URSO: When I was first prescribed URSO in... - PBC Foundation

PBC Foundation

8,149 members6,937 posts



When I was first prescribed URSO in December 2010 I was told to take two tablets in the day and two at night. I noticed on the leaflet that came with my latest lot of tablets that they recommend you take all four at night.

My last appointment with a hospital consultant was cancelled due to his illness and I am still waiting for a re-appointment so I haven't got anybody to ask but yourselves. My old doctor, who had some knowledge of PBC, left the practice and my new doctor, although he is very keen to learn more, does not know anything of PBC at the moment.

The thing is, since I have been following the advice of the leaflet and taking four tablets at night I have found great trouble sleeping, tossing and turning until 3 and 4 in the morning (I haven't had the itch yet so it has nothing to do with that). I don't know if this has anything to do with my taking four tablets or whether it is a pure coincidence. Has anybody else experienced this?

13 Replies

Hi Mopo, I was prescribed URSO 4 weeks ago by my consultant, I take 6 150mg tablets every evening just after my evening meal, I have had no problems with this. On my 1st prescription from the GP he had spaced my doseage out to 2 tablets 3 times a day, I rang hospital medicines help line, they contacted my consultant who confirmed to my GP I ha d to take all of my urso as one dose in the evening. Could you contact your medicines help line? hope that helps.

Hi MoPo I used to take Urso dont anymore but I always took it at night but for me the tossing and turning was due to the dreaded itch. Just a suggestion try taking it in the am see if that helps you sleep better so long as you are taking it once a day I dont think it matters when in the day you take it but just check with the pharmacist where you get your Urso to be on the safe side.

Hi thre I e just started on urso and it says on the sticky label that the pharmacy attach with your name on that I must take 2x 250 mg twice a day with or just after food but the leaflet inside the box says for the first eight weeks take 1 x 250 mg four times a day I also read somewhere a while ago that you should space out urso throughout the day so it keeps doing its job all very confusing isn't it i do t see my consultant unt July so going to ask him what's best although he pres ribed it in the first place so I presume it was him who said with or after food hope this helps x

Hi there. Wxactly same thing happened to me. I phone the PBC Foundation for advice and Collette told me to take them all in the morning it makes absolutely no difference to your treatment and it does help a great deal with the insomnia (I'm also using lanzoprozole now and that helps too)

Hidden in reply to Kaywal

Given bile is stored in the gallbladder I think perhaps after we have taken it could well be that it makes the way up our system and via the liver into the gallbladder as if urso is used in dissolving cholesterol gallstones then the urso has to end up there to dissolve them. Figures. So I suppose thinking more about what Kaywal says here, perhaps it really does not matter in the slightest when one takes urso, once, twice, three and four times per day.

I was reading this bit with interest about the taking all in a morning and I've never actually thought to try that way myself, only read about night but as said on this question here, urso was originally used for gallstones and taken all at night.

Hi MoPo,

I was instructed by my consultant when I was first prescribed to take 2 URSO 3 times a day, On the 2 occasions since then when I have seen him the instruction has not been mentioned. However reading the leaflet I quote "During the first 3 months of treatment, you should take Ursofalk 250mg hard capsules in the morning, at midday and in the evening. As liver function tests improve, the total daily dose may be taken once a day in the evening".

Hi there, I have been taken 3 Urso twice a day since last June. I have been taking other meds too and my Lft's have continued to improve. I have checked the dosage and the times to take it a few times with my consultant, his team and my own GP. I even checked with pharmacy. They all say that in my case this is the best way and the leaflet is really for guidance. They all agreed t change another tablet I take to night instead of morning as it was making me sick after the dosage increased and that has worked so it's really all about balance and what works for you. I wouldn't be too concerned about the order of things, the meds need to fit your life and do there job so if it means changing about a bit to see what you can tolerate better I would ask to do that and see how your bloodwork is..

