(er-soe-dye-ole) ,


(trade name),

Urso 250

(trade name),


(trade name),

Urso DS

(trade name),

Urso Forte

(trade name)


Therapeutic: gallstone dissolution agents
Pregnancy Category: B


Gallbladder stone dissolution and prevention.Primary biliary cirrhosis.Biliary atresia.TPN-induced cholestasis.


↓ cholesterol content of bile and bile stones by suppressing cholesterol synthesis and secretion from the liver and inhibits intestinal absorption of cholesterol.

Therapeutic effects

Gallstone dissolution and reduction in gallstone formation.
↓ progression of liver disease and improvement in liver function tests.


Absorption: 90%.
Distribution: Only small quantities are found in the systemic circulation; sites of action include the liver, bile, and gut lumen.
Protein Binding: 70%.
Metabolism and Excretion: Undergoes extensive enterohepatic recycling; excreted in feces via bile.
Half-life: 100 hr.

Time/action profile



Contraindicated in: Patients requiring cholecystectomy; Calcified cholesterol stones, radiopaque stones, bile pigment stones, or stones >20 mm;Complete biliary obstruction.
Use Cautiously in: Chronic liver disease.

Adverse Reactions/Side Effects

Central nervous system

  • anxiety
  • depression
  • fatigue
  • headache
  • sleep disorder


  • hair thinning
  • pruritus
  • rash


  • abdominal/biliary pain
  • constipation
  • diarrhea
  • flatulence
  • jaundice
  • ↑ liver enzymes
  • nausea
  • stomatitis
  • vomiting


  • arthralgias
  • myalgia


  • cough
  • rhinitis


Drug-Drug interaction

Cholestyramine, colestipol, and aluminum-containing antacids may ↓ absorption.Estrogens may ↓ its effectiveness.


Oral (Adults) Gallstone dissolution—Initial 8–10 mg/kg/day in 2–3 divided doses; maintenance: 250 mg/day at bedtime for 6 mo–1 yr; Gallstone prevention—300 mg twice daily; Primary biliary cirrhosis—13–15 mg/kg/day in 2–4 divided doses.
Oral (Children and Infants) TPN-induced cholestasis—30 mg/kg/day in 2–3 divided doses.
Oral (Infants) Biliary atresia—10–15 mg/kg/day.

Availability (generic available)

Capsules: 300 mg
Tablets: 250 mg, 500 mg

Nursing implications

Nursing assessment

  • Monitor abdominal pain prior to and periodically during therapy.
  • Monitor ultrasonograms at 6 mo intervals during the first year of therapy.
  • Lab Test Considerations: Monitor liver function tests (GGT, alkaline phosphatase, AST, ALT) and bilirubin levels every mo for three mo and every six mo thereafter. If increase to clinically significant levels, consider discontinuation of therapy.

Potential Nursing Diagnoses

Acute pain (Indications)


  • Administer with food. Tablets may be broken in half and swallowed with water. To minimize the bitter taste, advise patient to swallow the half-tablet quickly without chewing. Half-tablets should be stored separately for up to 28 days.

Patient/Family Teaching

  • Instruct patient to take ursodiol as directed.
  • Advise patient to avoid aluminum-containing antacids during therapy; may impair absorption.

Evaluation/Desired Outcomes

  • Dissolution and reduction in formation of gallstones. May take several mo of therapy and complete dissolution may not occur. Stone recurrence may occur after dissolution.
  • ↓ progression of liver disease and improvement in liver function tests.
Drug Guide, © 2015 Farlex and Partners


A drug used to dissolve gallstones as an alternative to cholecystectomy in patients with radiolucent, noncalcified gallstones ≤ 20 mm in diameter, and to prevent gallstone development in patients undergoing rapid weight loss. 
Contraindications Actigall does not dissolve calcified cholesterol stones, radiopaque stones, or radiolucent bile pigment stones. It is useless for acute cholecystitis, cholangitis, biliary obstruction, gallstone pancreatitis, or biliary-gastrointestinal fistula.
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.


Ursodiol, ursodeoxycholic acid An agent used to dissolve gallstones as an alternative to cholecystectomy in Pts with radiolucent, noncalcified gallstones ≤ 20 mm in diameter, and to prevent gallstone development in Pts undergoing rapid weight loss
McGraw-Hill Concise Dictionary of Modern Medicine. © 2002 by The McGraw-Hill Companies, Inc.
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References in periodicals archive ?
Protocol: Rocephin IV 2 gm b.i.d., 4 days on 3 off, with doxycycline 100 mg, 2 tablets 2 x per day, and Actigall.
Actigall. Retrieved from:
Medications also may help, such as insulin-sensitizing and lipid-lowering agents (statins), and medications that protect the liver such as ursodeoxycholic acid (Actigall).
The product is the generic version of Actigall capsules (Watson Pharmaceuticals Inc.), a gastrointestinal agent.
"These include insulin-sensitizing agents that help the body use insulin more effectively, lipid-lowering agents such as statins, and medications that protect the liver, such as ursodeoxycholic acid (Actigall and generic) and vitamin E.
* Cholelithiasis: Only one gallstone-solubilizing agent, ursodiol (Actigall, Urso), is available in the United States.
Due to rapid weight loss in the 6 months after RYGB, some patients develop gall stones and must take ursodiol (Actigall) to reduce or prevent their formation.
The medicinal benefits of bear gall are not denied in the west: Actigall, a synthetic form of ursodeoxycholic acid (UDCA) - the active ingredient in bear gall - is used to dissolve kidney stones and treat cirrhosis of the liver.
I am fairly stunned that the only thing given to protect the gallbladder and liver with the use of IV medications is Actigall, and some practitioners do not prescribe anything when giving IV treatment.
The product is the generic equivalent to Actigall, marketed by Watson Pharmaceuticals Inc.