Hepatoprotectors - drugs for treating the liver, the best drugs, tablets

The deteriorating environment, the stress of an urbanized society, along with bad habits and unhealthy lifestyles often create difficult conditions for the normal functioning of such a vital element of the human body as the liver.

Considering the importance of the functions it performs, it is necessary to prevent and promptly treat possible pathologies by selecting effective dosage forms. Based on the type of their effect, liver drugs are divided into several main groups, which suggests the need for a careful approach to choosing a drug in each specific case of the disease.

Symptoms of liver dysfunction

Before figuring out which pills to take to prevent the liver, let’s consider what functions it performs and what effects it is exposed to.

A normally functioning organ participates in the processes:

• metabolism, i.e. influence on the metabolism of hormones, proteins, vitamins, carbohydrates and other elements in the body;
• deposition (accumulation) of fats, proteins, minerals and so on that are not absorbed by the body;
• secretion – production of bile for digestion;
• detoxification - functions as a filter, retaining and neutralizing toxic elements;
• removing toxic substances from the body.

Signs that signal kidney disease:

• feeling of fatigue and loss of strength;
• you feel discomfort or spasms in the right hypochondrium;
• loss of appetite, nausea;
• the skin has changed color (a yellow tint or pigmentation has appeared).

When are hepatoprotectors needed?

In Russia there is a huge selection of hepatoprotectors, and these drugs are used very often. Moreover, the cost of the course of treatment costs patients large amounts of money, and many do not feel the result. Disputes about the need and advisability of such therapy have been going on for a long time; in our country, a doctor can prescribe hepatroprotectors in the following cases:

• Viral hepatitis (see symptoms of chronic hepatitis) - they are prescribed if antiviral drugs do not help or for some reason antiviral treatment is not possible. In this case, hepatoprotectors can be used to prevent liver cirrhosis in complex treatment.
• Alcoholic hepatitis, threatened by cirrhosis of the liver - in this case, you should avoid alcohol, these drugs do not have a significant effect. If alcohol intake continues, whether the patient uses hepatoprotectors or not is not important. No, even the best medications for the liver will help if a person continues to drink alcohol.
• Fatty liver disease (non-alcoholic) - in obese patients or those with type 2 diabetes, fat cells also form in the liver, which leads to its destruction (see symptoms of fatty liver disease). In this case, hepatoprotectors are needed to accelerate the effect only with an integrated approach to therapy - a diet that promotes weight loss, increased physical activity, antidiabetic drugs, lowering cholesterol (see how to reduce cholesterol without drugs).
• Drug-induced hepatitis (toxic), primary biliary cirrhosis - certain hepatoprotectors are prescribed in complex therapy.

It should be understood that it is impossible to restore the liver with medications alone; you should follow a diet, limit alcohol intake, quit smoking, and also treat concomitant diseases, since the patient often has impaired functions of other organs involved in digestion - the gallbladder, pancreas.

Why are hepatoprotectors as a class of drugs available only in Russia and the CIS countries?

The class of drugs “hepatoprotectors” exists only in Russia and the CIS countries; most of them are not registered in Europe, North America, or Australia. They are not included in the list of tablets for the treatment of liver diseases due to the fact that their therapeutic effectiveness has not been proven and clinical significance has not been confirmed.

Very rarely, some of them are used in the USA and Europe for narrow indications, used as dietary supplements (that is, their use does not guarantee effect). The French company Sanofi, one of the manufacturers of Essentiale, sends 99% of its production to Russia and the CIS countries, since no one in the world needs this drug.

It is worth noting that the pharmaceutical market in the 21st century is a very profitable business, in which competition is as fierce as in any sector of the market economy. And today it is very difficult to determine how effective a particular drug is, since research (very expensive) is funded by interested parties.

Classification of drugs for the prevention of liver diseases

When choosing which tablets are best for liver prophylaxis, purchase products with a complex effect, because they:

• protect and restore damaged cell membranes;
• activate metabolism in every cell;
• normalize bile production;
• accelerate the synthesis of enzymes;
• help remove toxic substances.

Almost all tablets for the treatment and prevention of the liver contain essential elements that actively affect the functioning of the organ:

• Glycyrrhizic acid has anti-inflammatory, antioxidant, and hepaprotective effects. It counteracts cirrhosis and is included in tablets to prevent the liver from drinking alcohol.
• Phospholipids, which are involved in the regeneration of destroyed cells, are prescribed over a long course (up to 3 months) to achieve a therapeutic effect.
• Ursodeoxycholic acids, which have a choleretic effect and promote the dissolution and removal of small stones. The best medicine for liver prevention with this element is ursofalk, which is taken only as prescribed by a doctor.
• Ademetionine is included in all medications for the liver as a prophylaxis after alcohol, as it restores the activity of the organ after toxic damage.
• Milk thistle extract is the most common natural element with an antioxidant effect, the action of which is the basis for inexpensive medicines for liver prevention.
• Fumitaria officinalis extract is included in preparations for the prevention of the liver and gallbladder, as it relieves spasms and normalizes the formation of bile.

When comparing a list of medications for liver prevention by price, consider the effectiveness of the ingredients and the effect they provide first.

Drugs for the prevention and treatment of liver diseases are divided into:

• means to maintain organ function while taking medications or medical procedures that negatively affect the liver (for example, chemotherapy);
• medications to restore the body after an illness (hepatitis, hepatic dystrophy, etc.);
• drugs as liver prophylaxis before or after drinking alcohol;
• after receiving physical harm to internal organs (trauma, surgery).

Which brand of liver medication is best to choose?

Among the huge variety of modern medications, it is difficult to immediately decide which drugs to cleanse the liver and prevent disorders. Domestic and imported pharmaceutical companies offer natural and safe tablets with improved formulas and new compositions.

The presented manufacturing companies are widely known due to the high quality and effectiveness of their products:

• Sanofi is a French-German pharmaceutical company specializing in a large number of medicines. Since its founding in 2004, the company has become the largest manufacturer of quality drugs, with representatives operating in more than 100 countries.
• Kanonpharma Production is a closed joint stock company in Russia, founded in 1998. In a short period of time, the company quickly acquired a modern production base.
• Madaus GmbH is a German company from Cologne, founded in 2007. The main slogan is the production of medicines using natural resources.
• Pharmcenter Vilar is a domestic pharmaceutical company specializing primarily in the creation of herbal medicines. Since its establishment in 1959, phytochemical production has been continuously improved.
• Clinic of the Institute of Bioregulation and Gerontology - the company has a patented technology for the serial production of drugs of natural origin. Founded in 2002 in St. Petersburg.
• Evalar is the largest production of dietary supplements and natural medicines in Russia, founded in 1991. Today, it is the absolute leader in the country in terms of sales and creation of natural medicines.
• Richard Bittner AG is an Austrian company with the patented trademark “BITTNER”, which is considered a sign of high quality throughout the world. The main activity is the creation of natural and safe medicines.
• Laboratories Rosa - Phytopharma is a French manufacturer specializing in the production of various groups of medications for the treatment of internal diseases.
• Europe-Biopharm is an NPO in Russia, founded back in 1991. Since then, production has been aimed at providing people with natural medicines, dietary supplements and functional foods.
• Merz Pharma is a German world-famous manufacturer of the best drugs of all groups and classifications. The main focus is on the fields of neurology, dermatology and psychiatry. The main advantage is extensive experience, since the company was founded in 1908.
• Falk P harma GmbH the company was founded in Germany in 1960 on the basis of a family pharmacy by Dr. Herbert Falk. Since then, the main activity has been aimed at producing drugs for the needs of hepatology and gastroenterology.
• Merkle GmbH - the creator was the richest man, Adolf Merkle. The company was founded in 1881, first in the Czech Republic and Slovakia, and after the war the activities moved to Germany.
• Sopharma is a private Bulgarian manufacturer that has been giving people health for more than 80 years. In 1933, an association of pharmacists began to create a laboratory; since then, technologies have been constantly improved and natural, effective medicines are created.
• Abbott Laboratories is a chemical and pharmaceutical manufacturer from America, founded in 1888. In addition to medicines, it produces baby food, medicinal products and supplements.
• R.P. Scherer GmbH & Co. KG is a German company founded in 1950 by Robert Pauli Scherer, who developed the soft capsule form. In addition, they produce various essential oils, multivitamins, and dietary supplements.

