OCABEST-10 Tablets OCABEST-10 contains Obeticholic Acid, a semi-synthetic bile acid analogue that acts as a selective and potent agonist of the farnesoid X receptor (FXR), a nuclear receptor expressed at high levels in the liver and intestine. Activation of FXR downregulates the transcription of cholesterol 7 alpha-hydroxylase (CYP7A1), the rate-limiting enzyme in bile acid synthesis, thereby suppressing endogenous hepatic bile acid production. Furthermore, FXR activation increases bile acid efflux from hepatocytes via upregulation of transport proteins and decreases ileal bile acid absorption. This hepatoprotective mechanism reduces hepatocellular exposure to toxic concentrations of bile acids, attenuating inflammation, cholangitis, and progressive hepatic fibrosis. OCABEST-10 is indicated for the treatment of primary biliary cholangitis (PBC) in combination with ursodeoxycholic acid (UDCA) in adults with an inadequate response to UDCA, or as monotherapy in adults unable to tolerate UDCA.