Ursodeoxycholic acid also known as ursodiol, originally used to help dissolve gallstones in patients who do not want or can not have gallbladder surgery. It is also used to prevent gallstones from forming in overweight patients. Later, it was learned ursodiol could help slow the progression of primary biliary cholangitis (PBC) patients. Ursodiol and new medication Ocaliva are the only treatments to help slow the progression of PBC.
PBC research & FDA approval recommended dosing of ursodiol treatments is according to patient’s weight. Chemically all ursodiol medications are made from ursodiol/ursodeoxycholic acid, but they are not the exact same product. Each has a different FDA approved indication and fillers. Various brands come in pill and capsule form. Some patients have found it easier to take the pill form.
Keith Lindor, MD, Vice Chair, Medical Affairs for the American Liver Foundation (“ALF”), and Professor of Medicine at the Mayo Clinic recommends dosing according to the patients weight to receive the full benefit of urso. (See chart below). Dr. Lindor stated “urso also improves survival while reducing the need for liver transplantation in these patients.”
Proper dosing for ursodiol treatments is confusing not only to the patients but some of the medical community. Some doctors prescribe ursodiol treatments according to the manufacturers recommended dosing instructions such as Actigall which is approved for gallstone treatment and has a dosing recommendation of 2-3 capsules per day. While this is the proper dosing for gallstones, it is most likely not the proper dose for PBC, depending on the patient’s weight. Also, some doctors do not feel it is necessary in early stage to take the full dosing recommendation. PBC Research (per Dr.Lindor and Dr. Kowdley, ) shows proper dosing should be based on the patient’s weight to receive the full benefits of ursodiol treatments in PBC. IMPORTANT: Whether you take brand name or generic urso, talk to your doctor to make sure you are taking the correct dosage for full treatment benefits. Never change your treatment plan without discussing with your doctor first.
Trying to avoid side effects, some doctors do not prescribed the full daily ursodiol treatment dosage upon diagnosis. They gradually increase the patient’s dosage over months to avoid some of the side effects listed, especially those who already experience stomach problems.
How to figure the number of tablets/capsules daily according to your weight. 13 mg multiplied by the KG divided by 250, 300 or 500 mg equals the number of recommended dosing tablets daily according to your weight. Dose should be rounded up, not down. First convert your pound weight into kilograms. Weight conversion table example dosage for person weighing 154 pounds. Weight of 154 pounds equals 69.8532 Kilograms (70 kilograms rounded off) Multiplied 70 by 13 mg equals 910 mg (70 X 13 = 910) Divided by 250 mg for URSO 250 equals 3.64 tablets per day. Round up to 4 pills per day. Divided by 300 mg for Actigall equals 3.03 capsules per day. Divided by 300 mg for generic equals 3.03 capsules per day.