What does Livacol 10mg do? Understanding its function and uses

October 6, 2025 •

3 min read

Primary Biliary Cholangitis affects approximately 1 in 1,000 women over 40. For those with an inadequate response to standard therapy, understanding what Livacol 10mg does is critical for managing this liver condition. As a medication containing Obeticholic Acid, Livacol works to improve liver function by reducing bile acid buildup, which can help prevent or delay liver damage.

Quick Summary

Livacol 10mg treats primary biliary cholangitis by activating the farnesoid X receptor (FXR), which decreases bile acid synthesis and enhances its removal from the liver. The medication reduces toxic bile buildup, mitigates liver damage, and is used either alone or in combination with other therapies.

Key Points

Active Ingredient: Livacol 10mg contains obeticholic acid, a potent farnesoid X receptor (FXR) agonist.
Primary Use: The medication treats Primary Biliary Cholangitis (PBC) in adults who do not respond adequately to or cannot tolerate ursodeoxycholic acid (UDCA).
Mechanism: By activating the FXR, it reduces bile acid synthesis and increases its removal, thereby protecting the liver from toxic bile buildup.
Key Side Effect: Severe itching (pruritus) is a very common side effect that may require dosage adjustment or additional medication.
Serious Liver Risk: Livacol has a boxed warning for worsening liver function, particularly in patients with cirrhosis. Close monitoring is essential.
Administration: The medication is taken once daily by mouth.
Contraindications: The drug is contraindicated in patients with complete biliary obstruction or advanced cirrhosis.

What is Livacol 10mg?

Livacol 10mg is a brand-name medication containing obeticholic acid. It's classified as a farnesoid X receptor (FXR) agonist and is primarily used for adults with Primary Biliary Cholangitis (PBC), a chronic autoimmune liver disease that damages bile ducts. This damage leads to bile buildup, potentially causing liver scarring (cirrhosis) and liver failure. Livacol 10mg is typically prescribed when ursodeoxycholic acid (UDCA), the usual first treatment, is insufficient or not tolerated.

The Mechanism of Action: How Livacol Works

Livacol 10mg activates the farnesoid X receptor (FXR), found in the liver and intestine. This activation impacts bile acid synthesis and removal, reduces inflammation and scarring, and helps protect liver cells, potentially improving function and slowing disease progression.

Primary Uses and Indications for Livacol 10mg

Livacol 10mg is approved for adult PBC patients who haven't responded well to or can't tolerate other therapies. It is used in combination with UDCA for those with an inadequate response to UDCA or alone for those unable to tolerate UDCA.

Administration

Livacol 10mg is taken once daily by mouth, with or without food.

Important Side Effects and Risks

Livacol 10mg can cause side effects and has a boxed warning about liver injury, especially in patients with advanced cirrhosis. Common side effects include severe itching (up to 70% of patients), fatigue, abdominal pain, rash, joint pain, and constipation. Serious side effects can include worsening liver problems, potentially fatal in those with cirrhosis, allergic reactions, and changes in cholesterol levels. Regular liver function and cholesterol monitoring is crucial during treatment.

Contraindications and Drug Interactions

Livacol 10mg is not suitable for patients with complete biliary obstruction, decompensated cirrhosis, or compensated cirrhosis with portal hypertension. Livacol can interact with other drugs like bile acid binding resins (requiring staggered dosing) and warfarin (requiring INR monitoring).

Livacol 10mg vs. Ursodeoxycholic Acid (UDCA)


Feature	Livacol 10mg (Obeticholic Acid)	Ursodeoxycholic Acid (UDCA)
Mechanism	Activates the Farnesoid X Receptor (FXR) to regulate bile acid synthesis and removal.	Increases bile flow and protects bile duct cells from toxic bile acids.
Usage	Second-line therapy for PBC in adults with inadequate response to or intolerance of UDCA.	First-line treatment for PBC.
Effectiveness	Approved based on reduction of alkaline phosphatase (ALP). Can help delay liver damage.	Standard of care for PBC, effective for most patients.
Common Side Effects	Itching, fatigue, abdominal pain, rash.	Diarrhea, nausea, weight gain.
Serious Risks	Potential for worsening liver problems in patients with advanced cirrhosis.	Generally well-tolerated, with fewer serious risks compared to Livacol.

Monitoring and Liver Health

Regular monitoring of liver function through blood tests is crucial while taking Livacol, especially for those with cirrhosis, due to the risk of serious liver injury. Patients with worsening symptoms should contact their doctor immediately. Supportive measures like diet, exercise, and avoiding alcohol and tobacco can also help manage PBC.

Conclusion

Livacol 10mg, containing obeticholic acid, is a targeted medication for adults with PBC who require additional therapy or cannot use standard treatments. Its action on the FXR receptor helps manage bile acids and reduce liver damage. While beneficial, it can cause side effects, notably severe itching and a risk of serious liver issues in advanced disease. Livacol treatment requires careful medical oversight and monitoring to balance its benefits against potential risks, making it an important, specialized option for liver health management.

Frequently Asked Questions

Primary Biliary Cholangitis is an autoimmune liver disease that causes the small bile ducts in the liver to become damaged and inflamed, leading to a toxic buildup of bile that can cause liver scarring.

Livacol 10mg, containing obeticholic acid, helps by activating the FXR receptor, which reduces the production of new bile acids and increases their removal from the liver. This helps improve liver function and reduce the toxic effects of bile buildup.

Yes, Livacol 10mg can be taken with or without food. However, it is recommended to take it at the same time every day to maintain a regular schedule.

The most common side effects are itching (pruritus), fatigue, abdominal pain, rash, and joint pain. Itching can be particularly bothersome and may require additional treatment or a dosage change.

Livacol should be used with extreme caution in patients with cirrhosis and is contraindicated in those with decompensated cirrhosis. The FDA has issued a boxed warning due to the risk of worsening liver problems in this population, sometimes leading to liver failure or transplant.

If you miss a dose, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.

Yes, Livacol can interact with certain drugs. It may reduce the absorption of bile acid binding resins like cholestyramine, and monitoring of INR is needed with warfarin. Always inform your doctor of all medications and supplements you are taking.

Yes, Livacol is a brand name for the medication obeticholic acid. Other brand names for obeticholic acid include Ocaliva.