Ursodeoxycholic Acid (UDCA): Liver Protection & Gallstone Dissolution
Ursodeoxycholic acid (UDCA) is a naturally occurring secondary bile acid. It is widely used in hepatology as a hepatoprotective, cytoprotective, and choleretic agent.
UDCA works by reducing the absorption of cholesterol in the intestines and decreasing its secretion into the bile. This shift in the bile composition prevents the formation of cholesterol gallstones and helps dissolve existing ones.
In addition to its stone-dissolving properties, Ursodeoxycholic acid protects liver cells from the toxic effects of other bile acids, making it a standard treatment for chronic cholestatic liver diseases.
Indications
- Gallstone Dissolution: Indicated for the dissolution of radiolucent (cholesterol) gallstones in patients with a functioning gallbladder.
- Liver Diseases: Treatment of Primary Biliary Cholangitis (PBC) and hepatobiliary disorders associated with cystic fibrosis.
- Gastric Issues: Treatment of biliary reflux gastritis.
- Note: It is ineffective against calcified (radio-opaque) gallstones.
Dosage and administration
Dosage is strictly weight-based and depends on the specific condition being treated. Available in capsules or tablets (typically 250 mg or 500 mg).
- For Gallstones: Approximately 10 mg/kg of body weight daily. Usually taken as a single dose at bedtime. Treatment may last from 6 to 24 months.
- For Primary Biliary Cholangitis: 12–16 mg/kg of body weight daily, divided into 2 to 3 doses.
- Administration: Swallow capsules/tablets whole with a glass of water. Do not chew.
- Gallbladder Issues: Non-functioning gallbladder, calcified gallstones, frequent episodes of biliary colic.
- Inflammation: Acute cholecystitis or cholangitis.
- Severe Organ Failure: Severe hepatic or renal impairment.
- Pregnancy: Not recommended unless strictly necessary.
UDCA is generally well tolerated. Potential side effects include:
- Gastrointestinal: Pasty stools or diarrhea (most common), upper right abdominal pain.
- Hepatobiliary: Rare calcification of gallstones.
- Dermatologic: Urticaria (hives), rash.
