Tab udiliv indication
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Udiliv ursodeoxycholic acid indications uses
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Here is a complete overview of Tab Udiliv (Ursodeoxycholic Acid / UDCA) indications:
Tab Udiliv (Ursodeoxycholic Acid) - Indications
Udiliv is the brand name for Ursodeoxycholic acid (UDCA / Ursodiol) - a hydrophilic, naturally occurring bile acid.
APPROVED / PRIMARY INDICATIONS
| Indication | Dose | Details |
|---|---|---|
| Cholesterol Gallstone Dissolution | 10 mg/kg/day orally for 12-24 months | For small (<5-10 mm), noncalcified, radiolucent cholesterol stones in a functioning gallbladder. Dissolution occurs in up to 50% of patients. For patients who refuse or are unfit for cholecystectomy |
| Primary Biliary Cholangitis (PBC) | 13-15 mg/kg/day | First-line agent. Improves liver biochemistry, slows histologic progression, reduces need for liver transplantation, and improves long-term survival |
| Gallstone Prevention | 10 mg/kg/day | Prevention of gallstone formation in obese patients undergoing rapid weight loss therapy |
| Cholestatic Drug Hepatotoxicity (DILI) | - | Used for cholestatic pattern of drug-induced liver injury |
| Intrahepatic Cholestasis of Pregnancy (ICP) | 10-15 mg/kg/day | Relieves pruritus, reduces bile acids, improves fetal outcomes |
MECHANISM BEHIND THERAPEUTIC USES
UDCA works by:
- Replacing toxic hydrophobic bile acids - displaces endogenous toxic bile acids (e.g., chenodeoxycholic, deoxycholic acid) that accumulate in cholestatic disease
- Reducing biliary cholesterol - decreases hepatic cholesterol secretion into bile, making bile less lithogenic (for gallstones)
- Cytoprotection - stabilizes hepatocyte canalicular membranes
- Immunomodulation - anti-inflammatory and immune-suppressive effects on hepatocytes
OTHER/OFF-LABEL USES
- Non-alcoholic fatty liver disease (NAFLD) / NASH - modest benefit in improving liver enzymes (though not strongly evidence-based for histological improvement)
- Primary Sclerosing Cholangitis (PSC) - used but evidence is controversial; high doses may be harmful
- Cystic fibrosis-related liver disease
- Total Parenteral Nutrition (TPN)-associated cholestasis
- Post-liver transplant - prevention of rejection/bile duct complications
CONTRAINDICATIONS
- Calcified (radio-opaque) gallstones
- Non-functioning gallbladder
- Bile duct obstruction / acute cholangitis
- Inflammatory bowel disease with bile acid malabsorption
- Allergy to bile acids
ADVERSE EFFECTS
Ursodeoxycholic acid is practically free of serious adverse effects. Unlike its predecessor chenodeoxycholic acid, it has no hepatotoxicity. Occasional mild diarrhea may occur.
Sources:
- Katzung's Basic and Clinical Pharmacology, 16th Ed - Clinical Use of Ursodiol
- Goodman & Gilman's Pharmacological Basis of Therapeutics - Bile Acids section
- Harrison's Principles of Internal Medicine 22E - Drug-Induced Liver Disease
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