Ursodeoxycholic Acid: Effects, Uses & Risks

Ursodeoxycholic acid (also known as ursodeoxycholic acid) is a natural, tertiary bile acid. It is used in the dissolution of small gallstones (up to a maximum of 15 mm) and in the therapy of certain diseases of the liver.

What is ursodeoxycholic acid?

Ursodeoxycholic acid (ursodeoxycholic acid) belongs to the group of sterols from the chemical point of view and is a steroid. It is a natural, tertiary bile acid that is partially synthesized by extracting cholic acid from the bile of slaughter cattle. About 3 percent of the acid is also found in human bile. Ursodeoxycholic acid (ursodeoxycholic acid) is primarily used to dissolve so-called cholesterol gallstones of small size. Ursodeoxycholic acid (ursodesoxycholic acid) is available in the form of film-coated tablets or capsules.

Pharmacological effects on the body and organs

Ursodeoxycholic acid (ursodeoxycholic acid) occurs in small amounts in natural bile acid and, unlike other bile acids, is soluble in water. The acid ensures inhibition of the absorption of cholesterol from the intestine and the release of cholesterol into the bile from the cells of the liver. By taking ursodeoxycholic acid (ursodeoxycholic acid) the mechanism is strengthened, the cholesterol in the bile decreases. Thus, it is much more finely distributed in the fluid. This results in gradual dissolution and flushing out of the cholesterol gallstones. The active ingredient also has a protective effect on the cells, and chronic inflammatory reactions are thus inhibited. Ursodeoxycholic acid is non-toxic in this process.

Medical application and use for treatment and prevention.

Primarily, ursodeoxycholic acid is used to dissolve cholesterol gallstones. However, therapy is only possible with small stones up to a maximum of 15 mm and a functioning gallbladder. In addition, the drug is used when cirrhosis of the liver is not to progress further. However, this must be due to chronic inflammation of the bile ducts and a backlog of bile that forms in the liver cells. Furthermore, ursodeoxycholic acid is used in the treatment of certain forms of inflammation of the gastric mucosa. Here, the reflux of digestive juices from the duodenum into the stomach is inhibited. Ursodeoxycholic acid must not be used for treatment in cases of hypersensitivity to ursodeoxycholic acid, acute inflammation of the gallbladder and biliary tract, obstruction of the bile ducts, hepatitis (chronic or acute), calcium-containing gallstones (shadows on X-ray), reduced gallbladder function, frequent biliary colic, and gallbladder that cannot be visualized on X-ray. Administration during pregnancy is also not indicated, as the unborn child may develop malformations. Therefore, pregnancy must be ruled out before starting therapy, and contraceptive measures are advisable during therapy. Even though treatment with ursodeoxycholic acid is rather rare in children and adolescents, it can be used from the age of 6 years in cases of biliary obstruction. Typically, the duration of treatment with ursodeoxycholic acid is between 6 and 24 months.

Risks and side effects

Side effects may also occur with the administration of ursodeoxycholic acid. These vary from patient to patient. They may or may not occur. The most common side effects include mainly mushy stools and diarrhea. Very rarely, calcification of gallstones, hives, or severe pain in the upper abdomen may also occur. The latter side effect is especially possible in the treatment of primary biliary cirrhosis. If advanced-stage biliary cirrhosis is treated with ursodeoxycholic acid, it may worsen in very rare cases. Once treatment is stopped, regression usually occurs. Interactions are also possible when taking ursodeoxycholic acid and other medications at the same time. For example, agents that bind bile acid (e.g., colestipol), agents that bind acid, alumina, or even aluminum salts can lead to a reduction in the absorption of ursodeoxycholic acid from the intestine. In these cases, intake should be delayed by at least 2 hours.In case of simultaneous intake of ciclosporin (agent for the prevention of transplant rejection), the effect of ciclosporin is enhanced. Ursodeoxycholic acid, on the other hand, has a weakening effect on the antibiotic ciprofloxacin and the calcium blocker nitrendipine. Especially at the beginning of therapy with ursodeoxycholic acid, regular monitoring of liver enzyme levels in the blood by the attending physician is necessary, and the gallbladder should also be examined regularly by ultrasound. If the bile does not decrease in size within a year or if it calcifies, then treatment should be terminated.