Adverse Drug Reaction Classification System

Pharmaceutical Information
Drug Name Obeticholic acid
Drug ID BADD_D01592
Description Primary biliary cirrhosis, or PBC, is a progressive and chronic condition that leads to hepatic injury often resulting in end-stage liver failure that requires liver transplantation.[A192786] Obeticholic acid is a farnesoid-X receptor (FXR) agonist used to treat this condition, possibly allowing for increased survival.[A18696] In 2016, it was granted approval to treat primary biliary cholangitis in combination with [ursodeoxycholic acid], which was previously the mainstay treatment for this condition.[A18696,L12633] In May 2021, the FDA updated its prescribing information to contraindicate the use of obeticholic acid in patients with PBC and advanced cirrhosis (e.g. those with portal hypertension or hepatic decompensation) due to a risk of liver failure, in some cases requiring liver transplantation.[L34650] Obeticholic acid is currently being considered for FDA approval to treat fibrosis caused by non-alcoholic liver steatohepatitis (NASH). The NDA from Intercept Pharmaceuticals was approved in November 2019 and obeticholic acid is expected to be granted full approval for this indication in 2020.[L12636]
Indications and Usage Obeticholic acid is indicated for the treatment of primary biliary cholangitis in combination with ursodeoxycholic acid (UDCA) in adults with an inadequate response to UDCA. It is also used as a monotherapy in adults with PBC that are unable to tolerate UDCA.[L12633] Obeticholic acid is currently being considered for FDA approval to treat fibrosis caused by non-alcoholic liver steatohepatitis (NASH), and is likely to be approved for this indication in 2020.[L12636]
Marketing Status approved
ATC Code A05AA04
DrugBank ID DB05990
KEGG ID D09360
MeSH ID C464660
PubChem ID 447715
TTD Drug ID D0M4WA
NDC Product Code 69516-010; 65089-0055; 68554-0121; 47848-056; 73435-004; 69516-005; 63190-0840; 69766-066; 71796-004; 59285-028; 0009-0098; 63190-0830
UNII 0462Z4S4OZ
Synonyms obeticholic acid | 6ECDCA | cholan-24-oic acid, 6-ethyl-3,7-dihydroxy-, (3alpha,5beta,6alpha,7alpha)- | 6alpha-ethyl-3alpha,7alpha-dihydroxy-5beta-cholan-24-oic acid | 6-ECDCA | 6alpha-ethyl-chenodeoxycholic acid | 6-ethyl-3,7-dihydroxycholan-24-oic acid | 6-ethyl chenodeoxycholic acid | 6-ethylchenodeoxycholic acid | DSP-1747 | DSP1747 | Ocaliva | INT 747 | INT747 | INT-747
Chemical Information
Molecular Formula C26H44O4
CAS Registry Number 459789-99-2
SMILES CCC1C2CC(CCC2(C3CCC4(C(C3C1O)CCC4C(C)CCC(=O)O)C)C)O
Chemical Structure
ADRs Induced by Drug
*The priority for ADR severity classification is based on FAERS assessment, followed by the most severe level in CTCAE rating. If neither is available, it will be displayed as 'Not available'.
**The 'Not Available' level is hidden by default and can be restored by clicking on the legend twice.
ADR Term ADReCS ID ADR Frequency (FAERS) ADR Severity Grade (FAERS) ADR Severity Grade (CTCAE)
Haemorrhage24.07.01.002---
Varices oesophageal07.15.05.001; 09.01.06.009; 24.10.02.0040.002085%-
Chronic hepatic failure09.01.03.0090.001564%-
Ocular icterus01.06.04.007; 06.08.03.009; 09.01.01.0070.004587%-
Hot flush08.01.03.027; 21.02.02.001; 24.03.01.0050.020537%
Cardiac disorder02.11.01.0030.006672%-
Inflammation08.01.05.007; 10.02.01.0890.001042%-
Decreased appetite08.01.09.028; 14.03.01.0050.022413%
Renal neoplasm16.08.03.001; 20.01.04.0040.001042%-
Ill-defined disorder08.01.03.0490.005317%-
Drug intolerance08.06.01.0130.014490%-
Hepatic lesion09.01.08.0050.002085%-
Unevaluable event08.01.03.0510.015533%-
Poor quality sleep17.15.04.002; 19.02.05.0050.002293%-
Bowel movement irregularity07.02.03.0030.003544%-
Skin haemorrhage23.06.07.001; 24.07.01.1030.006359%-
Liver injury09.01.07.022; 12.01.17.0120.001042%-
Adverse reaction08.06.01.0180.003544%-
Vulvovaginal burning sensation21.08.02.0070.002293%-
Anorectal discomfort07.03.03.0030.002293%-
Oropharyngeal pain07.05.05.004; 22.12.03.0160.021579%
Hepatic cancer09.04.02.008; 16.07.02.0040.001564%-
Hepatocellular carcinoma09.04.02.010; 16.07.02.0050.002606%-
Oesophageal ulcer haemorrhage07.04.05.007; 24.07.02.0510.001042%-
Concomitant disease progression08.01.03.0640.001564%-
Gastric varices07.15.03.004; 09.01.06.013; 24.10.02.0050.001042%-
Breast cancer metastatic16.10.01.008; 21.05.01.0160.001564%-
Hepatic mass09.01.08.0150.001042%-
Biliary obstruction09.02.02.0050.001042%-
Illness08.01.03.0910.003127%-
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