Hepatoprotectors - drugs for the treatment of the liver, the best drugs, pills. The best hepatoprotectors with proven effectiveness What is better legalon or Essentiale

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 are hepatoprotectors.

What are the functions of the liver

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 body processes - the metabolism of various substances, including those coming from outside, in the production of bile involved in the digestion process

The main functions of the liver:

• detoxification,
• Processing of vitamins and trace elements,
• Digestion.

Detoxification

First of all, the liver is designed to break down and remove toxins from the body. Toxins can either come directly from the environment, where they can come from chemicals or drugs, or they can be formed during digestion. Such compounds include phenol, acetone, ketone compounds.

Processing of vitamins and trace elements

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. They are metabolized in the liver and made available to the body.

Digestion

The liver produces a special fluid called 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:

• regulating the amount of hormones
• accumulation of glucose
• production of cholesterol and lipids,
• regulation of blood coagulation and its volume,
• metabolism regulation,
• synthesis of antibodies and immunoglobulins,
• hematopoiesis (during fetal development and early childhood).

Causes of liver diseases

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

What factors can negatively affect the functioning of the liver:

• drug use,
• diabetes,
• malnutrition,
• bad environment,
• medical treatment,
• obesity,
• genetic factors
• insufficient physical activity.

A class of drugs called hepatoprotectors is called to protect the liver from such complications. Of course, they will not replace drugs that fight the causes of liver disease, such as antivirals, but they can improve the functioning of liver cells.

Prevention of liver diseases

Prevention of liver diseases is the surest 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 drugs;
• high physical activity;
• control of excess weight, sugar, blood;
• 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 disease,
• drug-induced liver damage,
• viral hepatitis,
• cirrhosis and hepatosis of various etiologies,
• fatty liver disease in diabetes mellitus and obesity,
• alcoholic liver damage.

Alcoholic hepatitis

If excessive alcohol intake has led to severe liver dysfunction, turning into cirrhosis, then in this case, many doctors prescribe hepatoprotectors to patients. However, this type of preparation is not a miraculous elixir and cannot by itself cure a diseased liver. First of all, the patient needs to get rid of the addiction. Otherwise, the use of any drugs is meaningless.

Fatty liver disease

This disease is diagnosed in many people with diabetes and obesity. Also, the disease can appear as a result of malnutrition, eating a large amount 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, drugs alone will not be enough in this case. The patient must simultaneously diet and begin to lose weight, increase physical activity, take drugs 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 tissue and functionality of the liver.

Viral hepatitis

There are several types of hepatitis, differing from each other in their pathogens. These diseases differ 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 non-compliance with personal hygiene rules. Most hepatitis are serious diseases, the therapy of which is complex and expensive. Of course, hepatoprotectors will not replace standard antiviral drugs and diets. However, in many cases they will be able to reduce the effect caused by viral tissue damage.

What tool to choose?

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

There is no single 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 consult a doctor so that he would pick up a good medicine and tell you what to drink. Also, the doctor will 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 drugs for the liver 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 drug for the liver is aimed at solving one specific problem.

Liver recovery pills should be purchased 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 drugs should be chosen, focusing not so much on price as on their properties. In addition, it is worth remembering that inexpensive and effective drugs do not exist, inexpensive drugs are most often ineffective, and even are simple dummies.

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

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

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

Means for the liver based on animal components

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 drugs, they have a detoxifying and antioxidant effect, stimulate the regeneration of the parenchyma.

These remedies for the liver have many contraindications and side effects. For example, they can cause severe allergic reactions, and can also cause infection with difficult-to-treat infectious diseases. Therefore, before entering the drug, it is recommended to check the individual tolerability of the drug by the patient. Examples of such drugs are Hepatosan, Progepar, Sirepar.

Medicines for the liver from this group are dispensed by prescription. Used in the treatment of:

• fatty liver,
• medicinal and toxic hepatitis,
• cirrhosis.

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

Herbal preparations

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

Among herbal ingredients, the following extracts should be noted

• milk thistle fruit,
• pumpkin seeds,
• artichoke.

Preparations for maintaining the liver based on them have long been used in traditional medicine and have proven themselves well.

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

• medicinal fumes,
• yarrow,
• cassia,
• medicinal dandelion,
• club moss,
• cinchona,
• celandine.

milk thistle

The most widely used preparations 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 preparations with milk thistle is silymarin, which is a complex of flavonoid substances - silybin, silychristin and silydianin. It is they who, as scientists believe, 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, in most acute or toxic hepatitis, silymarin-based drugs are ineffective and require additional therapy. The course of treatment with silymarin preparations is usually several months.

Artichoke

The artichoke has also earned the fame 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 the level of bad cholesterol. The active substances in artichoke responsible for hepatoprotective properties are cynarin and cynaridine. They allow you to increase the production of bile and bile acids, contribute to the restoration of liver cells. Medicines based on artichoke extract are used in the treatment of hepatitis, alcohol intoxication, cholecystitis, cirrhosis.

pumpkin seeds

Also widely used as hepatoprotective agents are preparations based on pumpkin seed oil. 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 is able to stop the destruction of hepatocyte cells.

The best medicines for the liver based on herbal ingredients 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 up to 5 years. Application: Tablets are taken whole, they must be washed down with water. Reception of tablets does not depend on food intake. The standard dosage for adults (over 12 years old) is 1-2 tablets three times a day. 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 drugs. As a rule, they include 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 to 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 from the intestines, reduce liver energy costs, 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, 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, it is necessary to take them for a long time, at least six months. In some cases, phospholipids can provoke bile stasis. They are also rapidly metabolized when taken orally, and only a small proportion of the drugs enter the liver.

Essentiale Forte A drug for the restoration of a diseased liver. The preparation 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, 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 up to 12 years, individual sensitivity to the components of the drug. Side effects: disorders of the gastrointestinal tract, itching, urticaria. Usage: Two capsules three times a day with meals. The duration of the course 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 liver treatments with amino acids have been shown to be effective only when administered intravenously. When taken orally, amino acids are quite strongly metabolized and only a relatively small part of them reaches the liver.

Among this kind 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 the metabolism in the liver. Heptral is based on ademetionine.

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

Scope of amino acids:

• fatty liver,
• chronic hepatitis,
• toxic hepatitis.

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

Preparations of this group can be taken in tablets, as well as administered by infusion method (using droppers).

Heptral Antidepressant with hepatoprotective, antioxidant, detoxifying, 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, encephalopathies, incl. caused by liver failure, depression. Contraindications: Children's age. Be wary appoint during pregnancy and lactation. Side effects: angioedema, insomnia, headache, diarrhea. Usage: Tablets are best taken between the first two meals. The recommended daily dose is 2-4 tablets. The duration of the course is set 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 means designed to protect the liver. As a rule, they are taken as part of the complex therapy of liver diseases.

Lipid peroxidation inhibitors

This is an extensive 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 excretion of lactic acid from hepatocytes. This acid is formed in the liver cells when nitrogen combines with oxygen. Lactic acid has a certain toxic effect on cells, and the accelerated removal of acid weakens it.

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

• hepatitis of various types,
• fatty liver,
• cirrhosis.

Also, preparations 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 well in the treatment of the consequences of diabetes.

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

Ursodeoxycholic acid

It is used to dissolve gallstones and lower cholesterol levels in bile. Ursodeoxycholic acid has the largest evidence base among all hepatoprotectors. Its scope, however, is rather narrow, namely, the treatment of biliary cirrhosis, that is, cirrhosis caused by bile stasis in the liver. Also, the drug is used for hypomotor biliary dyskinesia, the presence of small sandy stones in the gallbladder or inflammation of the biliary tract.

The acid stimulates the excretion of bile from the liver and thus has a protective effect. However, this action does not apply to other types of liver diseases that are not associated with bile stasis, for example, alcoholic, toxic and viral hepatitis. Also, the acid has a hypoglycemic effect, lowers the level of cholesterol 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, pancreatic and kidney dysfunction. Therefore, it is not recommended to take drugs based on it without the recommendation of a doctor.

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

Examples of drugs containing ursodeoxycholic acid:

• Ursofalk,
• Urdoksa,
• Ursosan,
• Livodex.

Ursofalk Medicine for the treatment of the liver based on ursodeoxycholic acid. The main purpose is the dissolution of gallstones. Release form: Capsules and suspension. Contains 250 mg of ursodeoxycholic acid. The suspension is supplied in 5 ml vials. The remaining substances of 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: high calcium stones, severe renal and hepatic insufficiency, pregnancy and lactation. Side effects: Rare, mainly gastrointestinal disorders. Application: For children and adults weighing up to 50 kg, it is preferable to use a suspension. With biliary cirrhosis, the dose is calculated at the rate of 14 mg / kg of body weight, with gallstones, the dose is 10 mg / kg of body weight. The drug is taken once a day. With 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.

