Reproduction studies have been performed in rats and rabbits with ursodiol doses up to 200-fold the therapeutic dose and have revealed no evidence of impaired fertility or harm to the fetus at doses of 20- to 100-fold the human dose in rats and at 5-fold the human dose highest dose tested in rabbits. Studies employing 100- to 200-fold the human dose in rats have shown some reduction in fertility rate and litter size. There have been no adequate and well-controlled studies of the use of ursodiol in pregnant women, but inadvertent exposure of 4 women to therapeutic doses of the drug in the first trimester of pregnancy during the ursodiol trials led to no evidence of effects on the fetus or newborn baby. Although it seems unlikely, the possibility that ursodiol can cause fetal harm cannot be ruled out; hence, the drug is not recommended for use during pregnancy. hytrin
Like all medicines, Ursofalk capsules can cause side effects, although not everybody gets them. The overall effect of ursodiol is to increase the concentration level at which saturation of cholesterol occurs. McCabe D, O'Dwyer P, Sickle-Santanello B, Woltering E, Abou-Issa H, James A. Polar solvents in the chemoprevention of dimethylbenzanthracene-induced rat mammary cancer. Alam SS, Layman DL. Dimethyl sulfoxide inhibition of prostacyclin production in cultured aortic endothelial cells. Dr. Falk Pharma GmbH.
What other drugs will affect ursodiol? You have an acute inflammation of the gall bladder or biliary tract. Hepatotoxicity has not been associated with ursodiol therapy. However, in some individuals with a congenital or acquired reduction in ability to sulfate hepatotoxic lithocholic acid, the theoretical risk of lithocholate-induced liver damage may be increased. No important toxicity was noted in animal studies.
Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.
Appropriate studies on the relationship of age to the effects of ursodiol when used as an anticholelithic have not been performed in the pediatric population. However, studies performed to date in children and infants with cholestatic liver disease and biliary atresia have not demonstrated pediatrics-specific problems that would limit the usefulness of ursodiol in children. Store away from heat and direct light. Food and Drug Administration's FDA Division of Drug Information CDER evaluates and reviews OTC ingredients and labels. An OTC drug monograph is established for each class of product. The monograph contains acceptable ingredients, doses, formulations, and labeling. New products that conform to an existing OTC drug monograph may be marketed without further FDA review. Those OTC products that do not conform to an OTC monograph must undergo approval through the New Drug Approval System. Studies in rats with intrarectal instillation of lithocholic acid and other metabolites of ursodiol and chenodiol did not show evidence of tumorigenicity, except when these substances were administered in conjunction with a carcinogenic agent. Epidemiologic studies suggest that bile acids might be involved in the pathogenesis of human colon cancer in patients who have undergone a cholecystectomy; however, conclusive evidence is lacking. Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed. This may cause scarring of the liver. Common duct exploration quadruples the rates in all categories. The rates rise with each decade of life and increase tenfold or more in all categories with severe or extreme systemic disease. When orally administered MSM was given to rats at 5 to 7 times the maximum recommended dose in humans, no adverse events or mortality were observed after 90 days. In one study, similar rates of adverse effects were seen in the MSM and placebo group. Possible adverse events included bloating, constipation, decline in concentration, fatigue, headache, indigestion, and insomnia. This restricted class includes drugs such as pseudoephedrine, emergency contraception, and some Schedule V controlled substances. These products, while considered OTC, are kept behind the pharmacy counter and must be dispensed by a pharmacist pursuant to proper identification, age verification, and patient education. In March 2012, the FDA considered expanding the definition of nonprescription drugs to include cholesterol, blood pressure, asthma and birth control medications. This new Rx-to-OTC switch ruling is currently under review and commenting. There is 1 case study of a patient with unrelieved ichthyosis treated unsuccessfully with a variety of topical agents. Acta Hepatol Jpn 1987; 28: 1597-604.
