Modern view on ursodeoxycholic acid: answers to daily clinical questions

Objective — to summarize current data on the role of ursodeoxycholic acid (UDCA) in clinical practice and to highlight the most relevant directions of its therapeutic application. This review article is structured in a question‑and‑answer format, allowing clinicians to quickly navigate key aspects such as dosing, duration of therapy, combination strategies, and prediction of therapeutic response. The article summarizes up‑to‑date knowledge on the multifaceted mechanisms of UDCA at the level of the liver, gallbladder, and the mucosa of the upper gastrointestinal tract. It outlines the mechanisms of UDCA action that support its efficacy in the treatment of cholestatic diseases, steatohepatitis, biliary sludge, biliary reflux, postcholecystectomy syndrome, and estrogen dominance. The rationale for combining UDCA with S‑adenosylmethionine and metformin in patients with concurrent metabolic and functional disorders is also discussed. Special attention is given to a new therapeutic option — the European UDCA‑based drug Ursoker, registered in Ukraine. Ursoker is manufactured in a full‑cycle production facility in Italy, ensuring quality control at every stage. The product is available in a modern oral dosage form (250 mg capsules), with stable pharmacokinetic properties, good tolerability, and flexibility for individual treatment regimens. Its high quality, GMP compliance, convenient dosing, and optimal cost‑effectiveness ratio make Ursoker a promising option for long‑term use. Conclusions. UDCA remains a key component in the management of a wide spectrum of hepatobiliary and metabolic disorders. It demonstrates a multifactorial mechanism of action with proven clinical efficacy, and long‑term use is supported by a favorable safety profile. Ursoker represents a modern therapeutic solution that combines reliability, evidence‑based effectiveness, and convenience for everyday clinical use.