Hepaprotectors

Helps with discomfort. Hepaprotectors are inexpensive drugs for liver prevention that have a preventive effect. Such tablets for liver prevention are sold without a doctor's prescription, as they have a mild effect.

Ovesol

Ovesol detoxifies and restores the bile ducts. An inexpensive drug for the prevention of liver diseases, as it consists of natural ingredients (immortelle, oats, peppermint, turmeric roots and others). Take 1 tablet or 15-20 drops 2 times a day with meals. Repeat the course of treatment 3-4 times a year for 20-30 days. Contraindicated: pregnant and lactating women, children, persons with hypersensitivity to one of the components.

Stabilin

The drug is produced on the basis of natural ingredients:

• amino acids, which help produce new biologically active substances;
• L-caratine prevents oxygen starvation, increases the secretion of gastric juice;
• L-tyrosine works as a fat burner;
• B vitamins help normalize metabolic processes and participate in cell renewal;
• extracts of artichoke, tryptophan and glycine improve the permeability of blood vessels and accelerate metabolic processes.

All components are selected to combine with each other and enhance each other’s effects. This ensures a mild effect of the drug on the body. Stabilin drops can be used for prevention and periodic cleansing of the liver from waste and toxins. Dissolve 3-5 drops in liquid (water, tea, juice). Take morning and evening. Thanks to its natural composition, Stabilin has virtually no contraindications. Pregnant and lactating women should always consult a doctor before use. The drug is contraindicated for people with individual intolerance to the components of Stabilen.

	Clears away toxins and impurities
	Restores liver cells
	Increases resistance to infections

Stabilin drops are a new generation hepatoprotector that facilitates and supports liver function. For 1 course, the drug helps protect the liver from destruction. Stabilin drops replenish the supply of vitamins and nutrients.

Essentiale forte N

The drug is made from natural ingredients and causes virtually no negative consequences. The instructions for use for Essentiale Forte N recommend taking 2 tablets (capsules) 3 times a day (up to 6 tablets) per day. Analogues of Essentiale Forte N: Antraliv, Livolife, Essliver, Livenciale.

Hepatoprotectors

Among the most effective hepatoprotectors that are used in complex therapy, the following are worth highlighting.

Phosphogliv

A combination drug made on the basis of glycyrrhizic acid and phospholipids. Phosphogliv has a membrane-stabilizing, antioxidant, anti-inflammatory and antifibrotic effect. Doctors often prescribe Phosphogliv for the treatment of hepatosis of various origins, for the treatment of fibrosis, toxic and drug-induced hepatitis, and chronic viral hepatitis.

The drug goes on sale in capsule form. You can purchase it without a prescription. It is contraindicated to take capsules while pregnant and during lactation. The cost of Phosphogliv is 450-470 rubles per package.

Rezalut

The best remedy, a hepatoprotector, which includes vitamin E. Rezalut goes on sale in the form of capsules that improve fat metabolism and can help restore liver cells. The medication is prescribed for the treatment of fatty hepatosis.

Side effects such as diarrhea, skin rash and hives may occur when taking the drug. It is contraindicated to take capsules while pregnant, during lactation, and for children under 16 years of age. A package of medicines costs 790–820 rubles.

Essentiale

Its active component is essential phospholipids. Its effect is similar to the principle of action of the drug Resolute. Helps restore liver cells. The composition does not include vitamin E. Essentiale is actively used for the treatment of fatty liver and hepatitis.

A large package of medication will cost 1850–1900 rubles. After taking the capsules, individual intolerance and antiphospholipid syndrome may occur. Essential phospholipids restore damaged cells.

Essliver Forte

An effective product made on the basis of phosphatidylcholine, vitamins B, E and PP. The medication is excellent for the prevention of liver diseases. Occasionally it can be used for complex treatment. As a result of taking Essliver, allergic rashes on the skin and a feeling of discomfort in the upper abdomen may occur.

It is contraindicated to take the medicine for pregnant women, nursing mothers and children. The average price of a medicine is 460–480 rubles.

Drugs for the prevention of liver after alcohol

Leviron Duo

The Leviron Duo complex consists of two components:

1. Liver oil is taken on an empty stomach 3 times a day, 1 scoop.
2. Drops are taken 30 minutes before meals. Dissolve 10 drops in a glass of water.

The course of application is about a month. The drug can be used for the complex treatment of liver diseases and for prevention, since many diseases can occur without symptoms in the initial stages. In addition, undergo regular medical examinations to ensure timely detection of pathologies.

The composition of the drug includes:

• polysaccharides quickly remove waste and toxins;
• larch bark extract slows down the aging process;
• The mineral-vitamin complex restores metabolic processes and strengthens the immune system.

	Clears the effects of alcohol
	Relieves pain and heaviness
	Gently cleanses the liver of bile
	Protects against the effects of alcohol and smoking

Not only ordinary patients, but also celebrities leave positive results for liver restoration. The supplement helps solve liver problems within a month. In addition, many users note an improvement in skin condition, normalization of the gastrointestinal tract, and increased immunity.

Heptral

Heptral is recommended in case of damage to the organ by alcohol, drugs or toxic substances. The drug has concomitant antidepressant and antioxidant effects. It cleanses the liver and accelerates its regeneration, normalizes the functioning of the gallbladder. How to take Heptral tablets for liver prevention: 2-4 tablets of 400 mg between meals, without chewing. The drug has a number of side effects from the nervous system (dizziness, insomnia, headache), digestive system (bloating, diarrhea, nausea, vomiting), etc. Before taking, consult your doctor.

Karsil

Karsil - inexpensive tablets for the prevention of liver diseases. Allowed for children over 12 years old. Help relieve the effects of hepatitis, cirrhosis, and alcohol poisoning. For preventive purposes, take 2-3 tablets a day before meals with water.

Liv 52

An inexpensive and effective medicine for liver prevention - Liv 52 is made from plant materials (capers, chicory, yarrow). Recommended for cleansing the body after taking alcohol, antibiotics, oral contraceptives and other medications. In the instructions for use, Liv 52 is approved for children from 6 years of age. For prevention, take 2 tablets 2 times a day, regardless of meals.

Phosphogliv

The drug Phosphogliv and analogues (hepalin, ursoliv, silegon, etc.). Prescribed for alcoholism, fatty liver disease, and viral hepatitis. It contains glycyrrhizic acid and phospholipids, the drug helps restore liver function, has antiviral and immunomodulatory effects. It is recommended to take Phosphogliv with meals, 1-2 tablets 3-4 times a day, with water. The course of treatment is up to 3 months. Price for Phosphogliv from 491 rub. per package (50 capsules). Reviews of Phosphogliv claim that the drug has not only a preventive, but also a therapeutic effect.

Drug groups

The liver plays an important role in the digestive system, filtering and breaking down toxins, which prevents poisoning of the body. However, with a large accumulation of toxic substances, liver pathology may develop. In order to cure a damaged organ, the following drugs should be used:

• Antiviral group - drugs necessary for the treatment of viral hepatitis.
• Antiparasitic group - restorative tablets prescribed for organ damage by amoeba, lamblia, echinococcus and to improve the functioning of the gastrointestinal tract (GIT).
• Choleretic type. Indicated for patients who have impaired secretory function of the organ and difficulty digesting fats.

The following groups of medications are also used.

Hepatoprotectors

Remedies that allow you to cure and restore the liver, which has been destroyed by metabolic by-products and external toxins. Hepatoprotectors are of two types - plant and animal. Herbal hepatoprotectors include medicines based on plants that help the liver function. They are often prescribed for the treatment of toxic, drug-induced liver damage, hepatitis, fatty degeneration of the organ, cholecystitis, and gallstone diseases.

An effective herbal hepatoprotector is considered to be a collection or medicine made from milk thistle, fumyria, artichoke, chicory and yarrow. This category of medicines can be purchased at any pharmacy chain in the form of tablets, filter bags or infusions.

