Silymarin

Silymarin is a compound of 4 major flavonoids found inside the milk thistle fruit, slightly similar in molecular composition to steroids.

The composition of the drug contains silibinin (about 60%), silicristin (20%), as well as isosilybin and silidanine (10% each). Additional components of the drug are proteins with vegetable oils, histamine with tyramine, K-vitamin, resins, catech tanning components and some other trace elements. [1]

Indications Silymarin

It is used for such disorders:

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

Release form

The drug is released in the form of capsules, tablets, syrup and pills taken orally.

Pharmacodynamics

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

Flavonoids contribute to the improvement of microcirculation in the area of intrahepatic tissues and are involved 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. Together with this, it helps to prevent the passage of toxic ligaments and poisons into the hepatocytes. [2]

Exposure to drugs leads to a slowdown in fatty hepatic degeneration, as well as fibrotic lesions of the hepatic structure. During clinical tests of the drug, it was determined that it significantly improves the health of people with hepatic diseases and stabilizes their biochemical values.

The therapy significantly improves the health of people with liver failure, gradually stabilizing laboratory test results. In addition, there has been a significant increase in the percentage of survival of people with hepatic cirrhosis.

Pharmacokinetics

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

Metabolic processes of drugs develop in the intrahepatic tissues by conjugation.

The half-life is approximately 6 hours. Excretion is mainly realized with bile in the form of glucuronides or sulfates; the remainder is excreted by the kidneys.

The drug does not accumulate inside the body. Prolonged use of 0.42 g of drugs 3 times a day leads to obtaining stable blood counts.

Dosing and administration

It is necessary to use the medication orally, after a meal, with plain water.

In the case of severe disorders in the liver, the drug is usually administered 3 times per day, 0.14 g of the substance. Later, the daily portion is reduced to 0.28 g per day (for 2 applications).

As a supportive agent, take in the amount of 70 mg, 3 times a day.

In pediatrics or the elderly, it is usually prescribed to take the medicine orally in the form of a solution or syrup. Children need to adjust portion sizes. It is often applied in 1 dosage spoon, 3 times a day.

The duration of therapy is determined by various factors and is selected personally for the patient by his treating doctor.

• Application for children

There is not enough information regarding the safety of taking Silymarin in pediatrics, which is why it can be taken to the specified group only with the appointment of a doctor and under his supervision. At the same time, persons under the age of 12 are not prescribed it.

Use Silymarin during pregnancy

It is allowed to use the medication during breastfeeding or pregnancy only with the appointment of the attending doctor. Taking drugs should be done very carefully.

Contraindications

Among the contraindications:

• the presence of allergies to silibinin or similar elements;
• acute poisoning.

It is required to prescribe a medication very carefully for such violations:

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

Side effects Silymarin

This type of medication is often tolerated without complications. Of the side signs that may arise:

• allergy symptoms and diarrhea;
• potentiation of diuresis and nausea;
• epidermal rash of an allergic nature and itching;
• dyspnea, gastric indigestion and alopecia;
• occasionally, disorders of the function of the vestibular apparatus develop.

Overdose

There is no information available on cases of Silymarin poisoning.

If any unusual symptoms appear during therapy with the use of drugs, it is necessary to perform gastric lavage, take enterosorbents orally and consult a doctor. The medicine 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 medication weakens the therapeutic effect of oral contraception, as well as substances that contain estrogen.

The combination with vinblastine, diazepam or lovastatin causes an increase in their medicinal effect.

The use of drugs together with alprozolam increases the plasma parameters of the latter, and also increases the likelihood of negative signs.

Storage conditions

Silymarin must be stored in a place protected from sunlight. Temperature values - no more than 25oC.

Shelf life

Silymarin can be used within 2-5 years (taking into account the form of drug release) from the date of manufacture of the therapeutic agent.

Analogs

The analogues of the drug are the substances Silimar, Karsil, Darsil with Silibinin, Silibor and Silegon with Gepalex, and in addition Geparsil, Legalon with Hypoglisil and Silisem.