Obeticholic acid (Oral)
Warning: Hepatic Decompensation and Failure in Incorrectly Dosed PBC Patients with Child-Pugh Class B or C or Decompensated CirrhosisIn postmarketing reports, hepatic decompensation and failure, in some cases fatal, have been reported in patients with primary biliary cholangitis (PBC) with decompensated cirrhosis or Child-Pugh Class B or C hepatic impairment when obeticholic acid was dosed more frequently than recommended.The recommended starting dosage of obeticholic acid is 5 mg once weekly for patients with Child-Pugh Class B or C hepatic impairment or a prior decompensation event .
Medically reviewed on April 30, 2018.
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Gastrointestinal Agent
Uses For This Medicine
Obeticholic acid is used alone or in combination with ursodeoxycholic acid (UDCA) to treat primary biliary cholangitis (PBC) in patients who have received UDCA but did not work well.
Obeticholic acid is available only with your doctor's prescription.
Before Using This Medicine
In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For obeticholic acid, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to obeticholic acid or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.
Appropriate studies have not been performed on the relationship of age to the effects of obeticholic acid in the pediatric population. Safety and efficacy have not been established.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of obeticholic acid in the elderly. However, elderly patients are more sensitive to the effects of obeticholic acid than younger adults.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.
Interactions with Medicines
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking obeticholic acid, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using obeticholic acid with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Interactions with Food/Tobacco/Alcohol
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.
Other Medical Problems
The presence of other medical problems may affect the use of obeticholic acid. Make sure you tell your doctor if you have any other medical problems, especially:
- Biliary blockage, complete—Should not be used in patients with this condition.
- Hyperlipidemia (high cholesterol or fats)—Use with caution. May make these conditions worse.
- Liver disease, moderate to severe—Use with caution. The effects may be increased because of slower removal of the medicine.
Proper Use of This Medicine
Take obeticholic acid exactly as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered. To do so may increase the chance of side effects.
Take obeticholic acid with or without food.
If you are taking cholestyramine, colestipol, or colesevelam, take Ocaliva® at least 4 hours before or 4 hours after these medicines.
The dose of obeticholic acid will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of obeticholic acid. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For oral dosage form (tablets):
- For treatment of primary biliary cholangitis:
- Adults—At first, 5 milligrams (mg) once a day. Your doctor may adjust your dose as needed and tolerated. However, the dose is not more than 10 mg once a day.
- Children—Use and dose must be determined by your doctor.
- For treatment of primary biliary cholangitis:
If you miss a dose of obeticholic acid, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Ask your healthcare professional how you should dispose of any medicine you do not use.
Precautions While Using This Medicine
It is very important that your doctor check your progress at regular visits to make sure that obeticholic acid is working properly. Blood tests may be needed to check for unwanted effects.
Check with your doctor right away if you have dark urine or pale stools, nausea, vomiting, loss of appetite, pain in your upper stomach, or yellow skin or eyes. These may be symptoms of a serious liver problem.
Obeticholic acid may increase the level of cholesterol and fats in your blood. If this condition occurs, your doctor may give you a medicine to lower the cholesterol and fats. Talk to your doctor if you have concerns.
Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.
This Medicine Side Effects
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:More common
- severe itching skin
- clay-colored stools
- dark urine
- loss of appetite
- stomach pain and bloating
- unpleasant breath odor
- unusual tiredness or weakness
- vomiting of blood
- yellow eyes or skin
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- Bloating or swelling of the face, arms, hands, lower legs, or feet
- difficulty having a bowel movement
- difficulty with moving
- fast, irregular, pounding, or racing heartbeat or pulse
- muscle pain or stiffness
- pain in the joints
- rapid weight gain
- sore throat
- tingling of the hands or feet
- unusual weight gain or loss
- Skin rash, encrusted, scaly and oozing
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
See also: Side effects (in more detail)
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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More about obeticholic acid
- Obeticholic acid Side Effects
- During Pregnancy
- Dosage Information
- Drug Interactions
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- Drug class: miscellaneous GI agents
Other brands: Ocaliva