Hepatoprotectors with proven effectiveness for the liver - names, list. Hepatoprotectors: a complete list of drugs with proven effectiveness and price (inexpensive and expensive drugs) What is the best hepatoprotector

The list of hepatoprotective drugs with proven effectiveness cannot be called extensive. Pharmacies sell more than 700 types of hepatoprotectors of various origins. The protective and therapeutic effect of most of them is confirmed only by a subjective parameter - an improvement in well-being. Only a few drugs have undergone controlled studies (suppression). Among them are products with ursodeoxycholic acid and milk thistle extract.

Indications for the use of liver protective drugs

Hepatoprotectors with proven clinical effectiveness help with various liver diseases. They are prescribed:

against cirrhosis caused by a virus;
against alcohol;
for treatment (impaired flow of bile into the intestines);
after chemotherapy, s;
with (hepatoprotectors normalize the functioning of the biliary system);
in the liver against the background of diabetes mellitus.

Hepatoprotectors for hepatitis C are of particular importance. They help the body get rid of infection and maintain the integrity of liver cells.

Classification of hepatoprotectors

Clinical pharmacology allows us to understand which drug can be called the most effective. Since existing hepatoprotectors for the liver only partially meet the requirements put forward by Professor R. Preisig (1970), none of them can be called ideal. Hepatoprotectors are classified into groups taking into account their origin and chemical structure.

List of essential phospholipids

The preparations are made from highly purified soybean extract. The essential phospholipids contained in soy restore liver cells (hepatocytes), maintain their structure and participate in the transport of protein molecules through cell membranes. Today the effectiveness of the following drugs has been proven:

Essentiale forte H. The hepatoprotector is sold in capsules or in the form of liquid for injection (prescribed in severe cases). Recommended for viral and. The drug prevents narrowing of the bile ducts. The product is contraindicated for children under 12 years of age.
Essel forte. The drug is enriched with vitamins B and E. It is effective for various diseases of the digestive gland and its . The hepatoprotector is available in tablets.
Rezalut Pro. Sold in capsules of 30, 50 and 100 pieces per package. Prescribed for toxic poisoning, cirrhosis and fatty liver.

The duration of treatment with any essential phospholipid is individual. The daily adult dose is 6 capsules.

List of hepatoprotectors from amino acids

Preparations with aminocarboxylic acids may contain:

Ademethionine (Heptral, Heptor). The amino acid stimulates the production of phospholipids in the body, providing liver cells with a regenerating and detoxifying effect. Heptral and Heptor are administered intravenously for severe pathologies and are prescribed in tablets for moderate diseases. The drugs are considered hepatoprotectors, which help maintain the overall health of the body (improve metabolic processes, improve the quality of blood, promote the flow of bile into the intestines) in case of chronic.
Ornithine aspartate (Hepa-merz, Larnamin) - an amino acid that helps cope with hyperammonemia (poisoning of the body with ammonia, the enzyme urea), which is a consequence of liver intoxication. Preparations containing ornithine aspartate are expensive, which is why they are rarely prescribed for preventive purposes. Release form Hepa-merz is a granulated powder for the preparation of an oral solution, Larnamin is a liquid for injection in ampoules, granulated powder in a sachet.

Therapy with animal liver extracts

Any hepatoprotector based on animal components should only be purchased with a doctor's prescription.

Inexpensive drugs:

Hepatosan - contains an extract from pig liver cells. It has a therapeutic effect on fatty hepatosis and non-infectious cirrhosis. It is taken for two weeks, 2 capsules three times a day.
Sirepar is an analogue of Hepatosan, enriched with vitamin B12, which promotes normal hematopoiesis. Available in the form of a solution for intravenous administration.
Progepar - contains cattle liver extract. Prescribed for any lesions of the gland, with the exception of. Sold in tablets, which are taken in 1-2 pieces. 3 times a day for 2-3 months.

Hepatoprotective drugs based on animal components increase the risk of allergies. Therefore, they are not prescribed without determining the level of sensitivity of the body to their active components.

Modern hepatoprotectors with bile acids

Manufactured using chenodeoxycholic and ursodeoxycholic acid. The first gives many side effects (nausea, biliary colic, allergies, diarrhea). Contained in the preparations Henofalk, Henosan, Henochol. They are taken to destroy cholesterol.

According to doctors, the most effective hepatoprotector is the one made using ursodeoxycholic acid:

Ursosan;
Ursodez;
Ursofalk;
Livodex;
Ursoliv et al.

Preparations with UDCA are indicated for relieving symptoms of biliary cirrhosis, for the treatment of acute hepatitis, and drug-induced liver damage. The dosage and duration of therapy is individual. Due to the strong choleretic effect of bile acid, these drugs are not prescribed to patients with large.

Preparations of natural origin based on plants

Frequently prescribed hepatoprotectors of plant origin:

Gepabene;
Geparsil;
Karsil;
Legalon;
Silibor;
Silimar.

The name with the prefix “Forte” indicates that the drug has an enhanced effect.

These preparations are made using silymarin (the active substance of the extract). Its hepatoprotective properties help restore the liver affected by acute or chronic hepatitis and cirrhosis. To solve the problem of gland health, it should be taken for at least three months in a row.

Hepatoprotectors of plant origin also include preparations containing artichoke extract. They are sold in tablet form and gelatin capsules:

Chophytol;
Holiver;
Febichol.

The duration of use and dosage of hepatoprotectors is recommended by the attending physician, taking into account the type and severity of the disease.

Combined medications for the gallbladder and liver

List of new and known combined type hepatoprotectors (contain substances from different pharmacological groups):

Sirin - the drug contains methionine, extracts of artichoke, milk thistle, Schisandra chinensis and other plants. The product is drunk for 30-45 days, 1-2 tablets. morning and evening after meals.
Gepadif - a hepatoprotector is prescribed for alcohol, drug and infectious liver intoxication. Contains two amino acids (adenine, carnitine), enriched with B vitamins. Available in capsules (daily dose 4-6 pieces) and powder for infusion. Treatment may last two or more months.
Eslidin - contains the amino acid methionine and phospholipids. Sold in capsules. Take 2 pcs. three times a day for 1-3 months in a row.
Detoxil - made from extracts of artichoke, grapefruit, dandelion and methionine. The drug is fortified (vit. A, E, C, B). Sold in tablets. Take 1-2 pieces a month. in a day.

