Drug Index

Ursodeoxycholic acid

Synonyms :

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 :

10 to 30 mg/kg/day, given orally in two or three divided doses.

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 :

Dose in Renal Impairment GFR (mL/min)
20-50Dose as in normal renal function
10-20Dose as in normal renal function
<10Dose as in normal renal function

Dose in Patients undergoing Renal Replacement Therapies
CAPDUnknown dialysability. Dose as in normal renal function
HDUnknown dialysability. Dose as in normal renal function
HDF/High fluxUnknown dialysability. Dose as in normal renal function
CAV/VVHDUnknown dialysability. Dose as in normal renal function

Hepatic Dose :

No dosage adjustments are recommended.
03/13/2024 05:33:23 Ursodeoxycholic acid
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