6 best choleretic drugs
Digestion is a holistic process, but it is divided into parts that seem opposed and incompatible. So, in the stomach is very acidic, and in the duodenum is already alkaline. In order to reduce the acidity of the gastric juice that has entered the intestine, and to neutralize the activity of gastric enzymes, and transfer the change of the phases of digestion from acidic to alkaline (intestinal), a special liquid is produced in the liver, called bile.
Every day about a liter of this fluid is formed and excreted from an adult’s body. The bile of a healthy person has a greenish or yellow color, it tastes extremely bitter. After formation, it is transported along its own ducts to the vesica fellea, or gallbladder, where it is stored. After contraction of the smooth muscles of the gallbladder, it is excreted into the intestinal lumen as necessary, taking part in digestion.
Bile also helps emulsify, or dissolve fats in the intestines, and prepares them for digestion. It improves intestinal motility, increases the production of digestive hormones. Very important is its role in binding and excretion of cholesterol, and the breakdown product of hemoglobin contained in the blood. It is called bilirubin. Since this substance is not able to be filtered through the glomeruli, bilirubin is eliminated through the bile, and leaves the body with feces.
Most often in clinical practice, there are conditions associated with the slow formation of this fluid, with the difficulty of its entry into the small intestine, due to the development of cholelithiasis - stone disease, chronic inflammation of the bladder - cholecystitis and other pathologies of the pathways leading to bile. The resulting chemical or mechanical obstacles to the normal entry of bile into the intestine cause a number of painful symptoms.
This is a discomfort in the stomach on the right, bitterness, nausea, in severe cases, mechanical jaundice, bloating, fecal discoloration may occur. In order to normalize the passage of this important fluid, choleretic drugs are applied. This rating included the most effective and frequently prescribed products from this list. Choleretic agents differ in their mechanism and indications for their intended use. The review begins with the so-called choleretics.
Rating of the best choleretic drugs
| Nomination | a place | Name of product | price |
| Best Choleretic - Choleretics: Education Stimulants | 1 | Allohol | 44 ₽ |
| 2 | Odeston | 381 ₽ | |
| 3 | Holosas | 105 ₽ | |
| The best choleretic kinetics: stimulants of bile discharge | 1 | Magnesium sulfate | 26 ₽ |
| 2 | Sorbitol | 128 ₽ | |
| 3 | No-spa (Drotaverinum) | 112 ₽ |
Best Choleretic - Choleretics: Education Stimulants
Means that stimulate the formation of bile from its precursors are natural, or true, synthetic, as well as plant-based choleretic agents that have a bile-forming effect. True choleretics are often of animal origin. Below are the most popular choleretic drugs from all subgroups.Of these, Allohol is a true choleretic, Odeston is a synthetic agent, and Holosas is a gelatinous drug consisting of one herbal component.
Allohol
Rating: 4.9
Allohol is perhaps the most popular and affordable "popular" choleretic medicine. This is a combined agent, and Allohol contains dry bovine bile, dry nettle and garlic, as well as activated charcoal. All these components together give a stronger choleretic effect than just one bile. Allohol can increase intestinal contractions (peristalsis) of the intestine, and due to the presence of activated carbon, which has an antimicrobial and sorption effect, it reduces the processes of rotting and fermentation that can occur in the intestines.
Allohol is shown in the complex therapy of chronic cholecystitis, with cholangitis, and with symptoms of atonic constipation. It is usually taken in two pills, after meals, so that it shows the maximum choleretic effect. If the patient is prescribed a fractional diet, then the drug should be taken no more than 4 times. This technique must be observed a month, and then it is reduced by half the dosage. It is possible to repeat the course, but between them it is necessary to take breaks of at least 2 months.
Allohol is produced by Pharmstandard, a domestic company, and a large package containing 50 coated tablets costs only 42 rubles. In some pharmacies you can find it for 33 rubles, and the smallest package of 10 tablets costs only 12 rubles.
Advantages and disadvantages
Allohol acts "choleretic" quite softly, in contrast to synthetic drugs. Still, it contains natural bile. But, nevertheless, at a sufficiently high dosage, it can cause diarrhea and flatulence of the abdomen, and Allohol is contraindicated in acute ulcers, in mechanical (obstructive) jaundice, and if the gallbladder has calculi. This leads to a sharp increase in secretion, and if she has no place to move, then an expansion of the bladder and even its rupture with the development of peritonitis can occur. Allohol is contraindicated in acute and subacute hepatitis - inflammation of the liver, and in its progressive dystrophy. But this cholagogue, taken on the testimony, acts gently and helps to improve digestion and normalization of stool in very different groups of patients.
Odeston
Rating: 4.8
Odeston belongs to the group of infrequently used synthetic choleretics, and it has a rather pronounced choleretic effect. This tool in the form of the active substance contains gimekromon, and comes in the form of tablets weighing 200 mg each.
