Actigall: Effective Gallstone Dissolution Therapy
| Product dosage: 150mg | |||
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| Product dosage: 300mg | |||
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Synonyms | |||
Actigall (ursodiol) is a prescription medication specifically formulated to dissolve certain types of gallstones in patients for whom surgery is not a preferred option. As a bile acid, it works by decreasing the cholesterol saturation of bile, facilitating the gradual breakdown of cholesterol-rich stones. This oral therapy offers a non-invasive alternative for appropriately selected individuals, providing a targeted approach to managing symptomatic gallstone disease under medical supervision.
Features
- Active ingredient: Ursodiol 300 mg capsules
- Mechanism: Reduces cholesterol secretion into bile and disperses cholesterol as liquid crystals
- Formulation: Oral capsule for systemic absorption
- FDA-approved for gallstone dissolution in specific patient populations
- Requires prescription and medical monitoring
- Typically prescribed as long-term therapy (months to years)
Benefits
- Non-surgical alternative for cholesterol gallstone dissolution
- Reduces biliary cholesterol saturation and lithogenicity
- May prevent gallstone formation in high-risk patients
- Avoids risks associated with cholecystectomy surgery
- Can provide symptomatic relief from gallstone-related discomfort
- Preserves gallbladder function in appropriate candidates
Common use
Actigall is primarily indicated for the dissolution of radiolucent, cholesterol-rich gallstones in patients with functioning gallbladders who are not candidates for surgical intervention. It is particularly appropriate for individuals with small to medium-sized stones (typically less than 20 mm in diameter) that are non-calcified and floating in bile. The medication may also be used to prevent stone formation in obese patients experiencing rapid weight loss and is sometimes prescribed for primary biliary cholangitis management, though this represents an off-label use for the gallstone formulation.
Dosage and direction
The recommended dosage for gallstone dissolution is 8-10 mg/kg/day administered in two or three divided doses with food. Treatment typically continues for several months until gallstones dissolve and for three months thereafter as confirmed by ultrasound. Patients should swallow capsules whole with adequate fluid and maintain regular dosing schedules. Dosage adjustments may be necessary based on patient weight changes or treatment response. Regular monitoring through ultrasound examinations is essential every six months during therapy to assess dissolution progress.
Precautions
Patients should undergo thorough evaluation before initiating therapy, including confirmation of radiolucent, cholesterol gallstones via oral cholecystography or ultrasonography. Liver function tests should be monitored periodically during treatment. Women of childbearing potential should use effective contraception during therapy. Patients with chronic liver disease require careful assessment before treatment initiation. Therapy may not be suitable for individuals with radio-opaque calcified stones or those with frequent biliary colic episodes.
Contraindications
Actigall is contraindicated in patients with radio-opaque calcified gallstones, known hypersensitivity to ursodiol or bile acids, and those with non-functioning gallbladders. It should not be used in patients with acute cholecystitis, cholangitis, biliary obstruction, or biliary-gastrointestinal fistula. The medication is also contraindicated in patients with radiolucent bile pigment stones or complications requiring immediate surgical intervention.
Possible side effect
Common side effects include diarrhea or loose stools (occurring in approximately 10-20% of patients), which often diminish with continued therapy. Less frequently, patients may experience constipation, nausea, vomiting, dyspepsia, abdominal pain, or flatulence. Rare adverse effects include headache, dizziness, fatigue, hair thinning, and allergic skin reactions. Transient elevations in liver enzymes may occur but typically normalize with continued treatment. Patients should report persistent diarrhea or severe abdominal pain to their healthcare provider.
Drug interaction
Actigall may interact with aluminum-based antacids, cholestyramine, colestipol, and estrogen-containing medications, which can reduce its effectiveness. Concurrent use with clofibrate or other lipid-lowering agents may influence cholesterol metabolism. Cyclosporine levels may be affected by ursodiol therapy, requiring monitoring. The medication may alter the absorption of fat-soluble vitamins. Healthcare providers should review all concomitant medications, including over-the-counter products and herbal supplements.
Missed dose
If a dose is missed, patients should take it as soon as remembered unless it is nearly time for the next scheduled dose. In that case, the missed dose should be skipped, and the regular dosing schedule resumed. Patients should not double the dose to make up for a missed administration. Consistent daily dosing is important for therapeutic effectiveness, so establishing a routine with meal times may help maintain adherence.
Overdose
Ursodiol has a high safety margin, and serious complications from overdose are unlikely. Diarrhea represents the most probable consequence of excessive dosing. Management should involve symptomatic and supportive care. Patients experiencing suspected overdose should contact their healthcare provider or poison control center. Medical attention should be sought if severe diarrhea persists or if dehydration symptoms develop.
Storage
Actigall capsules should be stored at controlled room temperature (20-25°C or 68-77°F) in their original container, protected from light and moisture. The medication should be kept out of reach of children and pets. Capsules should not be used beyond the expiration date printed on the packaging. Proper storage conditions help maintain medication stability and effectiveness throughout the treatment period.
Disclaimer
This information serves educational purposes only and does not replace professional medical advice, diagnosis, or treatment. Always consult qualified healthcare providers regarding medical conditions or before starting any new treatment. Individual patient responses may vary, and therapeutic decisions should be based on comprehensive medical evaluation. The manufacturer and distributors assume no liability for inaccuracies or omissions in this information.
Reviews
Clinical studies demonstrate that Actigall achieves complete gallstone dissolution in approximately 30-40% of appropriately selected patients after 6-24 months of therapy. Success rates are highest in patients with small (<5 mm), floating cholesterol stones and functioning gallbladders. Many patients report satisfaction with this non-surgical option, though some express frustration with the extended treatment duration required. Healthcare providers generally consider Actigall a valuable therapeutic option for suitable candidates who wish to avoid surgery or are poor surgical risks. Regular monitoring and patient compliance remain critical factors influencing treatment outcomes.