Combined hepatoprotectors are prescribed for prevention purposes and for diffuse liver changes.

Dietary supplements and homeopathic medicines

Hepatoprotective products and herbs

seaweed;
pumpkin pulp;
low-fat fermented milk products;
dried apricots, prunes, raisins;
olives, olive oil;
meat and fish of dietary grades;
oat, millet, buckwheat cereals.

Every day you need to drink a decoction of rose hips or hawthorn, teas and infusions of hepatoprotective herbs - calendula flowers, nettle, milk thistle, artichoke.

Lifestyle

It is important for people with a diseased liver to lead an active lifestyle, but they should not subject the body to heavy stress. In a person who moves little, the processing of animal fats slows down. They are deposited in hepatocytes, which can provoke. The same thing happens to the liver of people who periodically engage in intensive sports, for example, in order to lose excess weight. For quick recovery, doctors recommend taking hour-long walks in the fresh air every day. Smokers should give up the bad habit.

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Schiff, Eugene R. Introduction to Hepatology / Eugene R. Schiff, Michael F. Sorrell, Willis S. Maddray; lane from English edited by V. T. Ivashkina, A. O. Bueverova, M.V. Mayevskaya. – M.: GEOTAR-Media, 2011. – 704 p. – (Series “Liver diseases according to Schiff”).
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Dear friends, hello!

The topic of today's conversation is hepatoprotective drugs. Your colleague and my co-author Anton Zatrutin helped me figure them out.

We will discuss:

How are hepatoprotectors divided?
When are they used?
How do drugs that belong to the same group of hepatoprotectors differ from each other?
When is it best to offer what?

How are hepatoprotective drugs divided?

All hepatoprotector drugs can be divided into 4 groups:

Essential phospholipids.
Amino acids.
Sequestrants (that is, “isolators”) of fatty acids.
Hepatoprotectors of plant origin.

Let's look at each group.

Essential phospholipids

Phospholipids are the main component of the membrane of any cell.

To create drugs, they are obtained from soybeans.

Various damaging factors (alcohol, hepatotoxins, etc.) destroy phospholipids in hepatocyte membranes, as a result of which intracellular metabolism is disrupted and the cells die.

Phospholipids are not only a building material for the cell membrane. They take part in cell division, transport of molecules within it, and stimulate the activity of various hepatocyte enzymes.

When taken orally, they, like other fat molecules, are broken down by pancreatic lipase and absorbed through the intestinal wall in a “disassembled” form - in the form of phosphatidylcholine (remember this name) and residues of unsaturated fatty acids. Moreover, only part of the incoming phospholipids is absorbed, and part is excreted through the intestines.

It is in a “disassembled” form that the drug enters the liver and, as needed, is reassembled into a phospholipid molecule.

In case of severe liver dysfunction, parenteral administration of the drug is necessary, since the affected liver will not be able to assemble the molecules “disassembled” in the intestines into medicine.

Another important point.

If there are problems with the pancreas and it produces insufficient amounts of lipase, then phospholipids in the intestine will not be absorbed. Therefore, taking drugs from this group in this case does not make sense.

In addition, you know that there are drugs for that suppress lipase activity. This is Orlistat (Xenical, Orsoten). Therefore, when a buyer purchases, for example, Xenical and asks for Essentiale Forte, explain that they will not “work” together. Offer a hepatoprotector from another group.

What do phospholipids do?

They are integrated into the membranes of the hepatocyte instead of their dead counterparts.
They bind free radicals that are formed under the influence of toxins.

But here there are two catches

First . Considering that some of the phospholipids entering the body are destroyed, the effectiveness of these drugs is low and they must be taken for a long time. For this reason, products based on essential phospholipids are registered as dietary supplements in many countries.

Second . The active substance of phospholipids is precisely the same phosphatidylcholine mentioned above. In the instructions, its content is indicated as a percentage next to the phospholipid content.

For example, if there are 300 mg of phospholipids, and 29% of phosphatidylcholine in them, then it turns out that the active substance is only 87 mg (29% of 300 mg = 87 mg).

So, by carrying out simple calculations, you can determine which drug contains more active substance.

For example:

Essential Forte N and Rezalut Pro contain 228 mg of phosphatidylcholine, Essliver Forte contains 87 mg, and Phosphogliv contains 48 mg.

When are essential phospholipids used?

For liver diseases.
For toxic liver damage: medications, alcohol, etc.
To protect the liver when taking medications and alcohol.

Let's look at popular drugs in more detail.

It contains 300 mg of phospholipids, of which 76% is phosphatidylcholine (228 mg).

It is noteworthy that the indications name toxicoses, among others. I wonder why the drug works in this case?

Take 2 capsules 2-3 times a day for at least 3 months, which means that for liver disease, a minimum of 360 capsules is needed per course.

Children - from 12 years old.

Pregnant, lactating Can.

Rezalut Pro

Rezalut Pro is similar to Essentiale Forte. Contains 300 mg of phospholipids (also 76% phosphatidylcholine - 228 mg).

So the composition of the drugs is interchangeable. Only you will give the first one to the one who prefers well-known drugs, and the second one to the one who asks for something cheaper.

Children from 12 years old, pregnant, lactating- carefully.

And this is strange, given the similar composition of Rezalut Pro with Essentiale Forte, where there are no such restrictions.

But the first is the original, the second is a copy, and that says it all. We talked about this in detail.

Essliver forte

Contains phospholipids 300 mg, of which the active substance is 87 mg, as well as vitamins B1, B2, B6, B12, PP, E.

