Livedoksa - instructions, reviews, analogs
In this article, you can read the instructions for using the drug Llewedx. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors specialists on the use of Livebowx in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Livevox in the presence of existing structural analogues. Use for the treatment of cirrhosis, hepatitis, biliary dyskinesia in adults, children, as well as during pregnancy and lactation. Composition of the preparation.
Llewedx hepatoprotector.It also has choleretic, cholelitholytic, hypolipidemic, hypocholesterolemic and immunomodulating effects. Stabilizes membranes of hepatocytes and cholangiocytes, has a direct cytoprotective effect. As a result of the drug on the gastrointestinal circulation of bile acids, the content of hydrophobic (potentially toxic) acids decreases. By reducing the absorption of cholesterol in the intestine and other biochemical effects has a hypocholesterolemic effect. Suppresses cell death due to toxic bile acids.
Possessing high polar properties, ursodeoxycholic acid forms non-toxic mixed micelles with apolar (toxic) bile acids, which reduces the ability of gastric reflux to damage cell membranes with biliary reflux gastritis and reflux esophagitis. In addition, ursodeoxycholic acid forms double molecules that can be incorporated into cell membranes, stabilize them and render them immune to the action of cytotoxic micelles. Reduces the saturation of bile with cholesterol due to the inhibition of its absorption in the intestine,suppression of synthesis in the liver and a decrease in secretion in bile; increases the solubility of cholesterol in bile, forming with it liquid crystals; reduces the lithogenic bile index. The result is the dissolution of cholesterol gallstones (a consequence of the change in the ratio of cholesterol / bile acids to bile) and the prevention of the formation of new concrements (the result of a decrease in the content of bile cholesterol). It induces choleresis, rich in bicarbonates, which leads to an increase in bile passage and stimulates the excretion of toxic bile acids through the intestine.
The immunomodulatory effect is due to inhibition of the expression of HLA antigens (HLA - human leucocyte antigens) on the membranes of hepatocytes and cholangiocytes, normalization of the natural killer activity of lymphocytes. Reliably restrains the progression of fibrosis in patients with primary biliary cirrhosis, cystic fibrosis and alcoholic steatohepatitis, reduces the risk of developing varicose veins of the esophagus.
Composition
Ursodeoxycholic acid + auxiliary substances.
Pharmacokinetics
Ursodeoxycholic acid is absorbed from the jejunum by passive diffusion, and from the ileum through active transport.The distribution of ursodeoxycholic acid characterizes a high degree of binding to plasma proteins, which can be 96-99%. Penetrates through the placental barrier. As a result of presystemic elimination of ursodeoxycholic acid, Taurine and Glycine conjugates are formed, which are secreted into bile. About 50-70% of the entire administered dose of ursodeoxycholic acid is excreted with bile. The rest of the unsweetened fraction of ursodeoxycholic acid enters the large intestine, where it undergoes bacterial cleavage (7-dehydroxylation) to form lithocholic acid. Litocholic acid is partially absorbed from the intestine, biotransformed in the liver into sulfolithocholylglycine and sulfolitocholyltaurine conjugates and is excreted.
Indications
- primary biliary cirrhosis in the absence of signs of decompensation (symptomatic therapy);
- Dissolution of small and medium cholesterol stones with a functioning gallbladder;
- biliary reflux gastritis and reflux esophagitis;
- chronic hepatitis of various genesis;
- alcoholic liver disease;
- non-alcoholic steatohepatitis;
- primary sclerosing cholangitis;
- cystic fibrosis (cystic fibrosis);
- dyskinesia of bile ducts.
Forms of release
Tablets coated with 150 mg and 300 mg.
Instructions for use and dosing regimen
Tablets are taken orally, without chewing, with enough water. A tablet can be divided in half.
To dissolve cholesterol gallstones, the average daily dose of Livedovox is 10 mg / kg (up to 12-15 mg / kg). The drug is taken in the evening, before going to bed. The course of treatment is 6-12 months.
For the prevention of repeated formation of stones, it is recommended to take the drug for several months after the dissolution of the stones.
Symptomatic therapy of primary biliary cirrhosis: the average daily dose is 10-15 mg / kg (up to 20 mg / kg, if necessary) from 6 months to several years. The drug is taken with food, squeezed with enough liquid.
With biliary reflux gastritis and reflux esophagitis, the dose is 10 mg / kg per day - 1 time per day before bedtime. The course of treatment - from 10-14 days to 6 months, if necessary - up to 2 years.
In chronic hepatitis of various genesis (toxic, medicinal, etc.), primary non-alcoholic steatohepatitis, alcoholic liver disease, the average daily dose is 10-15 mg / kg body weight in 2-3 doses. The duration of therapy is 6-12 months or more.
In primary sclerosing cholangitis, cystic fibrosis (cystic fibrosis), the average daily dose is 12-15 mg / kg (if necessary - up to 20-30 mg / kg per day) in 2-3 divided doses. The duration of therapy is from 6 months to several years.
