Treatment of Primary Biliary Cholangitis (Primary Biliary Cirrhosis)

How do doctors treat primary biliary cholangitis?

Doctors treat primary biliary cholangitis with medicines. Your doctor may prescribe ursodiol (Actigall, Urso). Although ursodiol does not cure primary biliary cholangitis, it can slow the progression of liver damage. People who respond to ursodiol early in the course of primary biliary cholangitis can live longer without needing a liver transplant.

If you do not respond to ursodiol, your doctor may prescribe obeticholic acid (Ocaliva). However obeticholic acid does not improve symptoms, and further research is needed to show whether it slows liver disease progression.

Two medicine capsules in the palm of a hand.
Doctors treat primary biliary cholangitis with medicines.

How do doctors treat the symptoms of primary biliary cholangitis?

Your doctor may recommend over-the-counter medicines or prescribe medicines to treat symptoms of primary biliary cholangitis.

For mild itchy skin, your doctor may prescribe hydroxyzine (Vistaril). For more severe itchy skin, your doctor may prescribe cholestyramine (Locholest, Questran).

How do doctors treat the complications of primary biliary cholangitis?

Doctors treat the complications of primary biliary cholangitis with medicines and dietary supplements. Your doctor may recommend changes in your diet and lifestyle.

High blood cholesterol levels. If you have higher-than-normal blood cholesterol levels, your doctor may prescribe medicines called statins and recommend lifestyle changes.

Osteoporosis. For osteoporosis, your doctor may prescribe medicines that slow or stop bone loss and improve bone density. Your doctor may recommend dietary supplements of calcium and vitamin D.

Fat-soluble vitamin deficiencies. For fat-soluble vitamin deficiencies, your doctor may recommend dietary supplements of vitamins A, D, E, and K. Follow your doctor’s instructions on the type and amount of vitamins you should take.

Cirrhosis. If primary biliary cholangitis leads to cirrhosis, doctors can treat the health problems related to cirrhosis with medicines, surgery, and other medical procedures. If cirrhosis leads to liver failure, you may need a liver transplant.

When do doctors consider a liver transplant for primary biliary cholangitis?

Your doctor will consider a liver transplant when your primary biliary cholangitis leads to liver failure. Doctors consider liver transplants only after they have ruled out all other treatment options. Talk with your doctor to find out whether a liver transplant is right for you.

What can I do to help prevent further liver damage?

To help prevent further liver damage, you can do the following:

  • Carefully follow your doctor’s instructions, and take your medicines and dietary supplements as directed.
  • Quit smoking.
  • Do not drink any alcohol or use illegal drugs.
  • Have regular checkups, as recommended by your doctor.
  • Talk with your doctor before taking
  • Try to keep a healthy body weight.
March 2017
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This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.

The NIDDK would like to thank:
John Moore Vierling,, M.D., Baylor College of Medicine