Combined drugs

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

Phosfonciale Combined hepatoprotector. 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 degeneration of the liver, cirrhosis, radiation sickness, intoxication. Contraindications: Individual intolerance to the components. Application: The medicine is best taken with meals. The standard dose is two tablets three times a day. The course of treatment depends on the disease. With viral hepatitis, it is 12 months, with other types of liver diseases - three months. For prevention - one capsule 2-3 times a day for three months.

For what 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 that comes across.

Viral hepatitis

In 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. The main type of drugs for viral hepatitis are antiviral agents.

Toxic hepatitis

The best type of therapy for this type of hepatitis is stopping the intake of a toxic substance into the body (for example, refusing to take any medications, drugs, alcohol). However, Heptral and Heptor are best for toxic hepatitis. In addition, Heptral is also an antidepressant and can be used to treat withdrawal syndrome, which often accompanies alcoholism.

Liver 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 the organization of proper nutrition, diet, increased physical activity. In this case, herbal preparations or bile acid preparations are best suited.

cirrhosis

Cirrhosis is a severe damage to the liver tissue, which is irreversible. The cause can be both toxic and viral lesions, autoimmune factors, bile stasis. With toxic cirrhosis, the choice can be stopped on drugs with amino acids, with the biliary nature of the disease - on ursodeoxycholic acid.
What does elevated 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 from infancy. Essentiale can be prescribed from the age of three. However, treatment of the liver with drugs in childhood can be carried out only after a doctor's prescription.

Is it possible to combine the use of drugs that protect the liver, and antibiotics?

It is believed that such drugs can balance the effect on the liver of some antibacterial drugs with high toxicity. However, there is no strong evidence for this effect. In addition, on the contrary, some drugs can affect the metabolism of antibiotics and thereby reduce their effectiveness.

Principles for the use of drugs that protect the liver

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 many dietary supplements on the market today that are designed to protect the liver, nevertheless, their benefits are questionable, and various side effects can negate it. In addition, you should tell your doctor about all medications you take, as some of them can 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 seek to be cured and adheres to his habits that aggravate the course of the disease, for example, drinking alcohol in excessive doses. In viral liver lesions, treatment with medicinal protective agents 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, one should remember about the treatment of other organs - the pancreas and gallbladder.

The next problem faced by most drugs designed to protect the liver is a weak evidence base for their effectiveness. This is expressed in the fact that very few drugs have passed serious clinical trials. At the same time, on sale you can also find such drugs 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 such a situation. Of course, one should not discount the dishonesty of individual manufacturers who do not skimp on advertising and praise for their product.

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 vast majority of patients, there is an opinion that the liver needs enhanced protection from various adverse factors - industrial pollution products, chemicals, alcohol, and medicines. Such perceptions generate demand, which is met by pharmaceutical manufacturers.

Meanwhile, liver protection cannot replace the antiviral therapy of hepatitis, or the treatment of diseases associated with the biliary system, as well as the prevention of liver diseases. It is sometimes easier for many people to take drugs than to change their lifestyle and avoid unwanted effects on the liver - do not take dubious medications, alcohol, eat right, avoid potentially dangerous chemicals entering the body. At the same time, the consumer is ready 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 liver-protecting agents are dietary supplements and are taken only in a limited number of cases.

Does this mean that liver remedies 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 preparations, for example, herbal ones, despite the lack of scientific evidence base, have been used for a very long time as a means of protecting the liver, and have positive reviews. Therefore, further research is needed in this area.

Which Liver Remedies Have a Firmly Established Beneficial Effect

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

List of popular drugs and their prices

Classification of hepatic drugs according to the type of active substances

Active ingredients	Preparations
animal liver cells	Hepatosan, Sirepar, Progepar
Milk thistle extract (silymarin)	Karsil, Gepabene, Galstena, Legalon, Phosfonciale, 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, Phosfonciale, Rezalut Pro, Gepatrin, Livesil Forte
Ursodeoxycholic acid	Ursofalk, Urdoksa, Ursosan, Livodex
Thioctic acid	Octolipen, Thiogamma, Berlition
Ademetionine	Heptral, Heptor
Ornithine	Hepa-Merz

Content

The liver is a unique organ that performs a protective function, cleanses the blood of toxins, toxins and other chemical elements that are harmful to the human body. At the same time, it is capable of self-healing, but sometimes, for various reasons, its own protective potential is not enough for it. Then modern pharmacology suggests using hepatoprotectors. Take these medicines according to the instructions and only on the advice of a doctor.

What are Liver Recovery Pills

Hepatoprotectors are an extensive class of medications that have a stimulating effect on liver cells, help restore its structure and functionality. These drugs are available in the form of tablets, pills or dragees. They help maintain the integrity of hepatocytes, improve the excretion of harmful substances, improve the outflow of bile and restore the absorption of vitamins by the body.

Groups

There are a lot of different hepatoprotectors today. Each of these drugs is generally responsible for one function - restoring the health of the organ and minimizing the damage caused to it, but in fact they can differ somewhat from each other. According to the active active substance, all preparations for liver restoration can conditionally be divided into several classes:

• Phospholipids are substances obtained by special processing of soybeans. Their action is to improve the state of cell walls at the lipid level, increase enzymatic activity, and increase the likelihood of a response to α-interferon. Phospholipid-based liver recovery pills include: Essentiale N, Essentiale Forte N, Essliver Forte, Phosfonciale, Gepagard, Phosphogliv, Rezalyut.
• Derivatives of amino acids. The active components of the preparations are involved in the production of phospholipids and the processes of assimilation of biologically active substances, reduce the level of ammonia, start the processes of self-healing of gland cells and purification. Medications with amino acids: Hepa-Merz (Ornithine aspartate), Heptral, Heptor.
• Medicines of animal origin. The composition includes hydrolyzed pork liver. Known medicines: Sirepar, Progepar, Hepatosan.
• Medicines with the addition of medicinal plants. They are used for organ damage by toxins, poisons or medicines, for cholecystitis, hepatitis, cholelithiasis and for preventive purposes. These include products based on milk thistle (Legalon, Karsil, Gepabene, Silimar), artichoke (Tsinariks, Hofitol), pumpkin seed oil (Tykveol, Peponen), elecampane or burdock root, volodushka herb, agrimony, corn stigmas.
• Homeopathic remedies. Drugs help eliminate numerous symptoms, improve the functionality of the organ, and are used to cleanse it. Best pills: Hepel, Galstena, May celandine and milk thistle.
• dietary supplements. Biologically active food supplements help to better absorb vitamins, cleanse the liver, and restore its structure. Popular supplements: Hepatamine, Hepatotransit, Artichoke extract, Hepatotransit, Milona 10, Ovesol, Dipana, Hepatrin.
• Bile acids. Medicines have a hypoglycemic and choleretic effect, lower cholesterol levels, increase the secretion of gastric juice, and affect immunological reactions. Popular tablets: Ursosan, Urdox, Livodex, Ursodez, Ursofalk, Ursoliv.

Indications for use

It is possible to be treated with hepatoprotectors only after consulting a doctor. They are prescribed for the following diagnoses:

• Alcoholic hepatitis, which increases the risk of developing cirrhosis. To achieve success with drug treatment, it is necessary that the patient completely refuses to drink alcohol.
• Fatty hepatitis - provided that it is not a consequence of alcoholism - the growth of fat cells. Often people with type 2 diabetes or obesity suffer from this disease.
• Hepatitis of viral etiology - primary treatment is carried out with antiviral drugs. Hepatoprotectors are prescribed only when the first course of therapy has not brought the desired result.
• Toxic hepatitis or primary biliary cirrhosis - hepatoprotectors are prescribed as the basis for the complex treatment of the disease and subject to diet.

Hepatoprotectors for the liver

In addition to restoring the cell walls of an organ, good hepatoprotectors should regulate intracellular metabolism, stimulate the outflow of bile, remove toxins and toxins, prevent further spread of infection, and stop the inflammatory process. To achieve good results, you must follow a diet, give up bad habits, and lead an active lifestyle. The following medicines have proven themselves well: Heptral, Essentiale, Liv 52, Osalmid and some others.

FanDetox

A biologically active supplement for the restoration of the liver gland is produced by the Korean company Coral Club in the form of a powder in individual foil bags weighing 4.5 grams each. The product contains only natural ingredients:

• glucose;
• persimmon fruit extract;
• extract of Chinese wolfberry;
• soy sprouts;
• Japanese mandarin peel extract;
• buckwheat seeds;
• taurine;
• citric acid;
• stevia glycoside;
• ascorbic acid.

FanDetox is prescribed to protect the body from the pathological effects of alcohol, drugs, and poor-quality food on it. Before taking the contents of the sachet must be dissolved with half a glass of warm water. The drink is drunk 2 times a day after meals for a month. No side effects were recorded during the treatment, but FanDetox is categorically contraindicated:

• during lactation;
• patients with bowel disorders;
• during pregnancy;
• with individual intolerance to the components;
• with disorders of carbohydrate metabolism.

Tablets for the restoration of hepatic function are available in cardboard boxes of 20 pieces. The drug has hepatoprotective, detoxifying, neuroprotective properties, pronounced antidepressant activity, activates the regenerating functions of the hepatic gland. Heptral contains:

• ademetionine (the main active ingredient);
• talc;
• magnesium stearate;
• polysorbate;
• silica;
• sodium glycolate;
• simethicone;
• purified water.

