Ursodeoxycholic acid (Exhol) 250 mg – [100 capsules]

Hepatoprotective drug, has a choleretic effect. Reduces cholesterol synthesis in the liver, its absorption in the intestine and its concentration in bile, increases cholesterol solubility in the biliary system, stimulates bile formation and excretion. It decreases bile lithogenicity and increases bile acids content; it causes intensification of gastric and pancreatic secretion, increases lipase activity and has hypoglycemic effect. Causes partial or complete dissolution of cholesterol stones in enteral administration, reduces bile saturation with cholesterol, which promotes mobilization of cholesterol from gallstones.

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

Indications for children

Cystic fibrosis (cystic fibrosis}

According to clinical reports, there is a long history (up to 10 years or more) of treatment with ursodeoxycholic acid in pediatric patients with hepatobiliary disease associated with cystic fibrosis (CFAHD). There is evidence that therapy with ursodeoxycholic acid can decrease bile duct proliferation, slow down the development of lesions detected by histological examination, and even promote reversal of hepatobiliary changes if therapy is started at early stages of CFAHD. In order to optimize the effectiveness of treatment, ursodeoxycholic acid therapy should be started as early as possible after the diagnosis of CFAHD.

Cholesterol gallstones dissolution, biliary reflux gastritis, primary biliary cirrhosis in the absence of decompensation signs, chronic hepatitis of various genesis, primary sclerosing cholangitis, cystic fibrosis, nonalcoholic steatohepatitis, alcoholic liver disease, biliary dyskinesia.

X-ray-positive (high-calcium) gallstones; impaired gallbladder contractility, bile duct obstruction (obstruction of the common bile duct or vesicular duct); frequent episodes of biliary colic; acute inflammatory diseases of the gallbladder and bile ducts; decompensated cirrhosis of the liver; expressed hepatic and/or renal insufficiency; hypersensitivity to the drug components or other bile acids, children under 3 years old (for solid dosage forms).

Indications for children

Unsuccessfully performed portoepterostomy or cases of absence of restoration of normal bile flow in children with biliary tract atresia.

In children under 3 years old, as well as in patients with difficulty in swallowing solid dosage forms, it is recommended to use preparations of ursodeoxycholic acid in form of suspension.

• Children and adults with a body weight of less than 47 kg are recommended to use ursodeoxycholic acid in the form of suspension.
• Dissolution of cholesterol gallstones
• The recommended dose is 10 mg of ursodeoxycholic acid per 1 kg of body weight per day, which corresponds to:
• Body weight Capsules.
• Up to 60 kg 2
• 61-80 kg 3
• 81-100 kg 4
• Above 100 kg 5
• Exhol capsules should be taken daily in the evening, before going to bed (capsules are not chewed), with a small amount of fluid.
• Duration of treatment 6-12 months. For the prevention of recurrent cholelithiasis is recommended to take the drug for several months after the dissolution of stones.
• Treatment of biliary reflux gastritis
• 1 capsule of Exhol preparation daily in the evening before going to bed, without chewing and with a small amount of water.
• Course of treatment – from 10-14 days to 6 months, if necessary – up to 2 years.
• Treatment of primary biliary cirrhosis
• Daily dose depends on body weight and is from 3 to 7 capsules (about 14 ± 2 mg of ursodeoxycholic acid per 1 kg of body weight).
• During the first 3 months of treatment the intake of Exxol® 250 mg capsules should be divided into several intakes during a day. After improvement of hepatic parameters the daily dose of the drug can be taken once in the evening.
• The following regimen is recommended:
• 250 mg capsules
• Body weight (kg) Exxol® Capsules 250 mg first 3 months of treatment Subsequently morning afternoon evening (once daily)
• 47-62 1 1 1
• 63-78 1 1 2 4
• 79-93 1 2 2 5
• 94-109 2 2 2 6
• over 110 2 2 3 7
• Exhol capsules should be taken regularly, without chewing, with a small amount of liquid.
• The use of ursodeoxycholic acid contained in Exhol capsules for treatment of primary biliary cirrhosis may be continued indefinitely.
• In patients with primary biliary cirrhosis in rare cases clinical symptoms may worsen at the beginning of treatment, for example, itching may increase. In this case, treatment should be continued by taking one capsule daily, then the dosage should be gradually increased, increasing the daily dose weekly by one capsule, until the recommended dosage regimen is reached again.
• Symptomatic treatment of chronic hepatitis of different genesis – daily dose 10-15 mg/kg in 2-3 doses. Duration of treatment – 6-12 months or more.
• Primary sclerosing cholangitis – daily dose is 12-15 mg/kg; if necessary, the dose may be increased to 20-30 mg/kg in 2-3 doses. Duration of therapy ranges from 6 months to several years (see sect.: “Cautions”).
• Cystic fibrosis (cystic fibrosis) – daily dose 20 mg/kg/day in 2-3 doses, with further increase to 30 mg/kg/day if necessary.
• Body weight(kg) Daily dose (mg/kg body weight) Exole® Capsules 250 mg morning daily evening
• 20-29 17-25 1 – 1
• 30-39 19-25 1 1 1
• 40-49 20-25 1 1 2
• 50-59 21-25 1 2 2
• 60-69 22-25 2 2 2
• 70-79 22-25 2 2 3
• 80-89 22-25 2 3 3
• 90-99 23-25 3 3 3
• 100-109 23-25 3 3 4
• >110 3 4 4
• Non-alcoholic steatohepatitis – average daily dose is 10-15 mg/kg in 2-3 doses. Duration of therapy is 6-12 months or more.
• Alcoholic liver disease – average daily dose is 10-15 mg/kg in 2-3 doses. The duration of therapy is 6-12 months or more.
• Biliary dyskinesia – average daily dose is 10 mg/kg in 2 doses for 2 weeks to 2 months. If necessary, it is recommended to repeat the treatment course.