Ursodeoxycholic Acid

Ursodeoxycholic Acid

Ursodeoxycholic acid differs from other hepatic medications when treating liver problems. This naturally occurring bile acid doesn't just target symptoms like conventional drugs—it replaces more toxic bile acids in the body. The FDA gave approval for its use in dissolving gallstones in 1987 and later approved it in 1996 to treat primary biliary cirrhosis. Today, it serves as the core of hepatology treatments.

Doctors mainly use ursodeoxycholic acid to treat primary biliary cholangitis, but they also prescribe it for gallstone dissolution and other forms of cholestasis. The medication reduces cholesterol secretion into bile, which helps lower cholesterol saturation and slowly dissolves cholesterol-rich gallstones. Additionally, research shows that it protects gastrointestinal tract cells and fights inflammation.

This article covers what patients should know about ursodeoxycholic acid. You will find details about its uses, how it works in your body, side effects, dosage guidelines, and key precautions. 

What is Ursodeoxycholic Acid?

Ursodeoxycholic acid exists naturally in small amounts within human bile. Ursodeoxycholic acid tablets work by lowering cholesterol levels in the blood and bile, so they help dissolve gallstones that contain mostly cholesterol. It also protects liver cells from toxic bile acids and improves liver function.

Ursodeoxycholic Acid Tablets Uses

The following are some common ursodeoxycholic acid uses:

• Primary biliary cholangitis (an autoimmune liver disorder)
• Cholesterol-rich gallstones (especially small- to medium-sized ones)
• Gallstone formation prevention during rapid weight loss
• Cholestatic liver diseases
• Cystic fibrosis-related liver conditions in children aged 6-18 years

How and When to Use Ursodeoxycholic Tablets

You should take ursodeoxycholic tablets after meals with water or milk. Your doctor will calculate your dosage based on your condition and body weight. 
The typical dose ranges from 10-15mg per kilogram daily, split into 2-4 doses. Gallstone dissolution treatment might last up to two years and should continue for three months after the stones dissolve.

Side Effects of Ursodeoxycholic Tablets

The following are some common adverse effects:

• Diarrhoea
• Abdominal pain
• Nausea
• Indigestion
• Skin rashes
• Dizziness
• Fast heartbeat
• Severe right upper quadrant pain (rare)

Precautions

• The medication's absorption decreases with aluminum-containing antacids, charcoal, cholestyramine, or colestipol. 
• Your doctor needs to monitor your liver function regularly during treatment. 
• People with acute gallbladder inflammation or biliary tract obstruction should not take this medication.
• Pregnant & breastfeeding women should consult their doctor before taking this medicine.

How the Ursodeoxycholic Acid Tablet Works

Ursodeoxycholic acid has multiple mechanisms to benefit the body:

• The liver cells get protection from toxic bile acids' damage
• Bile secretion increases (choleretic effect)
• The bile's cholesterol saturation decreases
• The intestines absorb less cholesterol
• Kupffer cells stop producing harmful reactive oxygen species

The acid revolutionises lithogenic bile (prone to stone formation) into non-lithogenic bile and dissolves cholesterol gallstones gradually.

Can I take Ursodeoxycholic Acid with Other Medicines?

The ursodeoxycholic acid interacts with several medications, such as:

• Aluminium-containing antacids 
• Ciclosporin
• Ciprofloxacin
• Cholestyramine
• Colestipol
• Nitrendipine 
• Rosuvastatin

Dosing Information

Your condition determines the dosage:

• Gallstone dissolution needs 8-10 mg/kg/day - split into 2-3 doses
• Primary biliary cirrhosis requires 13-15 mg/kg/day—split into 2-4 doses
• Weight loss and gallstone prevention need 300 mg twice daily

The best dose for early-stage primary biliary cirrhosis is 900 mg/day (about 13.5 mg/kg/day).

Conclusion

Ursodeoxycholic acid takes a unique approach compared to conventional medications. This natural bile acid targets liver conditions at their source instead of just treating symptoms. Patients see their cholesterol-rich gallstones gradually dissolve and their liver function tests improve during treatment.

