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Systematic review: ursodeoxycholic acid--adverse effects and drug interactions
W Hempfling1, K Dilger, U Beuers
1Department of Medicine II, Klinikum Grosshadern, University of Munich, Munich, Germany.
Alimentary Pharmacology & Therapeutics
|November 18, 2003
Summary
Ursodeoxycholic acid is generally safe for chronic cholestatic liver diseases. However, it can cause diarrhea and interact with certain medications, particularly those metabolized by cytochrome P4503A.
Area of Science:
- Hepatology
- Pharmacology
- Gastroenterology
Background:
- Ursodeoxycholic acid (UDCA) is widely used for chronic cholestatic liver diseases.
- A comprehensive review of UDCA's drug safety profile is needed.
Purpose of the Study:
- To systematically review adverse drug reactions and interactions associated with UDCA.
- To evaluate the safety of UDCA in liver disease management.
Main Methods:
- Systematic literature review.
- Refined search strategy for adverse events and drug interactions.
Main Results:
- UDCA generally well tolerated; diarrhea in a small subset of patients.
- Rare skin reactions attributed to adjuvants; potential for liver decompensation in end-stage cirrhosis.
- Interactions affecting UDCA absorption (colestyramine, etc.) and metabolism (CYP4503A substrates like cyclosporine).
Conclusions:
- UDCA demonstrates a favorable safety profile.
- Consideration of drug absorption interactions with anion exchange resins is important.
- Metabolic interactions with CYP4503A substrates are anticipated.