Guslandi M. Treatment of chronic liver disease with ursodeoxycholic acid. J Int Med Res 1990; 18: 497-505. FDA product labels and may differ in countries outside the USA. Every effort has been made to ensure that the information provided on this page is accurate, up-to-date and complete, but no guarantee is made to that effect. Drugs. Pharma US, Inc. 100 Somerset Corporate Boulevard Bridgewater, NJ 08807, USA. Ursodiol is used in patients with gallstones who do not need to have their gallbladders removed or in those in whom surgery should be avoided because of other medical problems. However, ursodiol works only in those patients whose gallstones are made of cholesterol and works best when these stones are small and of the “floating” type. Keep this medicine out of the sight and reach of children. Sarva RP, Fromm H, Farvier S, et al. Comparison of the effects between ursodeoxycholic and chenodeoxycholic acids on liver function and structure and on bile composition in the Rhesus monkey. Gastroenterology 1990; 79: 629-36. Delayed Release Enteric Coated side effects by likelihood and severity. The trial drug treatment period was for 6 months following this surgery. Your doctor will know what is right for you. Fleeger CA, editor. USP dictionary of USAN and international drug names 1997. Rockville, MD: The United States Pharmacopeial Convention, Inc; 1996. p. 753. Disclaimer: The indications, uses and warnings for individual medications outside the USA are determined by local regulatory bodies in each country or region. The Drugs. Ursofalk capsules or decide to stop your treatment early. Orally administered ursodiol is indicated for dissolution of cholesterol gallstones in selected patients with uncomplicated radiolucent gallstone disease. lamictal
Contact your veterinarian or go to nutramaxlabs. Take ursodiol with meals for best results, unless otherwise directed by your doctor. The tablet can be divided into equal doses. Read all of this leaflet carefully before you start taking this medicine. Berardesca E, Cameli N, Cavallotti C, Levy JL, Piérard GE, de Paoli Ambrosi G. Combined effects of silymarin and methylsulfonylmethane in the management of rosacea: clinical and instrumental evaluations. PBC patients, seven patients 11. If partial stone dissolution is not seen by 12 months of therapy, likelihood of success is greatly reduced. Its structure is shown below. The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables. OTC medications can carry risk. There is the possibility of side effects, drug or food interactions, or harm due to excessive doses. Patients should read the 'Drug Facts' label that is found on all OTC products. All consumers, including older patients, pregnant women, and parents of young children should always consult with their pharmacist or other health care provider if they have additional questions concerning OTC drug use. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended. Ultrasound images of gallbladder recommended at 6-month intervals for first year of therapy to monitor gallstone response. If gallstones appear to have dissolved, therapy should be continued and dissolution confirmed on a repeat ultrasound examination within 1 to 3 months. While using ursodiol, you may need gallbladder ultrasound exams, or frequent blood tests to check your liver function. Your doctor may also want to check your liver function every 6 months after you stop using ursodiol. Rosenbaum CL, Cluxton RJ Jr. Ursodiol: a cholesterol gallstone solubilizing agent. Drug Intell Clin Pharm 1988 Dec; 22: 941-5. Studies have shown that, in many cases, tablets or capsules given as a “dry swallow” do not pass into the stomach in cats but may become lodged in the esophagus. It is recommended for pet owners to administer 3-6 cc of water immediately following any tablet administration to speed passage of the tablet into the stomach. Humans and chimpanzees can sulfate lithocholic acid. order cheap ramipril shopping ramipril