With love to you, Marina Kuznetsova and Anton Zatrutin

Recently, the number of people suffering from liver diseases has increased significantly. Fortunately, modern pharmacology offers many ways to, if not completely cure, then at least alleviate these diseases. One of the groups of drugs that perform a similar function includes hepatoprotectors.

What functions does the liver perform?

The liver is one of the most important organs of the human body. In fact, this is a huge gland that takes part in many processes of the body - the metabolism of various substances, including those coming from the outside, in the production of bile, which is involved in the digestion process

Main functions of the liver:

Detoxification,
Processing of vitamins and microelements,
Digestion.

Detoxification

The liver is primarily designed to break down and remove toxins from the body. Toxins can come directly from the environment, where their sources can be chemicals or medications, or they can be formed during the digestion process. Such compounds include phenol, acetone, and ketone compounds.

Processing of vitamins and microelements

The liver receives various vitamins, both fat-soluble and water-soluble (D, E, K, B, PP, A), as well as trace elements - copper, iron, folic acid. In the liver they are metabolized and become available to the body.

Digestion

The liver produces a special fluid - bile. It enters the gallbladder, and then into the duodenum through the bile ducts and participates in the digestion process, breaking down complex fats and proteins.

Other features

The liver is also responsible for functions such as:

regulation of hormone levels,
accumulation of glucose,
production of cholesterol and lipids,
regulation of blood clotting and volume,
regulation of metabolism,
synthesis of antibodies and immunoglobulins,
hematopoiesis (during intrauterine development and early childhood).

Causes of liver diseases

The load on the liver is very high. And for this reason, the liver needs protection. The liver especially suffers if the body is poisoned by some chemicals or alcohol. In this case, liver cells may not cope with their functions and liver diseases such as cirrhosis appear. Infectious hepatitis that affects the liver can also add to these problems.

What factors can negatively affect liver function:

drug use,
diabetes,
unhealthy diet
poor environmental situation,
drug treatment,
obesity,
genetic factors
insufficient physical activity.

A class of medications called hepatoprotectors are designed to protect the liver from such complications. They, of course, will not replace medications that fight the causes of liver disease, such as antiviral drugs, but they can improve the functioning of liver cells.

Prevention of liver diseases

Preventing liver diseases is the most reliable guarantee that you will not need to spend huge sums on hepatoprotectors.

Prevention includes the following measures:

refusal to drink alcohol;
proper nutrition, avoidance of spicy and fatty foods;
hygiene to prevent viral hepatitis;
hepatitis vaccination;
refusal of uncontrolled use of medications;
high physical activity;
control of excess weight, blood sugar;
timely treatment of diseases that can affect the functioning of the liver - infectious.

Indications for the use of drugs for the treatment of liver diseases

Hepatoprotectors are used in case of the following diseases:

alcoholic liver damage,
drug-induced liver damage,
viral hepatitis,
cirrhosis and hepatosis of various etiologies,
fatty liver disease in diabetes and obesity,
alcoholic liver damage.

Alcoholic hepatitis

If excessive alcohol intake has led to severe liver dysfunction leading to cirrhosis, then many doctors prescribe hepatoprotectors to patients. However, this type of drug is not a miracle elixir and cannot on its own cure a diseased liver. First of all, the patient needs to get rid of the addiction. Otherwise, the use of any medications is pointless.

Fatty liver hepatosis

This disease is diagnosed in many people suffering from diabetes and obesity. The disease can also appear as a result of poor nutrition, eating large amounts of spicy and fatty foods. The disease is expressed in the fact that a fatty layer begins to form in the liver, as a result of which the efficiency of the liver decreases. As in the case of alcoholic cirrhosis, in this case drugs alone will not be enough. The patient must simultaneously follow a diet and begin to lose excess weight, increase physical activity, and take medications to lower cholesterol or blood sugar.

Drug-induced or toxic hepatitis

Taking certain medications or ingesting toxic substances can lead to severe liver dysfunction. In this case, the doctor may also prescribe medications designed to help restore liver tissue and functionality.

Viral hepatitis

There are several types of hepatitis, differing from each other in their pathogens. These diseases are distinguished from each other by the letters A, B, C, D, E. The disease can either be transmitted through infected people or occur as a result of weakened immunity and failure to comply with personal hygiene rules. Most hepatitis is a serious disease, the treatment of which is complex and expensive. Of course, hepatoprotectors will not replace standard antiviral drugs and diet. However, in many cases they will be able to reduce the effect caused by viral tissue damage.

Which product should I choose?

The list of drugs for the treatment of liver diseases is very long, and often the patient does not know which drug is suitable for his case.

There is no clear answer to the question of which medicine is the most effective. To choose the necessary remedy for the treatment of liver diseases, you need to see a doctor so that he can select a good medicine and tell you what to drink. The doctor will also help you make a choice between two drugs that are similar in their properties and suggest, for example, which is better - Hepatrin or Ovesol, Liv 52 or Karsil, Hofitol or Kkarsil. The fact is that many liver medications have contraindications. In addition, in order to determine liver disease, it is necessary to undergo some diagnostic procedures - ultrasound, tests. Hepatoprotectors should not be taken just like that, for the sake of prevention - a healthy liver does not require protection. Each liver drug is aimed at solving one specific problem.

You should purchase liver restoration tablets based on indications, effectiveness and availability. Many patients hesitate, not knowing what to buy and wonder, for example, Gepamerz or Essentiale - which is better for the price? Although such a question can hardly be considered appropriate, since you should choose drugs based not so much on the price, but on their properties. In addition, it is worth remembering that there are no inexpensive and effective drugs; inexpensive drugs are most often ineffective, or even just dummies.

Drugs for the treatment of liver diseases can be made from both plant and synthetic components. There are drugs for the liver that are available only in tablet form, there are injectable drugs, and there are drugs that have both dosage forms.

There are several types of drugs for the treatment of liver diseases:

medications for the liver based on animal components;
medicines for the liver based on herbal ingredients;
amino acids;
drugs based on ursodeoxycholic acid;
amino acids;
dietary supplements;
vitamins;
essential phospholipids;
inhibitors of lipid peroxidation.

