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1.9 DRUGS AFFECTING INTESTINAL SECRETIONS

1.9 Drugs Affecting Intestinal Secretions

    1.9.1 Drugs affecting biliary composition and flow

            Mainly used for unlicensed use in itching related to gall bladder problems
            AMBER     Ursodeoxycholic acid  
                              tablets 150mg, capsules 250mg
                              suspension 250mg in 5mL
            RED          Obeticholic acid▼                                                                                                         NHS England Commissioned 
                             film coated tablets 5mg, 10mg
                             Patients should be reviewed 12 months after initiation to review effectiveness and treatment should only  
                             continue if there is  evidence of clinical  benefit - as per NICE TA443
 
            Pruritis secondary to  primary sclerosing cholangitis 
            1st line option, unlicensed indication.
            CAUTION:  should not be prescribed alongside another statin
            AMBER   Bezafibrate tablets 200mg, 400mg
 
 
          Palliative Use Only: Bowel Obstruction - GI secretions associated with bowel obstruction.
          (suitable for initiation in Primary Care in line with restrictions)
          GREEN (Restricted)   Octreotide 500micrograms/ml solution for injection
          See Quick Guide: Bowel Obstruction
          [For full guidance see LSC Palliative Care Clinical Practice Summary]
 

    1.9.2 Bile acid sequestrants

            GREEN       Colestyramine sachets 4g (Questran Light®)
 

    1.9.4 Pancreatin

            GREEN       Creon® 10,000 capsules (protease 600/lipase 10,000/amylase 8000) 
            GREEN       Creon® 25,000 capsules (protease 1,000/lipase 25,000/amylase 18,000) 
            AMBER      Creon® micro granules (Amylase 3600 unit, Lipase 5000 unit, Protease 200 unit) 
                                [Paediatric use ONLY/specialist initiation]
            AMBER      Nutrizym 22® capsules (Amylase 19800 unit/Lipase 22000 unit/Protease 1100 unit) - second line option when    
                               creon® not tolerated
            RED            Pancrex V Powder®  administration via enteral feeding tubes to reduce malabsorption in patients on enteral feeds.
                               Gastroenterology use ONLY
 
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