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Ursofalk 250mg Hard Capsules

⚠ This medicine appears to have been discontinued

The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.

If you were prescribed this medicine, other products containing Ursodeoxycholic acid may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.

Active substance: Ursodeoxycholic acid

Source: electronic medicines compendium (emc)
Official leaflet: Read the PIL on emc

What it is and what it is used for

for Ursodeoxycholic acid (UDCA), the active substance in Ursofalk capsules, is a naturally-occurring bile acid. Small amounts are found in human bile. Ursofalk capsules are used: − for the treatment of a condition where the bile ducts in the liver become damaged; leading to a build-up of bile. This may cause scarring of the liver. The liver should not be so damaged that it is not functioning properly. This condition is called primary biliary cholangitis (PBC). − to dissolve gallstones caused by excess cholesterol in the gall bladder where the gallstones are not visible on a plain x-ray (gallstones that are visible will not dissolve) and not more than 15 mm in diameter. The gall bladder should still be working despite the gallstone(s). − for liver disease associated with a condition called cystic fibrosis in children aged 6 to 18 years.

What you need to know before you take it

e Ursofalk 250mg hard capsules Do NOT take Ursofalk capsules if: − you are, or have been told you are, allergic (hypersensitive) to bile acids like UDCA or to any of the other ingredients of Ursofalk capsules (listed in section 6) − your gall bladder does not work properly − your doctor has said you have calcified gallstones (they are visible on an x-ray) − you have an acute inflammation of the gall bladder or biliary tract − you have a blockage of the common bile duct or cystic duct (obstruction of the biliary tract) − you have frequent cramp-like pains in the upper abdomen (biliary colic).

−

you are a child with biliary atresia and have poor bile flow, even after surgery.

Please ask your doctor about any of the conditions mentioned above. You should also ask if you have previously had any of these conditions or if you are unsure whether you have any of them. Warnings and precautions Talk to your doctor or pharmacist before taking Ursofalk capsules. Your doctor should test your liver function regularly every 4 weeks for the first 3 months of treatment. After this time, it should be monitored at 3 month intervals. When used in the treatment of PBC, in rare cases the symptoms may worsen at the beginning of treatment. If this happens, please speak to your doctor about reducing your initial dose. When used to dissolve gallstones, your doctor should arrange for a scan of your gall bladder after the first 6-10 months of treatment. Please inform your doctor immediately if you have diarrhoea as this may require a reduction in the dose or discontinuation of treatment. Other medicines and Ursofalk capsules The effects of these medicines may be altered: A reduction in the effects of the following medicines is possible when taking Ursofalk capsules: − colestyramine, colestipol (to lower blood lipids) or antacids containing aluminium hydroxide or smectite (aluminium oxide). If you must take medication that contains any of these ingredients, it must be taken at least two hours before or after Ursofalk. − ciprofloxacin and dapsone (antibiotics), nitrendipine (used to treat high blood pressure). It may be necessary for your doctor to alter the dose of these medicines. A change in the effects of the following medicines is possible when taking Ursofalk capsules: − ciclosporin (to reduce the activity of the immune system). If you are being treated with ciclosporin, your doctor should check the amount of ciclosporin in your blood. Your doctor will adjust its dose, if necessary. − rosuvastatin (for high cholesterol and related conditions) Please inform your doctor if you are taking any blood cholesterol lowering agents such as clofibrate or medicines that contain oestrogen (estrogen) especially if you are taking Ursofalk capsules for the dissolution of gallstones, as they may stimulate the formation of gallstones. Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, even if they are medicines obtainable without a prescription. Treatment with Ursofalk capsules may still be allowed. Your doctor will know what is right for you. Pregnancy, breastfeeding and fertility If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. Pregnancy You should not take Ursofalk during pregnancy unless your doctor thinks it is absolutely necessary.

Women of child-bearing potential Even if you are not pregnant, you should still discuss this possibility with your doctor. Before starting treatment with Ursofalk your doctor will check that you are not pregnant and review your contraceptive method to make sure it is appropriate. Breastfeeding Tell your doctor if you are breastfeeding or about to start breastfeeding. Driving and using machines: No particular precautions are necessary.

