• Gallbladder stone dissolution and prevention.
• Primary biliary cirrhosis.

Unlabeled Uses:

• Biliary atresia.
• TPN-induced cholestasis.

Contraindicated in:

• Patients requiring cholecystectomy
• Calcified cholesterol stones, radiopaque stones, bile pigment stones, or stones >20 mm
• Complete biliary obstruction.

Use Cautiously in:

• Chronic liver disease
• Surgical enteroanastomoses or Crohn's disease (↑ risk of bezoar formation).

Derm: hair thinning, pruritus, rash.

EENT: rhinitis.

GI: abdominal/biliary pain, bezoar formation, constipation, diarrhea, flatulence, ↑ liver enzymes, jaundice, nausea, stomatitis, vomiting.

MS: arthralgia, myalgia.

Neuro: anxiety, depression, fatigue, headache, sleep disorder.

Resp: cough.

Drug-Drug:

• Cholestyramine, colestipol, and aluminum-containing antacids may ↓ absorption.
• Estrogens may ↓ its effectiveness.

(Generic available)

• Capsules: 200 mg; 300 mg; 400 mg;
• Tablets: 250 mg; 500 mg;

• PO (Adults): Gallstone dissolution: Initial 8–10 mg/kg/day in 2–3 divided doses; maintenance: 250 mg/day at bedtime for 6 mo–1 yr; Gallstone prevention: 300 mg twice daily; Primary biliary cirrhosis: 13–15 mg/kg/day in 2–4 divided doses.
• PO (Children and Infants): TPN-induced cholestasis: 30 mg/kg/day in 2–3 divided doses.
• PO (Infants): Biliary atresia: 10–15 mg/kg/day.

Actigall, Reltone, Urso 250, Urso Forte

• ↓cholesterol content of bile and bile stones by suppressing cholesterol synthesis and secretion from the liver and inhibits intestinal absorption of cholesterol.

• Gallstone dissolution and reduction in gallstone formation.
• ↓progression of liver disease and improvement in liver function tests.

Therapeutic Classification:

Absorption: 90% absorbed following oral administration.

Distribution: Only small quantities are found in the systemic circulation; sites of action include the liver, bile, and gut lumen.

Metabolism/Excretion: Undergoes extensive enterohepatic recycling; excreted in feces via bile.

Half-life: 100 hr.

Urso DS

• Instruct patient to take ursodiol as directed.
• Advise patient to avoid aluminum-containing antacids during therapy; may impair absorption.

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