Liver products based on animal ingredients

In preparations based on animal components, ingredients obtained from the liver of farm animals - pigs, cattle - are used.

According to the manufacturers of this type of preparation, they have a detoxifying and antioxidant effect and stimulate parenchyma regeneration.

These liver remedies have many contraindications and side effects. For example, they can cause severe allergic reactions, and can also cause infection with intractable infectious diseases. Therefore, before administering the drug, it is recommended to check the patient’s individual tolerance to the drug. Examples of such drugs are Hepatosan, Progepar, Sirepar.

Medicines for the liver from this group are available with a doctor's prescription. Used in the treatment of:

fatty hepatosis,
medicinal and toxic hepatitis,
cirrhosis.

The disadvantage of drugs in this group is that they can only be used for chronic hepatitis, and not for its active form.

Herbal preparations

In folk medicine, various plants have long been known to help people with liver disease. Some extracts from these plants are now used in preparations designed to support the liver. Compared to other types of drugs, drugs based on herbal components have a minimum number of contraindications. Herbal preparations have a choleretic effect, improve digestion, and normalize protein synthesis.

Among the herbal ingredients, the following extracts should be noted:

milk thistle fruits,
pumpkin seeds,
artichoke.

Drugs based on them to support the liver have long been used in folk medicine and have proven themselves well.

Also in herbal, homeopathic preparations and dietary supplements you can find components of the following plants:

medicinal fume,
yarrow,
cassia,
dandelion,
club moss,
cinchona,
celandine.

Milk thistle

The most widely used drugs are those based on the fruits of milk thistle. These plants contain a unique complex of vitamins and microelements. There are more than 200 different biologically active substances in the plant. Among them it is worth noting:

copper,
zinc,
selenium,
vitamins,
polyunsaturated fatty acids.

But the most effective component found in milk thistle preparations is silymarin, which is a complex of flavonoid substances - silybin, silicristin and silydianin. Scientists believe that they are responsible for the beneficial properties of milk thistle. Silymarin is also used as an antidote for toadstool poisoning. It has the following properties:

antioxidant,
anti-inflammatory,
regenerative,
antitoxic.

It also stimulates the formation of new liver cells, enhances the synthesis of phospholipids and proteins, prevents the appearance of connective tissue in the liver, the formation of free radicals in cells and stops the destruction of cell membranes. However, for most acute or toxic hepatitis, drugs based on silymarin are ineffective and require additional therapy. The course of treatment with silymarin preparations usually lasts several months.

Artichoke

The artichoke has also earned the reputation of a liver healer in folk medicine. It contains proteins, fats, carbohydrates, organic acids, vitamin C, P, B1, B2, B3. It has a choleretic effect, improves metabolism and reduces bad cholesterol levels. The active substances in artichoke responsible for its hepatoprotective properties are cynarin and cynaridine. They allow you to increase the production of bile and bile acids, promote the restoration of liver cells. Medicines based on artichoke extract are used in the treatment of hepatitis, alcohol intoxication, cholecystitis, and cirrhosis.

pumpkin seeds

Preparations based on pumpkin seed oil are also widely used as hepatoprotective agents. And this is not without reason, because pumpkin seeds contain a number of fatty acids important for health - oleic and linoleic, as well as a number of vitamins - B, C, beta-carotene and niacin, essential oils, tocopherol. There is reason to believe that pumpkin seed oil has an antioxidant effect and can stop the destruction of hepatocyte cells.

The best medicines for the liver based on herbal components are Gepabene, Karsil, Hofitol, Galstena, Hepel, Legalon, Liv 52, Tykveol, Peponen.

Karsil

Milk thistle preparation with antitoxic effect. Improves cellular metabolism. The main active ingredient is silymarin.

Release form: Tablets containing 22.5 mg of silymarin.

Indications for use: Liver damage of a toxic and alcoholic nature, inflammatory liver diseases, cirrhosis.

Contraindications: acute intoxication, age under 5 years.

Application: The tablets are taken whole and should be washed down with water. Taking pills does not depend on food intake. The standard dosage for adults (over 12 years of age) is 1-2 tablets three times a day. The dosage for children under 12 years of age is calculated based on body weight (3 mg per 1 kg). The duration of treatment depends on the severity of the condition. The standard course of treatment is 3 months.

Essential phospholipids

This is another common class of liver medications. As a rule, they contain soybean extract. They contain phosphatidylcholine and unsaturated fatty acids. The principle of their action is based on the fact that they contain substances that help liver cells restore their own walls, more than half consisting of phospholipids. In addition, phospholipids are designed to improve intracellular metabolism, enhance the detoxification ability of cells, neutralize poisons coming from the intestines, reduce energy costs of the liver, prevent the appearance of connective tissue in the liver, improve the effectiveness of interferons and have antioxidant properties. The most famous substance belonging to the class of phospholipids is lecithin.

Phospholipids are prescribed for the following liver diseases:

fatty tissue degeneration;
cirrhosis;
alcoholic, viral or toxic hepatitis, including chronic.

The most common drug in this class is Essentiale Forte. It can be produced both in tablets and in dosage form for injections and infusions. Other drugs of this class include Phosphogliv and Antraliv.

Essential phospholipids showed the greatest effectiveness when used simultaneously with interferons during the treatment of viral hepatitis C.

The disadvantage of these drugs for liver restoration is that in order to feel the effect, you need to take them for a long time, at least six months. In some cases, phospholipids can cause bile stagnation. They are also quickly metabolized when taken orally and only a small portion of the drugs reaches the liver.

Essentiale Forte

A drug for restoring a diseased liver. The drug is based on soybean extract containing up to 76% phospholipids. Phospholipids are designed to protect liver cells by providing the body with substances that make up the membranes of hepatocytes.

Release form: Gelatin capsules containing 300 mg of active ingredients.

Indications: it is recommended to use the drug for fatty liver degeneration, hepatitis, including alcoholic, cirrhosis, psoriasis (as an additional remedy), toxicosis of pregnancy, as well as for the prevention of the formation of gallstones.