Heptral is prescribed by physicians after the diagnosis and the following diagnoses:

• intrahepatic cholestasis against the background of fatty degradation, alcoholic hepatosis, viral or drug-induced hepatitis, toxic or drug-induced liver damage;
• chronic hepatitis of various origins;
• fibrosis;
• cirrhosis;
• severe intoxication with drugs, alcohol, food;
• depression.

Heptral must be taken in the morning. The daily dosage is 800-1600 mg, the course of treatment is determined individually. The drug should be abandoned for genetic metabolic disorders, patients under 18 years of age, people with bipolar disorder. While taking Heptral, undesirable effects may occur:

• within the nervous system - dizziness, migraine, paresthesia, insomnia. confusion of consciousness;
• cardiovascular system - phlebitis of superficial veins, heart rhythm disturbance, hot flashes;
• digestion - bloating, dry mouth, diarrhea, dyspepsia, flatulence, colic, gastrointestinal bleeding, nausea with vomiting;
• musculoskeletal system - muscle spasms, arthralgia;
• others - swelling of the larynx, allergies, fever, flu-like symptoms, sweating, urinary tract infections.

Essentiale forte

These are brown capsules. The active component of Essentiale forte - essential phospholipids - starts regeneration processes, normalizes metabolism and stops the replacement of healthy hepatocytes with connective tissue. Auxiliary components are:

• gelatin;
• purified water;
• ethanol 96%;
• α-tocopherol;
• castor oil;
• soybean oil;
• titanium dioxide;
• sodium lauryl sulfate.

Tablets are prescribed for recovery from toxicosis in pregnant women, chronic hepatitis, fatty liver degradation, cirrhosis, as an adjuvant therapy for psoriasis, and radiation syndrome. Essentiale forte should be taken with meals 2 capsules 2-3 times a day. The duration of treatment is 3 months, if necessary, can be repeated. Essentiale is well tolerated by the body, only occasionally causing stool upset. Essentiale has no serious contraindications.

Liv 52

This is a combined medicine to restore the functionality of the hepatic gland. The composition of Liv 52 consists entirely of vegetable raw materials:

• caper powder and common chicory;
• iron oxide;
• black nightshade;
• terminalia arjuna;
• cassia western;
• common yarrow;
• Gallic tamarix;
• ecliptic white;
• medicinal fumes;
• Ceylon pig;
• medicinal emblic;
• seed radish.

Liv 52 has antitoxic, choleretic, anti-inflammatory, hepatoprotective effects. The components of the composition restore intracellular processes and protein synthesis. Due to such positive properties, a homeopathic remedy is prescribed for:

• different types of hepatitis (drug, toxic, viral);
• cholecystitis;
• fatty hepatosis;
• violations of the outflow of bile;
• fibrosis;
• biliary dyskinesia;
• cholangitis;
• for the prevention of alcohol abuse.

Liv 52 is available without a prescription. Adults need to take 2-3 tablets up to three times a day, children - 1 tablet 2-3 times a day. The duration of drug therapy is determined by the doctor. The drug is well tolerated by patients, only sometimes causing allergic reactions or dyspepsia. Liv 52 is prescribed with caution to patients with acute inflammation of the gastrointestinal tract (gastrointestinal tract).

The drug to restore the functionality of the liver is produced in capsules of 30 pieces or dragees of 80-180 pieces. The active component of the capsules is a dry extract of milk thistle fruits, dragees - silymarin. The pharmacodynamics and pharmacokinetics of the drug have not been fully studied, but it is known that the drug has a membrane-stabilizing effect and an antioxidant effect, and is able to improve blood microcirculation.

Karsil is used to prevent liver damage with prolonged use of alcohol or drugs. As part of complex therapy, capsules are prescribed for:

• chronic hepatitis of non-viral nature;
• cirrhosis;
• steatosis of alcoholic or non-alcoholic etiology;
• recovery of the body after acute hepatitis;
• toxic cell damage.

Karsil rarely causes adverse reactions. Contraindicated in case of hypersensitivity to components from the composition, lactase deficiency, celiac disease. The dosage depends on the form of release:

• capsules - for severe lesions, take 1 piece 3 times a day, for pathologies of moderate severity - 2 times a day;
• dragee - 1 or 2 pieces 3 times a day;
• the duration of drug treatment is 90 days.

Ovesol

The drug is one of the natural dietary supplements. Ovesol contains natural components that have anti-inflammatory, detoxifying, restorative effects - this is an extract of sowing oats, turmeric, immortelle flowers, peppermint. Bioadditive carefully "washes" the liver, reduces stagnation of bile, reduces the chance of cholelithiasis.

Tablets can cause allergies, are contraindicated in people with hypersensitivity to one or more components. With caution, Ovesol is prescribed to patients with bending of the gallbladder or cholelithiasis. According to the instructions, it is necessary to take dietary supplements for 20 days twice a day, 1 tablet. The course must be repeated 3-4 times a year.

Phosphogliv

This combined medicine is able to stabilize the membranes of liver cells, protect the organ from negative effects, and relieve inflammation. Phosphogliv is available in the form of gelatin capsules of 50 pieces with several active ingredients - phospholipids and sodium glycyrrhizinate. Auxiliary substances are:

• microcrystalline cellulose;
• sodium carbonate;
• calcium stearate;
• talc;
• silica;
• aerosil;
• titanium dioxide.

Capsules are taken orally during meals, without chewing. Recommended dosage - 2 pcs. three times a day. The duration of rehabilitation therapy can be up to 6 months. Phosphogliv often provokes allergic reactions, rarely causes hypertension, swelling of soft tissues. From the use of tablets to restore the liver must be abandoned:

• people with hypersensitivity to the composition;
• pregnant women;
• nursing mothers;
• patients with antiphospholipid syndrome;
• children under 12 years of age.

Gepabene

Combined agents restore bile secretion, relieve spasm of the gallbladder, and have hepatoprotective properties. One capsule contains many active ingredients - dry extract of fume, protopin, milk thistle fruit, silymarin. Excipients:

• magnesium stearate;
• microcrystalline cellulose;
• silica;
• corn starch;
• macrogol;
• gelatin;
• povidone.

The drug should be taken orally during meals. To restore the functionality of the hepatic gland, doctors prescribe 1 capsule 3 times a day. Duration is selected individually. Gepabene can rarely provoke an allergic reaction or cause a laxative effect. It is contraindicated:

• adolescents who have not reached the age of majority;
• patients with active forms of biliary tract diseases;
• with increased sensitivity of the patient to the composition of the drug.

The drug is produced in the form of capsules with the active ingredient - ursodeoxycholic acid. Ursofalk reduces the tendency to form stones in the bile ducts, helps to dissolve cholesterol plaques. The auxiliary components are:

• magnesium stearate;
• colloidal silicon dioxide;
• corn starch;
• gelatin;
• titanium dioxide;
• completed.

Ursofalk must be taken at bedtime in accordance with weight: 2 capsules for patients weighing up to 60 kg, 3 for patients weighing up to 80 kg, 4 pieces for patients weighing up to 100 kg. The duration of therapy is 6-12 months. Ursofalk is not recommended by the manufacturer for patients with acute inflammatory diseases of the gallbladder, blockage of the ducts. Ursofalk is able to provoke the appearance of:

• nausea;
• pain in the abdomen or right hypochondrium;
• diarrhea;
• increased activity of hepatic transaminases;
• allergic reactions.

Galstena

A homeopathic remedy with a mild hepatoprotective, antispasmodic, anti-inflammatory and choleretic effect is available in the form of tablets. The main active ingredients are extracts of milk thistle, medicinal dandelion, large celandine, phosphorus, sodium sulfate. Galstena is prescribed to restore the organ, with diseases of the gallbladder or pancreas.

Galstena can rarely provoke the appearance of increased salivation. The drug is not prescribed for alcohol dependence, hypersensitivity to the components. The drug is taken half an hour or an hour before meals in dosages depending on the diagnosis and age of the patient:

• With hepatitis, hepatosis or pancreatitis: children under 12 years of age are prescribed ½, adults - 1 tablet. The duration of therapy before recovery is 3 months, the frequency of use is 3 times / day.
• In chronic cholecystitis, cholelithiasis: children - ½ tab., adults - 1 tablet. The frequency of admission is 3 times / day, the duration of therapy is 1 month.

Hofitol

The choleretic agent has the ability to increase diuresis, has a pronounced hepatoprotective effect, reduces blood azotemia, and intensively removes urea. Hofitol refers to homeopathic remedies. It contains only one active ingredient - an extract of fresh leaves of the field artichoke. Hofitol is available in the form of tablets of 60 pieces per pack.

