Ursodeoxycholic acid (ursodiol): what it does and how to use it
Ursodeoxycholic acid, often called ursodiol, is a prescription bile acid used to treat a few liver and gallbladder problems. It’s not a painkiller or a short-term fix — it changes bile composition and eases certain types of cholestasis and small cholesterol gallstones. People use it for primary biliary cholangitis (PBC), to help dissolve tiny gallstones when surgery isn’t an option, and commonly for intrahepatic cholestasis of pregnancy (ICP).
How it works
Ursodiol is a hydrophilic (water-friendly) bile acid. It replaces more toxic bile acids in the liver and bile ducts, which lowers liver inflammation and bile salt toxicity. For gallstones, it decreases cholesterol secretion into bile so small cholesterol stones can dissolve over months. For PBC and ICP, it helps move bile through the liver and reduces itching and liver test abnormalities.
Dosing & practical tips
Dose depends on why you’re taking it and your weight. Typical ranges: for PBC doctors usually prescribe about 13–15 mg per kg of body weight per day. For dissolving small cholesterol gallstones the dose is lower, often 8–10 mg/kg/day. For intrahepatic cholestasis of pregnancy many clinicians use roughly 10–15 mg/kg/day. Your doctor will pick the exact dose and adjust it based on response and blood tests.
Take ursodiol with food to help absorption and reduce stomach upset. Expect results to take time: dissolving gallstones can take months to more than a year, and liver tests may improve gradually. Don’t stop suddenly without checking in — some conditions need long-term treatment.
Common side effects are mild: diarrhea, constipation, nausea, or mild abdominal pain. Less commonly you may see dizziness, rash, or hair thinning. If you notice yellowing of the skin or eyes, worsening abdominal pain, fever, or signs of infection, contact your healthcare provider right away.
Ursodiol can interact with bile acid sequestrants (like cholestyramine), which block its absorption. If you take bile acid binders, space doses so they don’t overlap. Always tell your doctor about other meds, supplements, and pregnancy — ursodiol is often used in pregnancy for ICP but your obstetrician will weigh benefits and risks for you.
Doctors usually check liver blood tests before starting ursodiol and then periodically after that. If you have advanced cirrhosis or a blocked bile duct, ursodiol may not be appropriate. Your clinician will consider imaging and labs before and during treatment.
If you want to try ursodiol or were prescribed it, ask your provider how long you’ll need it, what exact dose fits your weight, and what tests they’ll run. Small lifestyle steps help too: avoid alcohol, follow liver-friendly diets when advised, and keep scheduled blood checks. If anything feels off while taking the drug, contact your healthcare team — they’ll help you adjust safely.
