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Re: Actigall

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Hi group--

I've said this before, but don't know if anyone commented. I asked to drop

my Actigall because of side effects, which they OKd last November. I dropped

from 600 mg a day to 300. My LFTs have steadily improved!! They're still

no where's near normal, but they are improving. Go figure!!

Laurie

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It doesn't really surprise me. The studies done with Actigall

haven't been extensive. Proper doseage levels may vary quite a

bit between individuals.

Congratulations on your improved LFTs. Can you tell if it has

had any effect on your infections? Or are they too masked by the

antibiotics?

Tim

--- Oceandrmer@... wrote:

> Hi group--

>

> I've said this before, but don't know if anyone commented. I

> asked to drop

> my Actigall because of side effects, which they OKd last

> November. I dropped

> from 600 mg a day to 300. My LFTs have steadily improved!!

> They're still

> no where's near normal, but they are improving. Go figure!!

>

> Laurie

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Tim--

I tried to go off Augmentin for a bit to see if pouchitis would recur and it

did 24 hrs

later. So much for better LFTs being in relation to pouchitis.

Laurie

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HI LYNN I JUST HAD MINE FILLED A FEW DAYS AGO. I GOT 90 TABLETS. THAT

SEEMS STRANGE. MAYBE YOU CAN FILL IT AT A HOPITAL MARSHA

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Lynn,

I had the same problem with my Actigall. Jim (my husband) and I get our main

rx's through his insurance by mail. He has rx for gout and Lipitor for

cholestrol; I have the Actigall and Azulfadine for liver and UC. When we

sent for our most recent refills everything came except for the Actigall.

They wrote that it was on back order. I waited until I ran out on Friday and

finally called them on Mon. They said it was a manufacturer's problem; they

just couldn't keep up with all the orders! I called my local pharmacy where

I used to get it all the time and got a 2-wk supply -- for $68. When I get

it by mailorder it's $7.50 for a 3-month supply! Quite a difference! I sure

hope the manufacturer gets their act together soon! The insurance people

said to talk to my dr. and see if there was something else I could use. I

don't think there is, is there?

Love,

Peggy McG

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On another list I saw about 2 weeks ago, some discussion of

Actigall being in short supply and even discontinued. A drug co.

rep posted that there was a distribution problem in Europe but

there were no plans to stop making Actigall. In general he said

there was about a month supply stockpiled here in the US and

availability shouldn't be a concern. I'm sure he was trying to

put as good a spin on the distribution problem as possible.

Tim

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Marsha...Thanks for your input. We called Hopkins and they said that there

was to be a distribution of Actigall today and to check with the

pharmacy...We did and they have it. Now I'm contemplating getting medication

in bulk....if there is such a thing

Lynn

Re: ACTIGALL

>HI LYNN I JUST HAD MINE FILLED A FEW DAYS AGO. I GOT 90 TABLETS. THAT

>SEEMS STRANGE. MAYBE YOU CAN FILL IT AT A HOPITAL MARSHA

>

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Lynn,

Others are being treated with Ursodiol. I have just a couple of days left

of Actigall. We'll see if my drugs-by-mail come in.

Dan

> Re: ACTIGALL

>

> Lynn,

> I had the same problem with my Actigall. Jim (my husband) and I get our

> main

> rx's through his insurance by mail. He has rx for gout and Lipitor for

> cholestrol; I have the Actigall and Azulfadine for liver and UC. When we

> sent for our most recent refills everything came except for the Actigall.

>

> They wrote that it was on back order. I waited until I ran out on Friday

> and

> finally called them on Mon. They said it was a manufacturer's problem;

> they

> just couldn't keep up with all the orders! I called my local pharmacy

> where

> I used to get it all the time and got a 2-wk supply -- for $68. When I

> get

> it by mailorder it's $7.50 for a 3-month supply! Quite a difference! I

> sure

> hope the manufacturer gets their act together soon! The insurance people

> said to talk to my dr. and see if there was something else I could use. I

>

> don't think there is, is there?

>

> Love,

> Peggy McG

>

> ------------------------------------------------------------------------

> FreeShop is the #1 place for free and trial offers and great deals!

> Try something new and discover more ways to save!

> http://clickhere./click/381

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>

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Dan...Joyce Majors at Hopkins said that there was a shipment of Acitgall

arriving today. She was correct we received ours.