Contraindications: age under 12 years, individual sensitivity to the components of the drug.

Side effects: disorders of the gastrointestinal tract, itching, urticaria.

Application: Two capsules three times a day with meals. The duration of treatment should be determined by the doctor individually.

Amino acids

Amino acids perform many functions in the liver. First of all, they participate in the synthesis of phospholipids, break down fats, and have a regenerating and detoxifying effect.

The most commonly used amino acid in hepatoprotectors is ademetionine. Other amino acids, such as ornithine, are also used.

However, many drugs for treating the liver with amino acids have shown effectiveness only when administered intravenously. When taken orally, amino acids are metabolized quite heavily and only a relatively small part of them reaches the liver.

Among this type of drugs, Heptral can be noted. It is a popular hepatoprotector, also used as an antidepressant. It can be used as a means to normalize metabolism in the liver. Heptral is based on ademetionine.

The drug Hepa-merz is based on ornithine aspartate. It helps reduce ammonia levels and can be used to protect the nervous system from the negative effects of liver products.

Scope of application of amino acids:

fatty hepatosis,
chronic hepatitis,
toxic hepatitis.

Another drug based on amino acids, Heptor, is also often used.

Drugs in this group can be taken in tablets or administered by infusion (using droppers).

Heptral

An antidepressant with hepatoprotective, antioxidant, detoxification, neuroprotective, choleretic and cholekinetic properties. Based on ademetionine.

Release form: Tablets with 400 mg of active substance, or 5 ml ampoules with 400 mg of active substance.

Indications: fatty hepatosis, angiocholitis, chronic hepatitis, cirrhosis, various liver intoxications, encephalopathy, incl. caused by liver failure, depression.

Contraindications: Children's age. Prescribe with caution during pregnancy and lactation.

Side effects: angioedema, insomnia, headache, diarrhea.

Application: Tablets are best taken between the first two meals. The recommended daily dose is 2-4 tablets. The duration of the course is determined by the doctor.

Vitamins

In order for the liver to function normally, it is necessary to consume vitamins of different groups. First of all, these are B vitamins (thiamine, pyridoxine, cyanocobalamin, riboflavin), as well as vitamin E (tocopherol). Vitamins facilitate metabolic processes in the liver and also accelerate the restoration of its cells.

Of course, vitamins cannot be the only remedy designed to protect the liver. As a rule, they are taken as part of complex therapy for liver diseases.

Lipid peroxidation inhibitors

This is a large group of drugs, which, however, contain the same active ingredient - thioctic acid. Examples of drugs in this group:

Octolipen,
Thiogamma,
Berlition.

What is the principle of action of these drugs? It is based on accelerating the removal of lactic acid from hepatocytes. This acid is formed in liver cells when nitrogen combines with oxygen. Lactic acid has a certain toxic effect on cells, and accelerated removal of acid weakens it.

Preparations based on thioctic acid are used for the following diseases:

hepatitis of different types,
fatty hepatosis,
cirrhosis.

Also, drugs based on thioctic acid are used for diseases of the nervous system and blood vessels.

Indications for the use of drugs in this area:

diabetic neuropathy,
consequences of a stroke,
neuritis,
atherosclerosis of small arteries.

However, the evidence base for the hepatoprotective properties of drugs based on thioctic acid is not sufficient, although these drugs have proven themselves in the treatment of the consequences of diabetes.

Thioctic acid preparations can be used both in the form of tablets and injections. Another disadvantage of these drugs is their relatively high cost.

Ursodeoxycholic acid

Used to dissolve gallstones and reduce cholesterol levels in bile. Ursodeoxycholic acid has the largest evidence base among all hepatoprotectors. The scope of its application, however, is quite narrow, namely the treatment of biliary cirrhosis, that is, cirrhosis caused by stagnation of bile in the liver. The drug is also used for hypomotor dyskinesia of the biliary tract, the presence of small sandy stones in the gallbladder or inflammation of the biliary tract.

The acid stimulates the removal of bile from the liver and thus has a protective effect. However, this effect does not apply to other types of liver diseases that are not associated with stagnation of bile, for example, alcoholic, toxic and viral hepatitis. The acid also has a hypoglycemic effect, reduces cholesterol levels in bile, improves the secretion of gastric juice and pancreatic enzymes. Stimulates the formation of T-lymphocytes. The disadvantage of the substance is that it is contraindicated in certain types of gallstones, acute inflammation of the intestines, gallbladder, and impaired pancreatic and kidney function. Therefore, it is not recommended to take drugs based on it without a doctor’s recommendation.

The main use of the drugs is biliary cirrhosis, dissolution of cholesterol stones, various alcoholic, viral and toxic hepatitis, including acute, hepatopathy during pregnancy, primary cholangitis. Preparations based on ursodeoxycholic acid can also be used in the treatment of liver diseases in children. Suspensions of drugs are used for this purpose.

Examples of drugs containing ursodeoxycholic acid:

Ursofalk,
Urdoxa,
Ursosan,
Livodex.

Ursofalk

A medicine for the treatment of the liver based on ursodeoxycholic acid. The main purpose is to dissolve gallstones.

Release form: Capsules and suspension. Contains 250 mg ursodeoxycholic acid. The suspension is supplied in 5 ml bottles. The remaining substances in the suspension are xylitol, glycerol, microcrystalline cellulose, water.

Indications: biliary reflux gastritis, dissolution of cholesterol stones, biliary cirrhosis, chronic hepatitis, biliary dyskinesia, alcoholic liver damage.

Contraindications: stones with a high calcium content, severe renal and liver failure, pregnancy and lactation.

Side effects: Rare, mainly gastrointestinal disorders.

Application: For children and adults weighing up to 50 kg, it is preferable to use the suspension. For biliary cirrhosis, the dose is calculated at 14 mg/kg body weight; for gallstones, the dose is 10 mg/kg body weight. The drug is taken once a day. For alcoholic lesions, the daily dose is 10-15 mg/kg, the frequency of administration per day is 2-3. The course of treatment lasts 6-12 months.

