Ursodeoxycholic acid (UDCA)
Content date: 15 November 2026
Ursodeoxycholic acid, also called ursodiol or UDCA, is a bile acid medicine and first-line treatment for primary biliary cholangitis (PBC). It is not a general “liver protector”.
Your next step
Check your written prescription and monitoring plan. If anything is unclear, ask your care team before changing a dose.
Get urgent help: Seek urgent care for sudden severe upper abdominal pain or fever with jaundice. Call emergency services for sudden swelling of the lips, tongue or throat, or difficulty breathing or swallowing; do not wait for swelling and breathlessness together.
How do I use it?
- Your liver team calculates the dose from your weight and diagnosis. For PBC, the usual total is 13–15 mg/kg/day, divided according to the prescribed product, often with food. Do not calculate or increase your own dose. Treatment for PBC is usually long term, even when you feel well. Ask the pharmacist before splitting a tablet.
How do I store it?
- Follow the temperature instructions for your brand and keep it away from children. Keep tablets in their supplied packaging; ask about storage and expiry if tablets are split or a liquid is supplied.
What tests do I need?
- Liver blood tests, including alkaline phosphatase and bilirubin, track safety and response. Testing is more frequent initially, then follows your liver team’s schedule. Response is formally reviewed around 12 months; an incomplete response may require additional treatment. Report important weight changes for dose review.
Possible side effects: what to expect
- Not everyone gets side effects. Loose stools or diarrhoea are common; if persistent, contact your liver team for dose review without stopping PBC treatment yourself.
- Very rarely, worsening liver function has been reported during treatment of advanced PBC. Scheduled tests help detect changes. Increasing jaundice or abdominal swelling needs prompt review; severe upper abdominal pain needs urgent assessment. Symptoms can also reflect the underlying disease.
Important points
- UDCA is not routine treatment for every liver condition. Use in primary sclerosing cholangitis (PSC) is a separate specialist decision; high-dose treatment can be harmful. Cholestyramine and some antacids can reduce its absorption, so ask for a medicine-spacing plan. Do not stop a prescribed PBC treatment without discussing it.
Brand / device: ........................ | Dose and how I take or use the medicine: ........................
Next dose: ........................ | Next blood tests: ........................
Team contact: ........................
When to get help
Seek urgent care for sudden severe upper abdominal pain or fever with jaundice. Call emergency services for sudden swelling of the lips, tongue or throat, or difficulty breathing or swallowing; do not wait for swelling and breathlessness together.
Contact your liver team for persistent diarrhoea, worsening jaundice or itching, or difficulty taking the prescribed dose.