Hepatoprotectors of animal origin are made from the liver of a healthy cow or pig, which is endowed with stimulators of hepatocyte regeneration. Similar compounds are included in medications. It is very important to follow the dosage of the medication prescribed by your doctor so as not to increase the inflammatory process and not provoke an allergic reaction.

Essential phospholipids

Products related to herbal preparations. Phospholipids serve as a kind of material intended for the structure of cell walls. Essential phospholipid serves as a kind of patch that is applied to the damaged cell.

The restored cells contribute to the normal functioning of the liver. Essential phospholipids are produced in the form of tablets, sachets and capsules. The drug is prescribed both to treat the organ and to prevent the occurrence of the disease. After taking medications, it is advisable not to eat for two hours.

Glycyrrhizic acid

Active component for the support of damaged cells, which can be obtained from licorice root. The acid is endowed with anti-inflammatory, antioxidant and antifibrotic properties.

Amino acids

They take an active part in the process of synthesis of phospholipids and biologically active components. Amino acids are prescribed for the treatment of chronic hepatitis, withdrawal syndrome, fatty liver and organ damage from various toxins. Amino acids can also be used for prevention.

The duration of treatment for liver pathology is usually 21–30 days. The substance is marketed in the form of powders intended for the preparation of a solution. You can purchase amino acids only with a prescription from your doctor. When taking medications, it is important to consider the dosage.

When taking a hepatoprotector, side effects such as diarrhea, skin rash and urticaria may occur.

Medicines for the prevention of liver and pancreas

Often, liver diseases are associated with damage to other abdominal organs, which are also involved in digestion and protection of the body.

Phosphalugel

Phosphalugel has an absorbent and antacid effect. Recommended for gastritis, diseases of the biliary tract and liver, and peptic ulcers. Instructions for use of phosphalugel - for adults and children over 6 years old, one or two sachets (no more than 6 sachets per day) 2-3 times a day. The course of treatment is up to two weeks.

Cyqualon

Cyclone, which has a choleretic effect, helps normalize the production of bile and its secretion. Adults and children over 7 years of age are prescribed 2 tablets three times a day after meals. Children under 7 years old - 1 tablet. The course of treatment is 1 month, which must be repeated 3-4 times a year.

Fumifera officinalis extract

Fumigata extract is considered an effective natural remedy that helps restore the functioning of the liver and gastrointestinal tract, allowing to relieve spasms of the gallbladder and bile duct. Dymyanka is contraindicated for patients with acute liver inflammation and children.

In case of liver ailments, it is very important to promptly seek advice from a doctor who will conduct an examination and prescribe treatment. This will help quickly restore lost health. During rehabilitation, you can use not only drug treatment, but also traditional methods of restoring the digestive gland after alcohol and cleansing the body.

Preparations for cleansing the liver and kidneys

Preparations for regular cleaning are a reliable preventive measure for the kidneys and liver.

Cheers Lux

Ura Lax is suitable for removing stones in urolithiasis, has an anti-inflammatory and antibacterial effect. Take 1 capsule twice a day with meals (preferably in the morning and at lunch).

CystoTransit

CystoTransit is a drug from the phytogroup, based on knotweed, cranberry, chamomile and other medicinal plants, which ensures the dissolution and removal of stones. Take 1 tsp. (5 ml), dissolved in a glass of water (250 ml), 4 times a day. Duration of treatment: 20 days. Repeat the course 4 times a year.

Gortex

Gortex is a herbal remedy based on hydrangea root. At the same time it has an antiseptic and analgesic effect. Take 2 capsules 3 times a day with meals. Duration of treatment: 1 month. Contraindications: pregnancy, breastfeeding, individual intolerance to the components of the drug.

Holidays and feasts affect more than one organ, so when deciding which inexpensive and effective drug to use for liver prevention, take care of the pancreas and the gastrointestinal system as a whole. For these purposes, a few days before the holiday, take medications that help stabilize the body’s functioning:

• Mezim,
• Panzinorm,
• Pancreatin,
• Allokhod,
• Holosas.

Ursodeoxycholic acid

Ursodeoxycholic acid can be used to dissolve gallstones and at the same time reduce cholesterol levels in bile. The acid is actively used in the treatment of liver cirrhosis, as well as biliary dyskinesia. The active component promotes the removal of bile from the liver, improves the secretion of gastric juice, and the formation of T-lymphocytes. It is unacceptable to use ursodeoxycholic acid in the presence of acute inflammation of the intestines, impaired renal function and pancreas.

Basically, medications made on the basis of ursodeoxycholic acid are prescribed for the treatment of:

• biliary cirrhosis;
• cholesterol stone;
• liver colic;
• toxic or viral hepatitis;
• hepatopathy during pregnancy;
• primary cholangitis.

Medicines containing acid can be prescribed even to children who suffer from liver diseases. It is best to give a child the drug in the form of a suspension. The best medicines containing ursodeoxycholic acid: Ursofalk, Ursosan, Livodexa, Urdoxa.

Medicines containing acid can be prescribed even to children who suffer from liver diseases

Herbal preparations

The most effective medicinal plant in this area is milk thistle. It is used in medicines due to the presence of silymarin in milk thistle, a means of protecting and activating cell activity and growth. Milk thistle extract is produced in the form of oil, capsules or other products from the group of dietary supplements.

Legalon

Legalon is prescribed for the prevention of the liver in case of toxic and medicinal damage, chronic hepatitis, cirrhosis, diseases of the biliary tract and gall bladder. Contraindicated only in case of hypersensitivity to one of the components of the composition. Take Legalon 70 1-2 capsules 2-3 times a day, Legalon 140 - 1 capsule 2 times a day.

Silimar

Suitable as a prophylaxis against intoxication of the body when taking medications and alcohol. Adults and adolescents over 12 years old, 1-2 tablets 3 times a day for 25-30 days. For chronic diseases, repeat taking the product after 1-3 months.

Silymarin

Silymarin is indicated for liver damage due to toxins, for hepatitis, for correcting lipid metabolism disorders, for the prevention of liver diseases. For preventive purposes, take 70 mg of the drug 3 times a day. Contraindicated in children under 12 years of age with intolerance to silibinin and analogues. To achieve maximum effect, while taking Silymarin, avoid drinking alcohol and follow a diet.

Gepabene

To enhance the effect, an extract from smokewort is added to the preparations, which relieves spasms and normalizes the passage of bile. Gepabene is produced with this composition. Take 1 capsule (maximum 6 capsules) over 24 hours at regular intervals.

Hofitol

Products based on artichoke are produced under the names “Bitter Artichoke”, Chofitol, etc. The active substance of this plant is cymarin. Relieves alcohol intoxication and swelling. Take 2-3 tablets or 2.5-5.0 ml of solution before meals 3 times a day. Continue the course for 2-3 weeks.

Lipid peroxidation inhibitors

How to support the liver after alcohol?

Whatever features the hepatoprotectors are endowed with, for full treatment, other effective medications will be required. Peroxidation inhibitors belong to a broad category of drugs containing thioctic acid.

The most effective drugs in this group were:

• Octolipen;
• Thiogamma;
• Berlition.

By taking these medications, you can accelerate the removal of lactic acid from hepatocytes. Such acid can be formed in liver cells during the period of combination of oxygen and nitrogen. Unfortunately, lactic acid releases toxins, which is why it is so important to remove it from the body in time and reduce the negative effect.

Medicines made on the basis of thioctic acids are used to treat hepatitis, fatty hepatosis, and cirrhosis. It is unacceptable for people suffering from neuritis, diabetic neuropathy, stroke and small artery atherosclerosis to take inhibitors. Medicines go on sale in the form of tablets and ampoules for injection. The main disadvantage of inhibitors is their high cost.

The doctor will tell you which medicine is best after the patient has been examined. When restoring the liver, you will need to first determine the degree of damage to the organ.

Thioctacid

Thioctacid is a hepatoprotector based on lipoic (thioctic) acid. Manufactured by GmbH MEDA Manufacturing (Germany). Thioctacid is available in the form of tablets and solution for intravenous injection.

The active component is thioctic acid. It normalizes lipid metabolism, reduces blood sugar levels, prevents the development of cirrhosis, has a powerful antioxidant effect, restores the functionality of the gallbladder and the production of liver enzymes.