3. How to take Ursofalk 250mg capsules Always take Ursofalk capsules exactly as your doctor has told you. You should check with your doctor or pharmacist if you are not sure. Ursofalk suspension is available if a lower dose is needed or you cannot swallow capsules. For primary biliary cholangitis (chronic inflammation of the bile ducts) Dosage During the first 3 months of treatment, you should take Ursofalk capsules in the morning, at midday and in the evening. As liver function values improve, the total daily dose may be taken once a day in the evening.

Body weight BW (kg)

Daily dose (mg/kg BW) Morning

47 – 62 63 – 78 79 – 93 94 – 109 over 110

12 – 16 13 – 16 13 – 16 14 – 16

1 1 1 2 2

Ursofalk 250mg hard capsules First 3 months Subsequently Midday Evening Evening (once daily) 1 1 3 1 2 4 2 2 5 2 2 6 2 3 7

How to take Ursofalk capsules Swallow the capsules whole with a drink of water or other liquid. Take your medicine regularly. Duration of treatment Ursofalk capsules may be continued indefinitely in cases of PBC.

To dissolve cholesterol gallstones Dosage Approximately 10mg per kg body weight (BW) daily, as follows: 50 – 62kg 2 capsules daily 63 – 85kg 3 capsules daily 86 – 120kg 4 capsules daily How to take Ursofalk capsules

Swallow the capsules whole with a drink of water or other liquid. Take the capsules in the evening at bedtime. Take your medicine regularly. Duration of treatment It generally takes 6-24 months to dissolve gallstones. If there is no reduction in the size of the gallstones after 12 months, therapy should be stopped. Every 6 months, your doctor should check whether the treatment is working. At each of these follow-up examinations, it should be checked whether a build-up of calcium causing hardening of the stones has occurred since the last time. If this happens, your doctor will stop the treatment. Both Indications: Use in elderly: There is no evidence to suggest that any alteration in the adult dose is needed but your doctor will take your age and health into consideration. Use in children and adolescents: The administration of Ursofalk is based on body weight and the condition being treated.

Use in children (6 to 18 years) for treatment of liver disease associated with cystic fibrosis Dosage The recommended daily dose is 20mg per kg body weight, divided in 2-3 doses. Your doctor may want to increase the dose further to 30mg per kg body weight daily if necessary. Body weight Daily dose Ursofalk 250mg hard capsules BW [kg] [mg/kg BW] Morning Midday Evening 20 – 29

17-25

1

—

1

30 – 39

19-25

1

1

1

40 – 49

20-25

1

1

2

50 – 59

21-25

1

2

2

60 – 69

22-25

2

2

2

70 – 79

22-25

2

2

3

80 – 89

22-25

2

3

3

90 – 99

23-25

3

3

3

100 – 109

23-25

3

3

4

3

4

4

>110

How to take it

Ursofalk capsules Take the capsules two to three times per day, as advised. Take the capsules regularly. Duration of treatment Treatment can be continued long term (up to 12 years) in children with cystic fibrosis associated hepatobiliary disorders. If you feel that the effect of Ursofalk capsules is too strong or too weak, please talk to your doctor or pharmacist.

If you take more Ursofalk capsules than you should: Diarrhoea may occur as a result of overdose. Please inform your doctor immediately if you have persistent diarrhoea. If you do suffer from diarrhoea, make sure you drink enough liquids to replace your fluid and electrolyte balance. If you forget to take Ursofalk capsules: Do not take more capsules the next time, but just continue the treatment with the prescribed dose. If you stop taking Ursofalk capsules: Always talk to your doctor before you decide to interrupt treatment with Ursofalk capsules or decide to stop your treatment early.

Possible side effects

Like all medicines, Ursofalk capsules can cause side effects, although not everybody gets them. Common: may affect up to 1 in 10 people − soft, loose stools or diarrhoea. Very rare: may affect up to 1 in 10,000 people − during the treatment of PBC: severe right-sided upper abdominal pain, severe worsening of liver scarring – this partially eases after treatment is stopped. − hardening of gallstones due to build-up of calcium. There are no additional symptoms of this but it will show up in tests. − nettle rash (urticaria) Not known: frequency cannot be estimated from the available data − itching − feeling sick, vomiting Reporting of side effects If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly as follows: Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store By reporting side effects, you can help provide more information on the safety of this medicine.

How to store it

Ursofalk 250mg capsules Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the carton and the container after "Expiry date". The expiry date refers to the last day of that month. This medicinal product does not require any special storage conditions. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.

