Ursodeoxycholic Acid (Ursodiol)

Bile acid

Ursodeoxycholic acid (UDCA), also called ursodiol

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.

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.

• 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.

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.

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.

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.

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.

• 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?

This guide comes from the Saudi Gastroenterology Association (SGA) patient library, prepared by the Approved for publication by SGA; individual clinician review is ongoing. Last reviewed: 2026-04-24. It is for education and does not replace your doctor's advice.