Chenodiol

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Information about Chenodiol[edit source]

Chenodeoxycholic acid (chenodiol) is a primary bile acid, synthesized in the liver and present in high concentrations in bile that is used therapeutically to dissolve cholesterol gallstones.


Liver safety of Chenodiol[edit source]

Chronic therapy is associated with transient elevations in serum aminotransferase levels in up to 30% of patients, but chenodiol has been linked to only rare instances of clinically apparent liver injury with jaundice.

Mechanism of action of Chenodiol[edit source]

Chenodeoxycholic acid or chenodiol (kee" noe dye' ol) is a naturally occurring bile acid that is used therapeutically to dissolve cholesterol gallstone in patients with a functioning gall bladder who have contraindications to cholecystectomy or refuse surgery. Chenodiol is the major bile acid synthesized by the liver and is usually the bile acid in highest concentration in serum, hepatocytes and bile. When given orally, chenodiol is passively absorbed from the small intestine and taken up by the liver via anion transport proteins. High concentrations of chenodiol in liver decrease the hepatic synthesis of both cholesterol and other bile acids, thereby increasing the cholic acid and decreasing cholesterol concentration in bile. This combination of events results in a decrease in cholesterol saturation of bile, the major impetus to the formation of cholesterol gallstones.

Gallstone dissolution[edit | edit source]

When given for 2 years or more, chenodeoxycholic acid can dissolve cholesterol gallstones in 15% to 30% of patients. Chenodiol is most effective on small “floating” gallstones. It is not effective for calcified gallstones or in patients with a non-functioning gallbladder. Even with successful therapy, however, gallstone recurrence is as high as 50% within a few years of stopping chenodiol. Chenodiol was approved for use in patients with radiolucent gallstones in 1983 and remains available, although it has largely been replaced by ursodiol which appears to be more effective and is better tolerated. In addition, the introduction of laparoscopic cholecystectomy has markedly decreased the need for medical therapy of gallstones.

Dosage and administration for Chenodiol[edit source]

Chenodiol is available as tablets of 250 mg generically and under the commercial names Chenix and Chenodal. The recommended dose is 13 to 16 mg/kg daily in two divided doses for up to 2 years.

Side effects of Chenodiol[edit source]

Side effects include gastrointestinal upset with diarrhea, bloating, cramps, dyspepsia, nausea and vomiting.

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Contributors: Prab R. Tumpati, MD