Lithium orotate, for example, has been investigated for use in treating alcoholism,[4][5] and complexes of cobalt, manganese, nickel, and zinc are known.

[6] The pentahydrate nickel orotate coordination complex converts into a polymeric trihydrate upon heating in water at 100 °C.

[6][7][8] Crystals of the trihydrate can be obtained by hydrothermal treatment of nickel(II) acetate and orotic acid.

In ornithine transcarbamylase deficiency, an X-linked inherited and the most common urea cycle disorder, excess carbamoyl phosphate is converted into orotic acid.

The hyperammonemia depletes alpha-ketoglutarate leading to the inhibition of the tricarboxylic acid cycle (TCA) decreasing adenosine triphosphate (ATP) production.