This should not be used if you have certain medical conditions. The following information includes only the average doses of ursodiol. Marañón G, Muñoz-Escassi B, Manley W, et al. The effect of methyl sulphonyl methane supplementation on biomarkers of oxidative stress in sport horses following jumping exercise. In worldwide clinical studies of ursodiol, approximately 14% of subjects were over 65 years of age approximately 3% were over 75 years old. In a subgroup analysis of existing clinical trials, patients greater than 56 years of age did not exhibit statistically significantly different complete dissolution rates from the younger population. No age-related differences in safety and effectiveness were found. Other reported clinical experience has not identified differences in response in elderly and younger patients. However, small differences in efficacy and greater sensitivity of some elderly individuals taking ursodiol cannot be ruled out. Therefore, it is recommended that dosing proceed with caution in this population. Urso ursodiol is a used to treat small in people who cannot have surgery, and to prevent gallstones in patients undergoing rapid weight loss. Urso is also used to treat PBC. Urso is available in form. Topical MSM showed benefit in combination with silymarin to treat rosacea in 46 patients. A statistically significant decrease in erythema, papules, and itch intensity occurred. MSM was theorized to be beneficial in rosacea due to strong photoprotective action along with antioxidant effects and desensitization of the skin to potential allergens. Hepatology 1990; 12: 438. Take the ursodiol tablet with food. Koga Y. Anti-cholestatic and cytoprotective properties of ursodeoxycholic acid. Treatment with Ursofalk capsules may still be allowed. In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. UDCA. Small amounts of UDCA are found in human bile. Take the capsules regularly. pharmacy raloxifene indication
Safety of use beyond 24 months is not established. LABORATORIES, VETERINARY SCIENCES, INC. Ursodiol experienced a 9%, 1%, and 5% incidence of gallstone formation, respectively. This medicinal product does not require any special storage conditions. Leuschner U, et al. Gallstone dissolution with ursodeoxycholic acid in patients with chronic active hepatitis and two years follow-up. A pilot study. Dig Dis Sci 1985 Jul; 307: 642-9. Young Place, East Kilbride G75 0TD. Ursodiol should be taken with meals or a snack since it dissolves more rapidly when bile and pancreatic juice are present in the intestinal chyme. Tablets are sensitive to moisture and extreme heat and should not be split or crumbled. Dispense contents in a tight, light-resistant container as defined in the USP. Do not stop taking any medications without consulting your healthcare provider. Keep out of reach of children. Ursofalk tablets can be continued indefinitely in cases of PBC. Clinical information regarding safety and efficacy in pregnancy is lacking. The first report evaluating the developmental toxicity of MSM in a mammalian model was published in 2007. Talk to your doctor or pharmacist before taking Ursofalk suspension.
It is not known whether this drug passes into milk. Consult your doctor before -feeding. Available in bottles of 100 tablets NDC 58914-785-10. Hepatology 1989; 104: 602. Although the exact mechanism of ursodiol's anticholelithic action is not completely understood, it is known that when administered orally ursodiol is concentrated in bile and decreases biliary cholesterol saturation by suppressing hepatic synthesis and secretion of cholesterol, and by inhibiting its intestinal absorption. The reduced cholesterol saturation permits the gradual solubilization of cholesterol from gallstones, resulting in their eventual dissolution. Leuschner U, Fisher H, Kurtz W, et al. Ursodeoxycholic acid in primary biliary cirrhosis: results of a controlled double-blind trial. Gastroenterology 1989 Nov; 975: 1268-74. In chronic cholestatic liver disease, ursodiol appears to reduce the detergent properties of the bile salts, thus reducing their cytotoxicity. purchase priligy guidelines
