In our body, there is a unique organ capable of recovery - it is the liver. Under the influence of various adverse factors, this gland experiences tremendous loads, and its cells die or degenerate into adipose tissue. A number of drugs are used in the treatment of the liver, one of which is Exhol. Instructions for use of this medication, indications, contraindications, features of therapy and other useful information are described in this article.
Release form and composition
This drug is available in the form of capsules, each of which contains an active substance - ursodeoxycholic acid in an amount of 250 mg, as well as auxiliary components: silicon dioxide, magnesium stearate, calcium hydrogen phosphate dehydrate, povidone, lactose monohydrate and others.
How does the drug work?
The pharmacological effects of the drug “Exhol” are described in the instructions for use as follows: it is a hepatoprotective drug with a choleretic effect.
The active substance has the following effects:
- reduces the synthesis of cholesterol in the liver, reduces its absorption in the intestines and content in bile;
- increases the quality of the dissolution of cholesterol in the bile excretion system, stimulating the formation of this secret and lowering its lithogenicity;
- stimulates a rise in the level of bile acids;
- enhances the secretion of gastric and pancreatic secretions;
- increases the activity of the lipolytic enzyme;
- has a hypoglycemic effect;
- stimulates partial or complete resorption of cholesterol type stones;
- reduces the saturation of bile with cholesterol, mobilizing it from stones;
- has the properties of an immunomodulator, regulating the response mechanisms in the liver;
- reduces the expression of antigens concentrated on the membrane system of hepatocytes;
- regulates the number of T-lymphocytes, interleukins-2;
- reduces the number of elsinophils.
What is the pharmacokinetics of the drug?
The drug "Exhol", the instructions for use of which are described in this article, is characterized by a high degree of absorption in the small intestine and the ability to penetrate the placenta. The maximum concentration of the drug substance in the blood is reached after 1-3 hours and is 5.5 mmol / L. Ursodeoxycholic acid to a large extent binds to plasma proteins and is metabolized in liver cells to conjugates of the taurine and glycine species, which are excreted in the bile.
Exchange products are excreted with feces by 50-70%. A small amount of unchanged active substance enters the intestines, where it is transformed by bacteria into lithocholic acid, which is sulfated in the liver and completely excreted from the body by the intestines.
Who should take the drug?
Direct indications for taking the drug "Exhol", instructions for use calls the following conditions:
- primary biliary cirrhosis with no signs of decompensation;
- the need to dissolve small and medium sized cholesterol stones, subject to the functioning of the gallbladder;
- gastritis (biliary reflux);
- chronic active hepatitis;
- liver disease with alcoholism;
- primary sclerosing cholangitis ;
- cystic fibrosis of the liver;
- non-alcoholic steatohepatitis;
- biliary dyskensia.
With these indications, Exhol capsules and tablets are often prescribed by a doctor and are highly effective.
Contraindications
A drug containing ursodeoxycholic acid is contraindicated in the following diseases:
- the presence of hypersensitivity to the components of the drug;
- lack of normal function, as well as empyema of the gallbladder ;
- the presence of stones with a high proportion of calcium detected by x-ray;
- fistula in the digestive tract;
- chronic hepatitis;
- inflammatory bowel disease;
- acute cholecystitis or cholangitis;
- decompensated cirrhosis of the liver ;
- infection of the gallbladder, its ducts and intestines;
- pregnancy and lactation;
- children under 3 years old;
- renal and liver failure;
- obturation of bile output.
In the presence of these contraindications, it is not recommended to prescribe Exhol drug to patients. The instruction indicates that this tool did not show a negative effect on the fetus when studied in animals, however, adequate studies in pregnant women were not performed.
special instructions
In a special way, instructions for use indicate some of the nuances of taking Exhol. The doctors' reviews about this drug are positive, but they draw the attention of women of childbearing age to the fact that during the treatment with this pharmaceutical product, additional contraception should be taken into account. In addition to hormonal contraceptives, whose effectiveness is reduced, barrier methods of protection against unwanted pregnancy should be used. It is not recommended that pregnant women be given thoughtless treatment with Exhol. The instruction indicates that in this situation, the risk to the mother should be higher than the risk to the fetus. When taking this drug, a lactating woman should stop lactation.
If the child has reached the age of 3, then, if necessary, the drug “Exhol” can be prescribed. Instructions for use for children calls for caution when treating babies under 4 years of age, as they may have problems swallowing the capsule.
How to apply the medicine?
The best treatment guide for Exhol is instructions for use. A photo of this tool will help you protect yourself from buying counterfeit products.
