Drug Action
Cholic acid is the predominant primary bile acid in humans, which can be used to provide a source of bile acid in patients with inborn deficiencies in bile acid synthesis.
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Drug reference
Cholic acid is the predominant primary bile acid in humans, which can be used to provide a source of bile acid in patients with inborn deficiencies in bile acid synthesis.
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Inborn errors of primary bile acid synthesis (initiated by a specialist) ▶BY MOUTH ▶Adult: Usual dose 5–15 mg/kg daily; increased in steps of 50 mg daily in divided doses if required, dose to be given with food at the same time each day; Usual maximum 500 mg/24 hours
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→Appendix 1: cholic acid
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Cholelithiasis (long term use). diarrhoea. pruritus SIDE-EFFECTS, FURTHER INFORMATION Patients presenting with pruritus and/or persistent diarrhoea should be investigated for potential overdose by a serum and/or urine bile acid assay.
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Limited data available—not known to be harmful, manufacturer advises continue treatment. Monitoring Manufacturer advises monitor patient parameters more frequently in pregnancy.
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Present in milk but not known to be harmful.
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Manufacturer advises caution and stop treatment if there are signs of severe hepatic failure— limited information available (no experience with impairment from causes not related to inborn errors of primary bile acid synthesis). Dose adjustments Manufacturer advises adjust dose as the degree of impairment improves during treatment.
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Manufacturer advises monitor serum and/or urine bile-acid concentrations every 3 months for the first year, then every 6 months for three years, then annually; monitor liver function tests at the same or greater frequency.
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Manufacturer advises capsules may be opened and the content added to infant formula, juice, fruit compote, or yoghurt for administration.
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There can be variation in the licensing of different medicines containing the same drug. Capsule CAUTIONARY AND ADVISORY LABELS 25 ▶Orphacol (Laboratoires CTRS) A Cholic acid 50 mg Orphacol 50mg capsules | 30 capsule P £1,860.00 Cholic acid 250 mg Orphacol 250mg capsules | 30 capsule P £6,630.00
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Counselling advised on administration.
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Usual dose 5–15 mg/kg daily; increased in steps
First-line fragment. Read the complete Indications and Dose section above.
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