ursodeoxycholic

Ursodeoxycholic acid, commonly abbreviated UDCA, is a bile acid found in small amounts in human bile. It is a secondary bile acid produced by intestinal bacteria from chenodeoxycholic acid and is also available as a synthetically produced medication. The name ursodeoxycholic acid comes from its historical association with bear bile, though it is now manufactured for medical use.

Therapeutic uses include the dissolution of cholesterol-containing gallstones in patients who are not suitable for surgical removal. UDCA may also be prescribed for certain cholestatic liver diseases, such as primary biliary cholangitis, where it can help improve liver biochemistry and patient symptoms. Its effectiveness can vary, and it is not appropriate for all biliary conditions or stone types. In some conditions, high-dose regimens have raised safety concerns, so treatment is guided by clinical guidelines and individual risk factors.

Mechanistically, UDCA is hydrophilic and less toxic than many other bile acids. It competes with more hydrophobic bile acids, reducing their damaging effects on hepatocytes and cholangiocytes. UDCA also promotes bile flow and helps to dilute the cholesterol content of bile, which can contribute to stone dissolution and improved bile circulation. The compound may exert cytoprotective and anti-apoptotic effects on liver cells, contributing to its therapeutic profile.

Pharmacokinetics and administration: UDCA is taken orally and is absorbed in the gut, then conjugated in the liver with glycine or taurine before being excreted into bile. It undergoes enterohepatic circulation. Commercial preparations are available as capsules, tablets, or oral solutions and are usually used as a long-term therapy under medical supervision.

Safety and monitoring: UDCA is generally well tolerated. Common adverse effects include diarrhea, dyspepsia, and abdominal discomfort. Rare hepatic adverse events and interactions with other hepatobiliary drugs can occur, so liver function tests and clinical monitoring are advised during treatment.