Maxxhepa Urso 200 ampharco treatments for cirrhosis due to raw bile, dissolving cholesterol gallbladder stones (3 blisters x 10 tablets)
Dosage form Box of 3 blisters x 10 tablets
Specifications Ursodeoxycholic acid
Ingredient
| Composition information | Content |
| Ursodeoxycholic acid | 200mg |
Uses
indications
Maxxhepa Urso 150 medicine indicated treatment in the following cases:
Ursodeoxycholic acid (UDCA, Ursodiol) is a natural water stem acid, derived from cholesterol, accounting for a small part of the total amount of bile acid in humans.
Ursodiol uses oral to increase the amount of this bile acid related to the dose, to become the main bile acid, replace/convert the toxic concentration of hydrophobic cavalry acids (bile acid tends to accumulate in bile clogged liver disease).
Ursodeoxycholic acid protects the liver, bile gums, dissolves gallstones, reduces blood lipids, reduces blood cholesterol and some immune -regulating effects:
pharmacokinetics
absorption:
normal ursodiol accounts for a small part of the total amount of bile acids in humans (about 5%). After drinking, most of Ursodiol are absorbed by passive diffusion and this absorption is incomplete.
Metabolism:
After being absorbed, about 70% of Ursodiol is secreted when there is no liver disease. This leads to low circulatory blood levels. As the liver disease gets worse, the level of liver secretes decreases. In the liver, Ursodiol combined with glycin or taurin, then excreted into the bile. These complexes of Ursodiol are absorbed in the small intestine according to passive and active mechanisms. These complexes can also be separated in the ileum by intestinal enzymes, leading to free ursodiol formation, which can be reabsorbed and combined in the liver. Ursodiol does not absorbed into the colon where almost reduced 7-oh into lithocholic acid.
A part of ursodiol is converted into the isomers of Chenodiol/Chenodexolic Acid (CDCA). Chenodiol is also reduced 7-oh into lithocholic acid. These metabolites are less soluble and excreted in stool. A small part of lithocholic acid is reabsorbed, combined with glycin or taurin in the liver and is mounted at the 3rd sulfate.
Distribution:
In healthy people, at least 70% of ursodiol (uneasy) is tied to plasma proteins. There is no information on the cohesion of ursodiol associated with plasma proteins in healthy people or patients with raw bile cirrhosis. However, because of the effect of Ursodiol related to its concentration in bile rather than in plasma, serum concentration is not a factor that indicates clinical bioactivity. The distribution volume has not been determined, but is thought to be low because the drug is distributed mainly in bile and small intestine. In honey, the peak concentration of Ursodiol is achieved in 1-3 hours.
Excretion:
Ursodiol eliminates mainly through feces. When treated, the excretion through the urine increases, but still less than 1%, except in serious cholestatic liver disease.
Before taking Maxxhepa Urso 200 ampharco treatments for cirrhosis due to raw bile, dissolving cholesterol gallbladder stones (3 blisters x 10 tablets)
How to use
oral tablets, should swallow whole tablet with water.
Dosage
Cirrhosis due to primary bile (PBC)
Adults: The recommended dose is 14 ± 2 mg/kg/day. In the first 3 months of treatment, Maxxhepa®uro should be divided doses a day. Along with the improvement of the liver values can be used once in the evening.
Children: Dosage calculated by body weight.
Dosage Maxxhepa®uro in the treatment of cirrhosis due to primary bile (12 - 16 mg/kg/day)
x 1 - 2 times/day
x 2 - 3 times/day
x 2 - 4 times/day
x 3 - 4 times/day
x 2 - 3 times/day
x 3 - 4 times/day
Adults: The common dose is 8 - 12 mg/kg/day used in the evening or divided into doses. When necessary, the dose can be increased to 15 mg/kg daily for obese patients. The treatment time can be up to two years, depending on the size of the gravel, and should be continued for three months after clearing the stones clearly.
Children: Cholesterol -rich gallbladder stones and cirrhosis due to primary bile are very rare in children, but when detected the disease, the dose should be calculated by body weight. There is no adequate data on efficiency and safety for children.
Elderly: There is no evidence that suggests to change the dose for adults but need to be cautious when used for older patients.