Combination drugs

These preparations may contain components belonging to several groups at once, for example, phospholipids and herbal preparations, phospholipids and vitamins, preparations of animal origin and vitamins. Examples of such drugs are Fosphonciale, Essel Forte, Esliver Forte, Rezalut Pro, Sirepar, Gepatrin.

Fosphonziale

Combined hepatoprotector. It contains essential phospholipids along with milk thistle extract containing silymarin - a complex of flavonoid compounds.

Release form: Capsules containing 188 mg of phosphatidylcholine and 70 mg of silymarin.

Indications: hepatitis of various origins, including alcoholic and toxic, fatty liver, cirrhosis, radiation sickness, intoxication.

Contraindications: Individual intolerance to the components.

Application: It is better to take the medicine with food. The standard dose is two tablets three times a day. The course of treatment depends on the disease. For viral hepatitis it is 12 months, for other types of liver diseases – three months. For prevention – one capsule 2-3 times a day for three months.

For which diseases which hepatoprotectors are best used?

The choice of drug should depend on the specific disease and type of liver damage. It should be remembered that universal remedies still do not exist, as well as remedies without side effects, so you should not take the first drug you come across.

Viral hepatitis

For viral hepatitis, drugs with phospholipids in combination with interferons are best recommended. Of course, this type of therapy cannot be considered the only possible one. Antiviral drugs remain the main type of drugs for viral hepatitis.

Toxic hepatitis

The best type of therapy for hepatitis of this type is to stop the entry of toxic substances into the body (for example, stopping taking any medications, drugs, alcohol). However, Heptral and Heptor are recommended best for toxic hepatitis. In addition, Heptral is also an antidepressant and can be used to treat withdrawal symptoms that often accompany alcoholism.

Hepatic obesity

This disease is usually caused by non-alcoholic factors. And again, here hepatoprotectors cannot serve as a panacea. The best way to stop the disease is to organize proper nutrition, diet, and increase physical activity. In this case, herbal preparations or bile acid preparations are best suited.

Cirrhosis

Cirrhosis is a severe damage to liver tissue that is irreversible. The cause may be both toxic and viral lesions, autoimmune factors, and bile stagnation. In case of toxic cirrhosis, the choice can be made on drugs with amino acids; in case of the biliary nature of the disease - on ursodeoxycholic acid.
What does increased bilirubin in the blood mean?

What hepatoprotectors can be used in the treatment of children?

The list of such drugs is small. However, drugs such as Galstena and Hepel can be used for children, starting from infancy. Essentiale can be prescribed starting from the age of three. However, treatment of the liver with medications in childhood can be carried out only after a doctor’s prescription.

Is it possible to combine liver protectants and antibiotics?

It is believed that such agents can balance the effects on the liver of some highly toxic antibacterial drugs. However, there is no serious evidence for this effect. In addition, on the contrary, some drugs can affect the metabolism of antibiotics and thereby reduce their effectiveness.

Principles of using liver protectants

All drugs of this type must be prescribed by a doctor. Only he can decide what to drink for acute or chronic liver diseases. Although there are currently many dietary supplements on the market designed to protect the liver, their benefits are, however, questionable, and various side effects can nullify them. In addition, you should tell your doctor about all the medications you are taking, as some may be toxic to the liver. This is especially true for herbal preparations.

The second feature is that drugs that protect the liver can only be taken as an adjuvant. And their use will be completely useless if the patient does not strive to recover and adheres to his habits that aggravate the course of the disease, for example, drinking alcohol in excessive doses. For viral liver lesions, treatment with protective drugs is ineffective compared to therapy with antiviral drugs. With cirrhosis caused by diabetes, liver treatment will be useless without increasing physical activity and reducing excess weight, lowering cholesterol, antidiabetic drugs, and diet. In addition, you should remember about the treatment of other organs - the pancreas and gallbladder.

The next problem that most drugs designed to protect the liver face is the weak evidence base for their effectiveness. This is reflected in the fact that very few drugs have undergone serious clinical trials. At the same time, you can also find drugs on sale for which there is no serious evidence of effectiveness, except for the clinical practice of individual doctors, whose opinion may be subjective. There are several reasons for this situation. Of course, one should not discount the dishonesty of individual manufacturers who do not skimp on advertising and praise for their products.

However, the origins of the situation are deeper. The fact is that the domestic view on the treatment of liver diseases is somewhat different from the view prevailing in Western medicine. In our country, among many doctors and the overwhelming majority of patients, there is an opinion that the liver needs enhanced protection from various unfavorable factors - industrial pollution products, chemicals, alcohol, medications. Such perceptions generate demand, which is satisfied by pharmaceutical manufacturers.

Meanwhile, liver protection cannot replace antiviral therapy for hepatitis, or therapy for diseases associated with the biliary system, as well as the prevention of liver diseases. For many people, it is sometimes easier to take medications than to change their lifestyle and avoid unwanted effects on the liver - do not take questionable medications, alcohol, eat right, and avoid ingesting potentially dangerous chemicals. At the same time, the consumer is willing to pay quite a lot of money for good tablets of this type. This is facilitated by the fact that there are a huge number of people with liver diseases in our country. At the same time, in Western countries, most of the drugs that protect the liver are classified as dietary supplements and are taken only in a limited number of cases.

Does this mean that liver products that do not have a solid evidence base are dummies? This is not excluded, although it would hardly be correct to state this categorically.

Many drugs, for example, herbal ones, despite the lack of a scientific evidence base, have been used for a very long time as agents that protect the liver and have positive reviews. Therefore, additional research is needed in this area.

Which liver remedies have a well-established positive effect?

The list of drugs with proven effectiveness is not that long. First of all, it is ursodeoxycholic acid, as well as amino acids. However, the effect of amino acids in most cases manifests itself only with injections, and ursodeoxycholic acid is used for liver diseases to treat only certain manifestations and cannot be considered as a universal drug.

