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Re: Medication Question

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What about Actigall? I think that's it.

>>> " ravenbird28904 " 4/25/2007 8:08 AM >>>

Can anyone tell me if there is another med other than Ursidol that they

give patients with PSC that does the same thing. I was first

prescribed Ursidol (pink/white capsule) but can't tolerate it and then

they prescribed Urso Forte but I can't afford it and my drug coverage

won't cover it and because I have drug coverage, I don't qualify for

assistance with the company that makes it (they get you either way

don't they!). Anybody have any suggestions??

Nikki

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Actigall, Ursodiol and Urso Forte (Urso-250), UrsoFalk are essentially the same

drug. If you can tolerate Urso Forte but not Ursodiol, you should be able to

get relief through your drug company with appropriate documentation from your

doctor. That will work for most insurance plans; I obviously don't know about

yours.

Arne

---- ravenbird28904 wrote:

=============

Can anyone tell me if there is another med other than Ursidol that they

give patients with PSC that does the same thing. I was first

prescribed Ursidol (pink/white capsule) but can't tolerate it and then

they prescribed Urso Forte but I can't afford it and my drug coverage

won't cover it.

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Hi Nikki;

I hope this article will answer your questions:

_____________

from: http://www.pscpartners.org/NewsVol-1-6.pdf

Ursodiol Formulations

Ursodiol is the " generic " name for ursodeoxycholic acid (UDCA), a bile

acid commonly prescribed for the treatment of cholestatic liver

diseases, such as primary biliary cirrhosis (PBC) and primary

sclerosing cholangitis (PSC). In the U.S.A., ursodiol is available

under two trade names; Actigall (typically available as 300 mg gelatin

capsules with a pink cap and white body containing a white/yellowish

powder), and URSO (typically available as white 250 mg tablets) [uRSO

250].

Actigall was developed by Novartis Pharmaceuticals Corporation

and is now marketed by Pharmaceuticals:

http://www.watsonpharm.com/

The Actigall capsules also contain as inactive ingredients: colloidal

silicon dioxide, ferric oxide, gelatin, magnesium stearate, starch

(corn), and titanium dioxide.

URSO is marketed by Axcan Pharma:

http://www.axcan.com/

Axcan Pharma has recently developed a 500 mg tablet marketed as URSO

Forte. The inactive ingredients of URSO are: microcrystalline

cellulose, povidone, sodium starch glycolate, magnesium stearate,

ethylcellulose, dibutyl sebacate, carnauba wax, hydroxypropyl

methylcellulose, PEG 3350, PEG 8000, cetyl alcohol, sodium lauryl

sulfate, and hydrogen peroxide.

According to Levy and Angulo (2004) " Milligram per milligram, the

bioavailability of Actigall preparation is about two-thirds that of the

URSO 250 tablet available in the United States " .

According to Axcan Pharma " URSO Forte and URSO 250 are the only

ursodiols approved by the Food and Drug Administration for the

treatment of patients with Primary Biliary Cirrhosis (PBC), a chronic

liver disease that slowly destroys the ducts that drain bile in the

liver. The recommended adult dosage for URSO Forte and URSO 250 in the

treatment of PBC is 13-15 mg/kg/day administered in two to four

divided doses with food. "

Ursodiol is currently not " indicated " for treatment of PSC in the U.S.A;

nevertheless, many doctors prescribe it for this condition, and at a

higher dose than in PBC (typically 20 - 30 mg/kg/day for PSC) because

preliminary results suggest that it improves liver biochemistry in PSC

patients, and it may also offer protection against the development of

colon cancer and cholangiocarcinoma (see p. 2 of this issue).

In Australia, ursodiol is available as Ursofalk (Dr Falk Pharma GmbH)

as white, opaque, hard gelatin capsules. Each Ursofalk capsule contains

250 mg of ursodeoxycholic acid. These capsules also contain maize

starch, silicon dioxide, magnesium stearate, gelatin and titanium

dioxide as inactive ingredients. A liquid formulation of Ursofalk has

recently been developed for pediatric patients (Setchell et al., 2005).

References

Levy C, Angulo P (2004) Ursodeoxycholic acid and long-term survival

in primary biliary cirrhosis. Am. J. Gastroenterol. 99: 269-270.

Setchell KD, Galzigna L, O'connell N, Brunetti G, Tauschel HD

(2005) Bioequivalence of a new liquid formulation of ursodeoxycholic

acid (Ursofalk suspension) and Ursofalk capsules measured by plasma

pharmacokinetics and biliary enrichment. Aliment. Pharmacol. Ther.

21: 709-721.

Ursodiol ( Gastroenterology Patient Education)

http://www.gicare.com/pated/ursodiol.htm

Ursofalk (Ursodeoxycholic Acid)

http://www.orphan.com.au/Ursofalk_cmi00.htm

_____________

It sounds like you were first given Actigall (in pink/white capsules)

and then switched to URSO to see if your intolerance to Actigall might

be related to the different " inactive " ingredients in the two

formulations? Sorry that your drug coverage does not cover URSO Forte.

I don't believe that there is any alternative to these 2 products in

the U.S.

Best regards,

Dave R.

> Can anyone tell me if there is another med other than Ursidol that

they give patients with PSC that does the same thing. I was first

prescribed Ursidol (pink/white capsule) but can't tolerate it and then

they prescribed Urso Forte but I can't afford it and my drug coverage

won't cover it and because I have drug coverage, I don't qualify for

assistance with the company that makes it (they get you either way

don't they!). Anybody have any suggestions??

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Guest guest

There are several forms of URSO

Actigall: pink and white capsule

Urso Forte: 500mg, expensive. Some data show better absorbtion %

Generics:(mine are from TEVA and are red and white capsules)

They all have the same ingredient, just packaged differently. Urso

Forte has the absorbtion advantage but the generics are so much cheaper

that you could take more to compensate for absorbtion and it would

still be a lot less.

PSC has enough random symptoms that it may difficult to say which

symptoms are medication reactions.

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