Chenodal Tablet: Uses, Dosage, Side Effects, Precautions and Alternates

Quick overview

Chenodal Tablet (chenodiol, also called chenodeoxycholic acid or CDCA) is a bile acid medicine used to dissolve certain radiolucent gallstones in patients with a working gallbladder who are not good candidates for surgery. It is not effective for calcified gallstones or bile pigment stones. Treatment is taken by mouth, usually continued for a long period, and requires regular blood tests and imaging to monitor progress and liver health.

What is Chenodal Tablet

Chenodal contains chenodiol, a bile acid that the body makes naturally in small amounts. It is made synthetically for use as a medicine. It works by changing the balance of substances in bile, the fluid your liver makes to help digest fat.

Chenodal Tablet uses

• Treating certain radiolucent (non-calcified) gallstones in patients who have a working gallbladder but are not good candidates for surgery because of higher surgical risk from age or other health conditions
• Not effective for calcified (radiopaque) gallstones or bile pigment stones

Benefits of Chenodal Tablet

• May gradually dissolve radiolucent cholesterol gallstones over time, which could help some patients avoid or delay gallbladder surgery
• Higher chance of stones dissolving if stones are small or 'floatable'
• Provides a non-surgical option for carefully selected patients
• Can gradually dissolve certain cholesterol gallstones
• May help avoid surgery in patients who are poor surgical candidates
• Available as a standardized 250 mg tablet

How Chenodal Tablet works

Chenodiol reduces the liver's production of cholesterol and another bile acid called cholic acid. Over time it builds up in the bile acid pool and helps make the bile less saturated with cholesterol, which allows cholesterol gallstones to gradually dissolve.

Chenodal Tablet dosage

Chenodal is taken by mouth, usually in two divided doses, morning and night. Dosage is usually started low and gradually increased over several weeks until the recommended or maximum tolerated amount is reached. If diarrhea occurs, your doctor may have you temporarily lower the dose until it settles, then go back to the previous dose. Treatment is generally continued for a long period of time (up to about 24 months) to allow gallstones to dissolve; safety beyond this time is not established. Regular blood tests and imaging (cholecystogram or ultrasound) are needed throughout treatment to check how the stones are responding and to monitor your liver. This medicine is not established as safe or effective in children.

Available forms and strengths

• Film-coated oral tablet, 250 mg

Side effects of Chenodal Tablet

Common

• Diarrhea
• Stomach cramps or stomach pain
• Constipation
• Nausea, vomiting, heartburn, flatulence, loss of appetite
• Headache
• High blood pressure
• Muscle weakness
• Nose or throat infection
• Mildly elevated liver enzyme test results
• Changes in cholesterol levels

Serious

• Liver damage (hepatotoxicity), including signs like yellowing of skin or eyes, dark urine, light-colored stools, severe tiredness, itching, or stomach pain
• Severe or persistent diarrhea
• Serious allergic reaction (swelling of face/lips/tongue/throat, difficulty breathing, hives)
• Worsening of gallstone symptoms or no improvement

Warnings and precautions

• This medicine is contraindicated in people with liver dysfunction or certain bile duct disorders such as intrahepatic cholestasis, primary biliary cirrhosis, or sclerosing cholangitis.
• Elevated liver enzyme levels above three times the normal upper limit require immediately stopping the medicine, as they usually come back if treatment is tried again.
• A patient with pre-existing serious liver and bile duct disease died during chenodiol treatment, and a contribution of the drug to this outcome could not be ruled out.
• This medicine must not be used in pregnancy because of the risk of serious harm to the developing baby.
• It is not fully known whether this treatment could contribute to colon cancer risk in susceptible individuals, based on indirect evidence from bile acid research.
• This medicine should not be used during pregnancy because it may seriously harm the unborn baby. Tell your doctor right away if you become pregnant while taking it.
• It isn't known whether this medicine passes into breast milk. Talk to your doctor about whether breastfeeding is safe while taking it.
• No specific renal dose adjustment is established in the prescribing information, but treatment should remain medically supervised.
• This medicine should not be used if you have liver disease or certain bile duct problems, and it requires regular blood tests to check for liver damage during treatment.
• It isn't known whether alcohol affects this medicine.
• Chenodal is not generally expected to impair driving, although patients should avoid driving if adverse effects affect alertness.

Storage

• Store at 20°C to 25°C (68°F to 77°F); brief excursions between 15°C to 30°C (59°F to 86°F) are permitted
• Store in a cool, dry place and keep the container tightly closed
• Dispense in a tight container

When to see a doctor

• Get emergency help right away if you have signs of a severe allergic reaction, such as swelling of the face, lips, tongue or throat, or trouble breathing.
• Call your doctor immediately if you notice signs of liver problems, such as yellowing of your skin or eyes, dark urine, light-colored stools, severe tiredness, itching, or upper stomach pain.
• Contact your doctor if diarrhea becomes severe or does not go away, as treatment may need to be stopped.
• Seek medical help or contact your local poison control center right away if you or someone else may have taken too much of this medicine.

Alternatives

• Ursodiol
• Laparoscopic cholecystectomy