List of popular drugs and their prices

Classification of liver drugs by type of active substances

Active Ingredients	Drugs
Animal liver cells	Gepatosan, Sirepar, Progepar
Milk Thistle Extract (Silymarin)	Karsil, Gepabene, Galstena, Legalon, Fosfontziale, Gepatrin, Livesil Forte
Artichoke extract	Hofitol, Hepatrin
Pumpkin seed extract	Tykveol, Peponen
Other herbal ingredients	Hepel, Liv 52, Ovesol
Phospholipids	Essentiale Forte, Phosphogliv, Antraliv, Essliver, Phosphonciale, Rezalut Pro, Hepatrin, Livesil Forte
Ursodeoxycholic acid	Ursofalk, Urdoxa, Ursosan, Livodexa
Thioctic acid	Octolipen, Thiogamma, Berlition
Ademetionine	Heptral, Heptor
Ornithine	Hepa-Merz

The human liver has an amazing property - the ability to regenerate on its own. However, in modern living conditions, she becomes easily vulnerable. The organ is especially vulnerable in those people who do not adhere to the right lifestyle: they drink alcohol, junk food, and various pharmaceuticals. It is not surprising that doctors recommend that many patients take hepatoprotectors - drugs, the list of which is quite extensive. All of them perform the most important function - they help protect the liver.

General information

Medicines that have a positive effect on the functioning of the liver and promote its recovery are hepatoprotectors.

The drugs, the list of which will be given below, perfectly protect the organ from:

aggressive medications;
exposure to poisons;
alcohol.

Using them allows you to improve your metabolism. They ensure the functioning of liver cells. Thus, the main function of drugs is to protect the organ from the negative effects of various damaging factors.

Modern pharmacologists have developed a wide variety of hepatoprotectors. The list of drugs is divided according to the principle of action and composition. However, all of these medications benefit the liver. But they should be taken only after consultation with a specialist.

In addition, it is important to understand: hepatoprotectors are not able to completely protect the organ from the harm caused by alcohol. The only method to prevent the damaging effect is to protect the body from alcohol-containing drinks.

Hepatoprotectors (drugs) are prescribed not only for treatment, but also for preventive purposes.

The list of medications included in this group has fairly broad indications for use:

It is advisable to use them for people who constantly interact with chemical, radioactive, and toxic components.
Such drugs are useful for older people, since their liver often requires drug support.
In addition, these funds are beneficial in the fight against diseases of the digestive tract and biliary tract.

But the most important thing is to remember that hepatoprotectors can only be used after a doctor’s prescription.

Mechanism of action

The liver can function normally only if the cell membranes are intact. If they are clogged, the organ cannot perform its cleansing function. In this case, hepatoprotectors for the liver are prescribed. The list of effective drugs that can speed up the metabolic process in cells is very wide. However, you should not use them at your own discretion, without a doctor’s prescription.

Hepatoprotectors improve the functioning of the organ's enzyme systems, accelerate the movement of substances, enhance cell protection, improve their nutrition, and participate in cell division. All this ensures liver restoration. In addition, the biochemical indicators of organ functioning are significantly improved.

Basic properties

It should be remembered that there are a wide variety of hepatoprotectors. Drugs, the list of which is classified depending on the mechanism of action and the main substance, perform various functions. Some medications restore damaged cells much faster. Others are better at cleansing the liver.

Despite these differences, all medicines have common properties:

Hepatoprotectors are based on natural substances, components of the body’s normal natural environment.
Their action is aimed at restoring impaired liver function and normalizing metabolism.
The drug neutralizes toxic products that enter the body from the outside or are formed internally as a result of impaired metabolism or disease.
Medicines promote cell regeneration and ensure their resistance to harmful effects.

Use of medications

So, hepatoprotectors are medications that have a positive effect on the functioning of the liver. However, they all differ in their mechanism of action. Such agents can provide the following properties to the body: anti-inflammatory, antifibrotic, metabolic.

These drugs are widely used for:

and non-alcoholic);
hepatitis (medicinal, viral, toxic);
cirrhosis;
psoriasis;
cholestatic lesions;
toxicosis during pregnancy.

Classification of drugs

Unfortunately, to this day there is no unified system that allows dividing hepatoprotectors (drugs) into groups.

The classification, which has found application in medicine, is as follows:

Essential phospholipids. Medicines included in this group are obtained from soybeans. These are excellent hepatoprotectors of plant origin. List of medications belonging to this group: “Essentiale Forte”, “Phosphogliv”, “Rezalut Pro”, “Essliver Forte”. Plant phospholipids resemble those found in human liver cells. That is why they naturally integrate into disease-affected cells and contribute to their recovery. Medicines have virtually no side effects. It is extremely rare that they can cause an allergic reaction if a person has an individual intolerance to the medication or loose stools.
Plant flavonoids. Such medications are natural compounds - natural antioxidants. The action of the drugs is aimed at neutralizing free radicals. Medicines are obtained from medicinal plants: celandine, fumes, milk thistle, turmeric. These are quite popular hepatoprotectors. List of drugs that make up this group: “Karsil”, “Gepabene”, “Silimar”, “Legalon”, “Hepatofalk Planta”. Such medications have a small list of side effects. In some cases, they can provoke allergic manifestations or loose stools. These drugs have not only a hepatoprotective effect. They perfectly relieve spasms of the gallbladder, help improve the outflow of bile and its production. That is why these medications are prescribed for hepatitis accompanied by cholecystitis.
Amino acid derivatives. These medications are based on protein components and other necessary substances for the body. This ensures the direct participation of these drugs in metabolism. They complement and normalize the metabolic process, have a detoxifying effect and help support the body. In severe forms of intoxication and liver failure, these are the hepatoprotectors that are prescribed. The list of drugs included in the amino acids is as follows: “Heptral”, “Heptor”, “Hepa-Merz”, “Hepasol A”, “Hepasol Neo”, “Remaxol”, “Gepasteril”. These drugs often cause side effects. Among them are: discomfort in the abdominal area, nausea, diarrhea.
Ursodeoxycholic acid medications. These medications are based on a natural component - the bile of the Himalayan bear. This substance is called ursodeoxycholic acid. The component helps improve the solubility and removal of bile from the human body. The substance leads to a decrease in damage and death of liver cells in a variety of ailments. Ursodeoxycholic acid has an immunomodulatory effect. In cases of cholelithiasis, fatty hepatosis, biliary cirrhosis, and alcoholic illness, these hepatoprotectors for the liver will benefit. List of the most effective drugs: “Ursodex”, “Ursodez”, “Ursosan”, “Ursofalk”, “PMS-ursodiol”, “Urdoxa”, “Ursofalk”, “Urso 100”, “Ursodeoxycholic acid”, “Ursoliv”, “ Ursolizin", "Ursorom S", "Ursohol", "Choludexan". These medications are contraindicated in cases of severe liver and kidney failure, pancreatitis, acute ulcers, calcium gallstones, and acute inflammation of the bladder.

