Recommended dosage of odexibat (Beierwei) and adjustment basis according to the condition

Odevixibat (Odevixibat) is a new oral small molecule inhibitor mainly used to treat cholestatic diseases in children and adults, such as familial or idiopathic intrahepatic cholestasis (PFIC). Its mechanism of action is by inhibiting the intestinal bile acid transporter (IBAT/ASBT), reducing the reflux of bile acids from the intestine to the liver, thereby reducing serum bile acid levels and improving itching and liver damage. Reasonable dosage design is crucial to drug efficacy and safety.

Clinically recommended starting doses are usually calculated based on patient weight. For pediatric patients weighing 5–20 kg, the recommended dose is 40 μg/kg taken orally once daily. This dose was effective in reducing serum bile acid levels while being well tolerated in most patients. Initial treatment is usually recommended to start with a low dose to observe the efficacy and side effects, and then adjust according to the patient's response.

The basis for dose adjustment mainly includes serum bile acid levels, improvement of itching symptoms and liver function indicators. If the patient's serum bile acids are still significantly elevated or pruritus symptoms persist at the initial dose, a gradual increase in dose may be considered. Each adjustment should be made under the guidance of a physician. Efficacy and tolerability are usually assessed every 2 to 4 weeks. On the contrary, if serious adverse reactions occur, such as significant diarrhea, weight loss, or abnormal liver function, the dose needs to be reduced or temporarily discontinued, and corresponding intervention measures need to be taken.

During long-term treatment, patients and their families should regularly monitor serum bile acids, liver function and growth and development indicators to ensure efficacy and safety. The drug should be taken orally at a fixed time as directed by the doctor, and avoid stopping the drug or adjusting the dose at will. Overall, odexibat can improve clinical symptoms and improve patients' quality of life while reducing bile acid load through individualized dose management guided by weight and disease conditions.

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