disease. In some particularly severe cases, UDCA may last for years.
Interaction with other drugs
When taking UDKH and "Cyclosporine" together, the absorption of the latter increases unpredictably. At the same time, the concentration of these drugs in the blood plasma sharply increases. In rare cases, taking UDCA simultaneously with the drug "Ciprofloxacin" the concentration of the latter decreases.
Ursodeoxycholic acid (analogues)
Ursodeoxycholic acid (capsules, tablets) is available under different names. Such funds differ from each other by the auxiliary substances that make up their composition. So, on sale you can find the following drugs with ursodeoxycholic acid:
• Ursosan capsules prescribed fortherapy of diffuse liver diseases, cholelithiasis, biliary reflux gastritis and reflux esophagitis, primary cirrhosis, drug and toxic liver damage, cholecystectomy, alcohol disease, sclerosing cholangitis, biliary atresia, non-alcoholic steatohepatitis. Ursodeoxycholic acid (Ursosan) is also used to prevent liver damage.
• Tablets "Ukrliv", which are taken for liver failure, chronic hepatitis, cholelithiasis.
• Capsules "Ursofalk", prescribed for various diseases of the gallbladder and liver, accompanied by cholestasis, a decrease in some liver functions, and an increase in cholesterol levels. These include: primary biliary cirrhosis and sclerosing cholangitis, reflux gastritis and reflux esophagitis, hepatitis of various etiologies, cholesterol stones, cystic fibrosis, various liver lesions, bile stasis. This drug is used as a prophylactic against liver damage when taking strong drugs.
• Tablets "Ursodex", which are taken with biliary cirrhosis without signs of decompensation and reflux gastritis. They are used to dissolve small cholesterol stones during the normal functioning of the gallbladder.
• Ursodez capsules used for splitting cholesterol stones, treating reflux gastritis, for symptomatic treatment of primary liver cirrhosis without signs of decompensation.
• Capsules "Ursolizin", prescribed for the dissolution of cholesterol stones and symptomatic therapy of biliary cirrhosis, cholesterosis of the gallbladder and reflux gastritis. The drug is used in complex therapy for the treatment of patients with chronic hepatitis and liver cirrhosis.
• Choludexan capsules used to treat uncomplicated cholelithiasis, chronic active hepatitis, alcoholic and toxic liver damage, non-alcoholic steatohepatitis, primary biliary cirrhosis, primary sclerosing cholangitis, cystic fibrosis, biliary dyskinesia, reflux gastritis and reflux -esophagitis.
• Urdox capsules, which are prescribed for primary biliary cirrhosis without signs of decompensation, reflux gastritis. The drug dissolves small and medium cholesterol stones well while maintaining normal gallbladder function.
• Ursor C capsules prescribed for uncomplicated cholelithiasis, primary cirrhosis of the liver, acute and chronic hepatitis, sclerosing cholangitis, intrahepatic atresia, reflux gastritis and reflux esophagitis, cholestasis, parenteral nutrition, biliary dyskinesia, pathology of the liver, with cystic fibrosis, fatty hepatosis, dyspeptic syndrome. The drug is also used to prevent liver damage when using hormonal contraceptives and cytostatics, the formation of stones in obesity.
Ursodeoxycholic acid, analogues of this substance are taken only as directed by the attending physician.
