Silymarin

Silymarin is a compound of 4 main flavonoids found inside the fruits of milk thistle, somewhat similar in their molecular composition to steroids.

The composition of the medicine contains silibinin (about 60%), silychristin (20%), as well as isosilybin and silidanin (10% each). Additional components of the medicine are proteins with vegetable oils, histamine with tyramine, vitamin K, resins, tannin components of catechu and some other microelements. [ 1 ]

Indications Silymarin

It is used for the following disorders:

• various liver lesions of a toxic nature (intoxication with medications, heavy metal salts or hydrocarbons containing halogen, as well as alcoholism );
• as a prophylactic drug;
• hepatitis, which has a chronic form;
• combination therapy for liver cirrhosis;
• hepatitis of infectious or toxic etiology;
• liver dystrophy and fat infiltration;
• as a medicine that corrects fat metabolism disorders.

Release form

The drug is produced in the form of orally administered capsules, tablets, syrup and dragees.

Pharmacodynamics

Silymarin interacts with free radicals of intrahepatic cells, weakening their toxic activity, and at the same time interrupts the process of lipid peroxidation and prevents the destruction of cell structures.

Flavonoids help improve microcirculation in the intrahepatic tissues and participate in the normalization of hepatocyte walls. The drug stimulates the binding of structural and functional phospholipids to protein molecules, activating the activity of RNA polymerase. At the same time, it helps prevent the passage of toxic ligaments and poisons into hepatocytes. [ 2 ]

The effect of the drug leads to a slowdown in fatty liver dystrophy, as well as fibrous lesions of the liver structure. During clinical testing of the drug, it was determined that it significantly improves the health of people with liver diseases and stabilizes their biochemical values.

The therapy significantly improves the health of people with liver failure, gradually stabilizing laboratory test results. In addition, a significant increase in the survival rate of people with liver cirrhosis is noted.

Pharmacokinetics

Silymarin has a weak absorption capacity. This process lasts 2.2 hours. Once inside the circulatory system, the drug enters the enterohepatic circulation.

Metabolic processes of drugs develop in intrahepatic tissues with the help of conjugation.

The half-life is approximately 6 hours. Excretion occurs mainly in the bile as glucuronides or sulfates; the remainder is excreted by the kidneys.

The drug does not accumulate in the body. Long-term use of 0.42 g of the drug 3 times a day leads to stable blood levels.

Dosing and administration

The medication must be taken orally, after meals, with plain water.

In case of severe liver dysfunction, the medicine is usually administered 3 times a day, 0.14 g of the substance. Later, the daily dose is reduced to 0.28 g per day (in 2 applications).

As a maintenance drug, take 70 mg 3 times a day.

In pediatrics or for the elderly, the medicine is usually prescribed orally in the form of a solution or syrup. For children, portion sizes need to be adjusted. Often, 1 measuring spoon is used, 3 times a day.

The duration of therapy is determined by various factors and is selected individually for the patient by his attending physician.

• Application for children

There is not enough information regarding the safety of taking Silymarin in pediatrics, which is why this group can only take it with a doctor's prescription and under his supervision. However, it is not prescribed to people under 12 years of age.

Use Silymarin during pregnancy

The use of the medicine during breastfeeding or pregnancy is allowed only with the prescription of the attending physician. The drug should be taken very carefully.

Contraindications

Among the contraindications:

• presence of allergy to silibinin or similar elements;
• poisoning of an acute nature.

It is necessary to prescribe the medication very carefully for such disorders:

• uterine fibroids or carcinoma;
• endometriosis;
• ovarian, prostate or breast cancer.

Side effects Silymarin

Often medications of this type are tolerated without complications. Side effects that may occur include:

• allergy symptoms and diarrhea;
• potentiation of diuresis and nausea;
• epidermal rash of allergic origin and itching;
• dyspnea, indigestion and alopecia;
• occasionally, vestibular dysfunction develops.

Overdose

There is no information regarding cases of poisoning with Silymarin.

If any unusual symptoms occur during therapy with the drug, it is necessary to perform gastric lavage, take enterosorbents orally and consult a doctor. The drug has no antidote.

Interactions with other drugs

The combined use of the drug with ketoconazole potentiates the toxic activity of the latter and increases its plasma values.

The drug weakens the therapeutic effect of oral contraception, as well as substances that contain estrogen.

Combination with vinblastine, diazepam or lovastatin increases their medicinal effect.

The use of the drug together with alprazolam contributes to an increase in the plasma levels of the latter, and also increases the likelihood of adverse effects.

Storage conditions

Silymarin should be stored in a place protected from sunlight. Temperature values should not exceed 25°C.

Shelf life

Silymarin can be used within 2-5 years (depending on the form of release of the drug) from the date of production of the therapeutic agent.

Analogues

The analogs of the drug are the substances Silimar, Karsil, Darsil with Silibinin, Silibor and Silegon with Hepalex, as well as Heparsil, Legalon with Hypoglisil and Silisem.