The medicine is used in the presence of diseases of the hepatobiliary system, diabetes mellitus, polyneuropathy (alcoholic), sensory-motor diabetic polyneuropathy. Can be taken for preventive purposes.

It is recommended to take one tablet per day. The daily dose for the solution is 600 mg. The duration of use of the medicine is limited to 4 weeks. A repeat course is carried out no earlier than after 2 months.

Thioctacid is contraindicated in case of hypersensitivity to its components, children under 18 years of age, pregnant and lactating women. Side effects of the medication include:

• For tablets - allergic reactions, vomiting, diarrhea, nausea, abdominal pain.
• For the solution - anaphylactic shock, local allergic reactions, increased intrahepatic pressure, convulsions, bleeding, vision problems, weakness.

In case of overdose, lactic acidosis and hypoglycemic coma are possible.

How are hepatoprotective drugs divided?

All hepatoprotector drugs can be divided into 4 groups:

1. Essential phospholipids.
2. Amino acids.
3. Sequestrants (that is, “isolators”) 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 phospholipids in hepatocyte membranes, as a result of which intracellular metabolism is disrupted and the cells die.

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

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

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

That's why

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

Another important point.

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

So, before recommending a product based on essential phospholipids, ask the buyer if he has problems with the pancreas.

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

What do phospholipids do?

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

But there are two catches here

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

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

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

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

For example:

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

When are essential phospholipids used?

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

Let's look at popular drugs in more detail.

Essentiale forte N

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

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

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

Children - from 12 years old.

Pregnant and breastfeeding women can.

Rezalut Pro

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

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

Children over 12 years of age, pregnant women and breastfeeding women - with caution.

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 here.

Essliver forte

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

Vitamins help the damaged liver in regulating the synthesis of proteins, fats, carbohydrates, and phospholipids in binding free radicals due to tocopherol.

True, some people have allergic reactions to B vitamins, so when selling Essliver Forte you need to find out from the buyer.

Children over 12 years of age, pregnant women and breastfeeding women - with caution.

The course is at least 3 months.

It is logical to offer it primarily to those who, along with the desire to “support” the liver, have signs of hypovitaminosis of B vitamins (for example, sticking in the corners of the mouth, peeling of the skin of the fingers, etc.), or to those who are on a diet.

Phosphogliv

Contains phospholipids 65 mg (48 mg phosphatidylcholine) and glycyrrhizic acid – 35 mg, which has anti-inflammatory and immunomodulatory effects. It stimulates the formation of interferon and suppresses the reproduction of the virus in the liver.

So this is more of a therapeutic drug than a preventive one.

Phosphogliv Forte

Contains phospholipids - 300 mg (219 mg phosphatidylcholine) and glycyrrhizic acid - 65 mg.

The drug restores liver function and reduces the proliferation of connective tissue.

Considering that the recommended doses and regimen for taking these drugs are the same, we can conclude:

Phosphogliv is recommended mainly for mild liver disease or for prophylactic purposes, and Phosphogliv forte - in more severe cases.

Children from 12 years old.

Contraindicated for pregnant and lactating women.

Since Phosphogliv is able to stimulate the production of interferons, it is especially indicated for viral hepatitis.

It is prescribed either in combination with antiviral drugs, or when for some reason interferon drugs cannot be used.

Amino acids

This group includes Hepa-Merz, Ornilatex (Ornithine), Heptral (Ademethionine), and the combination drug Progepar.

Ornithine

It is available in the form of concentrates for the preparation of a solution for intravenous administration under the names Hepa-Merz and Ornilatex, as well as in the form of powders for the preparation of a solution for oral administration - Hepa-Merz.

The effect of ornithine is that it binds ammonia, a toxic product of protein metabolism, and converts it into safe urea, which is safely excreted from the body.

And if ammonia accumulates in the blood, it enters the brain with the blood, causing brain damage. This condition is called hepatic encephalopathy.

So there are only two main indications for Ornithine:

1. elevated levels of ammonia in the blood, which can only be determined in a laboratory,
2. hepatic encephalopathy.

But apparently, the manufacturer realized that these indications for selling his brainchild would not be enough, and on the drug’s website he recommends using it in other cases: going to a banquet, taking medications, systematically drinking alcohol, and also when a “bizk” appears in your head, start cleaning liver. But we discussed last time that the liver does not accumulate toxins.

Here are the situations when serum ammonia increases:

• Cirrhosis of the liver,
• Viral hepatitis,
• Liver cancer,
• Severe fatty liver degeneration,
• Congenital and acquired liver enzymopathies,
• Taking certain medications: furosemide, narcotic analgesics, barbiturates.

Consequently, the use of Ornithine before or after a feast in order to protect the liver, as well as in other situations listed by the manufacturer, does not make sense.

Hepa-Merz is taken 1 sachet 2-3 times a day. Pregnant women with caution.

Ademetionine

It is a derivative of the amino acid methionine. Available under the names Heptral and Heptor in the form of tablets and lyophilisate for the preparation of a solution for intravenous and intramuscular administration.

I will try to translate the large and poorly understood pharmacokinetics instructions for the drug into human language.

Ademetionine:

1. Participates in the synthesis of phospholipids, which form the basis of the hepatocyte membrane.
2. Increases the ability of damaged liver cells to neutralize toxins.
3. Promotes the regeneration of hepatocytes.
4. Reduces the proliferation of connective tissue in the liver (its fibrosis).
5. Improves the formation and outflow of bile from the liver.
6. Reduces the toxicity of bile acids, which during bile stagnation are absorbed into the blood and cause skin itching.
7. Increases the resistance of hepatocytes to the action of free radicals.
8. Has an antidepressant effect.

That is why it is used for various hepatitis, cirrhosis, fatty liver, inflammation of the gallbladder and bile ducts, toxic damage to the liver, and hepatic encephalopathy.

Contraindicated for pregnant women in the 1st and 2nd trimesters, lactating women, and children.

But there's a catch:

The bioavailability of the drug when taken orally is only 5%, while when administered parenterally it is 95%.

In this regard, treatment regimens are often used when the drug is first administered intramuscularly or intravenously, and then the patient is transferred to a maintenance dose in the form of tablets.

Progepar

Made from bovine liver extract. Contains the amino acid cysteine, the substances choline and myo-inositol.

I read somewhere that to create the drug, young bulls up to six months old were taken. Let's hope that they are non-drinkers :), and therefore have a healthy liver. Not in the sense of big, but in the sense of not being exhausted by food and drink experiments.

The liver extract itself improves hepatic blood flow, stimulates the growth and division of hepatocytes, and protects the hepatocyte membrane from toxins.

Cysteine ​​is a powerful antioxidant that protects liver cells from damage by alcohol and toxins.

Choline removes fat from the liver, reduces the proliferation of connective tissue in it, and promotes the proliferation of hepatocytes.

Myo-inositol removes fat, strengthens hepatocyte membranes against the invasion of enemy entities - viruses, toxins.

For liver diseases, it is taken 1-2 tablets 2-3 times a day for 2-3 months, and for preventive purposes, 1 tablet 2-3 times a day for 1-2 months.

On the drug’s website, the manufacturer recommends it not only for liver diseases, but also when taking medications, alcohol, in case of nicotine addiction, and during food stress.

There is no information about pregnant or lactating women. Contraindicated for children.

But there's a catch.

The foreign protein can cause serious allergic reactions.

In addition, our smaller brothers also happen to get sick. For example, everyone has probably heard about mad cow disease. But the manufacturer avoids this topic.

Fatty acid sequestrants

These include drugs based on ursodeoxycholic acid.

It reduces the synthesis of cholesterol in the liver, its absorption in the intestines, increases its solubility in the biliary tract, and reduces its concentration in bile.

Therefore, one of the indications for the use of these drugs is the dissolution of cholesterol stones in the gall bladder.

Please note: only cholesterol!

In addition, ursodeoxycholic acid stimulates the formation and excretion of bile and has an immunomodulatory effect.

Therefore, there are 2 more indications:

• Biliary reflux gastritis, that is, the reflux of bile into the stomach.
• Primary biliary cirrhosis of the liver.

