Milk thistle extract - instructions for use, dose, side effects, contraindications

Means of plant origin. The main is the hepatoprotective effect. Flavolignans, including silybin, dehydrosilibin, isosilibin, silymarin, dehydrosilimarin, silichristine, tasifolin (2.8-3.8%) stabilize the lysosomal and cell membranes, preventing the escape of enzyme cells.

Interacts with free radicals in the liver and reduces their toxicity. Interrupting the process of lipid peroxidation, prevents further destruction of cellular structures. In damaged hepatocytes stimulates the synthesis of structural and functional proteins and phospholipids (due to specific stimulation of RNA polymerase A), stabilizes cell membranes,prevents the loss of cellular components and intracellular enzymes (transaminases), accelerates the regeneration of liver cells. It inhibits the penetration into the cells of some hepatotoxic substances (poison fungus pale toadstool).

It improves the general condition of patients with liver diseases, reduces subjective complaints, normalizes laboratory indicators (transaminase activity, gamma-glutamyltransferase, alkaline phosphatase, bilirubin level). Long-term use significantly increases the survival rate of patients suffering from cirrhosis of the liver.

Pharmacokinetics:Absorption is low and slow (the half-absorption period is 2.2 h). Subjected to enterohepaticheskth circulation. Metabolized in the liver by conjugation, the half-life is 6 hours. Excretion occurs predominantly with bile in the form of glucuronides and sulfates, to an insignificant extent with urine. Do not cumulate. After repeated oral administration of 140 mg 3 times a day, a stable concentration is achieved.

Indications:Toxic liver damage (alcoholism, intoxication with halogenated hydrocarbons, heavy metal compounds, medicinal liver damage including those caused by the use of aminoglycosides, tetracycline, immunosuppressants, NSAIDs, antituberculosis drugs, barbiturates, tranquilizers; organic solvents; poisoning with mushrooms) and their prevention. Chronic hepatitis, cirrhosis (as part of complex therapy), hepatocholecystitis, operations on the organs of the abdominal cavity; dyskinesia biliary tract, pancreatitis. Conditions after infectious and toxic hepatitis, dystrophy and fatty liver infiltration. Correction of lipid metabolism disorders, prevention of atherosclerosis.

ICD-10

XI.K70-K77.K70.1 Alcoholic Hepatitis

XI.K70-K77.K70.0 Alcoholic fatty degeneration of the liver [fatty liver]

XIX.T51-T65.T53 Toxic effect of halogenated derivatives of aliphatic and aromatic hydrocarbons

IV.E70-E90.E78 Disorders of lipoprotein metabolism and other lipidemia

XI.K70-K77.K71 Toxic liver disease

XI.K70-K77.K73.9 Chronic hepatitis, unspecified

XI.K70-K77.K74 Fibrosis and cirrhosis of the liver

XI.K70-K77.K76.0 Fatty degeneration of the liver, not elsewhere classified

XIX.T51-T65.T56 Toxicity of metals

Contraindications:Hypersensitivitychildren under 12;

Carefully:Patients with hormonal disorders (endometriosis, uterine myoma, carcinoma of the breast, ovaries and uterus, prostate carcinoma) - possibly the manifestation of estrogen-liketh effect of silymarin

Pregnancy and lactation:Category FDA is not defined. During pregnancy and lactation (breastfeeding), the use of the drug is not recommended.

Dosing and Administration:

Inside after eating, without chewing and washing down with a small amount of water. For treatment of severe liver damage, 0.14 g 3 times a day is prescribed, then 0.14 g 2 times a day, in less severe cases and for maintenance therapy - 0.07 g 3 times a day. Elderly patients and children are preferably used in the form of a solution for oral administration. With severe liver damage: adults - 1 scoop 4 times a day, children - 1 scoop 3 times a day; for maintenance therapy (3 times a day): adults - 1 scoop, children - 1/2 teaspoon.

Duration of treatment - at least 3 months.

Side effects:Diarrhea, allergic reactions.

Overdose:

To date, no cases of overdose have been reported.

Treatment: In case of accidental admission in a high dose, you should induce vomiting, perform gastric lavage with activated charcoal, symptomatic treatment.

Interaction:

Alprazolam. When combined application Milk thistle fruit extract, an inhibitory system of cytochrome P450, can enhance the effect of alprazolam.

Vinblastine. When combined application Milk thistle fruit extract, an inhibitory system of cytochrome P450, can enhance the effect of vinblastine.

Diazepam. When combined application Milk thistle fruit extract, an inhibitory system of cytochrome P450, can enhance the effect of diazepam.

Ketoconazole. When combined application Milk thistle fruit extract, an inhibitory system of cytochrome P450, can enhance the effect of ketoconazole.

Lovastatin. When combined application Milk thistle fruit extract, an inhibitory system of cytochrome P450, can enhance the effect of lovastatin.

Special instructions:

The solution for oral administration can be prescribed to patients with diabetes mellitus, since it does not contain dextrose.

There is a report on the antagonistic interaction of silymarin with yohimbine and phentolamine.

Instructions

Milk thistle extract (Extractum fructuum Sylibi mariani)