With dyskinesia of bile ducts, the average daily dose is 10 mg / kg in 2 divided doses for 2 weeks to 2 months. If necessary, the course of treatment is recommended to be repeated.
Children over 3 years of ursodeoxycholic acid are prescribed individually, at a rate of 10-20 mg / kg per day.
Side effect
- calcification of gallstones;
- increased activity of hepatic transaminases;
- diarrhea;
- nausea;
- abdominal pain;
- in the treatment of primary biliary cirrhosis, transient decompensation of liver cirrhosis that occurs after the drug cancellation can be observed.
Contraindications
- X-ray positive (high in calcium) gallstones;
- non-functioning gallbladder;
- acute inflammatory diseases of the gallbladder, bile ducts and intestines;
- cirrhosis of the liver in the stage of decompensation;
- marked violations of the kidneys, liver, pancreas;
- lactose intolerance, lactase deficiency or malabsorption of glucose-galactose;
- children under 3 years;
- increased individual sensitivity to the components of the drug.
Application in pregnancy and lactation
The use of Livevox during pregnancy is possible only if the expected benefit for the mother exceeds the potential risk for the fetus (adequate strictly controlled studies of the use of ursodeoxycholic acid in pregnant women have not been performed).
Data on the isolation of ursodeoxycholic acid with breast milk are currently not available. If it is necessary to use ursodeoxycholic acid during lactation, the question of stopping breastfeeding should be solved.
Use in children
Contraindicated in children under 3 years.
With caution should be used in children aged 3 to 4 years, t. it may be difficult to swallow tablets, although ursodeoxycholic acid has no age limitation in use.
special instructions
To successfully dissolve it is necessary that the stones are pure cholesterol, not more than 15-20 mm in size, the gallbladder is filled with stones no more than half and the bile ducts fully retained their function.
In the appointment with the purpose of dissolution of gallstones, it is necessary to control the activity of hepatic transaminases and alkaline phosphatase, GGT, bilirubin concentration. If the increased indices remain, the drug should be discontinued.
Cholecystography should be performed every 4 weeks in the first 3 months of treatment, then every 3 months. Control of the effectiveness of treatment should be performed every 6 months during ultrasound during the first year of therapy. After complete dissolution of the calculus, it is recommended to continue use for at least 3 months in order to facilitate the dissolution of stone residues, the sizes of which are too small for their detection.
If within 6-12 months after the beginning of therapy of partial dissolution of concrements did not occur, it is unlikely that the treatment will be effective.
Detection during treatment of a nonvisualizable gallbladder is evidence that no complete dissolution of the calculi has occurred, and treatment should be discontinued.
When calcification of gallstones, violation of the contractility of the gallbladder or frequent attacks of biliary colic, treatment should be discontinued.
Impact on the ability to drive vehicles and manage mechanisms
There is no evidence of the influence of ursodeoxycholic acid on the ability to drive vehicles and work with mechanisms.
Drug Interactions
Do not use the drug simultaneously with antacids containing aluminum and ion-exchange resins, as these drugs can interfere with the absorption of Livevox.
With simultaneous use, lipid-lowering drugs, estrogens, neomycin or gestagens (oral contraceptives) increase bile saturation with cholesterol and may reduce the ability of ursodeoxycholic acid to dissolve cholesterol bile stones.
Ursodeoxycholic acid can increase the absorption of cyclosporine from the intestine, which requires monitoring the concentration of cyclosporine in the blood, and, if necessary, correcting its dosage regimen.
Analogues of Livedovx drug
Structural analogs for the active substance:
- Grinterol;
- Urdoks;
- Urso 100;
- Ursodez;
- Ursodeoxycholic acid;
- Ursodex;
- Ursuliv;
- Ursolit;
- Ursoprim;
- Ursoron Rompharm;
- Ursosan;
- Ursofalk;
- Holudexan;
- Exxhol.
Analogues for the pharmacological group (hepatoprotectors):
- Alpha lipoic acid;
- Antraliv;
- Berlition;
- Bondjigar;
- Brentzialle forte;
- HepaMerz;
- Gepabene;
- Hepatosan;
- Hepafor;
- Heptor;
- Heptral;
- Glutargin;
- Dipan;
- Covechol;
- Karsil;
- Laennek;
- Legalon;
- Liv.52;
- Liventziale;
- Lipoic acid;
- Methionine;
- Octolipen;
- Progepar;
- Resalute Pro;
- Remaxol;
- Silibinin;
- Sylimar;
- Silymarin;
- Thioctic acid;
- Ursosan;
- Phosphogliv;
- Phosphogliv Forte;
- Phosphontsiale;
- Hepabos;
- Holudexan;
- Erbisol;
- Eslidine;
- Essentiale N;
- Essentiale forte N;
- Essential phospholipids;
- The Essler;
- Essliver forte.