There are many trade names of drugs in this group: Ursofalk, Ursosan, Ursodez, Livodex, etc.

Ursodeoxycholic acid preparations are contraindicated in the presence of calcium stones in the gall bladder, acute inflammation of the gallbladder and bile ducts, and decompensated cirrhosis of the liver.

For children it is used in the form of a suspension.

UDCA-based drugs are contraindicated for pregnant and lactating women.

Dosage calculations are based on weight, including for adults.

To dissolve cholesterol stones, it is taken for 6-12 months.

Hepatoprotective drugs of plant origin

And finally, the last group.

It includes Karsil, Legalon, Gepabene, Liv-52 and other drugs.

I probably won’t be wrong if I say that the most promoted and popular hepatoprotectors are milk thistle-based drugs.

Believe it or not, milk thistle is a thorny weed. It grows almost everywhere.

Meet: this beauty is called milk thistle:

They say that its name comes from the word “efficient”, since it is extremely “efficient” in exploring new territories.

Milk thistle fruits contain a number of biologically active substances, collectively called silymarin.

Silymarin stabilizes the cell membrane of hepatocytes, binds free radicals, improves the synthesis of protein and structural phospholipids in damaged hepatocytes, suppresses collagen synthesis, that is, reduces the proliferation of connective tissue (fibrosis), has an anti-inflammatory effect, stimulates hepatic blood flow.

Preparations based on milk thistle are used for various hepatitis, cirrhosis, fatty liver, toxic lesions, long-term use of medications, alcohol, and chronic intoxication.

Now more about the drugs.

Karsil

Contains 35 mg of active substance (silymarin).

Contraindicated for children.

Not recommended for pregnant and lactating women.

In mild cases, take 1-2 tablets 2-3 times a day, in severe cases - 4 tablets 3 times a day, for preventive purposes - 2-3 tablets a day.

Karsil forte

Contains 90 mg of active substance, that is, 2.5 times more active than Karsil.

Accordingly, single dosages are smaller, and this is more convenient.

In mild cases and for preventive purposes, take 1 capsule 1-2 times a day.

In severe cases, 1 capsule 3 times a day.

But there is a catch that applies to both Karsil and Karsil Forte.

And I suspect that this applies to all preparations containing milk thistle extract.

Silymarin has an estrogen-like effect, so it is better not to recommend it for endometriosis, uterine fibroids and other estrogen-dependent tumors.

And something else very important:

When used together with oral contraceptives and other estrogen-containing drugs, it may reduce their effectiveness. So check with your customers to see if they are taking any of these before you offer them milk thistle.

Although there is not a word about this in the instructions for other drugs with a similar composition. I wonder why?

But to avoid harm, when recommending a hepatoprotector, ask women if there are any gynecological problems?

By the way, prostate tumors are also estrogen-dependent. If you see that a man is taking one of the drugs for the treatment of prostate adenoma and at the same time asks for a hepatoprotector, then it is better to offer him essential phospholipids.

Legalon

It contains the same silymarin, and in the drug Legalon 70 the active substance is 70 mg, and in Legalon 140 twice as much.

For therapeutic purposes, Legalon 70 is taken 2 capsules 3 times a day, Legalon 140 - 1 capsule 3 times a day.

For preventive purposes, Legalon 70 mg is taken 1 capsule 3 times a day, Legalon 140 – one capsule twice a day.

It is easy to calculate that taking Legalon 140 (280 mg per day versus 210 mg) will be more effective.

Conclusion:

Legalon 70 is 2 times more active than Karsil, and Legalon 140 is more active than Karsil Forte.

Gepabene

Another popular hepatoprotector that contains milk thistle extract and fume extract.

If we compare the content of milk thistle with Karsil, then Gepabene contains 50 mg of active substance versus 35.

Plus there is smoke, which normalizes the motility of the biliary tract, which is disrupted with biliary dyskinesia. Have you heard this diagnosis?

This suggests that Gepabene, in addition to all the properties of milk thistle, also prevents stagnation of bile and facilitates its entry into the intestines.

What I liked about this drug at one time was that everything was clearly written in the instructions: 1 capsule 3 times a day.

(No “washiness” like 1-2 capsules 2-3 times a day. Like, take it as you want).

Contraindicated in children, as well as in acute inflammatory diseases of the liver and biliary tract.

Conclusion:

Gepabene is the optimal drug if the buyer knows that he has “biliary dyskinesia.”

Hofitol

It is made from artichoke leaves - in a sense, a “relative” of milk thistle.

In fact, the artichoke is considered a vegetable. It looks like a green cone.

Its homeland is North Africa, and it was brought to Russia from Holland during the time of Peter I.

Artichoke is recognized as a delicacy product. It is stewed, fried, boiled and even canned.

It is rich in inulin, carotene, vitamins B, C, calcium and iron salts.

Artichoke contains the active substances Cynarin and Cynaridin, thanks to which Hofitol has an antioxidant effect, stimulates the synthesis and secretion of bile by hepatocytes, promotes the regeneration of liver cells, reduces the level of cholesterol and urea in the blood, and has a moderate diuretic effect.

It is no coincidence that artichokes were used to treat gout and jaundice in ancient times.

Here's what it looks like:

Hofitol is available in the form of tablets, oral solution, and injection solution.

It is used to treat diseases associated with stagnation of bile in the bile ducts and their inflammation. In particular, it is also good for biliary dyskinesia. It is prescribed in the complex treatment of chronic hepatitis, liver cirrhosis, chronic kidney inflammation, and chronic renal failure.

Pregnant and lactating women can, but only as prescribed by a doctor.

Children: tablets from 3 years of age, solution earlier (age not specified).

The course of treatment is 2-3 weeks.

Contraindicated in acute diseases of the liver and kidneys (acute hepatitis, acute cholangitis, etc.), in the presence of stones in the biliary tract, obstruction of the biliary tract.

With long-term use, allergic reactions may develop, and with large doses, diarrhea.

Liv 52

Contains active substances of eight plants that have hepatoprotective and choleretic effects. Therefore, it is contraindicated for cholelithiasis.

Given its super-herbal composition, the risk of allergic reactions is high.

When recommending it, ask if there are any allergies to any plants. If there is, it is better to offer something else.

It is noteworthy that it is approved for use in children from 6 years of age (tablets. The drops seem to have disappeared).

Contraindicated for pregnant and lactating women.

Tykveol

Available in the form of capsules, oil for oral administration, suppositories. However, Tykveol suppositories are not a hepatoprotector, but are used in the treatment of hemorrhoids, anal fissures, and benign prostatic hyperplasia.

The drug contains a complex of biologically active substances contained in pumpkin seeds: polyunsaturated fatty acids, phospholipids, provitamin A, vitamin E.

Tykveol inhibits the processes of damage to hepatocytes, proliferation of connective tissue, reduces inflammation, normalizes the physical properties of bile, and reduces its ability to form stones.

With long-term use, it reduces blood lipid levels and reduces the risk of developing atherosclerosis.

Take 3-4 capsules 3-4 times a day for 1-3 months.

To be honest, I don't think it's effective. Even judging by the “horse” single doses.

But if you recommend it, keep in mind that it is contraindicated for cholelithiasis and exacerbation of gastric and duodenal ulcers.

How does your liver hurt?

Let us describe in more detail how the liver can hurt with different types of pathological disorders

• Aching, bursting pain syndrome, slightly pronounced on the right under the ribs. Appears with a sluggish lesion of an inflammatory or toxic nature. It usually occurs due to an increase in volume, which leads to pressure on the liver capsule.
• The presence of intense pain on the right side, spread over a wide area. A rare occurrence, it may indicate inflammation, or purulent pathology due to injury, or the formation of gallstones
• Acute point pain syndrome in the gland area. Most often associated with damage to the gallbladder or its ducts
• There is no pain. A frequent occurrence during indolent diseases, or at an early stage, it can later result in cirrhosis or liver failure.

Phospholipids

Phospholipids are hepatoprotective drugs for the liver, which are in great demand among patients. Essential phospholipids are available in the form of tablets, capsules, and solutions.

