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Indications for ACTIGALL:
Dissolution of radiolucent, noncalcified gallstones 20 mm in diameter in patients who refuse cholecystectomy or are at increased risk during surgery. Prevention of gallstone formation in obese patients experiencing rapid weight loss.
Dissolution: 8–10mg/kg per day in 2–3 divided doses. Prevention: 300mg twice daily.
Not for calcified, radio-opaque, or radiolucent bile pigment stones. Compelling need for cholecystectomy.
Obtain sonogram at 6 and 12 months. After complete dissolution, repeat sonogram in 1–3 months and then discontinue. Gallstones can recur. Measure SGOT (AST) and SGPT (ALT) at start, 1 and 3 months later, and then every 6 months; monitor frequently if levels increase, and discontinue if elevations persist. Pregnancy (Cat.B): not recommended. Nursing mothers.
Reduced absorption with bile acid sequestrants, aluminum-containing antacids. Estrogens, oral contraceptives, clofibrate, other lipid lowering drugs may reduce effectiveness by increasing hepatic cholesterol secretion.
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