Ursodeoxycholic acid

Ursodeoxycholic acid (UDCA), also known as ursodiol, is a naturally occurring bile acid that is used as a medication. It is commonly used to treat certain liver and gallbladder diseases by altering the composition of bile, decreasing the production of cholesterol, and increasing the flow of bile through the bile ducts. Ursodeoxycholic acid is known for its hepatoprotective properties and can help improve liver function and prevent liver damage.

Indications

Ursodeoxycholic acid is indicated for: Dissolving cholesterol gallstones in patients who prefer a nonsurgical option or for whom surgery is contraindicated. Primary biliary cholangitis (PBC), a chronic liver disease characterized by inflammation and damage to the bile ducts. Nonalcoholic steatohepatitis (NASH), in some cases, as an off-label use to improve liver function. Other liver disorders, such as cystic fibrosis-associated liver disease and other conditions where it may help improve bile flow and liver function.

Dosage

The dosage of ursodeoxycholic acid varies depending on the condition being treated: For gallstones: Typically 8–10 mg/kg body weight per day, divided into two or three doses. For primary biliary cholangitis: Usually 13–15 mg/kg body weight per day, divided into two or three doses. It's essential to follow your healthcare provider's instructions for the appropriate dosage and duration of treatment.

Contra-Indications

Ursodeoxycholic acid is contraindicated in: Patients with known hypersensitivity to ursodiol. Those with acute inflammation of the gallbladder or bile ducts. Patients with certain types of biliary tract obstructions or conditions where normal bile flow is not possible. Cases of severe liver disease where liver function is significantly compromised.

Special Precautions

When using ursodeoxycholic acid, special precautions should be taken: Regular monitoring of liver function tests is recommended to assess the patient's response to treatment. Use with caution in pregnant or breastfeeding women. Patients with other liver conditions or those on long-term treatment may require additional monitoring. Patients with gallstones should be monitored for any changes in stone size and number.

Side Effects

Common side effects of ursodeoxycholic acid include: Diarrhea or loose stools Nausea or upset stomach Abdominal pain or discomfort Less common but more serious side effects may include: Allergic reactions Liver enzyme abnormalities (increased transaminases)

Drug Interactions

Ursodeoxycholic acid may interact with: Cholestyramine, colestipol, and antacids containing aluminum, which can decrease the absorption of UDCA. Estrogens or certain drugs that increase cholesterol levels in bile, as these may counteract the effect of UDCA. Certain medications metabolized by the liver, as UDCA may affect their metabolism.