Adults are prescribed 2-3 tablets. 3 times a day before meals, children from 6 years old - 1-2 tab. The course of drug therapy is 3 months. Hofitol is well tolerated by patients, but can rarely cause minor allergic reactions or diarrhea. From taking pills to restore the liver will have to be abandoned when:

• acute diseases of the biliary or urinary tract;
• the presence of kidney stones;
• obstruction of the bile ducts.

tsikvalon

It is a synthetic drug developed on the basis of a single active ingredient - tsikvalon. The medicine is produced in the form of tablets for liver restoration with anti-inflammatory properties. Tsikvalon:

1. stimulates the secretion of bile;
2. reduces the severity of inflammatory processes;
3. relieves pain in diseases of the gallbladder;
4. prevents bloating;
5. eliminates fermentation in the intestines, normalizes stool.

Tsikvalon is prescribed for cholecystitis, cholangitis, cholelithiasis in dosages per gram 3-4 times a day. The course of treatment is 3-4 weeks (if necessary, it can be repeated in a month). Tsikvalon is contraindicated in case of blockage of the bile ducts. Tablets are well tolerated by patients and only occasionally can provoke a feeling of heaviness or a bitter taste in the mouth.

The phospholipid preparation has hepatoprotective properties, stabilizes cell membranes, activates tissue regeneration processes, inhibits collagen synthesis, and reduces cholesterol levels. The composition of tablets for liver restoration Rezalut Pro:

• phospholipids from soy lecithin;
• glycerol mono- or dialconate;
• soybean oil;
• α-tocopherol;
• gelatin.

Tablets should be taken 2 pieces 3 times a day before meals. The terms of rehabilitation therapy are selected for each patient individually. Rezalut pro is not prescribed to patients with antiphospholipid syndrome. With prolonged use, the drug provokes side effects from the systems:

• digestion - diarrhea, nausea, stomach discomfort;
• hematopoiesis - violation of the menstrual cycle in women, petechial rash;
• allergic reactions - urticaria.

Osalmid

The choleretic agent stimulates the formation and outflow of bile, has analgesic and anti-inflammatory properties, and normalizes the level of bilirubin. Osalmid is available in white or almost white powder, soluble in water. Take the drug inside 250-500 mg 3 times a day for up to 20 days. Osalmid can very rarely provoke diarrhea or allergies. Reception of the powder is contraindicated in:

• hypersensitivity;
• acute inflammation of the liver gland;
• dystrophic processes of soft tissues.

How to choose liver recovery pills

The list of hepatoprotectors offered by pharmaceutical companies is very wide, so it is often difficult for a patient to choose the best medicine. The fundamental factors are often the reviews of other patients, the price of the medicine, the proven effectiveness, but for liver diseases it is important to follow only one rule - the choice of medications should be made only by a doctor. Otherwise, the situation may worsen.

After alcohol

Drug treatment after severe alcohol intoxication is possible only after the patient completely refuses further use of alcoholic beverages. Homeopathic medicines, herbal remedies based on milk thistle, burdock root, and elecampane are considered the safest pharmaceutical products. They have a minimum of side effects and are used as a food supplement. Gepabene, Heptral, restorative Dipana, HepatoTransit, Tykveol have cleansing properties.

Hepatoprotectors for children

The list of drugs that are allowed for a child is not very long. Treatment of liver diseases in childhood must necessarily take place under the supervision of an experienced pediatrician or attending physician. Appointments:

1. From the age of one year it is allowed to use Galstena, Hepel.
2. Children who have reached the age of three may be prescribed Essentiale Forte, Antral.
3. After five years, Karsil, Gepabene, Ursosan are allowed.

With cirrhosis of the liver

Hepatotropic drugs will not allow the liver to collapse, restore its functionality as much as possible, and prevent the replacement of healthy cells with fibrous tissue in cirrhosis. At the initial stage of the disease, patients are prescribed a special diet and taking vitamin complexes. If the disease has entered the active phase, treatment is supplemented with essential phospholipids, herbal medicines with milk thistle or artichoke - these are Karsil, Lipolyic acid, Phosphogliv.

With hepatitis

Hepatoprotectors are often prescribed as adjuvant therapy for hepatitis, but the main treatment is carried out with special antiviral agents. Preparations for the liver help to restore its functionality, protect against the damaging effects of exogenous or endogenous factors, and accelerate the regeneration of its cells. Hepatitis is often prescribed:

• Ursoliv;
• Hofitol;
• Gepabene;
• Essentiale.

From fatty liver

Treatment of fatty hepatosis necessarily includes dieting, taking vitamin complexes and drugs with an antifibrotic effect:

• drugs with flavonoids - milk thistle tablets, Karsil, Silibor, Gepabene, Liv 52;
• hepatoprotectors with active ingredients of animal origin - Sirepar, Hepatostan;
• drugs with phospholipids - Essentiale, Essliver;
• preparations based on urodeoxycholic acid - Ursohol.

Hepatoprotectors while taking antibiotics

To prevent drug intoxication, drugs are prescribed to restore hepatic functionality with a minimum of contraindications and side effects. These are inexpensive hepatoprotectors with a strong cleansing function - Liv 52, Ovesol, Gepabene, Essentiale. To enhance the effect of these drugs, the doctor may prescribe Allochol, Essliver, HeptraLight.

Price

Most hepatoprotectors are available without a doctor's prescription. They can be bought at any pharmacy or ordered through an online store. The cost of the medicine will depend on its volume, manufacturer, pharmacy pricing and your region of residence. The average price of tablets for liver restoration in Moscow.

Among the diseases of the digestive system, liver pathologies occupy a leading position. First of all, this concerns the violation of the metabolic functions of this organ. Liver disease is associated with alcohol addiction, an increase in viral infections, exposure to drugs and toxins, and immune diseases.
Therapy of liver diseases involves work in two areas:

1. Etiotropic (if possible) - usually with viral hepatitis, aiming to cause the death of the pathogen or at least reduce its activity.
2. Pathogenetic treatment is a complex of methods and means of influence in order to normalize impaired functions.

Hepatoprotectors belong to the second line of therapy for liver diseases. The pathogenetic effect involves a proven reduction in inflammation, destruction of the cell structure, prevention of the growth of connective tissue (fibrosis).
Hepatoprotectors (from Greek hepatos, liver and Latin protection, protection, patronage) are drugs for the treatment of the liver, which selectively improve the functioning of its cells. They have a different effect on the structural elements of the liver:

• enhance the antitoxic functions of hepatocytes - the main cells of the liver;
• inhibit oxidative processes in the body;
• have anti-inflammatory action;
• interfere with the production of connective tissue components, preventing the development of fibrosis;
• stimulate the recovery of hepatocytes.

Therefore, the effects of hepatoprotectors differ.

Controversial opinions about hepatoprotectors

The term "hepatoprotector" implies that the drug must have a specific therapeutic effect: reduce the concentration of fatty acids, prevent the degeneration of the liver tissue, enhance the ability to neutralize toxins and restore cells, reduce the accumulation of fat.
The use of drugs of this group in wide clinical practice is debatable - from complete rejection to consideration as basic drugs for any liver pathology. Already in 1970, a list of stringent requirements for an ideal hepatoprotector was defined:

• the drug must be completely absorbed (absorbed) when taken orally;
• the medicine from the digestive tract should immediately enter the liver;
• have the ability to bind toxins or prevent their formation;
• reduce inflammation and suppress fibrogenesis;
• stimulate the regenerative abilities of the liver;
• improve metabolic processes (metabolism);
• not be toxic yourself;
• have extensive (associated with a quantitative, not qualitative change) cyclic circulation of bile acids in the digestive organs.

There is still no ideal drug with the properties listed in the work of Preisig R.. However, interest in the topic has not waned. The pharmaceutical market is filled with drugs that claim to be a hepatoprotector, but:

1. The mechanisms of action of many hepatoprotectors have not been fully established. This creates understandable difficulties in determining the indications for their use.
2. With all the variety of drugs on the pharmaceutical market, almost all of them lack reliable scientific data with a high level of evidence - large-scale multicenter randomized (random) placebo-controlled studies that would prove that hepatoprotective agents have a positive effect on the human body.

The opinion of the main part of medical practice experts is as follows: before bringing a hepatoprotective drug to the market, you should first carefully study what biochemical effects it gives, on what principle the drug acts on the human body, what chemical transformations occur with the drug when ingested, and how this can affect the patient's health.
The drug should have a positive effect on the main indicators of people's health - if the patient is sick, it is important to cure him, if he managed to save, then it is important that he live as long as possible.

When promoting a hepatoprotector in the pharmaceutical market, manufacturers rely on the opinion of experts who claim that their drug has a direct therapeutic effect - there is a positive dynamics of biochemical and physiological parameters, which is specifically targeted by the drug. This is a decrease in the symptoms of the disease, normalization of blood pressure, an increase in hemoglobin, restoration of functions. However, clinical and biochemical parameters are intermediate criteria. Doctors can not navigate them. The medicine should save from death, prolong life.
What is true in the treatment of hepatoprotectors? For all drugs, the main criterion is survival. Information on the effectiveness of hepatoprotectors is taken:

1. From systematic reviews.
2. In prospective randomized (reliable clinical) studies.

If not, then in descending order of importance:

• large prospective comparative but not randomized trials;
• retrospective comparative studies on a large group;
• on individual patients;
• a formalized opinion of experts, for example, obtained by the Delphi method (surveys, interviews, brainstorming sessions are conducted to achieve maximum unanimity in determining the right solution).

