Prescription for Ursodiol

So my return to the liver specialist reconfirmed my diagnosis and reveals for certain I am in the early stage of PBC. My doctor prescribed me Ursodiol 300 MG two times a day for the rest of my life. I will have to return to the office every three months for a review of blood work. Every two years I will require a liver biopsy to re-stage the disease and to look for signs of disease progression. Ursodiol is not a cure, but the medication should work in helping slow down the disease's progression. My doctor gave me some comfort by reiterating that PBC progresses slowly, and that I could go 20 or more years before I might require a transplant – While admittedly feeling some relief, I also found this unsettling and wondered if 20 years from now I would be physically strong enough to handle transplantation if necessary. For now, I'm diligent about taking the medication and continuing my research.  I've been taking the ursodiol for about four days now and I haven't noted too many side effects. I have noticed some shakiness in my hands on occasion, but I cannot yet attribute it to the use of this particular medication. 

Drug Efficacy 

According to the article appearing in “Gastroenterology (2002),” entitled “Primary biliary cirrhosis: Incidence and predictive factors of cirrhosis development in ursodiol-treated patients,” Christophe Corphechot, Fabrice Carrat, Raoul Poupon, and Renee-Eugenie Poupon, report some sufferers of PBC “escape and progress toward cirrhosis and end-stage disease,” despite receiving Ursodeoxycholic acid (UDCA) therapy. The group's study examined 183 PBC patients in various stages of the disease and the efficacy of UDCA. The findings revealed the following: 

Incidence of Cirrhosis in 5 years of UDCA Treatment 

Stage I = 4%
Stage II = 12%
Stage III = 59% 

Incidence of Cirrhosis in 10 years of UDCA Treatment 

Stage 1 = 17%
Stage II = 27%
Stage III = 76% 

Median Time for Cirrhosis Development 

Stage I = 25 years
Stage II = 20 years
Stage III = 4 years

Cirrhosis Predictive Factors 

Serum Bilirubin higher than 7 μmol/L
Serum Albumin less than 38 g/L
Moderate/severe piecemeal necrosis 

About Ursodiol 

Ursodiol (pronounced ur-so-DYE-all) is a generic name for my prescribed medication. This medication was approved by the FDA in 1987. It is also known by a variety of brand names including Urso DS, Urso Forte, Urso, and Actigall. The European identification of the drug is Ursofalk and the acid is marketed as Durlusan in France.

According to MedlinePlus, Ursodiol is naturally produced in the body. It's a bile acid called ursodeoxycholic acid and it's stored in a person's gallbladder. The medication helps to reduce the amount of cholesterol in the body and it dissolves the cholesterol in bile. According to Medicine.net, how Ursodiol works in slowing PBC progression is unclear.

Potential drug interactions include colestipol (Colstid), cholestyramine (Questran Light, Questran), and antacids can reduce the absorption and effectiveness of ursodiol. Oral contraceptives, estrogens, clofibrate (one of several cholesterol controlling medications) might minimize the effectiveness of ursodiol being used by patients with gallstones by increasing the liver's secretion of cholesterol and thereby increasing the chances of gallstone development. 

Active ingredients in ursodiol 

Ursodiol

Inactive ingredients 

Colloidal silicon dioxide
Ferric oxide
Gelatin
Magnesium Stearate
Corn Starch
Ferrosoferric oxide

Drug Interaction Summary 

antacids/aluminum hydroxide
calcium carbonate
colesevelam
colestipol (Colstid)
cholestyramine (Questran Light, Questran)
clofibrate
crofelemer
etrogens
ethinylestradiol
mestranol
oral contraceptives
sodium bicarbonate
sodium citrate/citric acid

Potential Side Effects

Note: Sources like the American Liver Foundation suggest that patients rarely experience side effects from the use of ursodiol.

Angioedema/edema/swelling
Back pain
Biliary pain
Cholecystitis/gallbladder inflammation
Cold symptoms – cough, sore throat, sneezing, and stuffy nose
Constipation
Diarrhea
Dizziness
Dyspepsia
Fatigue
Flatulence
Hair loss/Alopecia
Headache
Hyperglycemia
Leukopenia/Reduced white blood cell concentration
Mild abdominal pain
Mild itching/Pruritus
Nausea
Peptic ulcer
Peripheral edema
Vomiting
Rash
Thrombocytopenia/reduced amount of platelets.
Upper respiratory tract infection
Urinary tract infection
Weight gain

This medication needs to remain at room temperature or between 59 and 86 F.