saudigastro.com/patients/ursodeoxycholic-acid
This article is educational and does not replace your doctor's advice. Seek urgent care for any red-flag symptoms.
Drug class
Bile acid
Examples
Ursodeoxycholic acid (UDCA), also called ursodiol
How it works
Bile is the fluid the liver makes to help digest fats. In some liver and bile-duct diseases, bile flows poorly and harmful bile builds up. Ursodeoxycholic acid makes bile less toxic, helps the liver release it, and protects liver cells. In some patients with small cholesterol gallstones it can slowly dissolve them over many months.
What it treats
- Primary biliary cholangitis (PBC), a long-term bile-duct condition
- Dissolving small cholesterol gallstones in selected people who cannot or do not want surgery
- Cholestasis (poor bile flow), including in pregnancy, as decided by the specialist
- Preventing gallstones during rapid weight loss or after some weight-loss surgery, in selected people
- Some other bile-duct conditions, under specialist care
How to take it
Take it by mouth exactly as prescribed, usually with food, often split across the day or taken in the evening. The dose is set by your doctor, often based on weight, and may change over time. Take it regularly: it works only while you take it, and benefit builds over months. If you miss a dose, take the next dose as normal and do not double it.
Common side effects
- Loose stools or mild diarrhoea
- Mild stomach discomfort or nausea
- Mild hair thinning in some people
- Weight gain in some people
Serious side effects — call your doctor
Rash, itching all over, or swelling of the face, lips or throat
Could be an allergic reaction. If there is swelling or breathing trouble, call emergency services now.
Worsening yellow skin or eyes, dark urine, or pale stools
Could mean the liver disease is progressing or a bile duct is blocked. Contact your doctor promptly.
Sudden severe upper abdominal pain with fever or vomiting
Could be a gallstone attack, inflamed gallbladder or infected bile duct. Go to the emergency department.
Vomiting blood, black stools, or new swelling of the belly or confusion (if you have advanced liver disease)
These can be complications of advanced liver disease. Go to the emergency department now.
Interactions
Medicines that bind bile acids, such as cholestyramine or colestipol, and some antacids containing aluminium can reduce how much is absorbed; your doctor or pharmacist can advise you to take them several hours apart. Oestrogen-containing medicines and some cholesterol medicines may reduce its effect. Always show your doctor your full medicine list.
Monitoring
Liver blood tests are checked regularly to see how well it is working and to guide the dose. For gallstones, ultrasound scans are repeated to see whether stones are shrinking. Your doctor will explain what response to expect.
When and how to stop
In PBC it is usually taken long term, so do not stop it without your doctor’s advice. For gallstones, treatment may last many months and be stopped when stones have gone or if there is no response. Stones can come back after stopping.
Pregnancy & breastfeeding
It is often used under specialist supervision in pregnancy for certain bile-flow problems, but this must be decided by your doctor. Tell your doctor if you are pregnant, planning pregnancy or breastfeeding.
Questions to ask your doctor
Save this list or print it before your appointment — doctors appreciate prepared patients.
- What is the goal of treatment in my case?
- How long before I know if it is working, and how will we check?
- Do I need to take it for life?
- Are any of my other medicines affecting it?
- If it is for gallstones, what are the chances stones return and what are the other options?
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Status: Approved for publication by SGA; individual clinician review is ongoing · Published 24/04/2026
For general education only; it does not replace your doctor’s advice. Individual clinician review of this guide is ongoing. SGA clinician? Review this guide