Ocaliva (Obeticholic Acid) – Side Effects, Interactions, Uses, Dosage, Warnings

Primary biliary cholangitis (PBC) is a chronic liver disease that can destroy bile ducts in the liver and may lead to cirrhosis (scarring of the liver) and liver failure. PBC is a progressive disease that may have no symptoms for many years.

Obeticholic acid is used to treat PBC in adults who have not developed liver cirrhosis. Obeticholic acid is sometimes used with another drug called ursodeoxycholic acid (UDCA).

Obeticholic acid may also be used for purposes not listed in this medication guide.


What is Ocaliva (Obeticholic Acid) used for?

  • Biliary Cirrhosis


What is the most important information I should know about Ocaliva (Obeticholic Acid)?

You should not use obeticholic acid if you are allergic to it, or if you have:

  • advanced cirrhosis of the liver; or
  • complete blockage of your bile ducts.

Your doctor will perform tests to make sure obeticholic acid is the right treatment for you. Tell your doctor if you've had liver problems, especially cirrhosis.

Tell your doctor if you are pregnant or breastfeeding.

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Side Effects

What are the side effects of Ocaliva (Obeticholic Acid)?

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • new or worsening feelings of weakness, tiredness, dizziness, or drowsiness;
  • confusion, mood or behavior changes, slurred speech;
  • severe itching;
  • fever, chills, less urination;
  • stomach pain, nausea, vomiting, diarrhea, loss of appetite;
  • bloody or tarry stools, coughing up blood or vomit that looks like coffee grounds;
  • jaundice (yellowing of the skin or eyes); or
  • fluid build-up around the stomach–bloating, weight gain, trouble breathing, swelling in your stomach or legs.

Your doses may be delayed or permanently discontinued if you have certain side effects.

Common side effects may include:

  • skin rash, itching, dryness, redness, oozing, or crusting;
  • fever, dizziness, feeling tired;
  • stomach pain, constipation;
  • pain in your mouth or throat;
  • fast or irregular heart rate;
  • swelling in your hands or lower legs;
  • joint pain; or
  • abnormal thyroid function.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Pregnancy & Breastfeeding

Can I take Ocaliva (Obeticholic Acid) if I’m pregnant or breastfeeding?

Tell your doctor if you are pregnant or breastfeeding.


What drugs and food should I avoid while taking Ocaliva (Obeticholic Acid)?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Dosage Guidelines & Tips

How to take Ocaliva (Obeticholic Acid)?

Use Ocaliva (Obeticholic Acid) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

Take with or without food.

You may be given medication to prevent itching, a common side effect of obeticholic acid. Call your doctor if itching becomes severe.

You will need liver function tests and you may need to stop taking obeticholic acid based on the results, even if you have no symptoms.

Do not stop taking this medicine without your doctor's advice.

Store at room temperature away from moisture and heat.

What should I do if I missed a dose of Ocaliva (Obeticholic Acid)?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Overdose Signs

What happens if I overdose on Ocaliva (Obeticholic Acid)?

If you think you or someone else may have overdosed on: Ocaliva (Obeticholic Acid),  call your doctor or the Poison Control center

(800) 222-1222

If someone collapses or isn't breathing after taking Ocaliva (Obeticholic Acid), call 911



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