Why I am cautious about stopping urso without more info.

[Guest guest]

Dear All;

I'd like to express my specific concern about my son stopping taking

ursodiol without more information. My son is not only taking ursodiol

but is also taking rifampin (rifampicin) by prescription from his

hepatologist. The rifampin controls his itching (pruritus) very well.

There is good theoretical reason why the combination of rifampin and

ursodiol should be better than ursodiol alone. Please read these

papers to find out why:

Marschall HU, Wagner M, Zollner G, Fickert P, Diczfalusy U, Gumhold

J, Silbert D, Fuchsbichler A, Benthin L, Grundstrom R, Gustafsson U,

Sahlin S, Einarsson C, Trauner M 2005 Complementary stimulation of

hepatobiliary transport and detoxification systems by rifampicin and

ursodeoxycholic acid in humans. Gastroenterology 129: 476-485.

http://www.ncbi.nlm.nih.gov/pubmed/16083704

Boyer JL 2005 Nuclear receptor ligands: rational and effective

therapy for chronic cholestatic liver disease? Gastroenterology 129:

735-740.

http://www.ncbi.nlm.nih.gov/pubmed/16083726

Basically, the two compounds act together to promote more effective

bile transport and metabolism.

So can anyone predict what would happen if ursodiol was taken away

while maintaining rifampin? Would this precipitate a negative/toxic

reaction from rifampin? Should stopping urso be accompanied by also

stopping rifampin? These are questions that I can't answer yet.

I am not going to do such an experiment on my son without some

careful research, and this means first seeing the data from the urso

trial.

Best regards,

Dave

(father of (23); PSC 07/03; UC 08/03)