Lynn

Re: ACTIGALL

>>

>> Lynn,

>> I had the same problem with my Actigall. Jim (my husband) and I get our

>> main

>> rx's through his insurance by mail. He has rx for gout and Lipitor for

>> cholestrol; I have the Actigall and Azulfadine for liver and UC. When we

>> sent for our most recent refills everything came except for the Actigall.

>>

>> They wrote that it was on back order. I waited until I ran out on Friday

>> and

>> finally called them on Mon. They said it was a manufacturer's problem;

>> they

>> just couldn't keep up with all the orders! I called my local pharmacy

>> where

>> I used to get it all the time and got a 2-wk supply -- for $68. When I

>> get

>> it by mailorder it's $7.50 for a 3-month supply! Quite a difference! I

>> sure

>> hope the manufacturer gets their act together soon! The insurance people

>> said to talk to my dr. and see if there was something else I could use.

I

>>

>> don't think there is, is there?

>>

>> Love,

>> Peggy McG

>>

>> ------------------------------------------------------------------------

>> FreeShop is the #1 place for free and trial offers and great deals!

>> Try something new and discover more ways to save!

>> http://clickhere./click/381

>>

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>>

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>>

>>

>

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>http://clickhere./click/381

>

>

>

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Guest guest

What a price...Mike's is over an hundred for 60...Go figure!!!!!!!! But

everything should be back to normal. How about a stockpile? :)

Lynn

Re: ACTIGALL

>Lynn,

>I had the same problem with my Actigall. Jim (my husband) and I get our

main

>rx's through his insurance by mail. He has rx for gout and Lipitor for

>cholestrol; I have the Actigall and Azulfadine for liver and UC. When we

>sent for our most recent refills everything came except for the Actigall.

>They wrote that it was on back order. I waited until I ran out on Friday

and

>finally called them on Mon. They said it was a manufacturer's problem;

they

>just couldn't keep up with all the orders! I called my local pharmacy

where

>I used to get it all the time and got a 2-wk supply -- for $68. When I get

>it by mailorder it's $7.50 for a 3-month supply! Quite a difference! I

sure

>hope the manufacturer gets their act together soon! The insurance people

>said to talk to my dr. and see if there was something else I could use. I

>don't think there is, is there?

>

>Love,

>Peggy McG

>

>------------------------------------------------------------------------

>FreeShop is the #1 place for free and trial offers and great deals!

>Try something new and discover more ways to save!

>http://clickhere./click/381

>

>

>

>eGroups.com home: /group/

> - Simplifying group communications

>

>

>

>

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Lynn,

I just got back off vacation and was surprised to see 182 emails. I had no

problem

getting my perscriptions thru Columbia Freestate. I have tried to get a three

months supply from them but they don't consider that a mantainence drug. I

can get a three months supply of Asacol but not the Actigall. Glad to hear

you got the rest of yours.

larry

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Peggy McG--

I am HMO insured & meds are still expensive. The $7.50 for 3 month supply

sounds 10 Times better. Can anyone order through the mail - or is yours a

special situation? Would appreciate any info. on this--the phone # of the

mail order co. if you feel comfortable giving it. Tks.

Laurie

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Peggy,

You could use Urso, it is practically the same thing as Actigall from

what I have been told...I have also heard it is cheaper.

Love,

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Hi all - regarding Actigall, I was unable to fill my husbands prescription

through our health insurance's plan (three month supply for one co-pay) as

they said it was back ordered until the end of June. This has not happened

before. I have yet to try the local pharmacies, as he has some left, but I

think I will try today, having read the postings. Liz

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Laurie,

Our mail-order place is through my husband's insurance company, Anthem Health

& Life. There is a toll-free ph. # - . He's had this insurance

for several years and I don't know that I could get on it at this point

considering the PSC, but maybe it would be worth a phone call. It is a

wonderful way to obtain expensive rx. as long as they can get them!

Hopefully it won't be too long before the manufacturer will catch up with the

demand. In the meantime I think I'll call my dr. Monday and ask about the

possibility of Urso.

Take care,

Peggy McG

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Guest guest

My mail order for Actigall has also been back-ordered. I was just notified

by mail Friday so I don't know what their explanation is, but I'm sure it

is the same problem everyone has encountered.