With repeated dosing, bile ursodeoxycholic acid concentrations reach a steady state in about 3 weeks. Although insoluble in aqueous media, cholesterol can be solubilized in at least two different ways in the presence of dihydroxy bile acids. In addition to solubilizing cholesterol in micelles, ursodiol acts by an apparently unique mechanism to cause dispersion of cholesterol as liquid crystals in aqueous media. For a listing of dosage forms and brand names by country availability, see Dosage Forms sections. If you get any side effects, talk to your doctor or pharmacist. Do not use this medicine after the expiry date. II, methylsulfonylmethane, cetyl myristoleate, lipase, vitamin C, and bromelain, was published. In 89 patients with osteoarthritis, a decrease in the percentage of patients reported to have pain, stiffness, and tenderness in the treatment group was found after 3 months. Take the capsules two to three times per day, as advised. Denosyl is available in three strengths: as an enteric-coated 90 mg, 225 mg, and 425 mg tablet of active S-Adenosylmethionine. Because S-Adenosylmethionine is extremely sensitive to moisture, tablets are individually sealed in specialized moisture-resistant blister packs. Ursofalk tablets is based on body weight and the medical condition. Not all gallstones completely dissolve with ursodiol treatment, and you may develop new gallstones within 5 years after treatment. Talk to your doctor about your specific risks. Ursodiol is also used in patients with cirrhosis of the liver. Cirrhosis causes a patient's liver to have problems and not work properly. Ursodiol, USP ursodeoxycholic acid is a naturally occurring bile acid found in small quantities in normal human bile and in the biles of certain other mammals. It is a bitter-tasting, white powder freely soluble in ethanol, methanol, and glacial acetic acid; sparingly soluble in chloroform; slightly soluble in ether; and insoluble in water. The chemical name for ursodiol is 3α, 7β-Dihydroxy-5β-cholan-24-oic acid C 24H 40O 4. Ursodiol, USP has a molecular weight of 392. Oral, 300 mg two times a day. Talk to your doctor or pharmacist before taking Ursofalk tablets. You have frequent cramp-like upper abdomen pain biliary colic. Gallstone dissolution may require 6 months to 2 years of continuous dosing depending on the size and composition of the stones. Response should be monitored by ultrasonograms performed at 6-month intervals during the first year of therapy. pills similar to trihexyphenidyl trihexyphenidyl
Ursodiol in bile is concentrated in the gallbladder and expelled into the duodenum in gallbladder bile via the cystic and common ducts by gallbladder contractions provoked by physiologic responses to eating. Only small quantities of ursodiol appear in the systemic circulation and very small amounts are excreted into urine. If any of these effects persist or worsen, tell your doctor or promptly. Tap against the barrel of the syringe to remove any large air bubbles. Moreno-Otero R, et al. Primary biliary cirrhosis. Med Clin North Am 1989; 73: 911-29. The gall bladder should still be working despite the gallstones. In animals, it is found in the adrenal cortex of cattle, human and bovine milk, and urine. There are no age limits to the use of Ursofalk tablets. As an aid to patient consultation, refer to Advice for the Patient, Ursodiol Systemic. Denosyl may improve bile flow in cats. buspirone
The primary outcome was the reduction of pain intensity assessed by a visual analog scale VAS. Pain, swelling, and joint mobility were also scored on a 0 to 3 scale, with 3 as the most severe. The primary outcome was not reported; however, all groups except for placebo experienced statistically significant improvements in pain and swelling. The combination of glucosamine and methylsulfonylmethane showed statistically significant decreases in pain and swelling compared with either single treatment alone. Appropriate studies on the relationship of age to the effects of ursodiol have not been performed in the geriatric population. However, geriatrics-specific problems that would limit the usefulness of this medication in the elderly are not expected. The cup provided can be used for children over 10kg body weight. Remember that your doctor has prescribed this because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication not have serious side effects. Swallow the capsules whole with a drink of water or other liquid. Take your medicine regularly. Do not increase your dose or take this medication more often without your doctor's approval. Your condition will not improve any faster, and the risk of serious side effects may be increased. The most likely manifestation of severe overdose with ursodiol would probably be diarrhea, which should be treated symptomatically.