Odeston reduces the phenomenon of stagnation, reduces the processes leading to the formation of cholesterol stones, that is, reduces the loss of cholesterol in the form of crystals, and is indicated in the treatment of such diseases as biliary dyskinesia of the hyperkinetic type, chronic cholecystitis and cholangitis. It is prescribed after surgery on the gallbladder, and due to a chronic decrease in the secretion of bile.
Odeston is applied half an hour before meals, 1 or 2 tablets, three times a day. The daily dose should not exceed 6 tablets. The course is about 2 weeks. It is not recommended to skip a dose, but you cannot make it up later, taking a double dose right away. Odeston is produced by the Polish company Polfa, and it is possible to purchase a package of 50 tablets in the autumn of 2024 in major cities of the Russian Federation at an average price of 550 rubles.
Advantages and disadvantages
As with all choleretic drugs, Odestona has contraindications. These include obstruction, formed in the biliary tract, the phenomenon of renal and hepatic failure, gastric ulcer, impaired blood clotting and childhood. The tool has side effects, offset its rather strong choleretic action. This can lead to bloating, diarrhea, allergic reactions and abdominal pain.Since the remedy is synthetic, many doctors note, along with a strong effect, its some roughness: Odeston is not intended for mild stimulation.
Holosas
Rating: 4.7
Perhaps Holosas belongs to one of the most delicious and pleasant medicines in general, since it is a concentrated rosehip syrup with sugar. In some cases, if they are not hidden from small children, they can drink the whole bottle, and after that they will suffer from profuse diarrhea due to an overdose, but still, nothing terrible will happen to them anymore.
Holosas is indicated for various viral hepatitis, for inflammation of the biliary tract and bladder, for poisoning with various drugs, drugs that are metabolized by secreting into the bile, it is indicated for poisoning by alcoholic beverages. Holosas can be prescribed as a fortifying agent and vitamin C vitamin deficiency.
It should be used from 2 to 3 times a day, adults - 1 teaspoon per reception, and children - half a teaspoon, or even less. Kholosas is produced by the domestic company Altaivitamin CJSC, and the cost of one 140 ml bottle is an average of 86 rubles.
Advantages and disadvantages
Holosas is a natural plant monodrug, and only an individual intolerance, as well as severe diabetes mellitus, will serve as a contraindication, since Holosas contains sugar. The drug has no side effects, again with the exception of individual intolerance. Few people will experience unpleasant side effects on a delicious rosehip syrup. This tool is inexpensive, Holosas can be added to boiling water and drunk with a general strengthening purpose. Taking one teaspoon of Holosas fully satisfies the daily need for ascorbic acid.
About hydrocholagic
Hydroleretics call some table medicinal mineral waters. They simply reduce the density, viscosity of bile, and make it more fluid. Unlike ordinary water, when absorption of mineral water in the intestinal lumen and its penetration into the portal blood flow, it is absorbed by the liver cells in the first place, and increases the pressure in the bile ducts by osmosis. If it is necessary to increase the secretion of bile, then you need to choose such water as Essentuki No. 4 (low mineralization) and No. 17 (rich mineralization), Jermuk. They should be consumed 30 minutes before meals, preferably in a warm form and with released gas, if any.
The best choleretic kinetics: stimulants of bile discharge
Choleretic drugs of this list are divided into two types of opposite action. In that case, if the bladder is hypotonic, its smooth muscles are loose and weak, then it is necessary to increase its tone and strengthen its ability to contract. At the same time, these agents reduce tonic tension, and increase the lumen of the common bile duct structures. They simply irritate the intestines by activating a cascade of gastrointestinal hormones (cholecystokinin). An example of such a choleretic drug is magnesium sulfate, or magnesia.
These drugs are prescribed mainly for dyskinesia of the biliary tract on the hypotonic type, congestion in the gallbladder with a decrease in its tone. These drugs are shown in gastritis with low acidity, as well as cholekinetics, which reduce the gallbladder, are shown during duodenal sensing in a healthy person.
The second group of drugs includes antispasmodics, which relax the excessively reduced gallbladder, reduce its spasm, and simultaneously relax the biliary tract. This makes it possible to improve the flow of bile, and No-shpa, Papaverine, or the more powerful atropine and platyphylline, which are used in medical institutions and when calling an ambulance, are examples of such cholekinetics.
These funds are necessary for hypertensive dyskinesia, in the presence of stones in the gallbladder and bile ducts. They can reduce pain, which often occurs against the background of spasm of the biliary tract and in the presence of cholelithiasis.
Consider the most popular and effective cholekinetics, which are sold in pharmacies and entered the rating.
