Ursodeoxycholic acid therapy in hepatobiliary disease

Am J Med. 2000 Apr 15;108(6):481-6. doi: 10.1016/s0002-9343(00)00318-1.


Ursodeoxycholic acid is a hydrophilic bile acid that under normal circumstances represents a small fraction of the bile acid pool in humans. It is effective in dissolving cholesterol gallstones in appropriately selected patients. Ursodeoxycholic acid improves serum alkaline phosphatase and aminotransferase levels in primary biliary cirrhosis, but its effects on rates of liver transplantation and death are less certain. Ursodeoxycholic acid has had promising [corrected] effects in several other cholestatic liver diseases, such as cystic fibrosis and intrahepatic cholestasis of pregnancy, but data are too preliminary to make recommendations about its routine use in these conditions. Its effects are mediated by amelioration of damage to cell membranes caused by retained toxic bile acids. Ursodeoxycholic acid improves biliary secretion of bile acids, may improve bile flow, and it has immunomodulatory properties that may reduce immune-mediated liver damage. However, its use in the treatment of cholestatic liver disease remains uncertain pending additional randomized trials.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Biliary Tract Diseases / drug therapy*
  • Biliary Tract Diseases / etiology
  • Bone Marrow Transplantation / adverse effects
  • Cholagogues and Choleretics / immunology
  • Cholagogues and Choleretics / pharmacology
  • Cholagogues and Choleretics / therapeutic use*
  • Cholangitis, Sclerosing / complications
  • Cholestasis / drug therapy*
  • Cholestasis / etiology
  • Chronic Disease
  • Cystic Fibrosis / complications
  • Female
  • Graft Rejection / complications
  • Graft vs Host Disease / complications
  • Humans
  • Liver Cirrhosis, Biliary / complications
  • Liver Diseases / drug therapy*
  • Liver Diseases / etiology
  • Liver Transplantation / adverse effects
  • Parenteral Nutrition, Total / adverse effects
  • Pregnancy
  • Pregnancy Complications
  • Ursodeoxycholic Acid / immunology
  • Ursodeoxycholic Acid / pharmacology
  • Ursodeoxycholic Acid / therapeutic use*


  • Cholagogues and Choleretics
  • Ursodeoxycholic Acid