Prebichol 10

✔️ Uses

• Primary biliary cirrhosis

✔️ Possible Side Effects:

• Stomach pain
• Fatigue
• Dizziness
• Constipation
• Palpitations (irregular or rapid heartbeat)
• Thyroid irregularities

These side effects are typically mild and may resolve on their own. However, if they persist or worsen, consult your doctor.

✔️ Diet and Lifestyle Recommendations:

• Include a balanced diet with fruits and vegetables, as well as foods like bell peppers, citrus fruits, leafy greens, tomatoes, milk, fish, low-fat dairy, beans, nuts, lentils, tofu, and tempeh.
• Avoid high-fat, processed, or sugary foods, as well as tobacco and alcohol.

✔️ Usage Instructions:

• Take Prebichol 10 as prescribed by your doctor.
• The tablet should be swallowed whole with a glass of water—do not chew or crush it.

✔️ Overdose:

If you take more than the prescribed dose, symptoms of overdose may include yellowing of the skin or eyes, dark urine, loss of appetite, upper stomach pain, nausea, vomiting, or swelling around the stomach. If you suspect an overdose, seek immediate medical attention.

✔️ Obeticholic Acid (Ocaliva) Dosage and Management in Primary Biliary Cirrhosis (PBC):

Recommended Dosage Regimen:

• For PBC patients without cirrhosis or with compensated cirrhosis who:
  • Have not achieved adequate biochemical response to an appropriate dosage of UDCA for at least 1 year, or are intolerant to UDCA:
    • Start with 5 mg once daily for the first 3 months.
    • After 3 months, if there has not been an adequate reduction in ALP (alkaline phosphatase) and/or total bilirubin and Obeticholic acid is tolerated, increase to a maximum dosage of 10 mg once daily.

Monitoring for Safety and Discontinuation:

• Regular monitoring during treatment is essential, particularly for:
  • Biochemical response and tolerability of Obeticholic acid.
  • Progression of PBC.
  • Portal hypertension in patients with compensated cirrhosis, autoimmune hepatitis, alcoholic liver disease, or severe intercurrent illness.
  • Signs of hepatic decompensation, such as elevated bilirubin levels, prothrombin time, or worsening ascites.
• Discontinue Obeticholic acid if:
  • Laboratory or clinical evidence of hepatic decompensation develops.
  • Signs of portal hypertension emerge.
  • Clinically significant hepatic adverse reactions occur.
  • Complete biliary obstruction occurs.

Management of Intolerable Pruritus:

• If pruritus (itching) becomes intolerable:
  • Consider adding an antihistamine or bile acid-binding resin.
  • Reduce Obeticholic acid dosage:
    • 5 mg every other day for patients intolerant to 5 mg once daily.
    • 5 mg once daily for patients intolerant to 10 mg once daily.
  • Temporarily interrupt dosing for up to 2 weeks and then restart at a lower dose.
  • If symptoms persist despite adjustments, consider discontinuing Obeticholic acid treatment.

✔️ Drug Interactions:

• Severe interaction with Tizanidine.
• Moderate interaction with caffeine-containing foods or drinks.
• It may interact with medications like theophylline, warfarin, cholestryamine, colestipol, and colesevelam.

✔️ Contraindications:

• Child-Pugh Class B or C: Obeticholic acid is contraindicated in patients with severe liver impairment (Child-Pugh Class B or C), especially those who have had a prior decompensation event or have compensated cirrhosis with evidence of portal hypertension (e.g., ascites, gastroesophageal varices, persistent thrombocytopenia).

✔️ Important Warnings:

• Do not take Prebichol 10 if you are allergic to any of its components or if you have a blockage in your biliary tract (liver, bile ducts, or gallbladder).
• If you experience unbearable itching, consult your doctor.
• Prebichol 10 is not recommended during pregnancy or breastfeeding unless necessary. Discuss the risks with your doctor.
• This medication is not recommended for children and adolescents.
• Prebichol 10 may cause dizziness, so use caution when driving.
• Seek immediate medical help if you notice yellowing of the skin or eyes, black or tarry stools, dark urine, coughing up or vomiting blood, confusion, slurred speech, mood swings, anxiety, or swelling around the stomach.

✔️ Storage:

• Store in a cool, dry place, away from sunlight.