Side effects

During therapy with ursodeoxycholic acid, serious side effects occur only in very rare cases. Frequently (1 to 10 out of 100 patients), however, diarrhea is more frequent in patients. This is partly due to the inhibited absorption of cholesterol from the intestine into the body, which causes high levels of cholesterol to be excreted.

The stool is often described by the patients concerned as mushy. In very rare cases (less than 1 in 10,000 patients), calcification of the gallstones or urticaria may also occur during therapy. Patients with known cirrhosis of the liver (due to a backlog of bile) may also experience severe pain in the right upper abdomen. A worsening of liver cirrhosis is also possible in very rare cases and makes it necessary to discontinue therapy.

Interactions

The efficacy of ursodeoxycholic acid can be disturbed during treatment with bile acid-binding drugs. Among the bile acid-binding preparations is colestyramine. Colestyramine has the property of binding and excreting the bile acids in the intestine.

As a result, new bile acids must be formed from cholesterol in the liver, which can lower the cholesterol level in humans.At the same time, however, ursodeoxycholic acid is no longer absorbed in the intestine and can therefore no longer cause the gallstones to dissolve within the bile ducts. For this reason, a delayed intake (at least 2 hours) is recommended. Further interactions can occur through the metabolism of ursodeoxycholic acid via specific liver enzymes (including CYP3A4), via which numerous other preparations are also metabolised. Studies have already reported an increased effect of Ciclospoprin A and a reduced effect of Ciprofloxacin or Nitrendipin.

Contraindications

Ursodeoxycholic acid should not be taken if there is known hypersensitivity to the ingredient. In addition, the administration of ursodeoxycholic acid is not indicated for acute inflammation of the gallbladder or bile ducts. Ursodeoxycholic acid should also not be taken in acute or chronic liver inflammation (hepatitis). Ursodeoxycholic acid is also ineffective in the treatment of non-cholesterol-containing stones. These can be caused by an increased amount of calcium carbonate or bilirubin within the bile ducts, for example.