The drug is taken orally, preferably in the evening. Chewing capsules is not recommended, it is better to drink it with water in a small volume. If the patient weighs less than 34 kg, it is better to prefer a suspension with the same medicinal substance.
The dosage of the drug depends on the age and purpose of therapy.
For the purpose of splitting stones in the gall bladder and ducts, "Exhol" is taken in a daily amount of 10 mg / kg for 6-12 months and several months after reaching the result for prevention.
If the patient treats reflux gastritis, then he is prescribed one capsule of the drug once a day for a cycle from two weeks to six months, and if necessary, up to 24 months.
Treatment of biliary cirrhosis is performed according to the scheme: per day - 10-15 mg / kg with a duration at the discretion of the doctor.
For other diseases included in the list of indications for admission, the dosage of the drug and the duration of its administration is determined by the doctor individually.
Also, a special approach requires the use of Exhol drug for babies and adolescents. Instructions for use in children older than 3 years indicate the need for a dosage of 10-20 mg / kg per day. The exact rationing of the drug and the duration of therapy are determined by the doctor individually.
Do side effects and overdose occur during treatment?
During taking the drug "Exhol", side effects may occur, such as:
- back pain;
- digestive disorders;
- increased activity of liver transaminases;
- allergy;
- saturation of gallstones with calcium;
- relapse of psoriasis;
- allopecia.
If these effects occur, you should stop taking Exhol. Instructions for use, the composition of which is summarized in this article, indicates that no cases of overdose of this medication have been identified.
However, if the patient has symptoms of intoxication, symptomatic therapy is necessary.
Combination with other medicines
Joint administration with aluminum-containing antacians and ion-exchange resins reduces the absorption efficiency of Exhol. Hypolipidemic drugs, neomycin, estrogens or progestins contribute to increased saturation of bile with cholesterol and reduce the dissolution of stones.
Features of receiving funds
The first document that you should read before taking Exhol is the instructions for use. The capsule release form of this medication is most successful in relation to completely cholesterol stones, whose size does not exceed 15-20 mm. At the same time, the gallbladder should be filled with these formations no more than half, and the ducts 100% retained their function to eliminate bile.
In the process of therapy aimed at dissolving cholesterol deposits, it is necessary to control the activity of hepatic enzymes: transaminases, alkaline phosphatase, GGT and bilirubin. Once every 4 weeks, every 3 months of therapy, cholecystography should be performed. Every six months, the patient should undergo an ultrasound of the liver to assess the effectiveness of the treatment.
When the complete cleavage of stones was recorded, the use of Exhol should be continued for another three months with the goal of final dissolution of the invisible stones and prevention of the formation of new ones.
If in the first six months or a year of treatment even partial dissolution of stones is not observed, this means that it is inexpedient to continue treatment due to its inefficiency.
Analogs and synonyms
If the patient cannot be assigned an “Exhol” for any objective reason, then it can be replaced by one of the synonyms:
- capsules "Ursodeoxycholic acid";
- capsules "Ursoliv";
- capsules "Ursosan";
- film-coated tablets "Ursodex";
- capsules "Ursorom Rompharm";
- capsules "Urdoksa";
- suspension for internal administration "Ursofalk";
- capsules "Ursofalk";
- capsules "Ursolit";
- film-coated tablets "Livodeks";
- capsules "Greenterol"
If the patient has an individual intolerance to ursodeoxycholic acid, or it has been shown to be ineffective in treatment, then this drug can be replaced with an analog, which is the tablet form of “Cholenzym”. This medicine is a combination agent consisting of dry bile, powdered dihydrated pancreas and mucous tissues of the small intestine of livestock. By action, "Cholenzym" refers to choleretic drugs.
This drug is contraindicated in case of hypersensitivity, acute and exacerbated chronic pancreatitis. Allergic reactions in the form of lacrimation, hyperemia and skin rash may appear as adverse reactions from taking this drug.
Cost and patient reviews
This drug is produced by the domestic pharmaceutical company Kanofarma Production CJSC, which is located in the Moscow Region. The cost of packaging "Exhol" on average in Russia is 125 rubles. Many patients note the effectiveness of this medication, the convenience of its administration and an affordable price. People with diseases of the liver and biliary tract note that good results were achieved with Exhol. Together with effectiveness, patients note a good tolerability of this tool.
It is worth noting that the description of this drug is incomplete. To get detailed information about the drug "Exhol", you should familiarize yourself with the instructions included in the package with the medicine. The appointment of this tool is only the attending physician. Self-medication can be dangerous to your health.