Carbenoxolone

Abstract

Carbenoxolone sodium has been shown to accelerate the rate of healing of both gastric and duodenal ulcers, but its overall value in duodenal ulcer is probably less because of the high rate of natural remission of duodenal ulcers. Further studies are required to decide whether it should be used prophylactically to delay ulcer recurrence. Carbenoxolone may act by affecting both the proliferative activity of gastric epithelium and the differentiation of the epithelial cells to produce mucus (as well as favourably altering the physicochemical properties of mucus and by reducing peptic activity), factors which may be relevant ot the prevention of acute gastric ulcers. Some studies suggest that carbenoxolone adds to the effect of hospitalisation and bed rest on ulcer healing. Whether bed rest confers additional benefit to the drug's ulcer healing effect in outpatients is also uncertain. There is no evidence that accelerated healing by carbenoxolone is associated with improved overall prognosis. Carbenoxolone is of greatest benefit in accelerating the healing of gastric ulcers in patients for whom hospitalisation is not possible or desirable, but it should only be used in the ambulatory patient when careful and regular observation of serum electrolytes (particularly potassium), blood pressure and weight is possible and when it is known that the patient will attend regular follow-up. Patient must be educated in the proper use of the drug. If severe mineralocorticoid-like toxic effects such as sodium and water retention and hypokalaemia appear, as they do in a variable proportion of patients but most frequently in those receiving excessive doses, carbenoxolone should be stopped and the complication treated; they respond to thiazide diuretics and potassium supplements, and probably to amiloride given in conjunction with a low dose of a thiazide diuretic. Treatment with carbenoxolone can continue with concurrent diuretic therapy in patients with less severe side-effects. Optimum therapeutic effect in gastric ulcer with the least side-effects is achieved with a dosage of 100mg carbenoxolone tablets 3 times daily for the first week followed by 50mg 3 times daily thereafter, best taken before meals. A lower dosage is desirable in the elderly and in those with liver, cardiac or renal disease. Barium meal or preferably endoscopic examinations should be performed regularly and therapy continued until the ulcer is healed. Dosage for duodenal ulcer is 50mg 4 times daily, in special positioned-release capsules. These are best taken about 20 minutes before meals.

11β-hydroxysteroid dehydrogenase inhibition as a new potential therapeutic target for alcohol abuse

“…CBX, which inhibits both 11β-HSD isoforms, 21 has long been used in the clinic for the therapy of gastritis and peptic and duodenal ulcers. 69 However, its use has greatly diminished in favor of other classes of drugs, such as proton pump inhibitors and histamine H2 antagonists. This is in part because of the potential of chronic CBX use to induce pseudohyperaldosteronism, 70 , 71 which is due to inhibition by CBX of 11β-HSD type 2 isoform (11β-HSD2) in the kidney.…”

“… 46 However, this side effect can be managed by combination with an anti-kaliuretic diuretic, such as amiloride, or thiazide diuretics and potassium supplementation. 53 , 69 , 72…”

Chemical Induction of Hsp70 Reduces α-Synuclein Aggregation in Neuroglioma Cells

“…Carbenoxolone (CBX), a glycyrrhizic acid derivative, is widely used for the treatment of peptic ulcers 23 and was reported to have neuroprotective effects in animal models of isechemia. 24 Recent evidence showed that CBX activates HSF1 and upregulates Hsp70 levels in cells.…”

Gap Junction Blockers: An Overview of their Effects on Induced Seizures in Animal Models

“…CBX is a semisynthetic derivative of glycyrrhetinic acid. This molecule was developed since the 1960´s for the treatment of peptic ulcer disease [ 32 ]. Unfortunately, the medical use of CBX has been limited because of the several side effects associated with the mineralocorticoid-like actions [ 33 ].…”