Re: [AF] ácido ursodeoxicólico

[Amparo Valls Lattur]

URSODEOXYCHOLIC ACID

uses: anecdota use as additive therapy to cholesterol in smith-lemli-orpitz syndrome (in combination with chenodeoxycholic acid).  In cystic fibrosis related liver disease, including cholestasis in infants, to improve bile flow.  Biliary atresia in infants.  Inborn errors of bile acid synthesis.  Paediatric liver disease.

Presentatin: tablets 150mg, capsules 250mg, powder: may be extemporaneous prepared.  Suspension 250mg in 5ml(ursofalk).

Dosage: oral: 5-10mg/kg two-three times daily, masimum total daily dose of 45mg/kg/day.  (ages from birth to 18 years).

oral for cystic fibrosis patients: birth-1month: -----, 1month to 18 years: 10mg/kg twice a day(to improve bile flow in cystic fibrosis patients with liver impairment.  total daily dose may be given in three divided doses.

Administration: oral: the last dose of the day should be taken in the late evening to counteract the rise in biliary cholesterol saturation, which occurs in the early hours of the morning.  Take with food: this is especially useful with the late evening dose as it helps to maintain bile flow overnight.  Starting at a lower dose initially, increasing to the final dose over about 2 weeks can help to prevent initial problems with abdominal discomfort, which may occur.

Contraindications and warnings: active gastric or duodeal ulcers.

Interactions: avoid drugs hwick bind bile acids such as cholestyramine, and certain antacids ex aluminium huydroxide which may interfere with the absorption of ursodeoxycholic acid.  Drugs whick increase cholesterol eliminatin in bile; such as oestrogenic hormones, oestrogen-rich oral contraceptives and certain blood cholesterol lowering agents should not be used concurrently with ursodeoxycholic acid.  Increases absorption of ciclosporin.

Side-effects: diarrhoea has occurred occasionally.


Reference: Medicines for children, Royal college of paediatrics and child health.  RCPCH.  Neonatal and paediatric pharmacists group.

 

 

 

Espero que sea de ayuda.

 

Amparo Valls

Clinial pharmacist

Maidstone hospital