Urso Deoxy Cholic Acid (UDCA)
Discuss the indications?
PBC- UDCA in a dose of 13-15 mg/kg/day orally (in 2-3 divide doses) is recommended for patients with PBC who have abnormal liver enzyme values regardless of histologic
stage. UDCA has been shown to improve liver biochemistry, reduction in the need for liver transplantation and improved survival.
Gall stones- Oral dissolution therapy using 10 mg per kg per day (1-2 divided doses) of UDCA can be used in patients unfit or unwilling to undergo surgery. This treatment is suitable for small cholesterol rich stones without any calcification and good gallbladder function. Treatment may be required for up to 2 years depending on the size of the stone. Treatment should be continued for 3-4 months after stones dissolve. Gallstone recurrence is a disadvantage of this treatment; approximately 25 percent of patients develop recurrent gallstones within five years.
UDCA and PSC- UDCA use as a chemopreventative agent in PSC patients cannot be routinely recommended given the limited information available. The role for UDCA in slowing the progression of PSC-related liver disease is as yet unclear and indeed, high dose UDCA may b e harmful. Thus use of UDCA in PSC is not recommended.
Doses- available in 150, 250,300 mg tablets or capsules
Discuss side effects?
Nausea, vomiting, diarrhoea, gallstone calcification, pruritus
