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Maralixibat Side Effects

Medically reviewed by Last updated on Sep 1, 2022.

Applies to maralixibat: oral solution.

Serious side effects of Maralixibat

Along with its needed effects, maralixibat 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 while taking maralixibat:

More common

  • Bloody or black, tarry stools
  • bone fractures
  • chills
  • constipation
  • dark urine
  • diarrhea
  • dizziness
  • fever
  • headache
  • itching, rash
  • light-colored stools
  • loss of appetite
  • nausea
  • stomach pain
  • unpleasant breath odor
  • unusual tiredness or weakness
  • vomiting
  • vomiting of blood or material that looks like coffee grounds
  • yellow eyes or skin

For Healthcare Professionals

Applies to maralixibat: oral solution.


The most commonly reported side effects included diarrhea, abdominal pain, vomiting, and fat-soluble vitamin deficiency.[Ref]


Very common (10% or more): Diarrhea (up to 55.8%), abdominal pain (up to 53.5%), vomiting, (up to 40.7%), gastrointestinal bleeding (up to 10.4%)

Common (1% to 10%): Nausea

Frequency not reported: Abdominal discomfort, abdominal distention, gastrointestinal hemorrhage, hematemesis, hematochezia, lower abdominal pain, melena, upper abdominal pain[Ref]


Common (1% to 10%): Bone fractures

Frequency not reported: Clavicle fracture, forearm fracture, hand fracture, humerus fracture, pathological fracture, rib fracture, tibia fracture[Ref]


Frequency not reported: INR increase[Ref]


Very common (10% or more): Fat-soluble vitamin deficiency (up to 25.6%)

Frequency not reported: Vitamin A deficiency, vitamin D deficiency, vitamin E deficiency, vitamin K deficiency[Ref]


Very common (10% or more): Transaminases increased/ALT/AST (up to 18.6%)

Common (1% to 10%): Bilirubin increases above baseline

Frequency not reported: Abnormal ALT, abnormal AST, ALT increased, AST increased[Ref]


1. "Product Information. Livmarli (maralixibat)." Mirum Pharmaceuticals, Inc. (2021):

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.