Urodil 300

Pharmacologic classification: Bile salt.
Pharmacology: Ursodeoxycholic acid suppresses hepatic synthesis and secretion of cholesterol and also inhibits intestinal absorption of cholesterol.
Pharmacokinetics: Adsorption: Rapidly and completely absorbed from the GI tract.
Distribution: Protein binding: 96-98%. Undergoes enterohepatic recycling.
Metabolism: Partly conjugated in the liver before being excreted into the bile. Free and conjugated forms undergo 7a-dehydroxylation to lithocholic acid under the influence of gut bacteria. Some are reabsorbed and then further conjugated and sulfated by the liver.
Excretion: Faeces.

Ursodeoxycholic tablets are indicated for patients with radiolucent, non calcified gallbladder stones < 20 mm in greatest diameter in whom elective cholecystectomy would be undertaken except for the presence of increased surgical risk due to systemic disease, advanced age, idiosyncratic reaction to general anesthesia, or for those patients who refuse surgery. It is indicated for the prevention of gallstone formation in obese experiencing rapid weight loss.

Adults and Elderly: 10-15 mg ursodeoxycholic acid (UDCA) per kg per day in two to four divided doses or use as directed by physician.

Calcified and pigment gallstones, radio opaque gallstones. Non functioning gall bladders; chronic liver and peptic ulcer disease. Inflammatory disease of colon and small intestine. Pregnancy.

Ursodeoxycholic acid film-coated tablet should be taken under medical supervision.
During the first 3 months of treatment, liver function parameters AST (SGOT), ALT (SGPT) and y-GT should be monitored by the physician every 4 weeks, thereafter every 3 months. Apart from allowing for identification of responders or non-responders in patients being treated for primary biliary cirrhosis, this monitoring would also enable early detection of potential hepatic deterioration, particularly in patients with advanced stage primary biliary cirrhosis.
Dissolution of Cholesterol Gallstones: In order to assess therapeutic progress and for timely detection of any calcification of the gallstones, depending on the stone size, the gallbladder should be visualized (oral cholecystography) with overview and occlusion views in standing and supine positions (ultrasound control) 6-10 months after the beginning of treatment.
If the gallbladder cannot visualized on x-ray images or in cases of calcified gallstones, impaired contractility of the gallbladder or frequent episodes of biliary colic, ursodeoxycholic acid film-coated tablet should not be used.
Treatment of the Advanced Stages of Primary Biliary Cirrhosis: In very rare cases, decompensation of the hepatic cirrhosis has been observed; which particularly regressed after the treatment discontinued. If diarrhea occurs, the dose must be reduced and in cases of persistent diarrhea, the therapy should be discontinued.
Use in pregnancy & lactation: There are no adequate data on the use of ursodeoxycholic acid, particularly in the first trimester of pregnancy. Animal studies have provided evidence of a teratogenic effect during the early phase of gestation. Film-coated tablet must not be used during pregnancy unless clearly necessary. Women of childbearing potential should be treated only if they use reliable contraception.
Non hormonal or low estrogen oral contraceptive measures are recommended. However, in patients taking ursodeoxycholic acid film-coated for dissolution of gallstones, effective non-hormonal contraception should be used, since hormonal oral contraceptives may increase biliary lithiasis. The possibility of a pregnancy must be excluded before beginning treatment.
It is not known whether ursodeoxycholic acid passes into breast milk. Therefore, ursodeoxycholic acid film-coated tablet should not be taken during lactation.

Film-Coated Tablet: The evaluation of undesirable effects is based on the following frequency data: Very common (≥1/10), common (≥1/100 to <1/10), uncommon (≥1/1,000 to <1/100), rare (≥1/10,000 to <1/1,000), very rare (<1/10,000), not known (cannot be estimated from the available data).
Gastrointestinal Disorders: In clinical trials, reports of pasty stools or diarrhea during ursodeoxycholic acid therapy were common. Very rarely, severe right upper abdominal pain has occurred during the treatment of primary biliary cirrhosis.
Hepatobiliary Disorders: During treatment with ursodeoxycholic acid, calcification of gallstones can occur in very rare cases. During therapy of the advanced stages of primary biliary cirrhosis, in very rare cases, decompensation of hepatic cirrhosis has been observed, which partially regresses after the treatment was discontinued.
Skin and Subcutaneous Tissue Disorders: Very rarely, urticaria can occur.

Cholestyramine, charcoal and antacids may reduce effectiveness. Aluminum-based antacids may reduce absorption. Oestrogens and clofibrate may counteract effectiveness of ursodeoxycholic acid by increasing cholesterol elimination in bile. Possible increase in ciclosporin serum concentration. Decreased effectiveness of dapsone. Possible decrease in serum ciprofloxacin and nitrendipine.
Film-Coated Tablet: Ursodeoxycholic acid has been shown to reduce peak plasma concentrations (Cmax) and area under the curve (AUC) of the calcium antagonist nitrendipin. An interaction with a reduction of the therapeutic effects of dapsone was reported. These observations, together with in vitro findings could indicate a potential for ursodeoxycholic acid to reduce cytochrome P450 (CYP450) 3A enzymes. Controlled clinical studies have shown, however, that ursodeoxycholic acid does not have a relevant inductive effect on CYP450 3A enzymes. Estrogenic hormones and blood cholesterol-lowering agents eg. Clofibrate may increase biliary lithiasis, which is a counter-effect to ursodeoxycholic acid used for dissolution of gallstone.

Store at temperatures not exceeding 30°C.

Cholagogues, Cholelitholytics & Hepatic Protectors

A05AA02 - ursodeoxycholic acid ; Belongs to the class of bile acids. Used in bile therapy.

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