Liveric

Indications

Ursodeoxycholic Acid is used to dissolve small cholesterol gallstones in people whose gallbladder still works and who cannot or do not want to have surgery. It is also used for long-term liver conditions where bile flow is reduced, such as primary biliary cholangitis (a slow, autoimmune disease of the small bile ducts in the liver). Specialists may use it for other bile flow problems.

How It Works

It is a natural bile acid. It reduces the amount of cholesterol in bile so cholesterol stones can slowly dissolve, and it improves bile flow and protects liver cells from the harmful effects of other bile acids.

Dosage and Administration

The dose depends on body weight and the condition, so take it as prescribed.

• Gallstones: usually about 8 to 12 mg per kg of body weight a day, often taken as a single dose at bedtime or split into two doses. Treatment usually lasts 6 months to 2 years, with scans to check progress.
• Primary biliary cholangitis and other liver conditions: usually about 12 to 15 mg per kg a day in two or three doses, as prescribed by the specialist, often for life.
• Children: as prescribed.

Take with food or milk and swallow tablets or capsules whole with water.

Interactions

Antacids that contain aluminium and medicines such as Colestyramine and Colestipol can stop it being absorbed; take them at least 2 hours apart. It may change the level of Ciclosporin, so blood levels may need checking. Oestrogens, hormonal contraceptives and some cholesterol medicines (such as Clofibrate) can increase cholesterol in bile and work against gallstone treatment.

Contraindications

• Allergy to Ursodeoxycholic Acid or other bile acids.
• Acute inflammation of the gallbladder or bile ducts, or a blocked bile duct.
• A gallbladder that does not work or does not show on X-ray, frequent attacks of gallstone pain, or calcified (chalky) stones, when used to dissolve gallstones.

Side Effects

Common: soft stools or diarrhoea. Less common: stomach pain on the right side, itching or rash. Rarely, gallstones can become calcified during treatment.

Get urgent medical help if you have severe pain in the upper right side of the abdomen, fever with shivering, yellowing of the skin or eyes, dark urine with pale stools, vomiting that does not stop, or signs of an allergic reaction such as swelling of the face or difficulty breathing.

Pregnancy and Lactation

Do not take it in early pregnancy unless a doctor prescribes it; specialists may use it in later pregnancy for a liver condition called cholestasis of pregnancy. Women taking it for gallstones should use non-hormonal contraception. Very little passes into breast milk; ask your doctor before breastfeeding.

Precautions and Warnings

Your doctor will check liver blood tests regularly, especially in the first months, and may arrange ultrasound scans to check gallstones. Tell your doctor about severe liver disease or inflammatory bowel disease. Diarrhoea that persists may mean the dose needs lowering. Gallstones can return after treatment stops.

Overdose

Overdose usually causes diarrhoea. Drink fluids to avoid dehydration and seek medical advice.

Therapeutic Class

Bile acid (gallstone dissolving and liver protective agent).

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.