Contents of the pack and other information

What Ursofalk 250mg hard capsules contain: The active substance is UDCA. One capsule contains 250mg UDCA. The other ingredients are (capsule contents) silica, colloidal anhydrous, magnesium stearate, maize starch. (capsule shell) gelatin, titanium dioxide (E171), sodium lauryl sulphate What Ursofalk 250mg hard capsules look like and contents of the pack Ursofalk capsules are white, opaque hard gelatin capsules containing a white powder or granules. Ursofalk capsules are available in packs of 60 or 100 capsules. Not all packs may be marketed. Marketing Authorisation Holder: Dr Falk Pharma UK Ltd Unit K, Bourne End Business Park Cores End Road Bourne End, Buckinghamshire SL8 5AS, UK

Manufactured by: Dr. Falk Pharma GmbH Leinenweberstrasse 5 79108 Freiburg Germany Tel.: + 49 (0) 761 1514-0 Fax: + 49 (0) 761 1514-321 E-mail: [email protected] This leaflet was last revised in January 2025

Other sources of information: Further information, help, advice and details of local support groups can be found at: The PBC Foundation The British Liver Trust 2 York Place 2 Southampton Road Edinburgh Ringwood Scotland England EH1 3EP BH24 1HY Telephone: +44 (0) 131 556 6811 Telephone: +44 (0) 1425 481320

Frequently asked questions about Ursofalk 250mg Hard Capsules

How do I take Ursofalk 250mg Hard Capsules?

Ursofalk 250mg Hard Capsules comes as capsule containing 250mg. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.

What is the active substance in Ursofalk 250mg Hard Capsules?

The active substance in Ursofalk 250mg Hard Capsules is ursodeoxycholic acid.

Are there equivalent medicines to Ursofalk 250mg Hard Capsules?

Medicines with the same active substance, strength and form include: Ursodeoxycholic Acid 250 mg hard capsule, Ursodeoxycholic Acid 250 mg hard capsules, Ursodeoxycholic acid 250mg Hard Capsules. They are interchangeable only if your prescriber or pharmacist says so.

Where does this information come from?

This leaflet reproduces the patient information leaflet approved for Ursofalk 250mg Hard Capsules, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.

Can I get Ursofalk 250mg Hard Capsules without a prescription?

Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.

About this leaflet

The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.

Medical disclaimer: This page is for information only and does not replace advice from your doctor or pharmacist. Always read the leaflet supplied with your medicine. If you are unwell, call NHS 111; in an emergency, call 999.

Medicines with the same active substance: Ursodeoxycholic acid (13 medicines)
See every medicine containing this substance, or browse the full A–Z of active substances.
⚕For healthcare professionals — Summary of Product Characteristics (SmPC)Full SmPC: dosage, interactions, contraindications, warnings+
Technical information intended for healthcare professionals (doctors and pharmacists). The Summary of Product Characteristics (SmPC) is the official document approved by the MHRA/EMA. It does not replace the patient leaflet or a doctor’s advice.

4.1. Therapeutic indications

Ursofalk is indicated in the treatment of primary biliary cholangitis (PBC) and for the dissolution of radiolucent gallstones in patients with a functioning gall bladder.

Paediatric population

Hepatobiliary disorders associated with cystic fibrosis in children aged 6 to 18 years.

4.2. Posology and method of administration

There are no age restrictions on the use of Ursofalk 250mg hard capsules in the treatment of PBC and for the dissolution of radiolucent gallstones. For patients weighing less than 47 kg or patients who are unable to swallow Ursofalk capsules, Ursofalk suspension is available.

The following daily dose is recommended for the various indications:

For primary biliary cholangitis (PBC)

The daily dose depends on body weight, and ranges from 3 to 7 capsules (14 ± 2 mg UDCA per kg of body weight).

For the first 3 months of treatment, Ursofalk capsules should be taken divided over the day. With improvement of the liver values the daily dose may be taken once daily in the evening.

Body weight (kg)

Daily dose (mg/kg BW)

Ursofalk 250mg hard capsules

first 3 months

subsequently

morning

midday

evening

evening

(1 x daily)

47 – 62

12 – 16

1

1

1

3

63 – 78

13 – 16

1

1

2

4

79 – 93

13 – 16

1

2

2

5

94 – 109

14 – 16

2

2

2

6

Over 110

2

2

3

7

The capsules should be swallowed whole with some liquid. Care should be taken to ensure that they are taken regularly.