The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist. The various actions of ursodiol combine to change the bile of patients with gallstones from cholesterol-precipitating to cholesterolsolubilizing, thus resulting in bile conducive to cholesterol stone dissolution. Keep all medicines out of the reach and sight of children. The presence of other medical problems may affect the use of ursodiol. However, gallbladder nonvisualization developing during ursodiol treatment predicts failure of complete stone dissolution and in such cases therapy should be discontinued. Gallbladder stone dissolution with ursodiol treatment requires months of therapy. Complete dissolution does not occur in all patients and recurrence of stones within 5 years has been observed in up to 50% of patients who do dissolve their stones on bile acid therapy. Patients should be carefully selected for therapy with ursodiol, and alternative therapies should be considered. It generally takes 6-24 months to dissolve gallstones. No evidence of maternal toxicity was observed, nor any significant increases in the incidence of anomalies in the fetuses. It was not tumorigenic in mice. Always take Ursofalk capsules exactly as your doctor has told you. Ursofalk Jouveinal. In: Krogh CME, editor. CPS Compendium of pharmaceuticals and specialties. 28th ed. Ottawa: Canadian Pharmaceutical Association; 1993. p. 1287. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Ursodiol is 7-dehydroxylated more slowly than chenodiol. Do not store in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down. order meclizine online australia
For optimal absorption, tablets should be given on an empty stomach, at least one hour before feeding, as the presence of food decreases the absorption of S-Adenosylmethionine. Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. 'Multum' is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Lithocholic acid causes cholestatic liver injury and can cause death from liver failure in certain species unable to form sulfate conjugates. Lithocholic acid is formed by 7-dehydroxylation of the dihydroxy bile acids ursodiol and chenodiol in the gut lumen. As liver function tests improve, the total daily dose may be taken once a day in the evening. Store at room temperature away from moisture and heat. Tablets that are broken in half can be kept at room temperature for up to 28 days. This leaflet was last revised in November 2014. In good health or with moderate systemic disease. Use and dose must be determined by your doctor. Another commonly used name is UDCA. Take the suspension in the evening at bedtime. Guldutuna S, Wunderlich N, Nickel A, et al. Influence of ursodeoxycholic acid on bile acid metabolism of patients with primary biliary cirrhosis. Gastroenterology 1990; 98: A590. Ursofalk capsules must be used under medical supervision. Ursofalk capsules may pass into breast milk. Studies in rats at doses 20 to 100 times the human dose, and in rabbits at doses 5 times the human dose, have not shown that ursodiol causes adverse effects in the fetus. The information on this page is not a substitute for the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that a drug or drug combination is safe, effective or appropriate for any given patient. Drugs. Reviewers" consensus on monograph revision of 1988. ovem.info trandate
Read the package labeling or ask your for the storage requirements for the product you are using. not store in the bathroom. Keep all medicines away from children and pets. Commonly used brand names: Actigall; Ursofalk. If you miss a dose of this medicine, take it as soon as possible or double your next dose. Fleck CA. Managing ichthyosis: a case study. Ursofalk tablets or decide to stop your treatment early. CS, Czech Republic; Pro. WE CANNOT ACCEPT RESPONSIBILITY FOR ANY ERRORS IN THIS PROOF AFTER APPROVAL. Take your medicine regularly. If this is the case, your doctor will stop the treatment. Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. Most patients who eventually achieve complete stone dissolution show partial or complete dissolution at the first on-treatment reevaluation. If you or anyone else take too many of the capsules, seek immediate medical attention. In a pharmacokinetic study with fasted dogs given Denosyl, peak plasma levels were recorded in most dogs within 4 hours of administration. 1 A pharmacokinetic study in fasted cats showed peak plasma levels at 2-4 hours post Denosyl administration. It generally takes 6 - 24 months to dissolve gallstones. desloratadine
