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Chenodeoxycholic acid Side Effects

For the Consumer

Applies to chenodeoxycholic acid: oral tablet

Along with its needed effects, chenodeoxycholic acid may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking chenodeoxycholic acid:

Incidence not known
  • Black, tarry stools
  • chest pain
  • chills
  • cough
  • fever
  • painful or difficult urination
  • shortness of breath
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • swollen glands
  • unusual bleeding or bruising
  • unusual tiredness or weakness

Some side effects of chenodeoxycholic acid may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Diarrhea
Less common
  • Abdominal or stomach pain
  • acid or sour stomach
  • belching
  • bloated
  • cramps
  • difficulty having a bowel movement (stool)
  • excess air or gas in the stomach or intestines
  • full feeling
  • heartburn
  • indigestion
  • loss of appetite
  • nausea and vomiting
  • pain in the chest below the breastbone
  • pain or discomfort in chest, upper stomach, or throat
  • passing gas
  • stomach discomfort or upset
  • weight loss

For Healthcare Professionals

Applies to chenodeoxycholic acid: oral tablet


Hepatic side effects have included dose-related serum aminotransferase (mainly SGPT) elevations, usually not accompanied by
rises in alkaline phosphatase or bilirubin, occurring in 30% or more of patients treated with the recommended dose of chenodeoxycholic acid. In most cases, these elevations were minor (1½ to 3 times the upper limit of laboratory normal) and
transient, returning to within the normal range within six months despite continued administration of the drug.

Morphologic studies of liver biopsies taken before and after 9 and 24 months of treatment with chenodeoxycholic acid have shown that 63% of the patients prior to chenodiol treatment had evidence of intrahepatic cholestasis. Almost all pretreatment patients had electron microscopic abnormalities. By the ninth month of treatment, reexamination of two-thirds of the patients showed an 89% incidence of the signs of intrahepatic cholestasis. Two of 89 patients at the ninth month had lithocholate-like lesions in the canalicular membrane, although there were not clinical enzyme abnormalities in the face of continued treatment and no change in Type 2 light microscopic parameters.[Ref]


Gastrointestinal side effects have included diarrhea in 30% to 40% of patients and may occur at any time during treatment, but is most commonly encountered when treatment is initiated. Usually, the diarrhea is mild, translucent, well-tolerated and does not
interfere with therapy. Other less frequent, gastrointestinal side effects reported include urgency, cramps, heartburn, constipation, nausea and vomiting, anorexia, epigastric distress, dyspepsia, flatulence and nonspecific abdominal pain.[Ref]


Hematologic side effects have included decreases in white cell count but the drug was continued in all patients without incident.[Ref]


Metabolic side effects have included serum total cholesterol and low-density lipoprotein (LDL) cholesterol increases of 10% or more during drug administration; no change has been seen in the high-density lipoprotein (HDL) fraction; small decreases in serum triglyceride levels for females have been reported.[Ref]


1. "Product Information. Chenodal (chenodeoxycholic acid)." Manchester Pharmaceutical, Fort Collins, CO.

Some side effects of chenodeoxycholic acid may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

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