Drugs Affecting Intestinal Secretions

Warning

Drugs Affecting Biliary Composition and Flow

Preferred list (P)

URSODEOXYCHOLIC ACID

  • Treatment of Primary Biliary Cirrhosis (PBC): the daily dose depends on body weight.
  • For the first 3 months of treatment, ursodeoxycholic acid should be taken divided over the day (two or three times a day). Thereafter, if an adequate clinical response the divided dose can change to once daily in the evening.
  • For 500mg strength tablet the brand Cholurso® is currently the most cost-effective.

Pancreatin

Specialist initiation (S1)

PANCREATIN capsules (Creon®)

PANCREATIN capsules (Nutrizym 22®)

There are ongoing supply issues with Pancreatic Enzyme Replacement Therapy (PERT) Medications. 

Prescribing Notes:

  • Pancreatin is inactivated by gastric acid therefore preparations are best taken with food (or immediately before/after food). It can be mixed with food or liquids, but these must not be excessively hot as it is inactivated by heat. Mixtures must be ingested within one hour. Pancreatin can cause perioral and buccal irritation if retained in the mouth. High doses can cause perianal irritation.

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.