Ursodeoxycholic acid

UDCA, Ursodiol

Mechanism :

Ursodeoxycholic acid is a naturally occurring bile acid, is present as a minor fraction of the total human bile acids. Since in patients with gallstones, the total bile acid pool size is generally reduced, the exogenous supply of ursodiol helps to increase this bile acid pool size and increases the cholesterol saturation index. In addition, the fecal bile acid loss is increased and cholesterol secretion into the bile is reduced, without a concomitant reduction in phospholipids. Consequently, the cholesterol saturation of bile is reduced, allowing gradual solubilization of cholesterol from gallstones to occur.

Indication :

• Cholestasis
• Liver disease due to cystic fibrosis

Contraindications :

Contraindicated in patients with compelling reasons for cholecystectomy including unremitting acute cholecystitis, cholangitis, biliary obstruction, gallstone, pancreatitis or biliary-gastrointestinal fistula, and in patients with calcified cholesterol stones, radiopaque stones or radiolucent bile pigment stones.

Dosing :

Adverse Effect :

Exacerbation of pre-existing psoriasis, rash, urticaria, dry skin, sweating, hair thinning, biliary pain, cholecystitis, constipation, stomatitis, flatulence, headache, dizziness, diarrhoea, dyspepsia, fatigue, anxiety, depression, sleep disorder, arthralgia, myalgia, back pain, cough and rhinitis.

Interaction :

Cholestyramine: Binds bile acids.
Aluminium Hydroxide: May interfere with the absorption of chenodeoxycholic acid.
Estrogenic Hormones, Oestrogen-Rich OCPs and certain Blood Cholesterol Lowering Agents: Which increase cholesterol elimination in bile, should not be used concurrently with ursodeoxycholic acid.
Cyclosporine: Increases absorption of cyclosporine.

Renal Dose :

Hepatic Dose :