From the point of view of evidence-based medicine (a real system of actions, embedding one's own experience with the experience reflected in reliable clinical studies and reviews), the opinions of experts and specialists, as well as a series of cases, have a low level of evidence.

Medicine is a science. There is no truth in science. There are scientific facts proven or unproven in the course of a reliable scientific experiment. Such an experiment in medicine is randomized (random) double-blind placebo-controlled studies, when neither the doctor nor the patient during this event knows what the patient is receiving: a placebo (dummy medicine) or a drug. With such research, there is no way to manipulate the results.
A doctor in his work can rely on his own data only when there are no more valuable higher evidence. Therefore, from the standpoint of evidence-based medicine, all hepatoprotectors are divided into four groups:

1. With proven effectiveness.
2. With dubious (debatable) effectiveness.
3. Proven to be ineffective.
4. Hepatoprotectors that do not have reliable studies.

Modern methods of drug therapy for liver diseases do not reject the use of hepatoprotectors. However, the term is to some extent discredited by referring to this group of drugs, the effectiveness of which is highly questionable. The basis for the use of a number of them is often only the manufacturer's statements about the pharmacological properties of such "hepatoprotectors", based on the inconclusive results of uncontrolled studies. The fourth group includes hepatoprotectors that have not passed a single study proving their effectiveness and, importantly, safety.

Hepatoprotectors with proven effectiveness

The only hepatoprotector with high proven efficacy (randomized, double-blind, placebo-controlled studies) is the pharmaceutical substance with the international non-proprietary name ademetionine. Manufacturing companies produce these drugs under their own brand names. In Russian pharmacies, ademetionine is sold as Heptral (Italy) and Heptor (Russia).

Ademetionine is a substance that is produced in the liver of each of us from the food that contains methionine: meat, dairy products, fish. Glutathione is formed from ademetionine through a series of biochemical reactions. It takes part in all mechanisms of cellular detoxification (destruction and neutralization of toxins) in all types of poisoning.
Ademetionine is a precursor of glutathione. There is no drug that synthesizes glutathione. In all cases, in the treatment of intoxication, ademetionine is used, from which glutothione is produced.

Ademetionine and alcoholic liver disease

Patients with chronic alcoholism as a result of the destructive toxic effect of ethanol, or rather, the main product of its decay - acetaldehyde, suffer from alcoholic liver disease, leading to cirrhosis.

The poisonous effect of acetaldehyde depletes glutathione, an antioxidant that protects the cell from toxic agents. Due to the lack of an antioxidant, the secretion of substances involved in oxidative processes that have a detrimental effect on the liver increases. Cell membranes are damaged, collagen, the basis of connective tissue, begins to be excessively produced. Connective tissue begins to grow, replacing liver cells. fibrosis develops.
The goal of treating patients with alcoholic liver disease is to prevent the formation of fibrosis, and then cirrhosis. The direct task of therapy is to restore the biochemical parameters of the blood, eliminate pain, indigestion and depression.

Based on the reasons for the development of the disease, for the successful treatment of patients, it is of great importance to restore the lack of biologically active compounds that play an important role in all metabolic processes of the body. Therefore, hepatoprotectors based on ademetionine are also included in the complex treatment of pathology. This substance is found in all tissues and environments of the body, is actively involved in many biological processes, and is produced mainly in the liver.

Under the influence of alcohol, drugs, drugs, ademetionine is consumed very intensively, its resources are depleted, and there is a shortage of this active chemical. As a result, the production of other enzymes necessary for life support is disrupted, and their activity decreases. The liver can no longer cope with the neutralization of toxins, can not perform protective functions. The restoration of its main cells, hepatocytes, is also disrupted.

Taking ademetionine preparations compensates for the lack of a substance and stimulates its production in the body, primarily in the liver and brain. Clinical studies confirm that the use of ademetionine in the treatment of alcoholic liver disease increases the concentration of glutathione in the tissue of the organ, and also positively affects the survival of patients, especially in severe forms of the disease.

The effectiveness of ademetionine has been proven by the Spanish professor J.M. Mato. The study was published in 1999 in the prestigious medical journal of hepatology. The professor took a severe group of patients with alcoholic cirrhosis of the liver. One group received a placebo (dummy medicine), the other received ademetionine 3 tablets (1200 mg) per day for two years daily.

The study concluded that overall survival was significantly higher in the group of patients treated with ademetionine - 29% versus 12%. This concerned patients with cirrhosis of the liver, which could still be cured (class A and B). With the development of pathology at the level of class C, only liver transplantation saves.
Dosage forms of the drug - enteric-coated tablets 400 mg 20 pieces, lyophilisate (dried substance) 400 mg in a vial of 5 ampoules for preparing a solution for intravenous and intramuscular administration. The drug works much more effectively when used in the form of injections.

Ademetionine and chemotherapy

In the liver, almost all drugs against malignant tumors are activated and disintegrated. Toxic decay products hit her. When the liver is damaged by drugs, a “feedback” effect is created, when, due to the destruction of hepatocytes in the blood plasma, the concentration of the chemotherapy drug increases, and this, in turn, increases the toxic effect on the liver. The most poisonous drugs include fluorouracil, methotrexate, cyclophosphamide, epirubicin, doxorubicin.

You can understand how ademetionine works using the example of chemotherapy. The study was conducted by an Italian gastroenterologist practicing at the oncology center, Bruno Vincenti. The doctor conducted a study on patients with colorectal cancer who were treated with chemotherapy drugs. One group received a placebo, the other - ademetionine tablets. The reduction in chemotherapy-induced hepatotoxicity in the group that did not receive ademetionine was 44%, and in the group with ademetionine, the figure decreased to 12%.

Ademetionine and depression

Ademetionine is produced in the liver and consumed by the brain. All mental illnesses occur with a deficiency of ademetionine. Depressive syndrome is closely related to liver diseases: being in such a state, those who did not drink begin to drink, and those who drank drink even more. Many begin to eat a lot, overeating. This affects the liver.
Ademetionine treats depressive syndromes. As a result of a randomized, double-blind, placebo-controlled study, the effectiveness of the drug in the treatment of this disease, including in women during menopause, has been proven. Depressed menopausal women who took 4 tablets a day began to feel better already on the 10th day of the study.

In 2010, the antidepressant effect of ademetionine was confirmed by Professor G.I. Papakostas in Boston and published in the American Journal of Psychiatry. The patients suffered from depression, which could not be cured by the most modern serotonin reuptake inhibitors. Additionally prescribed ademetionine gave an effective result.
Indications for taking drugs based on ademetionine include:

• • hepatocellular or canalicular cholestasis due to acute and chronic liver diseases, passing with the syndrome of intrahepatic cholestasis and drug-induced hepatitis;
  • drug-induced hepatitis;
  • fatty degeneration of the liver;
  • hepatitis of alcoholic origin;
  • alcoholic liver disease;
  • liver fibrosis;
  • cirrhosis of the liver;
  • hepatic encephalopathy;
  • acute liver failure;
  • depression.

Medicines Heptral and Heptor are universal remedies with a wide range of clinical practice.

Hepatoprotectors Requiring Additional Evidence of Efficacy

Hepatoprotectors that require additional evidence of effectiveness are ursodeoxycholic acid (UDCA) and L-ornithine-L-aspartate (LOLA).

Ursodeoxycholic acid (UDCA)

Medicines containing ursodeoxycholic acid are produced under the following trade names: Ursosan, Ursofalk, Urdox, Ursodez, Livodex, Ursor, Ursoliv, Choludexan, Exhol, Grinterol.
Ursodeoxycholic acid belongs to the group of bile acids. The mechanisms of its work are not fully understood, as they are quite complex. It is assumed that UDCA effectively protects tissue cells by inhibiting the absorption of toxic cholic (bile) acids in the lower small intestine.
Ursodeoxycholic acid:

• • • reduces the concentration of cholesterol in bile, inhibiting its absorption in the intestine, suppressing production in the liver and reducing secretion into bile;
    • increases the solubility of cholesterol;
    • reduces the tendency of bile to form stones, increasing the content of bile acids in it.

Ursodeoxycholic acid is indicated in three cases:

• • 1. primary biliary cirrhosis of the liver to reduce clinical symptoms;
    2. dissolution of small and medium cholesterol gallstones;
    3. biliary reflux gastritis.

Ursodeoxycholic acid also has a regulatory effect on the immune system.

