From the FDA Drug Label
DOSAGE AND ADMINISTRATION Gallstone Dissolution The recommended dose for Ursodiol treatment of radiolucent gallbladder stones is 8 - 10 mg/kg/day given in 2 or 3 divided doses. Ultrasound images of the gallbladder should be obtained at 6-month intervals for the first year of Ursodiol therapy to monitor gallstone response If gallstones appear to have dissolved, Ursodiol therapy should be continued and dissolution confirmed on a repeat ultrasound examination within 1 to 3 months.
The patient should continue their ursodeoxycholic acid (UDCA) therapy as prescribed, and it is recommended to have a plan in place for monitoring and managing their condition while traveling.
- The patient should bring an adequate supply of their medication to last the duration of their trip.
- They should also have a plan for accessing medical care if needed, in case of any issues related to their gallbladder condition or UDCA therapy 1. It is also important to note that the safety of use of Ursodiol beyond 24 months is not established 1.
From the Research
For a patient with gallbladder sludge (cholelithiasis) taking ursodeoxycholic acid (UDCA) who plans to travel for 2 months, it is recommended to continue the medication without interruption during travel. The patient should ensure they have an adequate supply of UDCA for the entire trip, plus an additional 1-2 weeks' worth in case of travel delays. Typically, UDCA is prescribed at doses of 8-10 mg/kg/day divided into 2-3 doses (often 300 mg twice daily for average-sized adults) 2. The medication should be taken with meals to enhance absorption. Before traveling, the patient should consult their healthcare provider to obtain sufficient prescription refills and discuss any potential medication adjustments. They should carry the medication in original packaging with prescription labels and keep a copy of their prescription and a brief medical history letter explaining their condition. UDCA works by decreasing cholesterol secretion into bile and solubilizing existing gallbladder sludge, so consistent daily dosing is important for effectiveness 3. Patients should maintain their regular low-fat diet during travel, stay well-hydrated, and avoid excessive alcohol consumption, which can exacerbate gallbladder issues. If symptoms like right upper quadrant pain, nausea, or vomiting develop during travel, the patient should seek medical attention promptly.
Some key points to consider:
- The efficacy of UDCA in treating gallbladder sludge and small gallstones has been established 2, 3.
- The medication is generally well-tolerated, with minor adverse effects such as acidism and diarrhea reported in some cases 3.
- It is essential to maintain consistent daily dosing to ensure the effectiveness of UDCA in dissolving gallbladder sludge and preventing the formation of new stones.
- Patients should be aware of the potential risks and benefits of continuing UDCA therapy during travel and discuss any concerns with their healthcare provider before departing.
Given the available evidence, the most recent and highest quality study supporting the recommendation to continue UDCA therapy during travel is not explicitly provided, but the established efficacy and safety of UDCA in treating gallbladder sludge and small gallstones support this decision 2, 3.