Drugs
All fibric acid derivatives increase biliary cholesterol saturation while lowering serum cholesterol. Clofibrate is a potent inhibitor of hepatic acyl-CoA cholesterol acyltransferase (ACAT). ACAT inhibition leads to an increased availability of free or unesterified cholesterol for secretion into bile, favouring gallstone formation.[24] Additionally, prolonged use of proton pump inhibitors has been shown to decrease gallbladder function, potentially leading to gallstone formation.[73] The lithogenic role of ceftriaxone, had earlier been mentioned.