Lithora 300 mg Tablet

Bile acid for:

• Dissolving small cholesterol gallstones (non-calcified, in a functioning gallbladder) in people unsuitable for surgery
• Primary biliary cholangitis (PBC)
• Other cholestatic liver conditions (e.g. intrahepatic cholestasis of pregnancy, cystic fibrosis liver disease, primary sclerosing cholangitis — specialist)
• Biliary sludge, and prevention of gallstones during rapid weight loss
• Often used as adjunct in fatty liver disease (limited evidence)

Gallstone dissolution: 8–12 mg/kg daily as a single dose at bedtime or in two divided doses (up to 15 mg/kg), for 6–24 months; check with ultrasound every 6 months.

Primary biliary cholangitis: 12–16 mg/kg daily in 2–4 divided doses (13–15 mg/kg/day commonly), long-term.

Cholestasis of pregnancy (specialist): 500 mg–1 g daily in divided doses.

• Take with food (evening meal for single doses).
• Continue for 3–4 months after stones dissolve.

• Acute inflammation of the gallbladder or bile ducts
• Blockage of the bile duct (common bile duct or cystic duct)
• Frequent biliary colic, calcified or radio-opaque stones, non-functioning gallbladder
• Allergy to bile acids

Common: soft stools or diarrhoea.

Less common: abdominal pain, nausea, itching, rash.

Rare: calcification of gallstones; in advanced PBC, worsening of liver cirrhosis (very rare); upper right abdominal pain.

• Liver function tests every few months during treatment.
• Gallstone treatment needs ultrasound monitoring.
• Women using it for gallstones should use non-hormonal contraception (oestrogens increase cholesterol in bile).

Used in intrahepatic cholestasis of pregnancy on specialist advice; otherwise avoid in early pregnancy. Probably compatible with breastfeeding.

• Cholestyramine, colestipol, aluminium antacids (reduce absorption — take 2 hours apart)
• Ciclosporin (levels may change — monitor)
• Oestrogens, oral contraceptives, clofibrate (increase gallstone formation)
• Ciprofloxacin (absorption may be reduced)

Diarrhoea. Supportive care.

Store below 30°C.