What are the contraindications for using obeticholic acid (Obeticholic) and should I pay attention to it?

Although obeticholic acid has clear pharmacological value in primary biliary cholangitis (PBC), it is not suitable for all patient groups, and its use contraindications and precautions have been repeatedly emphasized in overseas guidelines. First of all, it needs to be made clear that obeticholic acid is not the first choice for all patients with primary biliary cholangitis, especially after the disease progresses to a certain stage, the risk of medication may increase significantly.

For patients who have decompensated cirrhosis, or who are accompanied by obvious jaundice, ascites, esophageal and gastric varices and other manifestations of portal hypertension, obeticholic acid should be used with extreme caution. Overseas drug use experience suggests that in such patients, drugs may increase the metabolic burden on the liver and even induce or aggravate liver function damage. Therefore, whether such patients are suitable for the use of obeticholic acid must be comprehensively evaluated by doctors with liver disease expertise and cannot be decided by themselves.

Additionally, safety data on obeticholic acid during pregnancy and lactation remain limited. There is currently insufficient evidence that it is completely safe for fetuses and infants, so its use by pregnant women is generally not recommended. For women of childbearing age, doctors often emphasize the importance of contraception before starting treatment to reduce potential risks. This medication principle is regarded as an important prerequisite in overseas instructions and clinical practice.

During daily use, patients also need to undergo regular laboratory tests, including liver function-related indicators, in order to detect abnormal changes early. Once obvious discomfort or index fluctuation occurs, you should communicate with the doctor in time to adjust the treatment strategy. Overall, obeticholic acid is a highly professional prescription drug, and its efficacy is based on strict indications and standardized management. A rational understanding of its contraindications and risks can help patients obtain safer and controllable long-term benefits during treatment.

Reference materials:https://en.wikipedia.org/wiki/Obeticholic_acid