Ursodesoxycholic acid

Ursodesoxycholic acid is a water-soluble, non-toxic, natural bile acid that is formed especially in polar bears (ursus = lat. the bear). It is used as a well-tolerated drug for dissolving small gallstones and for the treatment of a number of liver diseases. Ursodesoxycholic acid is subject to an enterohepatic cycle, i.e. it is excreted through the liver into the bile and reabsorbed through the small intestine.

• In dermatology it is successfully used for the treatment of pruritus gravidarum ( off-label use).
• Other indications include the therapy of gallstones, biliary reflux gastritis and the symptomatic treatment of primary biliary cirrhosis. Furthermore:

• non-obstructive cholestatic diseases, especially PBC and PSC

• Drug-induced liver damage

• Hepatitides

• Studies suggest that altering the bile composition with UDCA also leads to a reduction in the rate of colon cancer in patients with ulcerative colitis.

• Taking it in the first trimester of pregnancy is not indicated because there is not enough experience.
• During the lactation period, intake is not recommended due to lack of data.
• Off-label use in the therapy of pruritus gravidarum.

• Decreased enteral resorption of the ursodeoxycholic acid when taken simultaneously with colestyramine, colestipol or aluminium hydroxide and/or alumina-containing antacids.
• Increased absorption of ciclosporin by ursodeoxycholic acid.
• Decreased absorption of ciprofloxacin by ursodeoxycholic acid.
• Decreased plasma peak concentration of the calcium antagonist nitrendipine.
• Induction of cytochrome P450 enzymes by ursodeoxycholic acid possible.

1. Leuschner U et al (2005) Ursodeoxycholic acid in the therapy for primary biliary cirrhosis: effects on progression and prognosis. Z Gastroenterol 43: 1051-1059