Ursodiol (Actigall)

• Type of Drug: Gallstone dissolver.
• Prescribed for: People with cholesterol gallstones readily identifiable by x-ray examination who refuse gallstone surgery or for whom surgery might be risky.

Ursodiol (Actigall) General Information

Ursodiol is a natural bile acid that suppresses the production of cholesterol in the liver and interferes with the absorption of dietary cholesterol through the intestine. It will not dissolve gallstones that are encased in calcium, stones that are not visible on x-ray, or noncholesterol stones. Your doctor should examine your gallbladder every 6 months to see if the drug is working. Most people who show progress at the first 6-mpnth evaluation are likely to lose their gallstones. No change in the stones at 12 months is a sign that the treatment is not likely to work at all. An alternative to taking Ursodiol is watchful waiting to see if anything happens before taking action; it may be that no treatment will ever be needed. Only 7 to 27 percent of people with silent or mild gallstone problems will experience moderate to severe symptoms or a complication within 5 years.

Ursodiol (Actigall) Cautions and Warnings

Before taking this drug, it is important that your doctor perform a complete gallstone examination, including x-ray tests, to be sure your bile duct is functioning normally. Bile acids (including Ursodiol) may be weakly linked to the development of colon cancer among people who have had gall? bladder surgery.

People with chronic liver disease or who are allergic to bile acids should not take this product.

Possible Side Effects

• Most common: diarrhea.
• Less common: nausea; vomiting; upset stomach; abdominal pain; bile pain; gallstone pain; a metallic taste; constipation; stomach gas; itching; rash; dry skin; sweating; hair thinning; headache; fatigue; anxiety; depression; sleep disturbances; joint, muscle, and back pains; cough; and runny nose.

Drug Interactions

• Aluminum-based antacids, Cholestyramine, and Colestipol interfere with the absorption of Ursodiol.
• Blood-cholesterol-lowering drugs (especially Clofibrate), Neomycin, estrogens, and progestins may reduce Ursodiol’s ability to dissolve cholesterol gallstones.

Ursodiol (Actigall) Food Interactions

Follow your doctor’s dietary instructions while being treated for gallstones. For best results, take Ursodiol with meals.

Usual Dose

3.5 to 4.5 mg per pound of body weight per day, divided into 2 or 3 doses.

Overdosage

The most likely result of overdose is diarrhea. Call your local poison control center for more information.

Special Information

You must take this medicine for the full course of treatment, even if you begin to feel better. If you stop treatment, your gallstones may not dissolve as quickly as possible, or they may not dissolve at all. Months of Ursodiol treatment are required to dissolve most gallstones, and some may never be dissolved. Success with this drug depends on the size of the stones and their cholesterol content. Age, weight, and sex do not influence the dissolving of gallstones.

Half of all people who use this drug to dissolve their gallstones may have another gallstone attack within 5 years.

People with severe, uncontrollable gallstone attacks, bile duct obstruction, inflammation of the pancreas, or other serious problems should not depend on this drug to dissolve their stones; surgery is more appropriate. Your doctor will determine which is the proper course of action for you.

Report diarrhea and any severe side effects to your doctor, especially pain in the abdomen, nausea, vomiting, and severe right-upper-abdominal pain that travels to your shoulder.

If you take Ursodiol twice a day and forget a dose until it is almost time for your next dose, take 1 dose right away and another in 5 or 6 hours, then go back to your regular schedule. If you take Ursodiol 3 times a day and miss a dose, and it is almost time for your next dose, take 1 dose then and another in 3 or 4 hours, and go back to your regular schedule.

Ursodiol (Actigall) Special Populations

Pregnancy/Breast-feeding
Four women who accidentally took Ursodiol during the first 3 months of pregnancy all delivered normal babies. Still, the drug’s effect on the developing fetus is not known. Ursodiol should not be used by pregnant women.
It is not known if Ursodiol passes into breast milk. Nursing mothers must be cautious when taking this drug.

Seniors
Seniors may take this medicine without special restriction.