Cost wise I was paying about $160 for 60 tabs. I was thankful when my

insurance added a pharmacy card so I only pay $20 now for a month's supply.

Laurie -

I buy through Express Pharmacy Services - . My insurance just

started allowing us to buy through the mail so I don't have a lot of

experience although so far they have been good. you can also find others

by searching the internet.

Russ

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Thanks, Lynn. I'll look into it. Do you happen to have a # for CareMark?

Laurie

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  • 2 weeks later...
Guest guest

Marsha--

How long have you been on the increased dose?

Laurie

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Laurie,

The lady that got me involved in treatment for my IBS and other problems,

arthritus and allergies (she provides me with many of my supplements and her

advice has been a God-send to me) sent me the tape. She also told me at one

time

that bismith is actually good for you and to take it rather than the other

stomach antacids.

Peg

Oceandrmer@... wrote:

> Marsha--

> I don't know whether " leaky gut " and pouchitis are interrelated or not. I do

> know that I have participated in a couple of studies Mayo has done on it over

> the years, but neither of the things I tried worked. They didn't use

> placebos at all-it was the real medication. I do know that their theory is

> it is some type of bacteria. I'll have to re-read the initial e-mail on

> leaky gut to get an idea where this brought on the idea of pouchitis-related.

> My pouchitis is usually controlled, but then I'm on antibiotics all the time

> (although occasionally Pepto Bismol tablets let me go of them for a couple

> days).

>

> Laurie

>

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  • 3 weeks later...
Guest guest

Well, congratulations are in order. I went on Actigall last week, at the high

dose (20 mg/kg). So far, I feel fine, but for very minor diarrhea (sp?). The

frustrating thing is, how will I know if its working? One of the reasons I

finally stopped procrastinating and took the Actigall plunge was that my

itching has been bad recently. But we hear that it does not affect the

symptoms. How can this be true, since it radically lowers LFTs? Can anyone

explain this to me, please?

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Hi Erwin-

Congratulations on your Actigal plunge. I don't think they really know that it

doesn't effect the symptoms, just that the smaller doses do not seem to improve

the course of the disease. Certainly Dr Chapman feels that symptoms might

improve with the high doses.

It would seem that the improvement in bile flow would lessen the tendency for

bilirubin to " back up " or rise to high enough levels in the blood to cause it to

get into the skin (which is reportedly what causes the itching)

My feeling is that the high dose Urso/Actigal is about the only medication that

shows a possibility of slowing this thing down, so think positive and see what

happens.

(I'm only on a highish dose (slightly <20mg/kg) but am symptom-free and have

LFT's WNL now) In response to your other message about cholangitis, I wish

someone knew why the disease can progress in the absence of signs of infection,

but it apparently can. I don't think I've ever had a known episode of

cholangitis such as people describe here, but I know that my ducts are pretty

mangled, so something's been going on.

Really hoping your high dose helps your symptoms, as that might give us all some

encouragement. So take care and keep us all posted.

H.

Re: Actigall

Well, congratulations are in order. I went on Actigall last week, at the high

dose (20 mg/kg). So far, I feel fine, but for very minor diarrhea (sp?). The

frustrating thing is, how will I know if its working? One of the reasons I

finally stopped procrastinating and took the Actigall plunge was that my itching

has been bad recently. But we hear that it does not affect the symptoms. How can

this be true, since it radically lowers LFTs? Can anyone explain this to me,

please?

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Well, not to throw a monkey wrench into the matter, but I DROPPED my Actigall

dosage and my LFTs have gone DOWN. Go figure. I am only on 300 mg a day and

am up to 109# now, so 300 mg a day is not normally what the drs would

recommend. However, my Mayo dr. agreed with decreasing the dosage because of

side effects & the Omaha GI tx dr has not told me any differently.

Laurie

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Erwin,

Congratulation on starting treatmen. Although I'm not sure that

LFTs are " radically " lowered by ursodiol, though they usually

improve. Other treatments are mentioned in

http://cpmcnet.columbia.edu/dept/gi/PSC.html for itching. In my

case I didn't notice any change in itching when I tried the bile

acid-binding resins, nor any increase when I stopped using them.

