Ursodiol Dosage: What You Need to Know About Use, Side Effects, and Alternatives

When your doctor prescribes ursodiol, a bile acid used to dissolve gallstones and protect the liver. Also known as ursodeoxycholic acid, it's not a quick fix—but for many, it’s the only non-surgical option to avoid removing the gallbladder. It works by changing how your body makes bile, slowly breaking down cholesterol stones over months. This isn’t like popping a pill for a headache. You’re in it for the long haul, and getting the ursodiol dosage right makes all the difference.

People use ursodiol mainly for two things: gallstones, small, hard deposits in the gallbladder made of cholesterol and primary biliary cholangitis, a chronic liver disease that slowly destroys bile ducts. For gallstones, the usual dose is 8 to 10 milligrams per kilogram of body weight, split into two doses daily. If you weigh 70 kg, that’s about 560 to 700 mg a day. For liver conditions like PBC, the dose is often higher—13 to 15 mg per kg. It’s not one-size-fits-all. Your doctor will adjust it based on your weight, liver function, and how your body responds.

Side effects are usually mild—diarrhea, stomach upset, or back pain—but they happen. If you get severe diarrhea or yellowing skin, stop and call your doctor. Ursodiol doesn’t work for everyone. If your stones are too big or too calcified, it won’t touch them. And if you’ve had gallbladder attacks before, surgery might still be the better path. It also plays nice with some meds but can mess with cholesterol-lowering drugs and birth control pills. Always tell your doctor what else you’re taking.

There are alternatives, but they’re not better—just different. Surgery removes the gallbladder fast, but you live with the changes. Other bile acids like chenodeoxycholic acid work similarly but cause more side effects. For liver disease, obeticholic acid is newer but pricier and harder to get. Ursodiol remains the go-to because it’s been tested for decades, works for most, and is cheap.

What you’ll find below are real-world guides from people who’ve taken ursodiol—how they stuck with it, what they learned about timing doses, how they handled side effects, and when they knew it was time to switch gears. You’ll also see comparisons with other liver and gallbladder treatments, so you know what else is out there. No theory. No marketing. Just what works for real people trying to avoid surgery or manage a chronic liver issue.