In fact, this subgroup of drugs performs a kind of “structural function”. The products help restore damaged liver cells, prevent the development of destructive and inflammatory processes, normalize the molecular metabolism of enzymes and proteins, and prevent necrosis.

Under the influence of phospholipids, the activity of hepatocytes increases. These components are responsible for the synthesis of cholesterol, the breakdown of carbohydrates, the synthesis of bile salts, detoxification, and the production of bile.

The active components of phospholipids have the ability to integrate into damaged hepatocyte membranes, thereby ensuring the restoration of the integrity of membrane structures. In essence, medications have a protective effect, and at the same time normalize immunological and metabolic reactions.

It has also been proven that phospholipids protect hepatocytes from the toxic effects of drugs (including cytostatics), alcoholic beverages and even radiation.

EPLs even help reduce the level of bad cholesterol in the blood and increase the rate of “uptake” of low-density lipoproteins by hepatocytes. Even with their use, there is a decrease in the accumulation of fats in the liver cells.

The best drugs in this group are considered:

• Essentiale, Essentiale Forte, Essentiale Forte N. Available in the form of tablets and ampoules. The active component of the drugs is a mixture of essential phospholipids. Medicines are widely used in the treatment of fatty hepatosis, cirrhosis and other liver pathologies.
• Esliver Forte. It contains several active ingredients, namely essential phospholipids, nicotinamide, riboflavin, thiamine, pyridoxine, cyanocobalamin. The drug is prescribed for the treatment of viral hepatitis and cirrhosis. It can even be used for preventive purposes.
• Phosphonziale. It is a budget drug from the EPL group. It contains silymarin and lipoid C 100. It has the same indications as Essentiale.
• Phosphogliv. Powerful combined hepatoprotector. Has a choleretic effect. It contains two active ingredients: phospholipids and trisodium salt of glycyrrhizic acid. Prescribed for liver and gallbladder dysfunction.
• Result. It is the drug of choice for liver cirrhosis and fatty hepatosis. The composition includes phospholipids, medium chain triglycerides, glycerol, vitamin E, soybean oil. Can be used in the treatment of atherosclerosis and diabetes.

The above remedies are contraindicated for persons who have hypersensitivity to the active components of medications. Side effects when using EFL are extremely rare.

Liver treatment with amino acids

Ademethionine - Heptral, Heptor

Positive opinion - Amino acids, for example, ademetionine, take part in the synthesis of biologically active substances and phospholipids, and have regenerating and detoxifying properties. By the end of 1 week of use, Heptral also exhibits a pronounced antidepressant effect, breaks down fats and promotes their removal from the liver. These medications are used for fatty liver hepatosis (fatty degeneration), chronic hepatitis, toxic hepatitis, withdrawal syndrome, and depression.

Analysis of clinical studies conducted indicates the clinical effectiveness of ademetionine and indicates a pronounced hepatoprotective effectiveness in alcohol and drug-induced liver damage, cholestatic liver diseases (primary biliary cirrhosis), and chronic viral hepatitis. It has choleretic and cholekinetic effects, antioxidant, neuroprotective and antifibrosing properties.

Negative opinion - Heptral is registered as a medicine in Germany, Italy, and Russia. In Australia it is registered as a drug for animals (veterinary), in other countries as a dietary supplement, since studies have shown a dubious effect.

Practicing doctors - gastroenterologists, infectious disease specialists, hepatologists know that this drug is very effective, but only with intravenous infusions, since only a small part of the drug is absorbed when taken orally. Therefore, Heptral in tablets for serious liver pathology is an almost useless waste of money, in contrast to intravenous use.

Heptral Ingredients: active ingredient ademetionine. It has an antidepressant, regenerating, antioxidant effect. Slows down the development of liver cirrhosis. Side effects: may cause heartburn, stomach pain. Price: 20 tablets or 5 fl. 1700 -1800 rub.

Heptor Ingredients: active ingredient ademetionine Just like Heptral, it is indicated for toxic liver damage, depression, liver cirrhosis, treatment of the consequences of alcohol abuse. Contraindicated: for children, during lactation and in the first and second trimester of pregnancy. Price: 20 tablets 800-1000 RUR, 5 fl. 1200 rub.

Ornithine aspartate - Hepa-Merz

Positive opinion - Ornithine helps reduce high levels of ammonia, is used for disorders of brain function associated with impaired liver function, as well as for fatty degeneration and toxic hepatitis. This medicine is practically not used for prevention.

The effectiveness of Hepa-Merz was proven in a randomized multicenter study in patients with liver cirrhosis with elevated levels of ammonia in the blood. It is prescribed for various types of hepatitis, non-alcoholic steatohepatitis, especially for hepatic encephalopathy and cirrhosis of the liver.

Negative opinion - this drug has been widely advertised, but in case of alcoholic liver damage it has practically no effect; there is no point in using it for prevention, protection, or restoration of the liver. The only time its use produces a noticeable effect is during hepatic coma for a short-term recovery from it, since ornithine binds components in the blood that are toxic to the brain.

Hepa-Merz Ingredients: active ingredient Ornithine Used in the treatment of severe liver damage. Reduces high levels of ammonia in the body. Side effects: nausea, vomiting. Contraindicated: lactation, pregnancy with caution, in severe renal failure. Price: 10 pack. 650-700 rub., 30 packs. 1600-1700 RUR, 10 amp. 2500 rub.

Medicine "Hofitol"

Combination drugs for treating the liver are effective. This is exactly what the medicine “Hofitol” is. The drug 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 use for the treatment of chronic cholecystitis (calculous), hepatitis, liver cirrhosis, chronic intoxication, biliary dyskinesia. In addition, it is effective for kidney pathology.
2. Used in complex therapy for obesity and atherosclerosis.
3. It has practically no contraindications. The exception is acute diseases of the kidneys and liver, obstruction of bile ducts with stones.
4. Can be used for a long period of time.
5. Allowed (under medical supervision) during early toxicosis.
6. Does not affect reaction speed, therefore it is not contraindicated for drivers.

The disadvantages include the following:

• liver treatment tablets are not intended for children under 6 years of age;
• may cause side effects: itching, diarrhea, headache.

Hepatoprotectors for children

The liver can only function normally if the membranes of its cells are not damaged. In cases where the membranes are clogged, the organ cannot cope with its duties, which causes the development of various diseases. Adults are more likely to encounter such problems, but children are not immune to liver diseases. How to treat a child's liver? Treatment of children with hepatoprotectors should be prescribed by a doctor and carried out under his supervision.

Rating of the best products for children:

• For newborns: “Galstena”, “Hepel”.
• Children from 3 years old:
  “Essentiale”, “Duphalac”.
• For children over 4 years old:
  “Antral”, “Methionine”, “Gepabene” and other preparations based on milk thistle.
• From 5 to 12 years:
  “Ursosan”, “Legalon”, “Karsil”.
• For teenagers over 12 years old:
  “Holenzym”.

Liver support during and after chemotherapy

Since the administration of drugs during chemotherapy negatively affects all organs, the liver is forced to work in emergency mode to support the body. During this period, the organ needs special support, which helps prevent the development of toxic damage. In combination with specialized drugs, the patient is prescribed treatment with hepatoprotectors:

• from the group of products based on herbal components - Milk thistle, Liv 52, Gepabene;
• preparations with cells from donor liver of pigs or cattle - Hepatosan;
• essential phospholipids - Phosphogliv, Essliver, Essentiale Forte.

Liv 52 – hepatoprotector of plant origin

The drug "Heptral"

It should be remembered that only a doctor can recommend the best medications for treating the 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 it to be prescribed for:

1. Fatty liver degenerations.
2. Various toxic lesions of organs (hepatitis, alcoholic hepatosis), with drug-induced pathology that arose during long-term use of antitumor, antituberculosis, antiviral drugs.
3. Cirrhosis, fibrosis of the gland.
4. Intoxication with alcoholic beverages, narcotic substances, medicines, food.

When selecting effective drugs for treating the liver for a patient, the doctor often recommends the drug Heptral. It is not surprising, because the product has a number of advantages. For patients whose liver pathology is combined with other serious illnesses (encephalopathy, depression, joint and bone diseases), this medicine is most suitable.