Dosage Maxxhepa®uro in the treatment of gallbladder stones (8 - 12 mg/kg/day)
x 1 - 2 times/day
x 1 - 2 times/day
x 2 - 3 times/day
x 2 - 3 times/day
60 - 70 The recommended dose of Ursodeoxycholic acid is 20 mg/kg/day divided into 2-3 times, when necessary, it can increase to 30 mg/kg per day. Maxxhepa®urso dose in the treatment of liver disorders related to cystic fibrosis in children 6 - 18 years old (20 mg/kg/day) 1 soft capsules x 1 - 2 times/day x 2 - 3 times/day x 3 - 4 times/day x 3 - 4 times/day x 3 times/day x 3 - 4 times/day Specific measures are not necessary and should treat symptoms of diarrhea by restoring water and electrolytes. In an emergency, call the 115 emergency center immediately or go to the nearest local health station. weight (kg) dose (mg) maxhepa®urso 200 10 - 20 200 - 400 What to do when forgetting 1 dose? If this dose is close to the time of the next dose, skip the missed dose and use the next dose regularly according to the schedule. Do not use double dose.
Side Effects
In the recommended dose, Maxxhepa®urso is well tolerated and unwanted effects.
Common (ADR ≥ 1/100)
Very rare (ADR Gastrointestinal disorders: Severe upper abdominal pain, constipation.
Notify the physician the unwanted effects when using the drug.
Warnings
Before using the drug you need to read the instructions carefully and refer to the information below.
contraindicated
Maxxhepa®urso drugs contraindicated in the following cases:
Caution when using
Monitoring patients:
Serum liver function test [γ-glutamyl transferase (γ-GT), alkaline phosphatase, aspartat transaminase (AST), Alanin Transaminase (ALT)] and bilirubin levels should be monitored every month for three months after treatment, and every six months later.
Monitor each wave to detect the likelihood of liver function impairment, especially in patients with cirrhosis due to progressive bile bile. The serum concentration of these indicators usually decreases rapidly. Improving serum liver function tests (such as AST, ALT) are not always correlated with improvement. For patients with a history of biochemical response sufficient for treatment, it is advisable to consider stopping Ursodiol when serum liver function tests increase significantly clinically.
When used to treat cirrhosis due to progressive primary bile (PBC):
Understanding cirrhosis is very rare in the case, this condition is partially reduced after treatment.
In patients with primary biliary cirrhosis, very rare cases of clinical symptoms can deteriorate at the beginning of treatment, for example, itching may increase. In this case, the dose should be reduced to 200 mg daily and then gradually increased to the recommended dose.
If diarrhea, dose reduction and in case of prolonged diarrhea, treatment should be discontinued.
When used to melt gallbladder stones:
Should visit gallbladder (photometric gallbladder photography) with general images and clogged images in a standing and lying position (checking via ultrasound) 6 - 10 months after starting treatment to evaluate the progression of treatment therapy and timely detection of any gallbladder calcification, depending on the size of the gravel.
If you can't see the gallbladder on X -rays, or in the case of calculating gallbladder stones, decreased gallbladder spasms or frequent bile cramps, Maxxhepa® should not be used.
Women's patients use Maxxhepa®urso to melt gallbladder stones should use an effective method of contraception, because hormonal contraceptives can increase gallstones.
Special subjects
excipients:
The drug contains sorbitol. Patients with rare genetic diseases are not tolerated with fructose should not take this medication.
The drug contains methylparaben, propylparaben and Sunset Yellow can cause allergic reactions.
The effect of the drug on the ability to drive and operate machines
Ursodeoxycholic acid (UDCA) does not have or negligible effect on the ability to drive and operate machinery.
Use drugs for women during pregnancy and lactation
It is not known whether Ursodiol is excreted through breast milk. Therefore, maxxhepa®urso should not be used for nursing women.
Drug interaction
bile acid bonding substances (cholestyramin and colestipol), aluminum antacids that can hinder Ursodiol's activity by reducing its absorption.
Activated carbon can reduce Ursodiol absorption.
Ursodeoxycholic acid may increase ciclosporin absorption and increase serum ciclosporin levels. Therefore, the doctor should check the concentration of ciclosporin and adjust the dose if necessary.
Ursodeoxycholic acid can reduce the absorption of ciprofloxacin.
Ursodeoxycholic acid has shown that it may reduce the peak concentration in plasma (CMAX) and the area under the curve (AUC) of the calcium nitrendipine drug.
It is recommended that it should not be prescribed with drugs that increase cholesterol via bile, such as hormones that create estrogen, oral contraceptives and some cholesterol lowering drugs.
Storage
At temperatures below 30 ° C, avoid direct light and wet place.
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