[Clinical pharmacology of ursodeoxycholic acid (UDCA)]

Ursodeoxycholic acid (UDCA) is frequently confused with chenodeoxycholic acid (CDCA), although its pharmacological properties are quite different, clinical indications much broader and it produces practically no side effects. By several mechanisms (including, inter alia, induction of hypercholeresis and formation of liquid crystals with cholesterol) UDCA decreases bile saturation with cholesterol and increases bile metastability. Upon oral administration UDCA, which is hydrophilic, substitutes for and protects hepatocytes against damage by other more hydrophobic and toxic bile acids. In consequence it exerts hepatoprotective and immunocorrective influence. Clinical efficacy of UDCA in gallstone dissolution and prophylaxis, in treatment of biliary dyspepsias, in chronic active hepatitis, in primary biliary cirrhosis and in other cholestatic liver diseases is reviewed. Other therapeutic indications for the drug are also mentioned.