Ursodeoxycholic acid

What it is

Ursodeoxycholic acid is a naturally occurring bile acid that shifts the composition of bile towards a less toxic, more water-soluble mixture and improves bile flow. This protects liver cells and bile duct cells from the detergent effect of the body's own bile acids. It is a prescription medicine used for liver and biliary support, including cholestatic liver conditions and cholesterol gallstones.

A usual adult range, not a national label — the dose and the timing differ by country and by product.

Used for

• Liver support

Approved uses differ by country — some of these may be off-label or unapproved where you live.

What to know while taking it

It is taken with food and at bedtime, since bile acid handling and gallstone formation are most active overnight and food helps absorption. Liver enzymes and bilirubin — ALT, AST, GGT and total bilirubin — are followed to judge whether it is working, so blood tests are part of treatment rather than an optional extra. Bile acid binders and some cholesterol-lowering agents can reduce how much is absorbed. Long courses should be reassessed periodically with the prescriber rather than continued indefinitely by habit.

When to see a doctor

See a doctor if the skin or whites of the eyes turn yellow, the urine darkens, the stools go pale, or there is persistent right-sided upper abdominal pain, itching or fever.

Worth knowing

• Reassess the need for long courses

Markers to watch

• ALT
• AST
• GGT
• Total bilirubin