Chenodal

Drug overview for CHENODAL (chenodiol):

Generic name: chenodiol (KEE-noe-DYE-ol)
Drug class: Gallstone Solubilizing Agents
Therapeutic class: Gastrointestinal Therapy Agents

Chenodiol, a naturally occurring human bile acid, is used for dissolution of gallstones.

No enhanced Uses information available for this drug.

DRUG IMAGES

CHENODAL 250 MG TABLET

The following indications for CHENODAL (chenodiol) have been approved by the FDA:

Indications:
Cerebrotendinous xanthomatosis

Professional Synonyms:
Cholestanolosis
Sterol 27 hydroxylase deficiency
Van Bogaert-Scherer-Epstein syndrome

Dosing information for CHENODAL
DRUG LABEL	DOSING TYPE	DOSING INSTRUCTIONS
CHENODAL 250 MG TABLET	Maintenance	Adults take 2 tablets (500 mg) by oral route 2 times per day in the morning and evening

The following drug interaction information is available for CHENODAL (chenodiol):

Contraindicated
Severe
Moderate

There are 0 contraindications.

There are 0 severe interactions.

There are 1 moderate interactions. The clinician should assess the patient’s characteristics and take action as needed. Actions required for moderate interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration.

Drug Interaction	Drug Names
Chenodiol/Aluminum-Based Antacids; Bile Acid Sequestrants SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed. MECHANISM OF ACTION: Aluminum-based antacids, cholestyramine, or colestipol may bind to chenodiol, which may decrease gastrointestinal absorption and impair enterohepatic recirculation of chenodiol.(1,2) CLINICAL EFFECTS: Simultaneous administration of an aluminum-based antacid, cholestyramine, or colestipol may result in decreased absorption and effectiveness of chenodiol.(1,2) PREDISPOSING FACTORS: None determined. PATIENT MANAGEMENT: If concomitant therapy with aluminum-based antacids or colestipol is necessary, administer chenodiol at least 2 hours before or after the antacid or colestipol. If concomitant therapy with cholestyramine is necessary, administer chenodiol at least 1 hour before or 4-6 hours after cholestyramine.(2) DISCUSSION: Aluminum-based antacids have been shown to adsorb bile acids in vitro. Bile acid sequestrants reduce bile acid absorption.(1)	ALUMINUM HYDROXIDE, CHOLESTYRAMINE, CHOLESTYRAMINE LIGHT, CHOLESTYRAMINE RESIN, COLESTID, COLESTIPOL HCL, PREVALITE, QUESTRAN, QUESTRAN LIGHT

Drug Interaction

Drug Names

Chenodiol/Aluminum-Based Antacids; Bile Acid Sequestrants

SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.

MECHANISM OF ACTION: Aluminum-based antacids, cholestyramine, or colestipol may bind to chenodiol, which may decrease gastrointestinal absorption and impair enterohepatic recirculation of chenodiol.(1,2)

CLINICAL EFFECTS: Simultaneous administration of an aluminum-based antacid, cholestyramine, or colestipol may result in decreased absorption and effectiveness of chenodiol.(1,2)

PREDISPOSING FACTORS: None determined.

PATIENT MANAGEMENT: If concomitant therapy with aluminum-based antacids or colestipol is necessary, administer chenodiol at least 2 hours before or after the antacid or colestipol. If concomitant therapy with cholestyramine is necessary, administer chenodiol at least 1 hour before or 4-6 hours after cholestyramine.(2)

DISCUSSION: Aluminum-based antacids have been shown to adsorb bile acids in vitro. Bile acid sequestrants reduce bile acid absorption.(1)

ALUMINUM HYDROXIDE, CHOLESTYRAMINE, CHOLESTYRAMINE LIGHT, CHOLESTYRAMINE RESIN, COLESTID, COLESTIPOL HCL, PREVALITE, QUESTRAN, QUESTRAN LIGHT

The following contraindication information is available for CHENODAL (chenodiol):

Overview
Contraindicated
Severe
Moderate

Drug contraindication overview.

Women who are or may become pregnant. Presence of known hepatocyte dysfunction or bile duct abnormalities (e.g., intrahepatic cholestasis, primary biliary cirrhosis, sclerosing cholangitis). Gallbladder confirmed as nonvisualizing after 2 consecutive single doses of dye, radiopaque stone, gallstone complications, or compelling reasons for gallbladder surgery (e.g., unremitting acute cholecystitis, cholangitis, biliary obstruction, gallstone pancreatitis, biliary-GI fistula).

There are 4 contraindications. Absolute contraindication.

Contraindication List
Cholestasis
Disease of liver
Pregnancy
Primary biliary cholangitis

There are 0 severe contraindications.

There are 2 moderate contraindications. Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.

Moderate List
Diarrhea
Hypercholesterolemia

The following adverse reaction information is available for CHENODAL (chenodiol):

Overview
Severe
Less Severe

Adverse reaction overview.

Diarrhea (usually mild, translucent, well tolerated), increased serum total cholesterol and low-density lipoprotein (LDL)-cholesterol, and decreased leukocyte count (not below 3000/mm3) have been reported.

There are 2 severe adverse reactions.

More Frequent	Less Frequent
Abnormal hepatic function tests	None.

Rare/Very Rare
Neutropenic disorder

There are 11 less severe adverse reactions.

More Frequent	Less Frequent
Diarrhea Dyspepsia	Abdominal pain with cramps Anorexia Constipation Cough Fecal urgency Flatulence Nausea Vomiting

Rare/Very Rare
Hypercholesterolemia

The following precautions are available for CHENODAL (chenodiol):

Pediatric
Pregnant
Lactation
Geriatric

Safety and efficacy of chenodiol in pediatric patients have not been established.

Contraindicated

None

Severe Precaution

None

Management or Monitoring Precaution

None

Category X. (See Fetal/Neonatal Morbidity and Mortality under Warnings/Precautions: Warnings, in Cautions, and also see Cautions: Contraindications.)

It is not known whether chenodiol is distributed into human milk. The drug should be used with caution in nursing women.

No enhanced Geriatric Use information available for this drug.

Cerebrotendinous xanthomatosis
E75.5	Other lipid storage disorders