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

The drug "Essentiale Forte"

A complex product containing phospholipids. Improves the condition of cell membranes. It contains exclusively natural ingredients. These types of drugs are used quite effectively to treat the liver, especially in cases of autoimmune hepatitis and toxic damage.

The product perfectly improves metabolism. In addition, it helps reduce cholesterol levels. Another positive aspect of this medicine is its beneficial effect on the cardiovascular system.

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

However, the tool also has its drawbacks. If you are sensitive to any of the components of the drug, it should not be used. Sometimes adverse reactions are possible, which include diarrhea, allergies or abdominal pain.

Liver tablets of animal origin

Positive opinion: There are literally two such tablets for the liver - Sirepar and Hepatosan, they are not used for prophylaxis, are dispensed by prescription, are used only for the treatment of liver diseases according to indications (cirrhosis, hepatitis, fatty liver hepatosis (treatment), medicinal and toxic hepatitis) . They are produced from pig liver cells (Hepatosan) and from cattle liver hydrolysate (Sirepar), contain amino acids, cyanocobalamin, low molecular weight metabolites and fragments of liver growth factors. It is believed that these liver tablets have a hepatoprotective effect, detoxification, antioxidant properties, and stimulate the regeneration of liver parenchyma.

There is also a complex drug Progepar (composition: inositol, cyanocobalamin, liver extract KPC N (liver hydrolysate), cysteine ​​hydrochloride), improves blood flow in the liver tissue, restores the structure of hepatocytes, stops the formation of connective tissue in the liver, improves functional indicators of liver function, increases diuresis . It is used in the complex treatment of chronic hepatitis, cirrhosis, fatty liver, radiation sickness, and drug intoxication.

Negative opinion: There is no evidence base confirming their clinical effectiveness and safety. Moreover, taking these drugs is potentially dangerous:

• They should not be prescribed to patients with active forms of hepatitis, since the phenomena of immunopathological, mesenchymal-inflammatory and cytolytic syndromes may increase.
• These drugs have a high allergenic potential, so before starting treatment, it is necessary to determine whether there is increased individual sensitivity to the drug.
• The use of cattle liver hydrolysates increases the risk of contracting a patient with prion infection, which causes spongiform encephalopathy (fatal neurodegenerative disease - Creutzfeldt-Jakob disease). At the end of the 20th century, interest in this pathology arose when iatrogenic transmission of prions by administration of contaminated gonadotropin was demonstrated in 250 patients with spongiform encephalopathy.

Due to their potential danger and unproven effectiveness, it is not advisable to use drugs in this group for the treatment of liver pathologies.

Hepatosan Ingredients: dried liver cells from a donor pig. Contraindicated in: children under 1 year of age, acute hepatitis, pregnancy, lactation, hypersensitivity. Price: 10 caps. 400-520 rub.

Hepatamine The composition of the biological food additive is cattle liver. Price: 40 pcs 440 rub.

Progepar Complex drug, contraindicated for children. Price: 50 tablets 1400 rub.

Ursofalk

To restore normal functioning of the liver and gallbladder, you can use the drug Ursofalk. It has many positive reviews from doctors. This hepatoprotector belongs to bile acids.

Ursofalk is available in the form of capsules and suspensions. The medicine is produced by Losan Pharma GmbH (Germany) and Vifor AG (Switzerland). A package of 50 capsules costs about 1,200 rubles, and for the suspension you will have to pay about 2,500-3,000 rubles.

The active component is ursodeoxycholic acid. This substance:

• Reduces the amount of bile acids in bile and increases their excretion into the intestines, thereby normalizing digestion. Ursodeoxycholic acid also reduces the absorption of toxic hydrophobic bile acids.
• Normalizes lipid metabolism, reduces the level of bad cholesterol in the blood.
• Relieves inflammation, strengthens the immune system.
• Reduces the lithogenicity of bile.
• Dissolves cholesterol plaques.
• Strengthens gastric and pancreatic secretion.

Indications for the use of Ursofalk include liver cirrhosis, cholangitis, hepatitis of any type, biliary form of reflux esophagitis, biliary reflux gastritis, the appearance of cholesterol stones in the gall bladder, toxic liver damage, artresia of the intrahepatic bile ducts and cystic fibrosis. For preventive purposes, you can take a suspension or pills.

You need to take 2-4 capsules per day. The duration of use of Ursofalk is limited to 2 months. If necessary, the medicine is taken again after 3-4 months. It is advisable to conduct no more than 4 courses per year. As for the suspension, the daily dose ranges from 2-25 ml, depending on the age and body weight of the patient.

Contraindications:

1. Hypersensitivity to components.
2. Decompensation stage of liver cirrhosis.
3. Acute inflammatory processes in the intestines, gall bladder, bile ducts.
4. Non-functioning gallbladder.
5. Lactation/pregnancy period.
6. Children's age (up to 18 years). This contraindication applies only to capsules. The suspension can be taken even by newborns.

Side effects: allergic reactions, digestive disorders, calcification of gallstones, biliary cirrhosis (in rare cases).

Effective medications for treatment

There is no universal cure for all cases of liver disease, but based on clinical practice and reviews of doctors and patients, it is possible to rank the most effective remedies for the treatment of liver pathologies. The best medications are those that have demonstrated their effectiveness depending on the specific situation.

1. The drug most prescribed by gastroenterologists is Ursofalk; it is effective for liver diseases, including those complicated by cholelithiasis.
2. The most popular medication among the population is Essentiale Forte N from the group of plant phospholipids.
3. The best medicine for liver diseases occurring with depressive states, including alcohol, according to patients, is Heptral.
4. Excellent recommendations for a hepatoprotector based on soy phospholipids (lecithin) Rezalut Pro.

Factors that damage liver cells

Medicines

Before performing liver prophylaxis with drugs, it is often better to prepare. The body must first be cleansed for 2 days. The procedure is performed using olive oil, activated carbon and clean water, or using the same ingredients, but with the addition of lemon juice.

Please note: cleansing of liver cells must be performed after consultation with a treating specialist; he will tell you which procedure is suitable in a particular case and how to carry it out correctly. Otherwise, you can greatly harm the body and cause complications. For a number of diseases, cleaning the “main filter” is strictly contraindicated.

You also need to examine the tests and the patient’s liver profile.

The following medications are used to protect the liver and support its functionality:

Funds group	Features of the action	Medicines
Hepatoprotectors	Such tablets for the liver, for the prevention of diseases, drugs are needed that activate the processes of regeneration of organ tissues and normalize cellular metabolism. Hepatoprotectors promote fat processing and protein absorption. They produce an antioxidant effect and regulate the production of enzymes.	Hepatosan. The product restores the functionality and activity of hepatocytes. Prohepar. It restores cell membranes, preserves them from damage, and improves blood circulation. Karsil. It contains milk thistle extract. The duration of the preventive course is 1 month, but if metabolic processes are disrupted, it should be taken with caution. Essentiale forte. This product has virtually no side effects. Ovesol. The drug restores the bile ducts. It contains plant components: oats, immortelle, peppermint. Legal. Antral. Silibor.
Choleretic	Such preventive drugs for the liver stabilize the production of biological fluid. They help alleviate the condition of the organ. They should be taken 1 hour before meals and washed down with plain water. They are used over a long course and cannot be interrupted. After its completion, a break is taken for 30 - 60 days. You should not conduct more than 3 courses using these funds per year.	Eufilin; Papaverine; Hologon; Holenzyme; Spasmoverine.
Cleansing	They help remove toxins and cleanse the bile ducts.	Sorbitol. Magnesia. Holosas (contains rosehip extract).

In order to find out which tablets to take to prevent liver disease, you need to consult a doctor. It is necessary to avoid side effects, because what is useful for some patients may harm others. Amino acids and vitamins (Gepagard, Rozanol), antiparasitic and liver teas are also needed.

There are a number of drugs that take care of liver health: restore damaged cells, cleanse, improve bile secretion and metabolism, etc.

Patients' opinions

Maria, 43 years old, Magnitogorsk

I took Karsil after a long period of taking antibiotics, which resulted in pain and discomfort in the right hypochondrium, and bilirubin was elevated for a long time. The condition improved after 2 weeks of use, the pain disappeared, bilirubin returned to normal. The medicine turned out to be effective.