ursofalk purchase store usa, monthly cost ursofalk prescription, buy ursofalk online cheap uk, money order now ursofalk online, generic ursofalk buy now payment, ursofalk side effects, buy ursofalk payment europe, purchase ursofalk dose, ursofalk price in uk, ursofalk buy europe, costco brand for ursofalk, generic ursofalk purchase payment europe, generic ursofalk pill identification, ursofalk online shopping buy, ursofalk order online visa usa, ursofalk usa, ursofalk money order online australia, ursofalk in farmacia, generic ursofalk order canada, best price brand ursofalk, purchase cheap ursofalk store otc, order generic ursofalk shop europe, ursofalk in canada with prescription, online apotheke niederlande ursofalk, generic vs ursofalk, price ursofalk side, cheap real ursofalk canada, money order ursofalk visa usa, buy ursofalk in thailand, ursofalk buy online europe, ursofalk and india, buy ursofalk online cheap australia, name brand ursofalk better than generic, ursofalk in america, order generic ursofalk shop uk, ursofalk order mastercard australia, purchase ursofalk tablets online visa, ursofalk generic approval, ursofalk and effective, generic ursofalk kada, online pharmacy for ursofalk, order now ursofalk payment canada, cheap ursofalk order online visa, can you purchase ursofalk over the counter, ursofalk online money order, where to order ursofalk pills, cheap ursofalk order payment usa, canada ursofalk buller, buy ursofalk starter pack, world pharmacy ursofalk, compounding pharmacy for ursofalk, ursofalk mail order now otc, cheap ursofalk uk online, where to order ursofalk usa, buy generic ursofalk visa canada, purchase ursofalk legally online, buy now ursofalk cheap, ursofalk where to order otc, order ursofalk visa europe, order online ursofalk mastercard, cheap ursofalk buy pharmacy europe, costco price for ursofalk otc, ursofalk order online shopping uk, buy cheap ursofalk payment europe, ursofalk purchase now shop usa, ursofalk cost dubai, ursofalk price in saudi arabia, ursofalk in mexico, cheap ursofalk online, pharmacy ursofalk together, cheapest ursofalk order shop otc, where can i ursofalk uk, order generic ursofalk shopping, ursofalk vs generic brand, can you ursofalk in usa, pharmacy ursofalk indication, purchase ursofalk guidelines, order ursofalk online australia, ursofalk without pre, order ursofalk online store canada, pills similar to ursofalk, order cheap ursofalk shopping
Traub-Dargatz JL, McKinnon AO, Thrall MA, et al. Evaluation of clinical signs of disease, bronchoalveolar and tracheal wash analysis, and arterial blood gas tensions in 13 horses with chronic obstructive pulmonary disease treated with prednisone, methyl sulfonmethane, and clenbuterol hydrochloride. HOW TO USE: Take this medication exactly as directed by your doctor. MSM with glucosamine and the combination of the 2 in 118 patients with mild to moderate osteoarthritis for a minimum of 6 months. order gabapentin online store canada
Gastroenterology 1990; 98: 578. The nature and frequency of adverse experiences were similar across all groups. If you have any further questions, ask your doctor or pharmacist. Matsuzaki Y, Tanaka N, Osuga T, et al. Improvement of biliary enzyme levels and itching as a result of long-term administration of ursodeoxycholic acid in primary biliary cirrhosis. Am J Gastroenterol 1990; 851: 15-23. serophene without pre
Bertken R. “Crystalline DMSO”: DMSO2. Ursofalk suspension or to stop your treatment early. Man has the capacity to sulfate lithocholic acid. Although liver injury has not been associated with ursodiol therapy, a reduced capacity to sulfate may exist in some individuals, but such a deficiency has not yet been clearly demonstrated. The active substance is ursodeoxycholic acid. Podda M, et al. Effects of ursodeoxycholic acid and taurine on serum liver enzymes and bile acids in chronic hepatitis. Gastroenterology 1990 Apr; 984: 1044-50.
Ursodiol has not been studied in pregnant women. However, ursodiol has not been shown to cause birth defects or other problems in animal studies. Before taking this medicine, make sure your doctor knows if you are pregnant or if you may become pregnant. 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. Most patients who eventually achieve complete stone dissolution will show partial or complete dissolution at the first on-treatment reevaluation. If partial stone dissolution is not seen by 12 months of ursodiol therapy, the likelihood of success is greatly reduced.