Ursodeoxycholic acid (UDCA) is a bile acid used as a treatment for gallstones, cholestatic liver disease and intrahepatic cholestasis of pregnancy (ICP). UDCA is a cholesterol-lowering agent that helps dissolve cholesterol-rich gallstones and improves the flow of bile salts through the damaged liver.
UDCA is used to reduce the risk of gallstone formation and to manage the symptoms of cholestatic liver diseases, including primary biliary cirrhosis (PBC). It can also be used to treat ICP, a pregnancy complication characterized by high levels of bile salts in the amniotic fluid that can cause maternal and fetal complications.
| Brand Name | Ursocol |
|---|---|
| Type | Tablet |
| Weight | 150 mg |
| Generic | Ursodeoxycholic Acid |
| Manufacturer | Sun Pharmaceutical Ltd. |
| Available in | English বাংলা |
UDCA helps reduce the concentration of cholesterol in bile by increasing its mobilization from the liver and by reducing its absorption from the gastrointestinal tract. UDCA also increases the solubility of cholesterol in bile, reducing the risk of cholesterol gallstone formation. Furthermore, UDCA has a cytoprotective effect, protecting against cellular damage that can occur in the presence of cholestatic liver diseases.
It may take several months of UDCA treatment before gallstone dissolution is visible on imaging tests. For cholestatic liver disease, UDCA therapy may improve symptoms over the course of several weeks. In women with ICP, UDCA may help control symptoms within 2-3 days.
Approximately 10-30% of UDCA is absorbed in the small intestine.
UDCA is excreted primarily in the feces, with the majority of the drug conjugated with glycine or taurine and excreted as a bile acid.
The usual adult dosage is 8-10 mg/kg/day administered in two divided doses. For gallstone dissolution, UDCA usually is given for at least 6 months. For ICP, the usual dosage is 15-20 mg/kg/day for 10 days. The dosage may vary depending on the individual patient’s needs.
UDCA is administered orally, usually with food, in the form of tablets or capsules. The capsules should not be chewed, crushed, or opened.
Common side effects of UDCA include gastrointestinal upset such as nausea, diarrhea, and constipation. It is important to contact your healthcare provider if these symptoms persist or worsen. Other rare side effects may include rash, itching, and headache.
UDCA is considered to be generally safe and well-tolerated. The LD50 (the amount of a substance that will cause death in 50% of the test animals) of UDCA in humans has not been established.
Before taking UDCA, tell your healthcare provider about any other medications, vitamins, or supplements you are taking as UDCA can interact with some medications. Tell your healthcare provider if you are pregnant or breastfeeding. It is also important to inform your healthcare provider if you have any allergies or underlying medical conditions.
UDCA may interact with certain medications. In particular, UDCA can reduce the absorption of some cholesterol-lowering drugs. It also may potentiate certain anticoagulants and certain nonsteroidal anti-inflammatory drugs. Talk to your healthcare provider about any medications or supplements you are taking.
UDCA may interact with certain medical conditions, such as bowel obstruction, severe acute or chronic liver disease, or bile duct stones or inflammation. Talk to your healthcare provider if you have any of these conditions.
UDCA can interact with certain medications, including statins, anticoagulants, and nonsteroidal anti-inflammatory drugs. Talk to your healthcare provider if you are taking any of these medications.
UDCA works best when taken with food. Some fats can interfere with the absorption of UDCA, so it is important to follow a balanced diet that contains a moderate amount of fat.
UDCA can be used to treat ICP in pregnant women. However, UDCA is not recommended for use in pregnant women with gallstones or cholestatic liver diseases. There is limited safety data on the use of UDCA in pregnancy, so it is important to discuss any potential risks with your healthcare provider.
UDCA is excreted in breast milk and should be avoided by nursing mothers.
No serious effects of an acute overdose of UDCA have been reported.
UDCA should not be used in patients with a known hypersensitivity to bile acids.
Take UDCA exactly as prescribed by your healthcare provider. Swallow the tablets whole and do not break, crush, or chew the tablets. Take UDCA with food, and take it at the same time every day. If you miss a dose, take it as soon as possible. If it is close to the time for your next dose, skip the missed dose and resume your usual dosing schedule.
Store UDCA at 25°C (77°F) and away from moisture, light, and excessive heat. Keep UDCA out of the reach of children.
The volume of distribution of UDCA is not known.
The elimination half-life of UDCA is approximately 3 hours.
The clearance of UDCA is not known.
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Dr. Farhana Ahmed Nancy
Gynecology, Obstetrics, Gyne Cancer Specialist & Laparoscopic Surgeon