Elena, 35 years old, Moscow

The hepatologist prescribed Liv 52 after suffering from acute hepatitis; the drug consists of herbal components, therefore it is quite safe. After taking it, my health improved and the feeling of heaviness in the right hypochondrium disappeared.

When treating, you should take into account what should not be taken during an exacerbation of stomach disease, because this causes a feeling of nausea and vomiting, this happened to me while taking the drug during an exacerbation of gastritis. The price of the drug is affordable, it is sold in pharmacies without a prescription, but it is better not to take it on your own; you need a preliminary consultation with your doctor.

Recommendations for the use of medications for the liver

Medicines for the liver are prescribed to patients under the following circumstances:

• If the patient has hepatitis resulting from alcohol abuse, and the disease runs the risk of developing into cirrhosis. For effective therapy, the patient is also recommended to stop drinking alcohol. Only by observing this condition will the medicine for the liver help in the regeneration of damaged liver elements.
• If hepatitis is of bacterial infectious origin and has a protracted course. Such drugs are especially recommended if the infection has acquired form C, A or B;
• If the patient has been using medications for a long period of time that have caused disruption of the liver elements. Medicines that protect the organ from hepatitis in such a situation will protect its cells from the influence of harmful circumstances;
• If the patient has hepatosis of liver cells from overeating fatty foods. The deviation is recorded in patients leading a quiet life devoid of physical exercise or suffering from diabetes mellitus. When treating such cases, recommended liver medications must be combined with exercise and diet.

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 the herb fumitory. The drug has an active restorative effect. In addition, it perfectly normalizes the flow 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 and long-term use of hepatotoxic medications.

The disadvantages of the drug are:

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

Mechanism of action of hepatoprotectors

Malfunctions of the liver can develop due to many reasons, from mechanical effects on the organ to toxic poisoning of the body. The therapeutic effect of hepatoprotectors is due to the following effects on the body:

• normalization of liver functionality;
• regeneration of damaged cells;
• activation of recovery processes;
• protecting the body from the influence of toxins and harmful substances that enter the human body from the outside (with low-quality food, certain medications, chemicals, etc.).

Hepatoprotectors include an impressive list of drugs for the liver of plant origin with proven effectiveness, which can not only cleanse the body of toxic poisons, but also increase the body’s level of resistance to negative influences.

In addition, hepatoprotective therapy normalizes the process of production and outflow of bile.

Similarities and differences

Both drugs belong to the group of hepatoprotectors. Both Liv 52 and Karsil are made from natural ingredients. They effectively activate appetite, improve the quality of the digestive system, and also increase the level of bile production. But they cope best with their main task - the regeneration of damaged gland cells. In addition, they have approximately the same cost.

If we talk about differences, then Karsil:

• cannot be used for children;
• combines well with other medications;
• has pronounced effects (antiviral, anti-inflammatory and immunostimulating);
• characterized by fast results;
• acts directly in the affected organ;
• should not be taken for more than three months;
• if treatment conditions are violated, it can cause serious side effects.

In turn, Liv 52:

• can be used by small children;
• has much fewer side effects;
• can be taken for more than three months;
• does not combine well with other medications (for example, it reduces the absorption of Ibuprofen and some antibiotics into the blood);
• does not have an anti-inflammatory effect;
• aims to protect hepatocytes rather than fight infections or toxins.

Based on the above, we can conclude that Liv 52 or Karsil is better. But you should not self-medicate and choose the drug yourself. Only an experienced doctor should decide on the medication.

General information and indications for use

Why are hepatoprotectors needed (mistakenly called hepaprotective drugs for the liver), and what role do they play in treatment? In general, hepatoprotectors are a very controversial topic. Some experts are inclined to believe that it is impossible to do without these medications, others argue that hepatoprotectors are an ordinary scam and it is quite possible to do without them.

In the USA and European countries, this class of medications is practically not used, since the effectiveness of hepatoprotectors has not been proven. Independent research is sponsored by interested parties, so getting a truthful answer from experts is currently problematic.

However, now hepatoprotectors are used without fail in the treatment of diseases of the hepatobiliary system. With their help, you can significantly speed up the onset of remission.

The main indications for their use are the following pathologies:

1. Viral hepatitis. The most common is hepatitis A. Hepatitis B, C, D, E, F, G are much less common. These diseases are accompanied by inflammatory and destructive processes in the liver. Diseases can be chronic or acute. Hepatitis is characterized by changes in the color of the skin and eye sclera, general malaise, digestive disorders, and changes in the color of urine and feces. Hepatoprotectors for hepatitis C, B, A, E and others are used to reduce the pathogenic effect of viruses on liver cells, prevent the development of necrosis and further progression of the disease.
2. Alcoholic hepatitis. From the name it is clear that mainly alcoholics suffer from this pathology. This disease is characterized by acute pain in the right hypochondrium, changes in the color of the skin and eye sclera, malaise, vomiting, changes in the color of urine and kidneys. Untimely therapy is fraught with cirrhosis and even oncological processes. Hepatoprotectors are used to restore damaged liver cells and prevent further formation of fibrous tissue.
3. Fatty hepatosis (steatosis, fatty liver). Most often, people who have been diagnosed with diabetes mellitus suffer from this disease. This disease is characterized by the formation of fat cells directly in the liver, which can lead to complete destruction of the organ. There is a violation of carbohydrate and lipid metabolism. In such cases, hepatoprotectors help reduce the intensity of clinical signs and normalize metabolic processes.
4. Cirrhosis of the liver. The pathology is characterized by the replacement of healthy liver cells with fibrous tissue. With cirrhosis, the color of the skin and eye sclera changes, body temperature rises, digestive disorders are observed, bitterness appears in the mouth and acute pain in the right hypochondrium. Cirrhosis is considered a precancerous condition. Most often develops in alcoholics. Against the background of cirrhosis, hepatic coma, liver failure, thrombosis of the hepatic veins and other extremely dangerous complications are possible. Hepatoprotectors for cirrhosis help reduce the likelihood of developing severe consequences and stabilize liver function, as well as accelerate local regenerative processes.

Hepatoprotectors are also used as part of complex treatment of cholelithiasis, cholecystitis, drug-induced hepatitis, and alcohol intoxication. Medicines also help cope with various types of poisoning.

Sometimes drugs are prescribed for autoimmune diseases that are accompanied by the destruction of healthy liver cells.

Causes of diseases

Before considering which medications are most effective for treating the liver, you should understand what effects have a detrimental effect on this organ. Gland tissues are distinguished by their tremendous ability to recover. In addition, the liver is quite resistant to harmful environmental influences. Still, some factors can cause serious harm to her:

1. Viral agents. They cause inflammatory processes in the gland (acute or chronic), which in medical practice are called hepatitis.
2. Toxic effects. Systematic and long-term intake of harmful compounds into the human body contributes to damage to an important organ. These can be heavy metals, vapors, chemical compounds. A single intake of high concentrations of harmful substances is also dangerous. This effect can lead to organ enlargement and sometimes to massive necrosis.
3. Drug influence. Some medications are difficult for the liver to tolerate. The most aggressive are chemotherapeutic agents, hormones, and antibiotics.
4. Alcohol. Excessive consumption of alcoholic beverages is harmful to liver cells. Such exposure very often leads to cirrhosis.
5. Infections and parasites. The most dangerous for the body are alveococcus, roundworms, echinococcus, and leptospirosis pathogens.
6. Nutrition and diet. Constant preference for fried, fatty, smoked foods, and large amounts of spices lead to liver problems. Bile outflow is disrupted. Stagnant processes are often the source of stones.
7. Hereditary predisposition.
8. Injuries. Most people pay attention to them for a short time after they occur. However, a trauma suffered in the abdominal area may appear a few years later with the formation of a cyst or other pathology in the liver.
9. Ionizing radiation. Chemical and physical carcinogens are dangerous. They often cause cancerous degeneration of the liver tissue.

As you can see, diseases often arise from an incorrect lifestyle. Patients who established a healthy diet, gave up bad habits, and underwent drug treatment for the liver were able to completely heal the organ.