Ursodiol
Ursodiol is a naturally occurring, hydrophilic bile acid used primarily as an adjunctive treatment for hepatobiliary disease in dogs and cats. **Clinical Highlights:** * **Hepatoprotective:** It is highly beneficial in chronic liver diseases, particularly where cholestasis (bile toxicity) plays a role, such as cholangitis, cholangiohepatitis, and copper-associated hepatopathy. * **Gallstone Dissolution:** It can be used for the medical management of cholesterol-containing gallstones (radiolucent stones). * **Immunomodulatory:** It may help slow the progression of inflammatory hepatic disorders, including autoimmune hepatitis. > **Clinical Pearl:** Unlike hydrophobic bile acids which are toxic to cell membranes, ursodiol is a cytoprotective hydrophilic bile acid. It shifts the bile acid pool to a less toxic profile, reducing hepatocyte apoptosis and oxidative stress.
Mecanismo: Ursodiol exerts its effects through multiple hepatoprotective and choleretic pathways: * **Cholesterol Reduction:** Suppresses hepatic synthesis and secretion of cholesterol and decreases intestinal absorption of cholesterol. * **Gallstone Solubilization:** By reducing cholesterol saturation in the bile, it allows the solubilization of cholesterol-containing gallstones. * **Choleretic Effect:** Increases bile flow, which helps flush toxic bile acids from the liver. * **Cytoprotection:** Reduces the hepatocyte toxic effects of endogenous hydrophobic bile salts (e.g., lithocholate, deoxycholate) by decreasing their detergent action on cell membranes, thereby protecting hepatic cells from apoptosis and necrosis.
Dosificación por especie
- Cholestatic liver disease, cholangitis/cholangiohepatitis, chronic hepatitis, and copper-associated hepatopathy · 10-15 mg/kg PO once daily · PO · q24h · Safe and potentially beneficial.
- Chronic active hepatitis, fibrosis, and cirrhosis · 11-15.4 mg/kg PO either once daily or divided twice daily · PO · q12h-q24h · May use as primary or adjunctive therapy. Cats usually get 1/6th of a capsule mixed with a small amount of food. Cats may still eat their food even if drug is sprinkled on top.
- Adjunctive treatment of chronic hepatitis · 10 mg/kg/day PO · PO · q24h
- Adjunctive treatment of liver disease · 10-15 mg/kg PO once daily · PO · q24h
- Adjunctive treatment of chronic hepatitis · 5-15 mg/kg PO divided q12h · PO · q12h · With immunosuppressive therapy. Note: Use of this drug at this dose is preliminary, but promising.
- Cholestatic liver disease, cholangitis/cholangiohepatitis, chronic hepatitis, and copper-associated hepatopathy · 10-15 mg/kg PO once daily · PO · q24h · Safe and potentially beneficial.
- Chronic active hepatitis, fibrosis and cirrhosis · 11-15.4 mg/kg PO either once daily or divided twice daily · PO · q12h-q24h · May use as primary or adjunctive therapy.
Las dosis son una referencia clínica para médicos veterinarios. Confirme siempre con la información vigente del producto y el paciente individual.
Vías de administración
Contraindicaciones
- Rabbits and other hindgut fermenters (converted to toxic lithocholic acid)
- Biliary obstruction
- Biliary fistulas
- Cholecystitis
- Pancreatitis
- Cholangitis (if complete obstruction is present)
Efectos adversos
- Diarrhea
- Gastrointestinal upset (rare)
Interacciones farmacológicas
- Aluminum-containing antacids · May bind to ursodiol, thereby reducing its efficacy
- Cholestyramine resin · May bind to ursodiol, thereby reducing its efficacy
- Taurine · Theoretical concern that chronic administration in cats may lead to taurine deficiency
Monitoreo
- Efficacy via ultrasonography for gallstones
- Improved liver function tests for chronic hepatic disease
- SGPT/SGOT (AST/ALT) on a routine basis
Sobredosis
Overdosage of ursodiol would most likely cause **diarrhea**. **Treatment:** * Supportive therapy. * Oral administration of an aluminum-containing antacid (e.g., aluminum hydroxide suspension) to bind the drug. * Gastric emptying (if large overdose occurred recently) with concurrent administration of activated charcoal or cholestyramine suspension.
La referencia de fármacos de VetSheet está destinada a médicos veterinarios como apoyo a la decisión clínica; no sustituye el juicio profesional ni la información vigente del fabricante.