Ursodeoxycholic acid and gallstone disease

In 1993, 23 scientific studies were carried out. It involved 2000 patients. It has been proven that taking UDCA for more than 6 months leads to the dissolution of stones in 38% of patients with cholelithiasis.
Moreover, if ursodeoxycholic acid is combined with chenodoxycholic acid, making one drug, then the stones will dissolve in 70% of cases. But chenodoxycholic acid turned out to be a toxin, and the product was discontinued.
The appointment of a drug based on ursodeoxycholic acid is pathogenetically justified in diseases accompanied by intrahepatic cholestasis (reduced bile flow):

• • • primary sclerosing cholangitis;
    • chronic hepatitis with a cholestatic component (especially alcoholic and medicinal);
    • cystic fibrosis (cystic fibrosis);
    • atresia of the intrahepatic bile ducts;
    • cholestasis syndrome after liver transplantation;
    • cholestasis with parenteral (intravenous) nutrition.

However, gallstone disease is not a liver disease.

Ursodeoxycholic acid and alcoholic liver disease

In France, in 2003, a randomized (random) controlled trial of people with alcoholic cirrhosis of the liver with jaundice was conducted. The goal is to establish how ursodeoxycholic acid affects the survival of people.

The study was conducted with the participation of 24 medical centers. 139 men and 87 women (226 patients) were examined, in whom the presence of cirrhosis of the liver due to alcohol abuse was clinically proven. The patients also suffered from high levels of bilirubin in the blood. The average biological age of the participants was 49 years. The subjects were divided into two groups. In the main group, patients received UDCA according to the scheme of 13-15 mg per kilogram of body weight per day for six months, in the control group - placebo. During the study, 55 participants died. Among those who took UDCA - 35 people, in the group who took placebo - 20 patients.

With further intention to treat, the monthly survival rate among those taking ursodeoxycholic acid was lower than among those taking placebo (69% versus 82%, respectively). According to the main clinical and biological parameters, the content of bilirubin was higher in those who took ursodeoxycholic acid.
Later, it was possible to prove that ursodeoxycholic acid in alcoholic liver pathology is the maximum placebo. There is no convincing scientific evidence that this drug has a positive effect on survival in this disease.

Ursodeoxycholic acid and primary biliary cirrhosis

Primary biliary cirrhosis is a rare pathology that is very difficult to cure. Evidence-based research was carried out in 2001. In the course of its implementation, the authors proved that taking ursodeoxycholic acid significantly reduces jaundice, reduces the content of serum enzymes, bilirubin. But on itching, mortality, liver transplantation, fatigue, quality of life, accompanying autoimmune conditions, liver structure, pressure in the portal vein, the effect of the drug has not been confirmed.

Later in 2009, the guidelines of the European Community for the Study of the Liver recommended that with appropriate dosage and early treatment of primary biliary cirrhosis, especially those forms of the disease that significantly reduce the level of alanine aminotransferase, the appointment of hepatoprotective agents UDCA still have a positive effect on survival. But if the liver is already impaired, ursodeoxycholic acid cannot be prescribed.
Disadvantages of prescribing the drug:

• • 1. There is no form for injection (parenteral) administration of the drug.
    2. A side effect of using the medication is a violation of the stool (looseness).

Taken on a global scale, ursodeoxycholic acid is the only drug in the world's medical practice that, in high-level research, has shown a real result in increasing life expectancy in primary biliary cirrhosis. But the drug helps only with this pathology. Indications for the use of drugs based on ursodeoxycholic acid are expanding without evidence.

L-ornithine-L-aspartate (LOLA)

Trade names of the drug L-ornithine-L-aspartate: Ornitox (Great Britain), Ornithine (Russia), Hepa-Merz (Germany), Hepatox (Ukraine), Lornamin (Ukraine).
L-ornithine-L-aspartate, separated into aspartate and ornithine, is actively absorbed through the intestinal epithelial tissue in the small intestine. Both amino acids participate in the coordination of metabolic (exchange) processes in the main cells of the liver. In addition, aspartate serves as the main medium for the production of the amino acid glutamine, neutralizes ammonia by binding it in tissues. When the liver cannot cope with the neutralization of toxins, L-ornithine-L-aspartate reduces the amount of ammonia in the brain and other organs.

The drug is prescribed for hepatic encephalopathy, cirrhosis of the liver, non-alcoholic steatohepatitis, and various forms of hepatitis.
Eight studies with a high level of evidence (randomized clinical trials) confirmed that L-ornithine-L-aspartate (Ornitox, Hepa-Merz, Ornithine) is more effective than those who took placebo. The drug is effective in hepatic encephalopathy, lowers the concentration of ammonia in the blood. At the same time, when prescribing L-ornithine-L-aspartate, the frequency of adverse reactions does not increase, and the indicators of therapy tolerance do not decrease.

However, a joint analysis of two randomized clinical trials also confirms that lactulose has a similar efficacy in improving the treatment of hepatic encephalopathy. But lactulose is much cheaper. Also, the results of a high-quality study - analysis and evaluation of a number of published homogeneous original studies (systematic review) - suggest that L-ornithine-L-aspartate does not improve survival rates.

Hepatoprotectors with proven inefficiency

Hepatoprotectors, the inefficiency of which has been proven, include essential phospholipids and preparations based on milk thistle flavonoid extract.

Essential phospholipids

The plasma (cell) membrane of liver cells is 75% composed of phospholipids. Complex lipids perform not only a building function, but also others - they are involved in cell division, transport substances from one cell to another, and stimulate the activity of various enzyme systems.
Toxic substances damage the membranes of hepatocytes. This disrupts metabolic processes, the cell dies. Essential phospholipids strengthen the plasma membrane. This property is the basis of the hepatoprotective mechanism of drugs - to save the liver from fibrotic degeneration of tissues.

The effect of hepatoprotective agents based on essential phospholipids was investigated by Charles Lieber. An American scientist conducted a high-quality evidence study - randomized, double-blind, placebo-controlled. Charles Lieber was an employee at the US Army Veterans Treatment Center. In 1994, he conducted research on monkeys and there were good achievements in this direction of work. Essential phospholipids prevented fibrosis as well as cirrhosis in baboons.
To assess how essential phospholipids affect the development of liver fibrosis in alcoholic pathology, in 2003 the scientist conducted a study on humans. A study involving 789 patients was conducted at 20 US Veterans Affairs medical centers. The average age of the subjects was 48.8 years. Prior to the start of the experiment, participants drank about 16 servings of alcohol per day (one serving contains 10 grams of pure alcohol).

At the beginning of the study, a liver biopsy was performed. Further, the patients were divided into two groups. Patients in the first group took daily polyunsaturated phosphatidylcholine tablets in a total daily dose of 4.5 grams for two years. The second group took a placebo. After 24 months, they were re-examined for a biopsy.
The study showed that there was no significant difference between the groups: deterioration in the course of fibrosis in those who took essential phospholipids - 22.8%, in the placebo group - 20.0%.

Based on the results of the research, the authors concluded that the daily administration of essential photolipids for 24 months has no effect on the course of liver fibrosis. Moreover, the authors concluded that essential phospholipids are contraindicated in acute and chronic viral hepatitis, because they can reduce bile secretion and contribute to the destruction of the cell structure.

Since 2003, essential phospholipids have not been used in the United States of America or in the European Union. On the world market, they are sold exclusively as biologically active additives (BAA). As drugs, they are registered only in the post-Soviet space. Few studies demonstrate that essential phospholipids improve the well-being of patients, some biochemical parameters.
Disadvantages of the drug:

• • 1. The destruction of the plasma membrane of hepatocytes is observed with any inflammation of the liver tissues, however, the course of this process is subject to complex, more subtle natural laws. Only the strengthening of the cell membrane by obtaining essential phospholipids from the external environment does not affect inflammatory processes. The root cause of pathogenetic damage to the organ should be eliminated.
    2. No one has reliably proven that plant essential phospholipids that enter the body from outside have the ability to integrate into the shell of an animal cell.
    3. The effectiveness of drugs is confirmed only by the opinions of experts. And this level of evidence is the lowest in terms of significance and reliability. There are no published scientific papers.
    4. Upon entering the body, phospholipids enter the lymph, are transported to adipose tissue, where metabolic processes take place. Few substances reach the liver. The drug has low bioavailability.

The basis of any hepatoprotector, the pharmacological action of which is essential phospholipids, is soy:

• • • Essentiale forte N - phospholipids from soybeans;
    • Esslidine - soy + methionine;
    • Essliver forte - soy + vitamins of group B, PP, E;
    • Phosfonciale - soy + milk thistle;
    • Rezalut - soy lecithin;
    • Livolin Forte - soy lecithin + B 1, B 2, B 6, B 12, PP, E;
    • Phosphogliv - soy + glycerrisic acid.

Soy has been used in folk medicine for centuries. Take medicine from food. It's inexpensive and useful. A daily dose of regular food provides the body with five grams of essential phospholipids. Most of all and in the most varied amount of essential phospholipids are found in the yolk of a chicken egg - 3 - 4%. They are also found in sufficient quantities in poultry, fish, legumes, and meat. Enter into the diet sunflower seeds, unrefined sunflower oil.

