Ursodez - instructions for use, reviews, analogs and formulations (capsules or tablets 250 mg and 500 mg) of hepatoprotector medication for the treatment of liver, hepatitis, dyskinesia and fatty degeneration in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Ursodez. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Ursodez 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 ursodez in the presence of existing structural analogues.Use for the treatment of cirrhosis of liver, hepatitis, dyskinesias and gallstones in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Ursodez hepatoprotector. Has choleretic effect. Reduces the synthesis of cholesterol in the liver, its absorption in the intestine and concentration in the bile, increases the solubility of cholesterol in the bile excretory system, stimulates the formation and excretion of bile. Reduces the lithogenicity of bile, increases the content of bile acids. Causes an increase in gastric and pancreatic secretion, increases the activity of lipase. Has hypoglycemic effect.

Causes partial or complete dissolution of cholesterol stones when ingested, reduces the saturation of bile with cholesterol, which promotes the mobilization of cholesterol from gallstones.

It has an immunomodulatory effect, affects immunological reactions in the liver: reduces the expression of certain antigens on the hepatocyte membrane, affects the number of T-lymphocytes, the formation of interleukin-2, reduces the number of eosinophils.

Composition

Ursodeoxycholic acid + auxiliary substances.

Pharmacokinetics

Ursodez is absorbed from the small intestine due to passive diffusion (about 90%), and from the ileum through active transport. Binding to plasma proteins is high - up to 96-99%. Penetrates through the placental barrier. With a systematic intake of ursodeoxycholic acid becomes the main bile acid in the blood serum (48% of the total amount of bile acids). The therapeutic effect of the drug depends on the concentration of ursodeoxycholic acid in the bile. Metabolized in the liver (clearance at the "first passage" through the liver) with the formation of Taurine and Glycine conjugates. The resulting conjugates are secreted into bile. About 50-70% of the total dose of the drug is excreted by bile. A small amount of unsweetened ursodeoxycholic acid enters the large intestine, where it undergoes cleavage by bacteria (7-dehydroxylation); the resulting lithocholic acid is partially absorbed from the colon but is sulfated in the liver and is rapidly excreted as a sulfolithocholylglycine or sulfolithocholyltaurine conjugate.

Indications

• Dissolution of small and medium cholesterol stones with a functioning gallbladder;
• biliary reflux-gastritis;
• primary biliary cirrhosis in the absence of signs of decompensation (symptomatic treatment);
• chronic hepatitis of various genesis;
• primary sclerosing cholangitis;
• cystic fibrosis (cystic fibrosis);
• nonalcoholic steatohepatitis (fatty liver disease);
• alcoholic liver disease;
• biliary dyskinesia.

Forms of release

Capsules 250 mg and 500 mg (sometimes mistakenly called pills).

Instructions for use and reception scheme

The drug is taken orally.

Dissolution of cholesteric gallstones

The recommended (approximate) dose is 10 mg ursodeoxycholic acid per 1 kg of body weight per day. The drug should be taken daily in the evening, before going to bed (capsules are not chewed), squeezed with a small amount of liquid.

To dissolve gallstones, it usually takes 6-24 months. If after 12 months of treatment the size of the stones does not decrease, then the treatment should be stopped.

The effectiveness of treatment should be evaluated every 6 months with ultrasound or radiography. During the interim survey, it should be assessed whether stone calcification has occurred during the past period. In the case of calcification of stones, treatment should be discontinued.

For the prevention of repeated cholelithiasis, the use of the drug is recommended for several months after the dissolution of the stones.

Treatment of biliary reflux gastritis

The recommended dose is 1 capsule (250 mg) of the drug Ursodez daily in the evening before bedtime. Capsules should be washed down with a small amount of water.

The course of treatment - from 10-14 days to 6 months, if necessary - up to 2 years.

Symptomatic treatment of primary biliary cirrhosis

The daily dose depends on the body weight and is from 1 to 3 capsules (500 mg) or from 2 to 6 capsules (250 mg) (about 10 to 15 mg ursodeoxycholic acid per 1 kg of body weight) in 2-3 doses, the first 3 month of treatment. After improving the functional parameters of the liver, the daily dose can be applied 1 time in the evening. The duration of the course of treatment is not limited. In rare cases, clinical symptoms may worsen at the beginning of treatment (itching may occur). In this case, you should reduce the daily dose (up to 250 mg), and then gradually increase it (weekly increasing the daily dose) until the recommended dosing regimen is reached.

Chronic hepatitis of various genesis, non-alcoholic steatohepatitis and alcoholic liver disease

The average daily dose is from 10 to 15 mg ursodeoxycholic acid per 1 kg of body weight in 2-3 divided doses. The duration of therapy is 6-12 months or more.

Primary sclerosing cholangitis, cystic fibrosis (cystic fibrosis)

With the primary sclerosing cholangitis: 12-15 mg / kg per day (up to 20 mg / kg per day) in 2-3 divided doses. Duration of use - from 6 months to several years.

For cystic fibrosis (cystic fibrosis): 20-30 mg / kg per day in 2-3 divided doses. Duration of use - from 6 months to several years.

