Prescribing information
- Ursodeoxycholic acid is given as an example.
- Dissolution of gallstones, 8-12 mg/kg daily as a single dose at bedtime or in 2 divided doses. Treat for up to 2 years, and continue for 3-4 months after stones dissolve.
- Primary biliary cirrhosis, 10-15 mg/kg daily in 2-4 divided doses.
Drugs in this class
- Ursodeoxycholic acid
- Chenodeoxycholic acid
Treatment of cholesterol gallstones (not other types of gallstone): Ursodeoxycholic acid is used in the treatment of primary biliary cirrhosis and primary sclerosing cholangitis. These are unlicensed, specialist uses.
Cholic acids can worsen liver impairment in those with existing disease: Cholic acids can worsen peptic ulcer and symptoms from ileal disease; avoid in these patients. The manufacturer advises that these drugs should not be used in pregnancy, although there is no evidence of harm.
Gallstones
- These drugs will act only on cholesterol gallstones (which are radiotranslucent).
- Laparoscopic cholecystectomy is the treatment of choice for symptomatic gallstone disease.
- If the patient is unsuitable for surgery, consider treatment with the cholic acids.
- Treatment can be for up to 2 years.
- Stop the treatment 3 months after the stone has disappeared.
- A repeat ultrasound examination should be performed 4-12 weeks after the stone has disappeared to confirm this.
- The recurrence rate is high once treatment has stopped; it is estimated to be 25% after 1 year and 50% by 5 years.
- These drugs will act only on cholesterol gallstones (which are radiotranslucent).
- Laparoscopic cholecystectomy is the treatment of choice for symptomatic gallstone disease.
- If the patient is unsuitable for surgery, consider treatment with the cholic acids.
- Treatment can be for up to 2 years.
- Stop the treatment 3 months after the stone has disappeared.
- A repeat ultrasound examination should be performed 4-12 weeks after the stone has disappeared to confirm this.
- The recurrence rate is high once treatment has stopped; it is estimated to be 25% after 1 year and 50% by 5 years.
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