Milk thistle preparations

Silymarin flavonoids are a constituent of milk thistle flavonoid extract. In turn, silymarin is a mixture of three main compounds - silibinin, silychristin and silidianin. Hepatoprotectors of a similar composition: Silibinin, Silibor, Gepabene, Karsil, Leprotek, Silimar, Silymarin, Legalon.

The instructions indicate that silymarin is a natural antioxidant, regulates cell function, has antitoxic properties, preventing some poisons from penetrating into hepatocides. The drug promotes the production of proteins and complex lipids for the regeneration of the plasma membrane - the cell membrane. Medicines improve the general condition of patients with liver damage by poisons, including alcohol toxins.
Disadvantages of the drug:

• • 1. Silibinin, which has not undergone specific processing, has low bioavailability - little active substance reaches the liver.
    2. The drug should be taken with caution in patients with cholestasis - milk thistle preparations can increase bile stasis.

Milk thistle preparations are safe to use, but, unfortunately, they are ineffective. This was proven by studies conducted in 1998, which had a high level of evidence - a randomized, multicenter, double-blind study. Further studies were carried out in 2001 and 2008. The results conclusively confirmed that silymarin preparations are not effective. Which was subsequently confirmed by a meta-analysis of medical trials.

Meta-analysis involves the study of all research on the relevant problem. The final conclusion is the following: in alcoholic liver disease, hepatitis B and C, silymarin has little effect on sick people compared to the placebo group. The frequency of complications when taking milk thistle extract did not decrease, and the death of the disease did not decrease either.
Milk thistle is a placebo substance with no apparent medicinal properties. The only plus of the research is that it can be said with certainty that the drug is safe to use.

Hepatoprotectors without reliable studies

There is not a single reliable study confirming the effectiveness of all other drugs that claim to be called hepatoprotectors. These are Allohol, Liv.52, Remaxol, Ropren, Progepar, Hofitol, Holosas, Tanacehol and others. They cannot be attributed to medicines, the effectiveness of which has been proven. These drugs except Russia are not used anywhere else. Nevertheless, such drugs traditionally occupy a certain place in the treatment of various diseases of the liver and bile ducts.

Hepatoprotectors include drugs based on bovine liver extract. Animal preparations are hydrolysates that contain vitamin B12, secondary metabolites, amino acids, and, presumably, fragments of substances that stimulate liver regeneration.
The instructions say that the drug preserves and restores the structure of hepatocytes, inhibits the formation of fibrosis, promotes the regeneration of that part of the parenchyma that has undergone destruction, promotes more active circulation of local blood flow in the liver tissue, increases the volume of urine, improves the functional performance of the liver.

The drugs are recommended for use in complex therapy for chronic hepatitis, fatty degeneration of the liver of various origins, toxic hepatitis, including alcoholic hepatitis, and cirrhosis of the liver. But no studies have been conducted to confirm their effectiveness.
At the same time, the fact remains that drugs in this group are potentially dangerous. They should not be taken by patients with forms of hepatitis in the active stage, as they can aggravate cell destruction, immune inflammation syndrome, and reduce the body's defenses. Medicines based on animal liver extract have strong allergenic properties.

There are facts that taking hepatoprotectors of animal origin is associated with the risk of infection of the patient due to insufficient microbiological purity of the drug. Specifically, bovine liver extract can infect humans with a prion (protein) infection. It causes a serious disease of the nervous system - spongiform encephalopathy (mad cow disease), which affects cattle.

The effectiveness of such drugs has not been proven. And there is a potential danger to the body if used. Animal drugs cannot be used in medical practice.
Here, as an example, I would like to give the following. In Russia, hepatoprotector Sibektan is sold. The drug consists of four plant components, one of which is St. John's wort. St. John's wort is an extremely hepatotoxic herb. The concentration of a toxic substance in it is comparable to a course of chemotherapy for colon cancer. And the remedy is classified as hepatoprotective.

Until now, the final point of view on the effectiveness of hepatoprotective agents, their safety and limits of use has not been formed. When choosing an affected liver for therapy, it is important to clearly know the purpose for which they are prescribed, which “targets” need to be influenced to change the course of the disease. Hepatoprotectors contain different active substances, therefore, for each pathology of the liver, the choice of drugs in this group should be approached selectively. And a doctor should prescribe a hepatoprotective agent.

In the table of hepatoprotectors below, low-cost drugs are highlighted in bold.

International non-proprietary name	Trade name of the drug	Price	Release form	Manufacturer
Ademetionine	Heptral	1507 rub.	Tablets 400 mg, 20 pieces	Italy
		2017 rub.	Tablets 500 mg, 20 pieces
		1703 rub.	Lyophizate for solution 400 mg, 5 ampoules
	Heptor	991 rub.	Tablets 400 mg, 20 pieces	Russia
Ursodeoxycholic acid	Ursosan	820 rub.	Capsules 250 mg, 50 pieces	Czech Republic
	Ursofalk	949 rub.	Capsules 250 mg, 50 pieces	Germany
	Urdox	752 rub.	Capsules 250 mg, 50 pieces	Russia
	Exhol	1446 rub.	Capsules 250 mg, 100 pieces	Russia
L-ornithine-L-aspartate	Hepa-Merz	2583 rub.	Concentrate for solution for infusion, 10ml, 10 ampoules	Germany
	Ornithine	685 rub.	Granules for solution, 3 g, 10 pieces	Russia
Essential phospholipids	Essentiale Forte N	636 rub.	Capsules 300mg, 30 pieces	Germany
	Phosphogliv	480 rub.	Capsules, 50 pieces	Russia
	Phosfonciale	433 rub.	Capsules, 30 pieces	Russia
	Rezalut pro	471 rub.	Capsules 300 mg, 30 pieces	Germany
Milk Thistle Flavonoid Extract	Karsil	366 rub.	Dragee 35 mg, 80 pieces	Bulgaria
	Legalon	243 rub.	Capsules 70 mg, 30 pieces	Germany
	Silimar	103 rub.	Tablets 100 mg, 30 pieces	Russia

The liver is the largest gland in the human body, an internal organ that is located in the human peritoneum. She is responsible for the production of bile. But this is not the only function. The liver neutralizes poisons that come with the blood, toxins, allergens, and absorbs harmful bacteria. In addition, this organ is involved in metabolic processes, hematopoiesis and performs many other useful functions. That is why it is necessary to select drugs for the treatment of the liver with special attention.

Good to know

The liver has an amazing property. Few human organs are able to actively regenerate. Patients who have three-quarters of the gland removed have every chance of restoring it to its original size.

Speaking about the effective treatment of the liver, it should be noted that the best method of dealing with ailments of the organ is a timely appeal to specialist doctors.

It is very difficult to determine the moment when problems with the gland occur. The first symptomatology is poorly expressed. As a rule, people do not pay attention to the occurrence of belching. Nausea after eating or slight discomfort in the right hypochondrium are not considered sufficient reasons for a visit to the doctor.

The liver has no nerve endings. Therefore, for a long time it may not bother its owner at all. The patient comes to the doctor with a feeling of severe heaviness in the right side. But, unfortunately, this symptomatology already indicates serious problems with the gland.

But it is not all that bad. Modern medicine has developed a wonderful liver. They are able to perfectly protect it from further destruction and help restore.

Causes of diseases

Before considering which drugs for the treatment of the liver are most effective, it is necessary to understand what effect is detrimental to this organ. The tissues of the gland are distinguished by their tremendous ability to recover. In addition, the liver is quite resistant to harmful environmental manifestations. And yet, some factors can cause her serious harm:

As you can see, diseases often arise from an incorrect lifestyle. Patients who have established a healthy diet, abandoned bad habits, spent the liver, were able to completely heal the organ.

Classification of drugs

Drugs for the treatment of the liver are divided into three subgroups:

1. Hepatoprotective drugs. They are aimed at improving metabolic processes in the body, increasing resistance to various pathogenic effects, and accelerating the recovery of its functions after damage. This group includes many effective drugs for the treatment of the liver. List of the most popular drugs: Essentiale Forte, Karsil, Ovesol, Progepar, Hepatamine, Hepel.
2. Choleretic drugs. Such drugs increase the secretion of bile, thereby facilitating its release into the duodenal cavity. For these purposes, the drugs "Allohol", "Holenzim" are effectively used.
3. Cholelitholytic aimed at dissolving gallstones. These include ursodeoxycholic acid and chenodeoxycholic acid.

Consider the most effective and popular drugs for the treatment of the liver.

The drug "Essentiale Forte"

A complex agent containing phospholipids. Improves the condition of cell membranes. It contains only natural ingredients. Quite effectively, such drugs are used to treat the liver, especially in autoimmune hepatitis, toxic damage.

The tool perfectly improves the exchange. In addition, it helps lower cholesterol levels. Another positive aspect of this drug is a beneficial effect on the cardiovascular system.

The drug is well tolerated by children and adults. This remedy is not contraindicated for pregnant and lactating women. It is often used as adjuvant therapy for radiation sickness and psoriasis. It is an excellent prophylactic for recurrence of stone formation in the gallbladder.