In addition to the drugs listed above, there are other drugs that have hepatoprotective properties.

These include dietary supplements:

"Hepaphor."
"Sibektan".
"LIV-52".
"Gepagard."
"Pumpkin."

Some homeopathic medicines also have a hepatoprotective effect:

"Hepel."
"Galstena."
"Sirepar".

However, the concentration of necessary substances in these drugs is insufficient. Therefore, they are not recommended for use in case of illness.

Let's consider the most effective hepatoprotectors - a list of the best medications, according to doctors.

The drug "Galstena"

This remedy is one of the best medicines to combat liver diseases in children. This drug can be used from the first days of a baby’s life. The medicine is a representative of a group that includes combined hepatoprotectors (drugs).

The instructions indicate that the medication has a protective effect on liver cells. It promotes the production of bile of normal consistency. This prevents the formation of stones. The medicine relieves pain in the liver area and relieves spasms.

The medication is used in the treatment of hepatitis. It is also prescribed to prevent damage to liver cells. This remedy is recommended for patients undergoing chemotherapy or antibiotic treatment.

The medicine has practically no contraindications. It is not recommended for use only by those who have individual sensitivity to the components of the medication.

The drug "Essentiale"

The product is based on highly purified phospholipids. They perfectly normalize metabolic functions in the gland and protect its cells from external influences. In addition, this drug stimulates liver recovery.

The product is used for the following ailments:

fatty hepatosis;
cirrhosis;
hepatitis.

The drug "Essentiale" in the form of a solution is allowed to be used by children from 3 years of age. The medicine in capsules is recommended for use from 12 years of age.

Means "Antral"

The medicine is used to combat various forms of hepatitis. The drug is excellent at reducing the level of bilirubin, liver enzymes that penetrate into the bloodstream as a result of cell damage. In addition, it is used for prophylaxis in immunodeficiency or chemotherapy.

The product has an excellent anti-inflammatory effect and helps activate regenerative processes in cells.

The medication has a small number of contraindications and side effects. It is not recommended for use in acute renal failure.

The medicine is not prescribed to children under 4 years of age.

Milk thistle

This is one of the popular hepatoprotectors of plant origin. The necessary substance, silymarin, is obtained from the ripe fruits of milk thistle. It is found in many effective medicines.

Milk thistle-based hepatoprotector preparations:

"Legalon".
"Gepabene."
"Karsil".

Such medications are used for toxic liver damage, hepatitis, and fatty disease. In addition, milk thistle has been scientifically proven to have antioxidant properties. It protects the liver from the development of connective tissue and provides an excellent anti-inflammatory effect.

Such features make it possible to prescribe these hepatoprotectors of origin) to patients suffering from chronic gland pathologies.

Medicines based on silymarin are approved for use in children from the age of five.

Medicine "Hepel"

The homeopathic medicine relieves spasms, restores liver cells, and improves the functioning of the gallbladder. The product is used for various glandular ailments due to its many therapeutic effects. In addition, this medication is effective for gastrointestinal pathologies and some skin diseases.

The drug can be prescribed even to newborn babies (for jaundice). However, only under the supervision of a doctor.

Medicine "Cholenzim"

The product is an effective combination drug. It combines bile and certain pancreatic enzymes. This drug increases the flow of bile and significantly improves digestion.

The product is used for cholecystitis, chronic hepatitis and some pathologies of the digestive system. Contraindications to the use of the drug "Cholenzim" are: acute pancreatitis. In some cases, side effects in the form of allergic reactions (itching, redness) are possible.

This product is contraindicated in children under 12 years of age.

Medicine "Ursosan"

The active ingredient is ursodeoxycholic acid. It ensures the formation of liquid compounds with cholesterol. As a result, the body protects itself from the formation of stones.

In addition, this substance reduces the production of cholesterol and is an effective protection for liver cells. The product is used to combat gallstone disease. Effectively eliminates the symptoms of biliary cirrhosis.

The medicine is contraindicated in case of bile duct obstruction or the presence of calcified stones.

The medication can only be used for those children who are already 5 years old.

The drug "Heptral"

The product is based on ademetionine, an amino acid that takes part in many biochemical reactions occurring in the body. This substance improves the physical qualities of bile, reduces toxicity and facilitates its removal.

The medication is prescribed for:

cholestasis,
fatty degeneration,
cirrhotic liver disorders,
chronic hepatitis.

The drug has side effects. It can provoke gastrointestinal dyspeptic disorders, sleep disorders, and mental disorders. Sometimes causes allergic reactions. This product is not intended for persons under 18 years of age, pregnant or nursing mothers.

The best drugs for children

All of the above allows us to conclude what hepatoprotectors are used for babies.

The list for children contains the following drugs:

From the newborn period. Medicines used: Galstena, Hepel.
Children from 3 years old. It is allowed to use the medication "Essentiale".
Children from 4 years old. The drug "Antral" is prescribed.
Five year old children. The following drugs may be included in therapy: Karsil, Legalon, Gepabene, Ursosan.
From the age of 12. The medicine Cholenzym is prescribed.
Persons over 18 years of age. You can take Heptral.

However, do not forget that any medication should be taken only after it has been prescribed by a doctor.