cholic acid at a glance
Medicine class
Primary bile acid replacement therapy
Licensed role
Two specified inherited defects of primary bile-acid synthesis
Specialist care
Treatment is started and monitored by an experienced liver or gastroenterology specialist
Administration
Take with food; swallow capsules whole with water without chewing
What is cholic acid used for?
UK-licensed use is limited to specialist treatment of inherited primary bile-acid synthesis defects.
3β-hydroxy-Δ5-C27-steroid oxidoreductase deficiency from one month of age through adulthood
Δ4-3-oxosteroid-5β-reductase deficiency from one month of age through adulthood
How does cholic acid work?
Cholic acid restores part of the normal bile-acid pool and bile flow. It signals the liver to reduce bile-acid synthesis, limiting abnormal, potentially liver-damaging intermediates and supporting absorption of fats and fat-soluble vitamins.
cholic acid preparations and strengths
Capsule
Route: Oral
Strengths: 50 mg, 250 mg
How to take cholic acid
Follow the specialist team's instructions. Take capsules with food and swallow them whole with water without chewing.
For babies and children unable to swallow capsules, the capsule may be opened and its contents mixed with infant formula or suitable apple/orange or apple/apricot juice.
cholic acid side effects
Common or expected effects
- Diarrhoea — frequency unknown
- Itching — frequency unknown
- Raised liver transaminases on blood tests — frequency unknown
Get urgent medical advice
- Gallstones have been reported during long-term treatment; severe or persistent upper abdominal pain, fever or jaundice needs urgent assessment.
- Persistent itching or diarrhoea may indicate excessive exposure and needs prompt specialist assessment.
- Worsening liver function requires urgent clinical review.
cholic acid in pregnancy
Pregnancy experience is limited, but reported exposed pregnancies have not identified adverse outcomes. Contact the specialist team promptly if pregnancy is planned or suspected so treatment and monitoring can be reviewed.
cholic acid while breastfeeding
Cholic acid and its metabolites enter breast milk, but effects on a breastfed infant are not anticipated at therapeutic exposure. The licensed product can be used while breastfeeding; inform the specialist team.
cholic acid interactions
The specialist team should review all prescribed, pharmacy and complementary products.
Phenobarbital and primidone
They oppose cholic acid's effect and must not be used concurrently.
Ciclosporin
It can alter cholic acid handling and action.
Bile-acid sequestrants and aluminium-containing antacids
They bind cholic acid and reduce its effect.
Ursodeoxycholic acid
It may reduce cholic acid absorption and feedback activity.
Common questions about cholic acid
Answers are fully visible for fast scanning and source review.
What conditions is cholic acid licensed to treat?
Two inherited primary bile-acid synthesis defects: 3β-hydroxy-Δ5-C27-steroid oxidoreductase deficiency and Δ4-3-oxosteroid-5β-reductase deficiency.
Is cholic acid naturally present in the body?
Yes. It is a primary bile acid normally produced by the liver.
Why is specialist monitoring needed?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.