The main ursodeoxycholic acid uses include the treatment of small cholesterol-containing gallstones (cholelithiasis). Modern western societies average about 15 to 20% of people suffering from gallstone disease. Women are affected more often than men. In addition to the female gender, typical risk factors include overweight (obesity), old age (older than 40 years) and the presence of gallstones in first-degree relatives. In 80% of the cases, the gallstones are stones containing cholesterol. Symptoms only appear in about 25% of patients with gallstones. This typically results in an upper abdominal pain on the right side, which can also radiate into the shoulders or the back.
How Does Ursodeoxycholic Acid Work?
Gallstones are caused by an imbalance in the various substances in the bile. In addition to the bile acids, there are also dissolved substances (e.g. cholesterol) in the bile. A high proportion of cholesterol combined with a low concentration of bile acids leads to the stones containing cholesterol within the bile ducts.
Introduction – Ursodeoxycholic Acid Mechanism of Action
Ursodeoxycholic acid also occurs naturally in very low concentrations in the bile. It counteracts the formation of gallstones in various ways and also leads to the termination of small, cholesterol-containing stones. On the one hand, ursodeoxycholic acid inhibits the absorption of cholesterol from the intestine into the human body, while at the same time the release of cholesterol from the liver cells into the bile is reduced. Ursodeoxycholic acid stimulates the release of bile acids from the liver cells into the bile. The lower cholesterol and higher bile acid concentrations prevent the formation of cholesterol-containing gallstones and at the same time small, existing stones can be dissolved.
In addition, ursodeoxycholic acid uses include a cell-protecting effect by inhibiting chronic inflammatory reactions. Damaged liver cells can be protected by chronic inflammation and the progression of cirrhosis can be delayed.
A Guide to Ursodeoxycholic Side effects
Serious side effects occur only very rarely during therapy with ursodeoxycholic acid. Average statistics are 1 in 10 of 100 patients experience side effects the main being diarrhea. This is due, among other things, to the inhibited absorption of cholesterol from the intestine into the body, as a result of which high amounts of cholesterol are excreted. The stool is often referred to as mushy by the patients concerned.
In very rare cases (less than 1 in 10,000 patients), calcification of the gallstones or hives may occur as part of the therapy. Patients with known cirrhosis of the liver (due to a backlog of bile) can also experience severe pain in the right upper abdomen. Worsening of cirrhosis of the liver is also possible in very rare cases and requires treatment to be discontinued.
Possible Ursodeoxycholic Interactions
The effectiveness of ursodeoxycholic acid can be impaired during treatment with bile acid-binding drugs. The bile acid-binding preparations include colestyramine. This has the property of binding and excreting the bile acids in the intestine. As a result, new bile acids have to be formed in the liver from cholesterol, which can lower the cholesterol level in humans. At the same time, however, ursodeoxycholic acid is no longer absorbed in the intestine and can therefore no longer cause the gallstones to dissolve within the bile ducts. For this reason, a delayed intake (at least 2 hours) is recommended.
Further interactions can arise through the metabolism of ursodeoxycholic acid via specific liver enzymes (e.g. CYP3A4), through which numerous other preparations are also metabolized. Studies have already reported an increased effect of ciclosporin and a weakened effect of ciprofloxacin or nitrendipine.
To recap UDCA or Ursodeoxycholic acid brand name is ursodiol. But this is only one there are over 50 brand names listed in Medindia’s drug directory. It is produced as a tablet form i.e. ursodeoxycholic acid 150mg and ursodeoxycholic acid 250mg. Other versions of the chemical can be found as an ingredient in capsules, creams, gel, liquid, and ointments.
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