For 10 years I took 2x 250mg Urso every morning after breakfast but 2 years ago it was increased to 3 x 250mg. I have never had a problem with this and my consultant knows when I take them and has never queried this. I always have Ursofalk so I go to the chemist that dispenses them.

I`m wanting to help but think I may have confused you more. I hope you get it sorted so you feel you are doing the right thing for yourself.


I agree with Oidra and others, you have to do what is right for you. I was diagnosed with PBC and commenced on Urso in Feb last year. My consultant did say that once I was established on the Urso I could take them all in one go. However, I have continued to spread mine throughout the day i.e. I take one with breakfast, one after lunch and the last one after my evening meal. On occasions I have forgotten to take one after lunch so taken 2 in the evening, but I feel that I do not tolerate this as well. (I am also on 2 other medications). My last 2 blood tests have shown a vast impovement.

Good luck.


Hello MoPo.

I did read my leaflet originally when I got urso (I got URDOX then but at somep point later last yr when I got the tablets, the URDOX had gone from packaging altho' same company and very similar info leaflet), this was in Dec 2010.

As I understand it, urso was originally used for gallstone dissolution but it went on to be used for PBC. I think you might find that the taking of urso altogether at night that is for gallstone patients?

You didn't state what brand or company you are taking. But you started taking them same time as I did.

Now I have 600mgs per day and I get packets of tablets that are in 300mg doses. I started taking them back in 2010, one at morning with breakfast and then the final one around 9p.m. at night with a few biscuits/snack.

I then for some reason decided it might be better taking one at morning and then the final one with the evening meal around 5p.m. to 6p.m. so I switched to that. Seems to be working ok for me.

Now I did develop the itch earlier in 2010 and that was what prompted me to see the GP and then by end of yr I had the label of PBC and the urso to go with it.

I know for me taking 4 tablets a day would have been such a bind, I occasionally forget to grab an urso with the evening meal and remember awhile afterwards.

I think you'll find with everyone with PBC it is what suits you yourself and ifyou are getting a result in the good way from the bloods then that's all that matters.

Some patients with PBC would prob say that they like to have the urso in their system pretty much circling the system all the time and will more than likely take it 4 times per day but at the end of the day it is personal preference with these. My opinion here is that we don't actually eat throughout the night and bile tends to be released when we eat anything, fat usually so to me in particular it makes sense to take the urso during the waking hours when we are likely to be eating.

I also had a few temporary side-effects taking urso in the beginning but they dissipated after awhile. I know myself I couldn't take the whole lot of tablets in one go at night as bile is an acid and I'd not want the amount in my stomach that wouldn't have had any food in it for several hours by that time. I know if one has cholesterol gallstones that urso is for, then it makes sense taking the whole lot at night just before bedtime as the volume of it would prob do its job in dissolving the gallstones best.

So I'd say try taking it when you feel you'd be best and see how you get along.


Ps To stop confusion regards my mention of 'I know for me taking 4 tablets a day would have been such a bind, I occasionally forget to grab an urso with the evening meal and remember awhile afterwards' I was originally going to be prescribed 4 x 150mgs of urso on starting but told the GP I wouldn't be taking them 4 times per day.

Back then I wasn't well up on urso and had I have got the 150mgs I would have been taking 2 of a morning and 2 of a night as you mentioned.

Hi All

I was originally prescribed two Urso tablets per day and took them one in the morning and one in the evening. However my consultant increased my daily dose to three tablets ilast October and said that it didn't matter at all when I took them. She said I should take them when it was most convenient to me so I now take all three in the morning after breakfast and it actually suits me much better. At least I don't forget a dose when I take them all together.

As others have said though I think you should do whatever works best for you. I'm sure your body will tell you if it's not happy with when you take the dose.

Good luck

I recently went back to taking two in the morning after breakfast and two after dinner....that seems to work best for me. After being on urso for three years, I

I also discovered the manufacturer also makes a big difference. I was unable to tolerate a certain generic.

This site is very informative and helpful.

Laura stonellilaura@yahoo.com....love to hear from anyone who would like to chat

You may also like...