Ursodeoxycholic Acid (Paediatric)

How it works

It enriches the bile acid pool with a less toxic, more hydrophilic bile acid, improves bile flow and reduces the hepatocellular injury caused by accumulation of cytotoxic hydrophobic bile acids.

Prescribing in practice

• It should be avoided where there is complete biliary obstruction, as bile flow cannot be improved and harm may result, so biliary patency should be considered before use.
• Diarrhoea is the most common adverse effect and may necessitate dose adjustment.
• It is given as tablets or a liquid; confirm the appropriate preparation and weight-based dose against a children's formulary.

Monitoring

Monitor liver function tests periodically to assess response and detect deterioration.

Counselling the patient

• Take the medicine regularly as prescribed for the best effect.
• Report loose stools or worsening jaundice, dark urine or pale stools.
• Continue treatment and attend liver blood-test reviews even if the child seems well.

Evidence & guidelines

Ursodeoxycholic acid is used in paediatric cholestatic liver disease to improve bile flow and biochemical markers, with management directed by paediatric hepatology.