Magnesium sulfate
Rating: 4.9
Magnesia is the simplest and most accessible choleretic and laxative remedy. This colorless powder, readily soluble in water, has an intense bitter-salty taste, and drinking magnesium is unpleasant. But besides the choleretic effect, it also has an anticonvulsant effect, contributes to the normalization of the heart rhythm, has a hypotensive effect and is able to fight against constipation. Magnesia is used for cholecystitis and cholangitis, for obtaining a cystic bile portion during duodenal intubation, for hypotonic-type gallbladder dyskinesia, for bowel cleansing. Apply magnesia is necessary, dissolving one packet (25 g) in one glass of warm water, and after drinking between meals 3 times a day, before meals. In this case, on average, after one or two hours, the drug will have the necessary choleretic effect, which will last for 4 or even 6 hours. Usually, a certain relaxation of the stool occurs after this, since an osmotically active solution of magnesia will facilitate an intensive influx of water into the intestinal lumen.
Magnesium sulphate is produced by the Moscow Pharmaceutical Factory, and one packet of 25 g in weight is an average of 32 rubles.
Advantages and disadvantages
The advantages of magnesia include its all availability and low cost, the onset of a quick effect, and a simple and understandable mode of application. But this drug has contraindications. You cannot take magnesia if the patient has loose stools, symptoms of kidney failure, and low pressure and slow heartbeats (bradycardia). Magnesia is contraindicated in patients with various cardiac arrhythmias, since it can significantly worsen their condition, especially in the case of complete atrioventricular block, when the atrial pulses are separated from ventricular contractions.
Sorbitol
Rating: 4.8
Sorbitol, or, more precisely, sorbitol, is a polyhydric alcohol, and in addition to choleretic, has an osmotic and laxative effect. Sorbitol is also used in some cases to reduce the symptoms of intoxication: it removes a poisonous substance into the intestinal lumen.
Sorbitol is produced in the form of powder for oral administration, in bags, 5 g each, sometimes in powder, packaged in 200, 300, 500 g. Sorbitol is indicated to be taken for biliary dyskinesia, hypotonic type, for chronic hepatitis in complex therapy, for addiction to constipation.
It is necessary to use sorbitol with choleretic purpose, dissolving 5 g of the drug in half a cup (100 ml) of water, slightly warmed. It is necessary to take this sweet solution 10 minutes before meals twice a day. The course of treatment is 1 month. Sorbitol is produced by the domestic company Sweet World, and you can buy the largest package weighing 500 g at an average price of 122 rubles.
Advantages and disadvantages
The advantage of sorbitol is its great cheapness, great breadth of use, since it can be prescribed not only for dyskinesia and cholecystitis, but also for the treatment of constipation. However, sorbitol is contraindicated in all acute conditions, with intolerance to fructose, which is part of it, and if you exceed the required amount, and make the solution too strong or drink too much, intense diarrhea, dry mouth, nausea, and dehydration symptoms may occur. . But sorbitol can be safely used by diabetics, since its composition does not include glucose.
No-spa (Drotaverinum)
Rating: 4.7
The most well-known antispasmodic tablets No-shpa, or drotaverine hydrochloride, are produced by the Hungarian pharmaceutical company Hinoin.But-shpa is the tool that allows you to reduce smooth muscle spasms not only of the gallbladder and biliary ducts, but also smooth muscles of the urinary tract, so this drug is indicated for renal colic.
But-shpa allows to reduce the expressed pain syndrome in hypertensive form of biliary dyskinesia, in cholangitis, and in cholecystitis. But-shpa is produced not only in tablets, but also in solutions, therefore, very often it is injected intramuscularly. Only antispasmodics are indicated for pain in the abdominal cavity, in the state of "acute abdomen". The fact is that if you use strong painkillers, you can relieve the pain, and miss the state when urgent surgery is required, for example, in acute appendicitis. Antispasmodic drugs do not have an analgesic effect, and all he can do is relax the muscles.
Therefore, if there is a center of progressive inflammation in the abdominal cavity, for example, with the same calculous cholecystitis, No-shpa will not help, but if the pain is caused by a spasm in the gallbladder neck, then the desired effect will be achieved, the spasm will resolve, the bile will into the intestines, and the patient's condition improves.
It is necessary to use No-shpu in tablets from 1 tablet 40 mg to 6 tablets per day, that is, no more than 2 tablets three times a day, it is desirable to take it before meals, so that during the meal it shows its effect and relaxes smooth muscle biliary tract. There is one pack of no-shpy in the amount of 24 tablets of about 100 rubles.
Advantages and disadvantages
The big plus of No-shpy is its rather high activity and speed. Rarely, overdose symptoms such as arrhythmias are encountered, but for this to happen, the patient must initially have severe heart disease. But shpa is a universal drug, it not only contributes to an increase in the flow of bile, but also helps to normalize the flow of urine, since both the ureters and the bile ducts have the same smooth muscle elements. There are few side effects. Of the rare symptoms - tachycardia, headache and nausea, allergic reactions. But, despite all the minor drawbacks, No-shpa is quite in demand, and has long existed in every home first-aid kit, as a means of choice for abdominal pain, since only taking antispasmodics will avoid serious complications if surgery is necessary.
Attention! This rating is subjective, is not advertising and does not serve as a guide to the purchase. Before buying, you should consult with a specialist.