The advantages go beyond treating primary biliary cholangitis. Patients of all types with cholestatic conditions, cystic fibrosis-related liver problems, and those who might develop gallstones during rapid weight loss show positive results. The medication converts harmful bile into a healthier form and protects liver cells from damage.

FAQs

1. Is ursodeoxycholic acid high risk?

Ursodeoxycholic acid has a good safety profile, and people handle it without problems. The medication remains safe for most approved uses at standard doses (13-15 mg/kg/day). High doses (28-30 mg/kg/day) might cause adverse effects, especially when you have primary sclerosing cholangitis. 

2. What is the main use of ursodeoxycholic acid?

The medication works best to:

• Dissolve cholesterol gallstones in patients who can't have surgery
• Treat primary biliary cholangitis (formerly called primary biliary cirrhosis)
• Prevent gallstone formation during rapid weight loss

3. What is the best time to take ursodeoxycholic acid in the morning or evening?

Doctors often recommend evening doses to dissolve gallstones effectively. The last dose should be taken at bedtime for twice-daily prescriptions to work best. Your doctor's specific instructions about timing should always be followed.

4. How long does ursodeoxycholic acid take to work?

Liver function tests start showing improvements after 3-4 weeks. Gallstone dissolution needs more time and can take 6-24 months, based on the stone's size and composition.

5. Is ursodeoxycholic acid good for the liver?

Yes, it is. The medication protects liver cells from damage and reduces toxic bile acids. Your liver's bile flow improves and enzyme levels like ALT, AST, GGT and alkaline phosphatase decrease.

6. What happens if I miss a dose?

You should take the missed dose once you remember it. Skip the missed dose if your next scheduled dose is within 4 hours and continue normally. Taking a double dose won't help compensate.

7. What happens if I overdose?

Diarrhoea is the main symptom of an overdose. You should get emergency medical help right away if you suspect an overdose. Medical treatment focuses on managing symptoms and balancing fluid levels.

8. Who cannot take ursodeoxycholic acid?

Stop or avoid taking ursodeoxycholic acid if you experience:

• Acute inflammation of the gallbladder or biliary tract
• Biliary tract blockage
• Radio-opaque calcified gallstones
• Frequent episodes of biliary colic
• Impaired gallbladder contractility
• Pregnancy or breastfeeding
• Non-functioning gallbladder

9. How many days to take ursodeoxycholic acid?

Your condition determines the treatment duration:

• Gallstone dissolution: up to 2 years, plus 3-4 months after stones dissolve
• Primary biliary cholangitis: lifelong treatment if tolerated
• TPN-induced cholestasis: until liver enzyme levels normalise

10. When to stop ursodeoxycholic acid?

Your doctor must approve stopping treatment. However, treatment should stop if:

• Persistent diarrhoea occurs
• Liver function deteriorates substantially
• Treatment goals are achieved
• Severe side effects develop

11. Is it safe to take ursodeoxycholic acid daily?

The prescribed doses (10-15 mg/kg) of ursodeoxycholic acid are generally safe for daily use. Clinical trials confirm good tolerance with minimal adverse reactions. Regular monitoring will give continued safety assurance.

12. What to avoid when taking ursodeoxycholic acid?

Take these medications at least 2 hours apart from ursodeoxycholic acid:

• Aluminium-containing antacids
• Cholestyramine and colestipol
• Oestrogen-rich oral contraceptives
• Alcohol (may increase risk of liver damage)

13. What foods should I avoid when taking ursodeoxycholic acid?

Dietary guidelines recommend limiting:

• High-fat foods
• Trans fats
• Processed foods
• White bread, pasta and sugar
• Foods high in cholesterol

14. What is the warning for ursodeoxycholic acid?

Your liver function needs regular monitoring. Watch for signs of decompensation of hepatic cirrhosis, which might partially improve after stopping treatment. Be extra careful if you have variceal bleeding, ascites or hepatic encephalopathy.