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Actigall (Ursodiol) is an oral gallstone solubilizing agent intended for dissolution of radiolucent gallstones. It also is used to treat primary biliary cirrhosis. This agent is a naturally occurring bile acid, found in small quantities in normal human bile, that suppresses hepatic synthesis, secretion of cholesterol, and the intestinal absorption of cholesterol.
Gallstone dissolution requires months of therapy, and complete dissolution may not occur in all patients. Ultrasound imaging of the gallbladder should be performed at 6-month intervals for the first year of therapy. This drug was approved by the FDA in 1987.
Avoid use in patients with unremitting acute cholecystitis, cholangitis, biliary obstruction, gallstone pancreatitis, biliary-gastrointestinal fistula, allergies to bile acids, chronic liver disease.
Drug Interactions: Aluminum-based antacids: Can decrease absorption by absorbing bile acids. Cholestyramine and colestipol: Can decrease absorption.
Adverse Reactions: Diarrhea, nausea/vomiting, dyspepsia, metallic taste, abdominal pain, biliary pain, cholecystitis, constipation, stomatitis, flatulence, headache, fatigue, anxiety, depression, sleep disorders, arthralgia, myalgia, back pain, cough, rhinitis.
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