Biliary dyskinesia

The average daily dose is 10 mg ursodeoxycholic acid per 1 kg of body weight in 2 divided doses for 2 weeks to 2 months. If necessary, the course of treatment should be repeated. Dosage regimen is set by the doctor.

For children from 3 years - individually (at the rate of 10-20 mg / kg per day).

Side effect

• diarrhea;
• nausea;
• pain in the epigastric region and right hypochondrium;
• calcification of gallstones;
• increased activity of hepatic transaminases;
• In the treatment of primary biliary cirrhosis, transient decompensation of liver cirrhosis can occur, which disappears after drug withdrawal;
• allergic reactions.

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;
• severe renal dysfunction;
• severe liver dysfunction;
• pronounced impairment of pancreatic function;
• adults and children weighing up to 34 kg;
• Children under 3 years old (for this dosage form);
• hypersensitivity to the components of the drug.

Application in pregnancy and lactation

The drug Ursodez is contraindicated in pregnancy and lactation (breastfeeding).

Use in children

The use of the drug in the form of capsules is contraindicated in children under 3 years of age.

The drug is not prescribed for children weighing up to 34 kg.

special instructions

The use of Ursodez should be carried out under the supervision of a doctor.

During the first 3 months of treatment, liver function tests (transaminases, amphoteric and GGT) in the blood serum should be monitored every 4 weeks, and then every 3 months.Control of these parameters allows us to identify violations of liver function in the early stages. This also applies to patients in the late stages of primary biliary cirrhosis. In addition, it is possible to quickly determine if the patient is responding to primary biliary cirrhosis for ongoing treatment.

Application for the dissolution of cholesteric gallstones

In order to assess the progress in treatment, as well as to detect signs of calcification of stones in a timely manner, the gallbladder should be visualized (oral cholecystography) with examination of blackouts in standing and lying on the back (US) 6-10 months after the start of treatment. If the gallbladder can not be visualized on X-rays or in the case of calcification of stones, weak contractility of the gallbladder or frequent attacks of colic, the drug Ursodez should not be used.

Treatment of patients in advanced stages of primary biliary cirrhosis

Very rarely there were cases of decompensation of liver cirrhosis. After discontinuation of therapy, regression of manifestations of decompensation was noted.

Long-term therapy with ursodeoxycholic acid in high doses (28-30 mg / kg / day) can lead to the development of serious side effects inpatients with primary sclerosing cholangitis.

Patients with diarrhea should reduce the dose of the drug. With persistent diarrhea, treatment should be discontinued.

Impact on the ability to drive vehicles and manage mechanisms

Influence on ability to drive vehicles and mechanisms is not revealed.

Drug Interactions

Colestramine, colestipol and antacids containing aluminum hydroxide or smectite (aluminum oxide), reduce the absorption of ursodeoxycholic acid in the intestine and, thus, reduce its absorption and efficiency. If the use of drugs containing at least one of these substances is necessary, they must be taken at least 2 hours prior to taking Ursodez.

Ursodeoxycholic acid can increase the absorption of cyclosporine from the intestine. Therefore, in patients taking cyclosporine, you should check the concentration of cyclosporine in the blood and adjust the dose of cyclosporine, if necessary.

In some cases, ursodez can reduce the absorption of ciprofloxacin.

Lipid-lowering drugs (especially clofibrate), estrogens,Neomycin or gestagens increase bile saturation with cholesterol and may decrease the ability to dissolve cholesterol bile calculi.

Analogues of drug Ursodez

Structural analogs for the active substance:

• Grinterol;
• Livedoksa;
• Urdoks;
• Urso 100;
• Ursodeoxycholic acid;
• Ursodex;
• Ursuliv;
• Ursolit;
• Ursomik;
• Ursoprim;
• Ursoron Rompharm;
• Ursosan;
• Ursofalk;
• Holudexan;
• Exxhol.

Analogues for the pharmacological group (hepatoprotectors):

• Antraliv;
• Bondjigar;
• HepaMerz;
• Gepabene;
• Hepatosan;
• Hepafor;
• Heptor;
• Heptral;
• Glutargin;
• Dipan;
• Covechol;
• Karsil;
• Karsil Forte;
• Laennek;
• Larnamine;
• Legalon;
• Liv 52;
• Liventziale;
• Lipoic acid;
• Lipoid;
• Lasfall;
• Maxar;
• Methionine;
• Moliksan;
• Octolipen;
• Ornilatex;
• Ornitsetil;
• Polythion;
• Progepar;
• Resalute Pro;
• Remaxol;
• Ropren;
• Sibektan;
• Silibinin;
• Sylimar;
• Silymarin;
• Thioctic acid;
• Thiolipone;
• Tiotriazolin;
• Phosphogliv;
• Phosphogliv Forte;
• Phosphontsiale;
• Hepabos;
• Holudexan;
• Erbisol;
• Eslidine;
• Essentiale N;
• Essentiale forte N;
• Essencigliv;
• Essley forte;
• The Essler;
• Essliver forte.

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