Ursodeoxycholic acid (UDCA) is a secondary bile acid naturally produced by the gut microbiota and also synthesized for medical use. It is primarily prescribed to treat certain liver and gallbladder conditions.
Key Uses
1. Primary Biliary Cholangitis (PBC): UDCA is a first-line treatment for PBC, an autoimmune liver disease, helping to slow disease progression and improve liver function.
2. Gallstones: It dissolves cholesterol gallstones in patients who cannot undergo surgery.
3. Cholestatic Liver Diseases: UDCA is used to manage cholestasis (impaired bile flow) in conditions like primary sclerosing cholangitis (PSC) and intrahepatic cholestasis of pregnancy.
4. Cystic Fibrosis-Related Liver Disease: It may benefit some patients with liver issues due to cystic fibrosis.
Mechanism of Action:
- Choleretic Effect: Increases bile flow, reducing bile toxicity.
- Cytoprotective: Shields liver cells from bile acid damage.
- Immunomodulatory: Modulates immune responses in autoimmune liver diseases.
Dosage:
- PBC: Typically 13-15 mg/kg per day, divided into doses.
- Gallstones: Usually 8-10 mg/kg per day, taken at bedtime.
Side Effects:
- Common: Diarrhea, constipation, nausea, abdominal pain.
- Rare: Allergic reactions, worsening liver function.
Contraindications:
- Acute inflammation of the gallbladder or bile ducts.
- Biliary obstruction.
- Known hypersensitivity to UDCA.
Monitoring:
- Regular liver function tests and bile acid levels are recommended during treatment.
Conclusion:
UDCA is effective for managing specific liver and gallbladder conditions, with a generally favorable safety profile. Always consult a healthcare provider for proper use and monitoring.