Chenodiol (Chenodeoxycholic Acid)

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Inhibits
  • Drug Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names


Germany: Xenbilox; Poland: Chenofalk; Portugal: Xebyl.

North America

USA: Chenodiol.


Japan: Chenix.

Drug combinations

Chenodiol and Ursodeoxycholic Acid


Chenodiol: C~24~H~40~O~4~. Mw: 392.58. (1)(4R)-4-[(3R,5S,7R,8R,9S,10S,13R,14S,17R)-3,7-dihydroxy-10,13-dimethyl-2, 3,4,5,6,7,8,9,11,12,14,15,16; (2) 3α, 7α-dihydroxy-5β-cholan-24-oic acid. CAS: 99102-69-9.

Pharmacologic Category

Cholelitholytic Agents; Human Bile Acid. (ATC-Code: A05AA01).

Mechanism of action

Chenodiol suppresses hepatic synthesis of both cholesterol and cholic acid, gradually replacing the latter and its metabolite, deoxycholic acid, in an expanded bile acid pool. These actions contribute to biliary cholesterol desaturation and gradual dissolution of radiolucent cholesterol gallstones in the presence of a gall-bladder visualized by oral cholecystography. Chenodiol has no effect on radiopaque (calcified) gallstones or on radiolucent bile pigment stones.

Therapeutic use

Indicated for patients with radiolucent stones in well-opacifying gallbladders, in whom selective surgery would be undertaken except for the presence of increased surgical risk due to systemic disease or age.

Pregnancy and lactiation implications

Chenodiol is contraindicated in women who are or may become pregnant. Caution should be exercised when administered to nursing women.

Unlabeled use


Presence of known hepatocyte dysfunction or bile ductal abnormalities such as intrahepatic cholestasis, primary biliary cirrhosis or sclerosing cholangitits. A gallbladder confirmed as nonvisualizing after two consecutive single doses of dye. Radiopaque stones, gallstone complications or compelling reasons for gallbladder surgery including unremitting acute cholecystitis, cholangitis, biliary obstruction, gallstone pancreatitis, or biliary gastrointestinal fistula.

Warnings and precautions

Safe use of chenodiol depends upon selection of patients without pre-existing liver disease and upon faithful monitoring of serum aminotransferase levels to detect drug-induced liver toxicity. Aminotransferase elevations over three times the upper limit of normal have required discontinuation of chenodiol (2%-3%). Epidemiologic studies suggest that bile acids might contribute to human colon cancer, but direct evidence is lacking.



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