Ursoliv/Ursoliv 500 Special Precautions

Ursoliv: Liver Tests: Patients given Ursodeoxycholic acid should have SGPT (ALT), SGOT (AST), GGT, ALP and bilirubin measured at the initiation of therapy and thereafter as indicated by the particular clinical circumstances. Monitoring of serum values is recommended upon initiation of treatment, every 1 to 3 months for the first 3 months of treatment (depending on the indication for use), and then every 6 months during treatment; Ursodeoxycholic acid must be discontinued if increased values persist.
Use in Children: Safety and efficacy have not been established.
Use in Pregnancy & Lactation: Should not be used during pregnancy and lactation without medical advice.
Ursoliv 500: Ursodeoxycholic Acid (Ursoliv) film-coated tablets should be taken under medical supervision.
During the first 3 months of treatment, liver function parameters AST (SGOT). ALT (SGPT) and γ-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.
When used for dissolution of cholesterol gallstones: In order to assess therapeutic progress and for timely detection of any calcification of the gallstones, depending on stone size, the gall bladder should be visualised (oral cholecystography) with overview and occlusion views in standing and supine positions (ultrasound control) 6-10 months after the beginning of treatment.
If the gall bladder cannot be visualised on X-ray images, or in cases of calcified gallstones, impaired contractility of the gall bladder or frequent episodes of biliary colic, Ursodeoxycholic Acid (Ursoliv) film-coated tablets should not be used.
When used for treatment of the advanced stages of primary biliary cirrhosis: In very rare cases decompensation of the hepatic cirrhosis has been observed; which partially regressed after the treatment discontinued. If diarrhoea occurs, the dose must be reduced and in cases of persistent diarrhoea, the therapy should be discontinued.
Female patients taking UDCA 500 mg film-coated tablets for dissolution of gallstones should use an effective non-hormonal method of contraception, since hormonal contraceptives may increase biliary lithiasis.
In patients with PBC, in rare cases the clinical symptoms may worsen at the beginning of treatment, e.g. the itching may increase.
Long-term, high-dose UDCA therapy (28-30 mg/kg/day) in patients with primary sclerosing cholangitis was associated with higher rates of serious adverse events.