Ursodeoxycholic Acid

Ursodeoxycholic Acid is a bile acid — gallstone dissolution and cholestatic liver disease therapy medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

Doctors prescribe Ursodeoxycholic Acid for:

• Dissolving gallstones — small, non-calcified (radiolucent) cholesterol stones in a gallbladder that still works, in patients who cannot or prefer not to have surgery
• Primary biliary cholangitis (PBC) — the standard long-term treatment to slow disease progression
• Other cholestatic conditions under specialist care, such as intrahepatic cholestasis of pregnancy or biliary sludge

It does not work on calcified or pigment stones, and it is not a treatment for an acutely inflamed gallbladder, which usually needs urgent surgical care. Ultrasound and liver tests guide whether Ursodeoxycholic Acid is the right choice for you.

The dose of Ursodeoxycholic Acid is calculated from body weight — commonly around 8–12 mg/kg per day for gallstones and 13–15 mg/kg per day for PBC — given as a single evening dose or divided doses. Your doctor decides the exact dose, schedule and duration.

• Take it with food or milk; meals trigger bile flow and improve the medicine's effect, and the evening dose matters most for gallstones.
• Gallstone treatment is a long course — usually 6 to 24 months, with ultrasound about every 6 months, and often continued for around 3 months after stones disappear.
• Take it every day without gaps; if you miss a dose, take the next one normally — never double up.

Ursodeoxycholic Acid is usually well tolerated. Possible side effects include:

• Pasty or loose stools and diarrhoea — the most common effect; often settles after the dose is adjusted
• Nausea, mild stomach discomfort or wind
• Itching or skin rash
• Rarely, gallstones can develop a calcified shell during treatment, which stops them dissolving
• In advanced liver cirrhosis, worsening of the condition has rarely been reported — such patients need specialist monitoring

Seek medical attention promptly if you develop severe right-upper abdominal pain, fever with chills, vomiting or yellowing of the eyes or skin during treatment — these suggest a blocked duct or gallbladder inflammation rather than a side effect.

For safe and effective treatment with Ursodeoxycholic Acid:

• Complete the full course — stones that have only partly dissolved regrow quickly if treatment stops early.
• Attend the scheduled ultrasound scans and liver function tests; they show whether the stones are shrinking and the liver is responding.
• Remember that stones can recur after successful treatment — keeping a healthy weight, avoiding rapid crash dieting and eating a balanced, lower-fat diet reduce that risk.
• Tell your doctor about cirrhosis, peptic ulcer or any change in symptoms such as repeated biliary pain.
• Keep your doctor informed of all other medicines, since several reduce the absorption or effect of UDCA.

Some medicines stop Ursodeoxycholic Acid from working properly:

• Cholestyramine, colestipol and antacids containing aluminium bind UDCA in the gut. Keep a gap of at least 2 hours (longer for cholestyramine, ideally 4 hours) between them and Ursodeoxycholic Acid.
• Oestrogens (including some birth control pills) and lipid-lowering medicines such as clofibrate increase cholesterol in bile and can work against stone dissolution.
• Ursodeoxycholic Acid can increase ciclosporin absorption — transplant patients need level monitoring — and may reduce absorption of ciprofloxacin.
• It may enhance the glucose-lowering effect of some diabetes medicines; monitor as advised.

Share your full medicine list, including antacids and herbal products, with your doctor and pharmacist.

Do not take Ursodeoxycholic Acid if you have:

• Allergy to Ursodeoxycholic Acid, other bile acids or any ingredient of the product
• Acute inflammation of the gallbladder or bile ducts (cholecystitis, cholangitis)
• Blockage of the common bile duct or cystic duct
• Frequent episodes of severe biliary colic
• Calcified gallstones or a gallbladder that no longer functions or cannot be seen on imaging
• Severe liver or pancreatic disease, unless a specialist decides otherwise

In these situations the medicine either cannot work or may delay surgery that is genuinely needed — your doctor will confirm suitability with an ultrasound first.

For gallstone treatment, Ursodeoxycholic Acid is generally avoided during pregnancy, and women of child-bearing age are usually advised to use effective non-hormonal contraception during long courses, since hormonal pills can also work against stone dissolution. However, specialists do use UDCA during pregnancy for intrahepatic cholestasis of pregnancy — a liver condition causing severe itching — where experience suggests it is reasonably safe under supervision.

Only tiny amounts pass into breast milk, and no harm to breastfed babies has been reported at usual doses; even so, breastfeeding while on Ursodeoxycholic Acid should be discussed with and approved by your doctor.

Store Ursodeoxycholic Acid below 30°C in a cool, dry place, protected from direct sunlight and moisture. Keep the in its original blister or container until use, and avoid humid places such as the bathroom or kitchen — remember that gallstone courses last many months, so proper storage of the whole supply matters.

• Keep all medicines out of the reach and sight of children.
• Do not use the medicine after the expiry date printed on the pack.
• Do not throw unused medicine into household waste or drains; ask your pharmacist about safe disposal.