Bile acid
Chenodeoxycholic acid
Brand names: Chenodeoxycholic acid Leadiant
Adult dose
Dose: Initial 250mg/day in divided doses; titrate to 750mg/day max divided doses
Route: PO
Frequency: divided
Clinical pearls
- Cerebrotendinous xanthomatosis (CYP27A1 deficiency) — replaces deficient bile acid
Contraindications
- Acute biliary inflammation
- Pregnancy
Side effects
- Diarrhoea
- Hepatotoxicity
Interactions
- Bile acid sequestrants reduce absorption (give 4–6 hours apart)
- Aluminium-containing antacids reduce absorption
Monitoring
- LFTs
Reference: BNF; https://bnf.nice.org.uk/drugs/chenodeoxycholic-acid/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Lower Gastrointestinal Bleed · BSG 2019; NICE NG141
- Variceal Upper GI Bleed · BSG 2015; Baveno VII (2022)
- Spontaneous Bacterial Peritonitis (SBP) · BSG / EASL 2018
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Hepatic Encephalopathy · EASL 2014; West Haven criteria
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021