The use of Ursofalk capsules in PBC may be continued indefinitely.

Dissolution of Gallstones:

Adults: The usual dose is 8–12mg/kg/day to be taken in the evening, e.g. 750mg, daily in the evening.

The time required for dissolution of gallstones is likely to range from 6 to 24 months depending on stone size and composition.

Follow-up cholecystograms or ultrasound investigation may be useful at 6 month intervals until the gallstones have disappeared.

Treatment should be continued until 2 successive cholecystograms and/or ultrasound investigations 4-12 weeks apart have failed to demonstrate gallstones. This is because these techniques do not permit reliable visualisation of stones less than 2mm in diameter. The likelihood of recurrence of gallstones after dissolution by bile acid treatment has been estimated as up to 50% at 5 years. The efficiency of Ursofalk in treating radio-opaque or partially radio-opaque gallstones has not been tested but these are generally thought to be less soluble than radiolucent stones. Non-cholesterol stones account for 10-15% of radiolucent stones and may not be dissolved by bile acids.

Older people

There is no evidence to suggest that any alteration in the adult dose is needed but the relevant precautions should be taken into account.

Paediatric population

Cholesterol rich gallstones and PBC are very rare in children but when they occur, dosage should be related to bodyweight. There are no adequate data on the efficacy and safety in this population.

Hepatobiliary disorders associated with cystic fibrosis:

Paediatric population

Children with cystic fibrosis aged 6 to 18 years: 20 mg/kg/day in 2-3 divided doses, with a further increase to 30 mg/kg/day if necessary.

Body weight

BW [kg]

Daily dose

[mg/kg BW]

Ursofalk 250mg hard capsules

Morning

Midday

Evening

20 – 29

17-25

1

--

1

30 – 39

19-25

1

1

1

40 – 49

20-25

1

1

2

50 – 59

21-25

1

2

2

60 – 69

22-25

2

2

2

70 – 79

22-25

2

2

3

80 – 89

22-25

2

3

3

90 – 99

23-25

3

3

3

100 – 109

23-25

3

3

4

>110

3

4

4

4.3. Contraindications

Ursofalk 250mg hard capsules should not be used in patients with:

• Acute inflammation of the gall bladder or biliary tract

• occlusion of the biliary tract (occlusion of the common bile duct or a cystic duct)

• frequent episodes of biliary colic

• radio-opaque calcified gallstones

• impaired contractility of the gall bladder

• hypersensitivity to bile acids or any excipient of the formulation

When used in hepatobiliary disorders associated with cystic fibrosis in children aged 6 to 18 years.

• Unsuccessful portoenterostomy or without recovery of good bile flow in children with biliary atresia

4.4. Special warnings and precautions for use

Ursofalk capsules should be taken under medical supervision.

During the first 3 months of treatment, liver function parameters AST (SGOT), ALT (SGPT) and γ-GT should be monitored by the physician every 4 weeks, thereafter every 3 months. Apart from allowing for identification of responders and non-responders in patients being treated for PBC, this monitoring would also enable early detection of potential hepatic deterioration, particularly in patients with advanced stage PBC.

When used for treatment of advanced stage of primary biliary cholangitis:

In very rare cases decompensation of hepatic cirrhosis has been observed, which partially regressed after the treatment was discontinued.

In patients with PBC, in rare cases the clinical symptoms may worsen at the beginning of treatment, e.g. the itching may increase. In this case the dose should be reduced to 250mg daily and then gradually increased to the recommended dose described in section 4.2.

If diarrhoea occurs, the dose must be reduced and in cases of persistent diarrhoea, the therapy should be discontinued.

When used for dissolution of cholesterol gallstones:

In order to assess therapeutic progress and for timely detection of any calcification of the gallstones, depending on stone size, the gall bladder should be visualised (oral cholecystography) with overview and occlusion views in standing and supine positions (ultrasound control) 6-10 months after the beginning of treatment.

If the gall bladder cannot be visualised on X-ray images, or in cases of calcified gallstones, impaired contractility of the gall bladder or frequent episodes of biliary colic, Ursofalk should not be used.

Female patients taking Ursofalk for dissolution of gallstones should use an effective non-hormonal method of contraception, since hormonal contraceptives may increase biliary lithiasis (see section 4.5. and 4.6.)

