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Actigall (Ursodiol): Comprehensive Information
Actigall, with the active ingredient ursodiol (also known as ursodeoxycholic acid or UDCA), is a medication primarily used to dissolve certain types of gallstones and to treat primary biliary cholangitis (PBC).
Composition and Forms
Actigall is an oral medication containing ursodiol as the active pharmaceutical ingredient. It is typically available in capsule form, with each capsule containing 300 mg of ursodiol.
Indications
Actigall is indicated for:
- Dissolving cholesterol-type gallstones in patients for whom surgical treatment is nto an option.
- Treatment of primary biliary cholangitis (PBC), a chronic liver disease, in adult patients.
Mechanism of Action
Ursodiol is a naturally occurring bile acid. In the context of gallstones, it works by:
- Reducing the saturation of cholesterol in bile, which inhibits the formation and growth of cholesterol gallstones.
- Gradually dissolving existing cholesterol gallstones by decreasing the absorption of cholesterol from the intestine and reducing hepatic synthesis of cholesterol.
In primary biliary cholangitis, ursodiol is thought to exert cytoprotective effects on liver cells, improve bile flow, and reduce inflammation and fibrosis in the liver.
Safety Profile
Benefits: Actigall can be an effective non-surgical option for gallstone dissolution and is a standard treatment for PBC, improving live function and slowing disease progression.
Potential Side Effects: Common side effects may include diarrhea, nausea, vomiting, abdominal pain, indigestion, and rash. Less common but serious side effects can occur.
Contraindications: Actigall should not be used in patients with calcified cholesterol gallstones, gallstones that are not primarily cholesterol stones (e.g., pigment stones), or those with certain gallbladder, bile duct, or intestinal conditions. It is also contraindicated in patients with severe liver disease or frequent bouts of severe abdominal pain.
Warnings: Ursodiol should be used with caution in patients with inflammatory bowel disease. Liver function tests should be monitored regularly during treatment. Pregnant or breastfeeding women should consult their healthcare provider before use.
Dosage Table
| Disease | Recommended Dosage | Treatment Duration |
|---|---|---|
| Cholesterol Gallstone Dissolution | 300 mg twice daily (or 200 mg three times daily) | 6 months to 2 years, depending on stone size and composition |
| Primary Biliary Cholangitis (PBC) | 13-15 mg/kg body weight per day, divided into 2-4 doses | Continued as long as medically indicated |
Frequently Asked Questions
Q1: How long does it take for Actigall to dissolve gallstones?
A1: The time it takes for Actigall to dissolve gallstones varies depending on the size and number of stones, typically ranging from 6 months to 2 years of continuous treatment.
Q2: Can Actigall be used for all types of gallstones?
A2: No, Actigall is primarily effective for dissolving cholesterol-type gallstones. It is not effective for pigment stones or calcified stones.
Q3: What should I do if I miss a dose of Actigall?
A3: If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and coontinue with your regular dosing schedule. Do not take a double dose.
Q4: Is Actigall safe for long-term use in PBC?
A4: Yes, Actigall is generally considered safe for long-term use in patients with primary biliary cholangitis when monitored by a healthcare professional. Regular liver function tests are important.