Chenodal
Chenodal (chenodiol) can be taken to dissolve certain types of gallstones (radiolucent), but it's not commonly used because it can damage the liver. This medication is only for select people who can't get their gallbladder surgically removed because of their age or other health problems. If Chenodal (chenodiol) can't dissolve your stones, you might still need surgery to remove your gallbladder. You will need to follow up with your provider periodically while on this medication.
What is Chenodal (chenodiol)?
What is Chenodal (chenodiol) used for?
- Dissolving radiolucent gallstones
How Chenodal (chenodiol) works
Chenodal (chenodiol) is a bile acid. It stops the liver from making cholesterol and cholic acid, and prevents cholesterol from getting into your bile. This allows your body to dissolve the stones.
Drug facts
Side effects of Chenodal (chenodiol)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Diarrhea (30-40%)
- Rise in liver enzyme levels (30% or more)
Less Common Side Effects
- Rise in total cholesterol and LDL "bad" cholesterol
- Urgency to pass stools
- Stomach cramps
- Heartburn
- Constipation
- Nausea or vomiting
- Loss of appetite
- Passing gas
- Drop in white blood cell counts
Chenodal (chenodiol) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Liver problems: yellowing of the skin or eyes, dark urine, feeling tired, vomiting, loss of appetite, upset stomach, or stomach pain
The following Chenodal (chenodiol) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Incidence not known
Black, tarry stools
chills
painful or difficult urination
shortness of breath
sores, ulcers, or white spots on the lips or in the mouth
swollen glands
unusual bleeding or bruising
unusual tiredness or weakness
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Less common
Abdominal or stomach pain
acid or sour stomach
belching
bloated
cramps
difficulty having a bowel movement (stool)
excess air or gas in the stomach or intestines
full feeling
indigestion
loss of appetite
pain in the chest below the breastbone
pain or discomfort in chest, upper stomach, or throat
passing gas
stomach discomfort or upset
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Chenodal (chenodiol)
Pros
- Is a form of bile acid that is naturally produced in your body
- Most of the common side effects go away relatively quickly
- Provides an alternative for people who cannot have surgery to remove their gallbladder
Cons
- Only available as a brand medication
- Can't take if pregnant or have a history of liver problems
- Requires regular check ups due to liver and cholesterol problems
- Stones have recurred within 5 years in about half of the people taking this medication
Pharmacist tips for Chenodal (chenodiol)
- You can take Chenodal (chenodiol) with or without food.
- Talk to your provider if you start having diarrhea. This may happen at any time during your treatment, but it's most common when you first start taking Chenodal (chenodiol). Diarrhea is usually mild, temporary, and doesn't affect your treatment. If needed, your provider can adjust your dose or suggest an anti-diarrhea medication.
- Keep taking Chenodal (chenodiol) even if you begin to feel better. It can take up to a year before you start seeing your gallstones dissolve.
- It's not known if Chenodal (chenodiol) passes into your breast milk, so let your provider know if you are breastfeeding.
Common questions about Chenodal (chenodiol)
Chenodal (chenodiol) should only be used for select people who can't have gallbladder surgery because of their age or because of other health problems that put them at high risk for complications during or after surgery. Chenodal (chenodiol) also works best if your stones are small or can float. If the medication is given to someone with nonfloatable stones and it doesn't work, their risk of needing sudden surgery would go up because the right treatment was delayed. Chenodal (chenodiol) can also damage the liver, so it should only be used in people without liver problems.
No, you shouldn't take Chenodal (chenodiol) if you are pregnant. This medication can cause harm to your unborn baby. Animal studies show that Chenodal (chenodiol) can lead to lesions in the liver, kidneys, and adrenal glands (small, triangular glands on top of kidneys). If you are pregnant or planning on getting pregnant, talk to your provider to find a different treatment.
How long you take Chenodal (chenodiol) depends on your body's response to the medication. It could take up to 12 months before you see any benefits from the medication. If your stones haven't dissolved at all after 9 to 12 months of treatment, the chances of Chenodal (chenodiol) working are low. You should speak with your provider about stopping Chenodal (chenodiol) if there are no effects after 18 months. It's not known if it's safe to use Chenodal (chenodiol) for longer than 24 months.
Chenodal (chenodiol) can damage your liver and raise your cholesterol levels, so your provider might have to do occasional testing. Liver testing is recommended once a month for the first 3 months, then every 3 months thereafter. Your cholesterol levels will likely be monitored every 6 months. Your provider might also monitor how well your stones are dissolving every 6 to 9 months.
Antacids with aluminum, such as Maalox, Mylanta, and Gaviscon, and cholesterol medications, such as cholestyramine (Prevalite) and colestipol (Colestid), can lower the amount of Chenodal (chenodiol) that your body absorbs. Estrogens and birth control can raise your cholesterol levels, which can affect how well Chenodal (chenodiol) works. Taking Chenodal (chenodiol) with certain blood thinners like warfarin (Coumadin), can raise your risk of bleeding. For these reasons, it's best to avoid taking Chenodal (chenodiol) with these medications.
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Risks and warnings for Chenodal (chenodiol)
Chenodal (chenodiol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Only for select people
Chenodal (chenodiol) should only be used for select people, and you must have your liver function monitored periodically during treatment. Chenodal (chenodiol) isn't the right medication for many people with gallstones because it can cause liver damage and can increase the risk of needing emergent surgery to remove the gallbladder due to a delay in the proper treatment.
Liver problems
- Risk factors: History of liver conditions | Taking other medications harmful to the liver
Chenodal (chenodiol) can damage the liver, so you shouldn't take this medication if you have a history of liver problems. Contact your provider right away if you experience any signs of liver problems during your treatment, which includes yellowing of the skin or eyes, dark urine, feeling tired, vomiting, loss of appetite, upset stomach, or stomach pain.
Diarrhea
Chenodal (chenodiol) can cause diarrhea. This is more likely to happen at the start of your treatment. It's usually mild and doesn't interfere with your treatment. If this becomes a problem for you, your provider might have to lower your dose or recommend an anti-diarrhea medication. Your provider might have you stop taking Chenodal (chenodiol) if your diarrhea doesn't go away.
Harm to your unborn baby
- Risk factors: Currently pregnant or may become pregnant
Chenodal (chenodiol) shouldn't be used during pregnancy or in women who may become pregnant because it can cause harm to your unborn baby. In animal studies, Chenodal (chenodiol) has caused lesions in the liver, kidneys, and adrenal glands (small, triangular glands on top of kidneys). If you find that you're pregnant, stop taking Chenodal (chenodiol) right away and talk to your provider.
Chenodal (chenodiol) dosage
Typical dosage for Chenodal (chenodiol)
The typical starting dose of Chenodal (chenodiol) is 250 mg by mouth twice daily for 2 weeks. After 2 weeks, your provider will raise your dose by 250 mg per day every week until you reach the recommended dose.
The recommended dose of Chenodal (chenodiol) will vary depending on your weight. Each tablet contains 250 mg of Chenodal (chenodiol).
Recommended dose:
- 100-130 lbs: 3 tablets per day
- 131-185 lbs: 4 tablets per day
- 186-200 lbs: 5 tablets per day
- 201-235 lbs: 6 tablets per day
- 236-275 lbs: 7 tablets per day
Interactions between Chenodal (chenodiol) and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
Chenodal (chenodiol) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Chenodal (chenodiol) will not be safe for you to take.
- Liver or bile duct problems
- Currently pregnant or may become pregnant
What are alternatives to Chenodal (chenodiol)?
