药品信息:
--------------------------------------------------------------- 详细处方信息以本药内容附件PDF文件(201411919384538.pdf)的“原文Priscribing Information”为准 --------------------------------------------------------------- 部分中文URSO处方资料(仅供参考)
药品信息
化学性质
本品为白色粉末;无臭,味苦。Mp 200-204℃。在乙醇和冰醋酸中易溶,在氢氧化钠试液中溶解,在氯仿中不溶。UDCA为CDCA的同分异构体,其溶石作用强于CDCA,无腹泻及肝脏毒性。UDCA能降低胆固醇的吸收,并能降低胆固醇的合成及胆汁中的胆固醇含量。另外,UDCA亦能降低伴刀豆蛋白A结合片段,该物质能促进胆汁结晶的形成,从而抑制结石的形成。UDCA和CDCA联合使用,可增强各自单独使用的溶石作用,同时减轻副作用。两者联用主要用于治疗胆囊胆固醇结石,患者胆石与胆汁等密度或者胆石CT值低于75单位时, UDCA的溶石速度最快。胆石症病人使用本品后,可增加外周血小板数量。
用途
胆石溶解药。主要用于不宜手术治疗的胆固醇型胆结石,尤其是胆囊功能基本正常、结石直径在15mm以下、透X线、非钙化型的浮动胆固醇结石的治愈率高。对中毒性肝炎、胆囊炎、原发性硬化性胆管炎、原发性胆汁淤积性肝硬化也有一定的治疗效果。提高α-干扰素治疗慢性丙型肝炎的疗效。有腹泻,罕见便秘、过敏反应、瘙痒、头痛、头晕、胃痛、胰腺炎及心动过缓等。胆道完全阻塞和严重肝功能减退者及孕妇忌用。
用途
适用于预防及治疗胆固醇性胆结石
生产方法
方法一、以鹅去氧胆酸为原料
3α, 7α-二乙酰胆酸甲酯的制备 取无水甲醇36ml,通入1g干燥氯化氢气体,加胆酸12g,搅拌,加热回流20-30min,室温放置数小时后析出晶体,冷冻,过滤,用乙醚洗涤,干燥,得胆酸甲酯。取胆酸甲酯2g,加苯9.6ml,加吡啶2.4ml,加乙酐2.4ml,振摇10-15min,室温放置20h,将反应液倒入100ml水中,除去苯层,反复用蒸馏水洗涤,回收溶剂,固体残渣用石油醚洗涤1次,用甲醇-水溶液重结晶,得3α,7α-二乙酰胆酸甲酯。
胆酸→胆酸甲酯→3α,7α-二乙酰胆酸甲酯
鹅去氧胆酸的制备 取二乙酰胆酸甲酯1.5g,加乙酸24 ml,加铬酸钾溶液(取铬酸钾0.76g溶于1.8ml水中),加热至40℃,反应8h,加水120ml,振摇片刻,放置12h,过滤,用蒸馏水洗至中性,干燥,得3α,7α-二乙酰氧基- 12-酮基胆烷酸甲酯,简称12-酮。取12-酮15g,加二乙二醇醚150ml,加80%水合肼溶液15ml,加氢氧化钾15g,加热至30℃回流15h,升温至195-200℃,回流2.5h,升温至217℃反应片刻,冷却至190℃,加水合肼溶液0.7ml,在3h内由215℃升温至220℃,冷却,加蒸馏水600ml,加10%硫酸调pH 3,析出结晶,过滤,水洗至中性,加乙酸乙酯,弃去水层,有机层用水洗1-2次,减压蒸馏,得白色3α,7α-二羟基胆烷酸,即鹅去氧胆酸。
3α,7α-二乙酰胆酸甲酯→3α,7α-二乙酰氧基-12-酮基胆烷酸甲酯→3α,7α-二羟基胆烷酸(鹅去氧胆酸)
熊去氧胆酸精品的制备 取鹅去氧胆酸2g,加100ml乙酸,加乙酸钾20g,振摇溶解,加铬酸钾1.5g(溶于10ml水中),室温放置过夜,加水200ml,析出结晶,过滤,水洗,干燥,得3α-羟基-7-酮基胆烷酸。取3α-羟基-7-酮基胆烷酸4g,加正丁醇100ml,加热至约115℃,分次加入金属钠8g,逐渐有白色浆状物析出,继续反应30min,加水120ml,搅拌升温溶解透明,减压蒸去有机层,残渣加水500ml,溶解,过滤,滤液加10%硫酸调pH3,有白色絮状物沉淀,过滤,水洗至中性,干燥,加乙酸乙酯洗涤,稀乙醇结晶,得3α,7β-二羟基胆烷酸,即熊去氧胆酸精品。
鹅去氧胆酸[铬酸钾]→3α-羟基-7-酮基胆酸[金属
115℃]→3α, 7β-二羟基胆烷酸(熊去氧胆酸)
方法二、以猪胆盐或猪胆汁为原料 利用薄层层析法从猪胆盐或猪胆汁中,分离出熊去氧胆酸。猪胆盐中含有游离型和结合型的UDCA,其含量约30%;猪胆汁中含有结合型UDCA,含量约0.6%
Urso - Indication:
Urso 250® and Urso Forte® (Ursodiol) tablets are indicated for the treatment of patients with primary biliary cirrhosis (PBC).
Ursodiol is a bile acid that decreases the amount of cholesterol produced by the liver and absorbed by the intestines. Ursodiol helps break down cholesterol that has formed into stones in the gallbladder. Ursodiol also increases bile flow in patients with primary biliary cirrhosis.
Ursodiol is used to treat small gallstones in people who cannot have gallbladder surgery, and to prevent gallstones in overweight patients undergoing rapid weight loss. Ursodiol is also used to treat primary biliary cirrhosis.
Ursodiol is not for treating gallstones that are calcified.
Ursodiol may also be used for purposes other than those listed in this medication guide.
Used for: Treating and preventing gallstones. It may also be used for other conditions as determined by your doctor.
Urso is a bile acid naturally found in the body. It works by dissolving the cholesterol that makes gallstones and inhibiting production of cholesterol in the liver and absorption in the intestines, which helps to decrease the formation of gallstones. It can also reduce the amount of other bile acids that can be harmful to liver cells when levels are elevated.
Ursodiol (also known as ursodeoxycholic acid) is one of the secondary bile acids, which are metabolic byproducts of intestinal bacteria. Primary bile acids are produced by the liver and stored in the gall bladder. When secreted into the colon, primary bile acids can be metabolized into secondary bile acids by intestinal bacteria. Primary and secondary bile acids help the body digest fats. Urso helps regulate cholesterol by reducing the rate at which the intestine absorbs cholesterol molecules while breaking up micelles containing cholesterol. Because of this property, Urso is used to treat gall stones non-surgically.
Indications: primary biliary cirrhosis
Indications: cholesterol gallstones
Indications: cholesterol gallstones, biliary-tract disorders, liver disorders
Treatment of primary biliary cirrhosis, Treatment of bile reflux gastritis, Dissolution of cholesterol gallstones.
Indications: Dissolution of cholesterol-rich gallstones.
Cirrhosis and other hepatic disorders. |