4.5. Interaction with other medicinal products and other forms of interaction

Ursofalk capsules should not be administered concomitantly with colestyramine, colestipol or antacids containing aluminium hydroxide and/or smectite (aluminium oxide), because these preparations bind UDCA in the intestine and thereby inhibit its absorption and efficacy. Should the use of a preparation containing one of these substances be necessary, it must be taken at least 2 hours before or after Ursofalk.

Ursofalk capsules can affect the absorption of ciclosporin from the intestine. In patients receiving ciclosporin treatment, blood concentrations of this substance should therefore be checked by the physician and the ciclosporin dose adjusted if necessary.

In isolated cases Ursofalk capsules can reduce the absorption of ciprofloxacin.

In a clinical study in healthy volunteers concomitant use of UDCA (500mg/day) and rosuvastatin (20mg/day) resulted in slightly elevated plasma levels of rosuvastatin. The clinical relevance of this interaction also with regard to other statins is unknown.

UDCA has been shown to reduce the plasma peak concentrations (Cmax) and the area under the curve (AUC) of the calcium antagonist nitrendipine in healthy volunteers. Close monitoring of the outcome of concurrent use of nitrendipine and UDCA is recommended. An increase of the dose of nitrendipine may be necessary. An interaction with a reduction of the therapeutic effect of dapsone was also reported. These observations together with in vitro findings could indicate a potential for UDCA to induce cytochrome P450 3A enzymes.. Induction has, however, not been observed in a well-designed interaction study with budesonide, which is a known cytochrome P450 3A substrate.

Oestrogenic hormones and blood cholesterol lowering agents such as clofibrate increase hepatic cholesterol secretion and may therefore encourage biliary lithiasis, which is a counter-effect to ursodeoxycholic acid used for dissolution of gallstones.

4.6. Fertility, pregnancy and lactation

Animal studies did not show an influence of UDCA on fertility (see section 5.3). Human data on fertility effects following treatment with UDCA are not available.

Pregnancy

There are no or limited amounts of data from the use of UDCA in pregnant women. Studies in animals have shown reproductive toxicity during the early phase of gestation (see section 5.3). Ursofalk must not be used during pregnancy unless clearly necessary.

Women of childbearing potential:

Women of childbearing potential should be treated only if they use reliable contraception: non-hormonal or low-oestrogen oral contraceptive measures are recommended. However, in patients taking Ursofalk capsules for dissolution of gallstones, effective non-hormonal contraception should be used, since hormonal oral contraceptives may increase biliary lithiasis.

The possibility of a pregnancy must be excluded before beginning treatment.

Breastfeeding

According to few documented cases of breastfeeding women, milk levels of UDCA are very low and probably no adverse reactions are to be expected in breastfed infants.

4.7. Effects on ability to drive and use machines

UDCA has no or negligible influence on the ability to drive and use machines.

4.8. Undesirable effects

The evaluation of undesirable effects is based on the following frequency data:

Very common (≥ 1/10)

Common (≥ 1/100 to < 1/10)

Uncommon (≥ 1/1,000 to < 1/100)

Rare (≥ 1/10,000 to < 1/1,000)

Very rare / Not known (< 1/10,000 /cannot be estimated from available data)

MedDRA system organ class

Common

Very rare

Not known

Gastrointestinal disorders

Soft stools or diarrhoea

Severe right upper abdominal pain during treatment of PBC

Nausea, vomiting

Hepatobiliary disorders

Calcification of gallstones, decompensation of hepatic cirrhosis1

Skin and subcutaneous tissue disorders

Urticaria

Pruritus

1Observed during therapy of the advanced stages of PBC and which partially regressed after treatment was discontinued.

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the national reporting scheme:

United Kingdom

Yellow Card Scheme

Website: www.mhra.gov.uk/yellowcard

4.9. Overdose

Diarrhoea may occur in cases of overdose. In general, other symptoms of overdose are unlikely because the absorption of UDCA decreases with increasing dose and therefore more is excreted with the faeces.

No specific counter-measures are necessary and the consequences of diarrhoea should be treated symptomatically with restoration of fluid and electrolyte balance.

Additional information on special populations:

Long-term, high-dose UDCA therapy (28-30 mg/kg/day) in patients with primary sclerosing cholangitis (off-label use) was associated with higher rates of serious adverse events.

💬 Ask about this leaflet

Ask anything about Ursofalk 250mg Hard Capsules. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.

Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.

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