However, the tool also has its drawbacks. In case of sensitivity to any of the components of the drug, it should not be used. Sometimes side reactions are possible, which are manifested by diarrhea, allergies, or pain in the abdomen.

The drug "Legalon"

The product is based on the extract of spotted milk thistle. Analogues are the drugs Silibor, Karsil, Silibinin. Due to their composition, these drugs are quite in demand for the treatment of the liver.

The drug has a strong hepatoprotective effect. It significantly improves digestion and intracellular metabolism. The drug is able to stabilize the membranes of hepatocytes. The tool is included in therapy for any liver ailments. In addition, it has a rapid healing effect.

The use of this remedy improves the breakdown of lactic acid by the liver. This process helps to increase the overall endurance of the body. In addition, the "Legalon" agent binds free radicals, as a result of which inflammation in the organ is reduced.

Medicine "Karsil"

Considering the best drugs for the treatment of the liver, it is impossible to ignore this wonderful remedy. It is widely used to restore the functions of the gland. It is often prescribed for prophylactic purposes, to prevent the pathological development of changes in liver cells.

Such a preparation was created on the basis of an extract of the fruits of spotted milk thistle. Indications for use are liver ailments, such as steatosis, hepatitis, cirrhosis of completely different etiology (drug, viral, toxic). The drug is an excellent prophylactic for long-term use of hepatotoxic drugs.

Allowed to receive children who are 12 years old. Almost always well tolerated. Very rarely side effects can develop.

However, the drug also has disadvantages. It is forbidden to take this drug during pregnancy and lactation. Sometimes there may be side effects such as nausea, diarrhea, itching, baldness, vestibular disorders.

Women should use the Karsil drug with extreme caution in case of ailments of the reproductive system that occur with hormonal disorders (endometriosis, fibromyoma, carcinoma of the breast, ovaries or uterus). Caution should also be observed by men who have a prostate tumor.

The drug "Heptral"

It should not be forgotten that only a doctor can recommend the best liver. Some patients may be prescribed this drug.

The drug exhibits hepatoprotective properties. The main active ingredient is ademetionine. This drug has detoxifying, neuroprotective, antioxidant, regenerating and antifibrosing effects.

Multiple positive properties allow you to assign it when:

1. Fatty degenerations of the liver.
2. A variety of toxic lesions of organs (hepatitis, alcoholic hepatosis), with drug pathology that arose with prolonged use of antitumor, antituberculosis, antiviral drugs.
3. Cirrhosis, fibrosis of the gland.
4. Intoxication with alcohol, drugs, drugs, food.

When choosing effective drugs for the treatment of the liver for the patient, the doctor often advises the medicine "Heptral". It is not surprising, because the tool has a number of advantages. For patients in whom liver pathology is combined with other serious ailments (encephalopathy, depression, diseases of the joints, bones), this medicine is most suitable.

However, you should be very careful with the remedy, as it has a large number of side effects. These can be headaches, impaired consciousness and sleep, allergic reactions, heart failure, nausea, diarrhea, intestinal and stomach bleeding, joint and muscle discomfort.

The drug "Gepabene"

Many effective drugs are widely used to treat liver diseases. The medicine "Gepabene" is one of them. The combined herbal remedy is based on the fruits of milk thistle and herb fumes officinalis. The drug has an active restorative effect. In addition, it perfectly normalizes the outflow of bile.

The main advantages of this drug include:

1. The ability to stabilize the patient's condition after cholecystectomy.
2. Approved for use during pregnancy.
3. It has membrane-stabilizing and antioxidant effects in drug-induced hepatitis, long-term use of hepatotoxic drugs.

The disadvantages of the drug are:

• Not used for acute ailments of the liver and biliary tract.
• Prohibited for use by patients under the age of 18.

The drug "Galstena"

Medicines for the treatment of the liver are available in the form of drops and tablets. The drug "Galsten" is sold in two forms, it is a homeopathic remedy. It is distinguished by an effective and mild hepatoprotective effect. It perfectly normalizes. The drug has anti-inflammatory, antispasmodic and choleretic effects. In addition, an effective remedy prevents stone formation in the gallbladder.

Drops and tablets for the treatment of the liver "Galsten" have many advantages:

1. The composition of the drug includes only vegetable, natural ingredients (milk thistle, celandine, dandelion).
2. The medicine is approved for use at any age. It is used even for newborns.
3. Effective for cholangitis, cholecystitis, pancreatitis, biliary dyskinesia, hepatitis, hepatosis.
4. It is used after to improve the rehabilitation process.
5. It can be used for a long period without causing adverse reactions in the patient.

Like any drug, the tool has disadvantages:

• sometimes there are side effects (diarrhea or increased salivation);
• the drug is not intended for people with alcohol dependence.

Medicine "Hofitol"

Combined preparations for the treatment of the liver are effective. This is exactly what the medicine "Hofitol" is. The agent has an active hepatoprotective, choleretic and moderate diuretic effect. Helps reduce blood azotemia as a result of increased urea excretion. The medicinal effect is due to the artichoke.

The positive aspects of the drug include:

1. Possibility of application for the treatment of chronic cholecystitis (calculous), hepatitis, liver cirrhosis, chronic intoxication, biliary dyskinesia. In addition, it is effective in kidney pathology.
2. It is used in complex therapy for obesity and atherosclerosis.
3. Virtually no contraindications. The exceptions are acute ailments of the kidneys and liver, obstruction of bile duct stones.
4. Can be used for a long period of time.
5. Allowed (under medical supervision) during early toxicosis.
6. It does not affect the reaction rate, therefore it is not contraindicated for drivers.

The disadvantages include the following:

• liver tablets are not intended for children under 6 years of age;
• can provoke side effects: skin itching, diarrhea, headache.

The drug "Rezalut Pro"

An excellent complex hepatoprotector. Able to stabilize membranes and regenerate liver cells. In addition, it normalizes lipid metabolism and lowers cholesterol levels.

The drug is used for:

• hepatitis;
• hepatoses;
• cirrhosis;
• toxic damage to the body;
• fatty degeneration of the gland;
• atherosclerosis;
• hyperlipidemia;
• ailments of blood vessels and heart;
• psoriasis, eczema, neurodermatitis.

With antiphospholipid syndrome, this drug is contraindicated. It is not intended for children under 12 years of age. The remedy is used very carefully by pregnant and lactating women.

Conclusion

The human body is designed in such a way that all organs can be classified into auxiliary and vital. Undoubtedly, the liver belongs to the second group. Its importance for the viability of the organism is great. It is not surprising that any failures in its functioning are reflected in many human systems.

Such a powerful organ combined the functions of the digestive gland and a kind of biochemical laboratory. After all, it is in the liver that all the reactions that are responsible for supporting vital processes occur. But, unfortunately, this body is vulnerable. Even despite the excellent regenerative abilities, the number of patients with gland diseases is steadily growing. That is why it is important to start the fight against pathologies in a timely manner and very carefully select effective drugs for the treatment of the liver.

Dear friends, hello!

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

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 the best time to offer?

How are hepatoprotective drugs divided?

All drugs hepatoprotectors can be divided into 4 groups:

1. Essential phospholipids.
2. Amino acids.
3. Sequestrants (that is, "insulators") of fatty acids.
4. 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 the phospholipids of hepatocyte membranes, as a result of which intracellular metabolism is disturbed, and cells die.

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

When ingested, they, like other fatty molecules, break down under the action of pancreatic lipase and are absorbed through the intestinal wall "in disassembled" form - in the form of phosphatidylcholine (remember this name) and unsaturated fatty acid residues. Moreover, only a part of the incoming phospholipids is absorbed, and a part is excreted through the intestines.

It is in the "disassembled" form that the drug enters the liver and, as necessary, is reassembled into a phospholipid molecule.

In 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 intestine into a medicine.

Another important point.

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

In addition, you know that there are drugs for that suppress the activity of lipase. 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. Suggest a hepatoprotector from another group.

What do phospholipids do?

• Embedded in the membrane of the hepatocyte instead of dead counterparts.
• They bind free radicals, which are formed under the action of toxins.

But here there are two tricks

The first . Given that some of the phospholipids that enter the body are destroyed, the effectiveness of these drugs is low, and they need to 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 just the same phosphatidylcholine, which was mentioned above. In the instructions, its content is indicated as a percentage next to the content of phospholipids.

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

So, by doing simple calculations, you can determine which drug has more active substance.

For example:

In Essential Forte N and Rezalut Pro phosphatidylcholine 228 mg each, in Essliver forte - 87 mg, in the preparation Phosphogliv - 48 mg.

When are essential phospholipids used?

• With liver diseases.
• With toxic liver damage: drugs, alcohol, etc.
• To protect the liver when taking drugs, alcohol.

Let's take a closer look at popular drugs.

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

It is noteworthy that in the testimony, among others, toxicoses are named. Interestingly, due to what the drug works in this case?

2 capsules are taken 2-3 times a day for at least 3 months, which means that in case of liver disease, at least 360 capsules are 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 are interchangeable. Only you will give the first to someone who prefers well-known drugs, and the second to someone 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