Silymarol

Silimarol is a drug with an intense hepatoprotective therapeutic effect.

It contains the active ingredient silymarin, which is obtained from the fruits of a medicinal plant called milk thistle. Silymarin itself is a combination of 4 isomers of flavonolignans (including silychristin, silibinin with isosilibinin, and silidanin). The drug has pronounced antitoxic and hepatoprotective properties. [ 1 ]

Indications Silymarol

It is used in cases of liver intoxication and in maintenance therapy in individuals with chronic liver inflammation orliver cirrhosis.

Release form

The medicine is released in tablets - 15 pieces in a cell pack; in a box - 2 such packs.

Pharmacodynamics

It has been found that silymarin has an antagonistic effect on many hepatotoxic elements, including toxins of the mushroom Amanita phalloides, galactosamine with lanthanides, thioacetamide and tetrachloromethane. The antihepatotoxic effect develops with the competitive interaction of silymarin with the endings of the corresponding toxins inside the hepatocyte wall (thus developing a membrane-stabilizing effect). As a result, the processes of liver fibrosis and steatosis are slowed down.

The drug exhibits cell-regulating and metabolic activity, affecting the strength of cell walls, inhibiting the 5-lipoxygenase pathway (especially affecting leukotriene B4) and synthesizing with reactive free oxygen radicals.

The medicine promotes activation of phospholipid and protein binding (functional and structural proteins) inside infected liver cells (stabilizes lipid metabolism), normalizes the strength of their cell walls and synthesizes free radicals (has an antioxidant effect), thereby protecting intrahepatic cells from negative influences, and also helping to restore them.

The effect of flavonoids, including silymarin, is due to their antioxidant properties and positive effect on microcirculation. The clinical expression of these effects is the stabilization of liver function values (reduction of bilirubin, transaminase and γ-globulin levels) and improvement of objective and subjective signs. As a result, the general condition improves and the number of complaints regarding digestive function decreases, and in people with impaired digestibility of food (associated with liver diseases), appetite improves.

Pharmacokinetics

Silimarol is absorbed at a low rate in the gastrointestinal tract (the absorption half-life is 2.2 hours).

It is subject to intensive distribution within the body, in high concentrations it is registered in the liver; minor amounts are noted in the lungs with kidneys, heart and other organs. Metabolic processes occur in the liver by means of conjugation.

Excretion occurs mainly with bile (approximately 80%) in the form of sulfates with glucuronides; the remainder is excreted with urine (approximately 5%). Approximately 40% of silymarin excreted with bile returns to the intrahepatic circulation. The half-life is 6 hours. The drug does not accumulate in the body.

Dosing and administration

The medication should be taken in a dosage of 2 tablets, 3 times a day, after meals.

The duration of the therapeutic cycle is selected individually by the attending physician, taking into account the nature and course of the pathology. On average, therapy usually lasts 3 months.

• Application for children

Silimarol is not prescribed to persons under 12 years of age, because there is no information regarding the use of the drug in this category.

Use Silymarol during pregnancy

There is no information regarding the medicinal efficacy and safety of the drug when used in pregnant or breastfeeding women, which is why it is not used during these periods.

Contraindications

It is contraindicated for people with severe intolerance to elements of the drug or plants from the Rosaceae order, as well as in cases of acute intoxication of various origins.

Side effects Silymarol

The medication is often tolerated without complications. In case of severe personal intolerance, the following side effects may be observed:

• digestive disorders: vomiting, heartburn, dyspepsia, mild diarrhea and nausea;
• respiratory dysfunction: dyspnea;
• problems with the urinary tract: potentiation of diuresis;
• epidermal lesions: potentiation of alopecia. Allergy symptoms may also occur, including itching and rash on the epidermis;
• other: possible potentiation of existing vestibular disorders.

Negative symptoms are transient and disappear after discontinuation of the drug without any special procedures.

Overdose

There have been no cases of poisoning with Silimarol.

If a large dose is accidentally administered, gastric lavage, vomiting, and activated charcoal should be induced. Symptomatic measures should be taken if necessary. There is no antidote.

Interactions with other drugs

The combined use of drugs in the highest possible doses and oral contraception or substances administered during estrogen replacement therapy may lead to a weakening of the medicinal effect of the latter.

Since silymarin suppresses the action of the hemoprotein P450 system, it can potentiate the effect of certain medications, including: hypocholesterolemic agents (lovastatin), antiallergic drugs (fexofenadine), antipsychotics (alprazolam with diazepam and lorazepam), as well as anticoagulants (warfarin with clopidogrel), antifungals (ketoconazole) and certain medications for the treatment of carcinoma (vinblastine).

Storage conditions

Silimarol should be stored in a place closed to children. Temperature level – no more than 25°С.

Shelf life

Silimarol is approved for use for a period of 36 months from the date of manufacture of the pharmaceutical product.

Analogues

Analogues of the drug are the following drugs: Hepalex, Darsil with Simepar, Heparsil and Karsil with Levasil, as well as Silibor, Legalon and Geparette.