" Current medical therapy does not have a significant impact on

slowing the progression of PSC but has an important role in the

treatment of complications. Ursodiol improves laboratory

parameters but it probably does not prolong survival or time to

referral for liver transplant. Pruritus (itching) is a frequent

complication that can be treated with bile acid-binding resins

such as cholestyramine and opioid antagonist. Deficiencies in

fat-soluble vitamins are treated by supplementation. Aggressive

antibiotic therapy is necessary to treat episodes of bacterial

cholangitis. There may be some role for endoscopic dilatation of

dominant bile duct strictures in some cases but there have been

no controlled clinical trials. If such a procedure is

contemplated, a physician with considerable experience in

treating patients with PSC should be consulted. As there is an

increased incidence of cholangiocarcinoma in patients with PSC,

this should always be suspected, especially in patients with

long-standing disease whose condition worsens. "

Tim

--- ISZAT@... wrote:

> Well, congratulations are in order. I went on Actigall last

> week, at the high

> dose (20 mg/kg). So far, I feel fine, but for very minor

> diarrhea (sp?). The

> frustrating thing is, how will I know if its working? One of

> the reasons I

> finally stopped procrastinating and took the Actigall plunge

> was that my

> itching has been bad recently. But we hear that it does not

> affect the

> symptoms. How can this be true, since it radically lowers

> LFTs? Can anyone

> explain this to me, please?

_____________________________________________________________

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  • 2 weeks later...
Guest guest

Dear H.,

You mentioned in an email a couple of weeks ago that you are taking slightly

less than 20 mg/kg of Actigall, and that you are symptom-free and your LFTs

are within normal range. Congratulations, first of all! Second, could you

please tell me about the interval between when you started the current dose

of Actigall and when your symptoms disappeared and your LFTs fell within

normal. I am scheduled for my first post-Actigall blood test in about a week,

and I am curious what to expect. Also, my symptom (itching) does not appear

to have been improved by the drug in the first three weeks (I guess I seem

impatient!), and I wonder whether it takes a certain amount of time to work.

The manufacturer's instructions state that it takes three weeks to reach a

" steady state " in your body. Thanks for any ideas and info, Erwin

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HI Erwin-

Again, I can only relate what I interpret as my own experience and what I have

discussed with my Drs. I don't think I have ever had much itching from the

disease (yet) but I do think I probably had 1 or 2 episodes of cholangitis

before diagnosis as well as some occasional sharp URQ pain. Prior to starting

on Actigal, my AlkPhos and GGT were about 5X normal levels and and other values

were running about 2x normal. I started on lower dose about May1,1998 and

higher dose about a month later. There was some decrease in LFT's right away,

but as of 9/98, the values were normal except GGT a few points above the range.

When I went to Mayo in April 99, all values were WNL and bile flow via

ultrasound was pretty good. Ultrasound had shown a significant stricture in one

of the ducts in the winter 98. Overall scarring and smaller strictures

throughout biliary tree were seen when ERCP was done in 4/98 (no therapeutic

dilation or stenting was done as it would not have done any good-so changes

would have to be due to meds) By the way, my Dr. said I " must have had this

for a while " and he would " give me about 5 years. "

I feel very well, but again, I don't think I have ever had severe symptoms of

the PSC. Since I was diagnosed with " pretty bad " UC/Crohn's at the same time,

it is hard for me to know for sure which symptoms to attribute to which disease.

The UC or Crohn's has also been totally fine since several months after starting

treatment with Asacol. Just my experience.

I really hope that you see some improvements in your tests, as well as your

symptoms and overall well-being. Let us know.

H.

Re: Actigall

Dear H.,

You mentioned in an email a couple of weeks ago that you are taking slightly

less than 20 mg/kg of Actigall, and that you are symptom-free and your LFTs

are within normal range. Congratulations, first of all! Second, could you

please tell me about the interval between when you started the current dose

of Actigall and when your symptoms disappeared and your LFTs fell within

normal. I am scheduled for my first post-Actigall blood test in about a week,

and I am curious what to expect. Also, my symptom (itching) does not appear

to have been improved by the drug in the first three weeks (I guess I seem

impatient!), and I wonder whether it takes a certain amount of time to work.

The manufacturer's instructions state that it takes three weeks to reach a

" steady state " in your body. Thanks for any ideas and info, Erwin

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