Ocaliva (obeticholic acid) is used to treat primary biliary cholangitis (PBC) in adults, either in combination with ursodeoxycholic acid (UDCA) for patients who don't respond well to UDCA or alone for those who cannot tolerate UDCA. It is for use in patients without cirrhosis or with compensated cirrhosis but no portal hypertension. Ocaliva works by activating the farnesoid X receptor (FXR) in the liver and intestines, reducing bile acid production and alleviating cholestasis in PBC.