Silymarin

Pharmacological properties

the active substance of the drug darsil - silymarin - is obtained from the extract of the fruit of the plant of milk thistle silybum marianum.

The bioactive components of silymarin neutralize free radicals in the liver, prevent the destruction of cell structures, in particular, stabilize the membranes of hepatocytes. In damaged hepatocytes, they stimulate the synthesis of structural and functional proteins and phospholipids due to specific stimulation of RNA polymerase, prevent the loss of cell components (transaminases), and accelerate the regeneration of liver cells. Inhibit the penetration into the hepatocytes of some poisons, in particular the poison of the fungus is a pale toadstool. Significantly reduce the activity of lipid peroxidation in the membranes of hepatocytes, thereby contributing to their strengthening.

They improve the general condition in patients with liver diseases, reduce subjective sensations (weakness, a feeling of heaviness in the right hypochondrium). They contribute to the normalization of biochemical indicators of the functional state of the liver (activity of transaminases, γ-glutamylaminotransferase, alkaline phosphatase, bilirubin level).

Pharmacokinetics After oral administration, silymarin is slowly but not completely absorbed in the digestive tract. It practically does not bind to plasma proteins. It is metabolized in the liver by conjugation with the formation of sulfates and glucuronides. It is excreted mainly with bile, in the small intestine it is again absorbed into the systemic circulation, making multiple gradually fading enterohepatic circulation. T_½ is about 6 hours. It practically does not cumulate in the body.

Indications

Toxic liver damage: for the supportive treatment of patients with chronic inflammatory liver disease or cirrhosis.

Application

Darsil tablets are taken orally after a meal without chewing, with a sufficient amount of liquid.

Adults and children over the age of 12 years: in cases of mild to moderate severity, the drug is used in a dose of 1-2 tablets 3 times a day, in severe forms of the disease, the dose can be doubled to 2-4 tablets 3 times a day.

The duration of the course of treatment is determined by the doctor individually, depending on the nature and course of the disease. The average duration of treatment is 3 months.

Contraindications

Hypersensitivity to the active substance or to other components of the drug; acute poisoning of various etiologies.

Side effects

The drug is well tolerated. rarely in some cases and with individual hypersensitivity the following side effects may occur.

From the nervous system: headache.

On the part of the hearing organ and labyrinth disorders: amplification of existing vestibular disorders.

From the digestive tract: digestive disorders, loss of appetite, dyspepsia, heartburn, bloating, flatulence, anorexia, nausea, vomiting, diarrhea.

From the respiratory system, organs of the chest cavity and mediastinum: shortness of breath.

From the musculoskeletal system: arthralgia.

From the urinary system: increased urine output.

From the immune system: hypersensitivity reactions, including rashes, anaphylactic shock, itching, alopecia.

Adverse reactions that occur with the use of the drug are transient and disappear after its withdrawal.

special instructions

Drug treatment for liver diseases will be effective when dieting.

In the case of jaundice, you should consult your doctor to correct the therapy.

The drug is used with caution in patients with hormonal disorders (endometriosis, uterine fibroids, carcinoma of the breast, ovary and uterus, carcinoma of the prostate), due to the possible estrogen-like effect of silymarin. In such cases, patients should consult a doctor.

The composition of the drug includes crystalline sugar, this should be considered in patients with diabetes mellitus.

It is necessary to refrain from drinking alcohol during treatment with the drug.

The composition of the drug includes lactose, therefore, in patients with rare hereditary galactose intolerance, lactase deficiency or glucose-galactose malabsorption, the drug should not be used.

Use during pregnancy and lactation. Due to the lack of data on safety and effectiveness, the drug should not be used during pregnancy and lactation.

Children. It is not recommended to use the drug in children under the age of 12 years.

The ability to influence the reaction rate when driving vehicles or other mechanisms. The drug does not affect the reaction rate when driving vehicles or other mechanisms, however, in case of any vestibular disorders, you should refrain from driving vehicles or other mechanisms.

Interactions

With the simultaneous use of silymarin with other drugs, the following interactions are possible:

with oral contraceptives, drugs that are used with estrogen replacement therapy - a decrease in the effectiveness of the latter;

with anti-allergic drugs (fexofenadine), anticoagulants (clopidogrel, warfarin), antipsychotic drugs (alprazolam, diazepam, lorazepam), hypocholesterolemic drugs (lovastatin), some drugs for the treatment of cancer (vinblastine), anti-fungal drugs the effectiveness of the latter (due to inhibition of the cytochrome P450 system by silymarin).

Plant products containing silymarin are widely used as hepatoprotectors in oncological practice simultaneously with cytostatics. Clinical studies show a slight risk of possible pharmacokinetic interactions of silymarin as an inhibitor of the isoenzyme CYP 3A4 and UGT1A1 and cytostatics, which are substrates of these enzymes.

Overdose

No cases of overdose have been identified.

If you accidentally take the drug in a high dose, you should induce vomiting, rinse your stomach, take activated charcoal and, if necessary, apply the symptomatic treatment prescribed by your doctor.

Storage conditions

In the original packaging at a temperature not exceeding 25 ° C.