Hepatoprotectors principle of action indications for use. Hepatoprotectors for the liver: what is it? Organ functions and drug action

Dear friends, hello!

As Anton and I promised, the topic of today's conversation is hepatoprotective drugs.

All this past week, after work evenings, I've been trying to delve into this group to get to the bottom of it.

But I'd rather not do it. Because the “essence” often turns out to be impartial and only complicates everything.

It would be much easier to compare drugs by composition, describe how and when they are taken, and put a “tick” that one more topic has been completed.

But no! And what kind of nature is this!

Well, who asked me to “climb a tree on which a casket hangs, in which a hare sits, in which a duck sits, in which there is an egg, in which a needle is hidden, at the end of which is the “essence”?

And when you receive it, you don’t know what to do with it, since from the very blog I set myself the task of helping you in your work, and not hindering you!

Therefore, after the “essence” is in my hands, I have to twist it this way and that, in order to turn a barrel of tar into a spoon, and in order to illuminate for you the dark realm of confusion in one or another group of drugs, so that you become easier to sell it.

But I'll leave the "essence" for a "snack".

I finish with a prelude and move on to the topic of conversation.

My friend and your colleague Anton Zatrutin helped me to deal with hepatoprotectors.

How are hepatoprotective drugs divided?

All drugs hepatoprotectors can be divided into 4 groups:

Essential phospholipids.
Amino acids.
Sequestrants (that is, "insulators") of fatty acids.
Hepatoprotectors of plant origin.

Let's look at each group.

Essential phospholipids

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

To create drugs, they are obtained from soybeans.

Various damaging factors (alcohol, hepatotoxins, etc.) destroy 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, 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? Do you happen to know? 🙂

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.

P.S. And here is the promised recording of the report on hepatoprotectors:

Indications for use drugs, which will be discussed further, are fatty liver, hepatitis and the need for the prevention of liver damage after taking hepatotoxic drugs.
Preparations intended for the treatment of the liver have a positive effect on the functioning of this organ. All hepatoprotectors have the same feature - they protect liver cells from deformation or destruction, which helps to slow down the progression of the disease, or prevents its occurrence.

The therapeutic effect of drugs for the treatment of the liver may have different mechanism of development and strength of action. And most of all disputes about effectiveness arise around hepatoprotectors with an active ingredient of plant origin.

Taking hepatoprotectors can often cause side effect in the form of an allergic reaction. And the main contraindication for treatment with these drugs is the individual intolerance of the components.

It is important for the patient to pay attention to the following information: in most cases, any hepatoprotector is used as an auxiliary drug. He cannot eliminate the cause of the disease, because. designed to reduce the negative effects of liver damage.

Features of the treatment of liver diseases suggest taking hepatoprotectors in combination with drugs against the cause of the development of pathology. For example, antiviral agents and a hepatoprotector may be prescribed in the treatment of viral hepatitis. When alcohol is the cause of hepatitis, then the main condition for therapy will also be a complete rejection of alcoholic beverages.

It is worth noting that maximum effect from taking hepatoprotectors can be obtained with long-term therapy, the terms of which and the dosage of drugs are prescribed by the doctor.

Description of the important features of hepatoprotectors that the patient should know about

1. "Urosan", "Ursofalk", "Livodex", "Urdoksa", Ursodez, "Ursoliv" and "Exhol". The active substance of these drugs is ursodeoxycholic acid, they are considered the most effective, because. their influence has been proven by large-scale clinical studies.
The drugs are applicable to treat any type of liver damage, they dilute bile, destroy small cholesterol stones and prevent their formation. These funds help lower cholesterol levels, can be used to treat severe heartburn. In addition, women can be prescribed to prevent complications after taking hormonal drugs.

Possible side effects : diarrhea and nausea.

Contraindications : the presence of gallstones with a high content of calcium, are prohibited in case of problems in the functioning of the gallbladder, in acute cholecystitis, renal failure, liver failure and blockage of the biliary tract.

2. "Heptral" and "Heptor". The active substance is ademetionine, which has a powerful therapeutic effect, which is clinically proven. The drugs, in addition to the regenerating effect on liver cells, also have an antioxidant and antidepressant effect. They inhibit the development of cirrhosis and fibrosis of the liver, are effective in the treatment of toxic damage to the organ and as part of a complex treatment for the consequences caused by alcohol abuse.

Possible side effects: heartburn, stomach pain.

Contraindications: prohibited during pregnancy in the I and II trimesters, breastfeeding, children and adolescents under 18 years of age.

3. "Rezalyut" and "Essentiale Forte N". Phospholipids, the main active ingredient of these drugs, are part of the cell walls, so they actively contribute to the restoration of the liver. The use of drugs significantly improves fat metabolism, so they are often prescribed for elevated cholesterol levels.

Possible side effects: very rarely there is discomfort in the abdomen, or diarrhea.

Contraindications: prohibited for children under 12 years of age.

4. "Essliver forte". Active ingredients: phospholipids in combination with vitamins B1, B2, B6, B12, E and PP. Thanks to the vitamins of group B contained in the preparation, it is excellent for the prevention of liver diseases. And for medicinal purposes, it is rarely used, because. contains little phosphatylcholine.

Possible side effects: in rare cases, provokes discomfort in the upper abdomen.

Contraindications : care must be taken when taking the drug during pregnancy, lactation and children under 12 years of age.

5. "Livolin forte". The active substance is a combination of lecithin with vitamins B1, B2, B6, B12, E and PP. This drug is similar in effectiveness, side effects and contraindications to Essliver Forte.

6. "Eslidin". Phospholipids and methionine (the main components) have hepatoprotective properties, while normalizing metabolic processes in the body - protein, fat, carbohydrate and general metabolism. The active components of the drug prevent the deposition of fat in the liver. The drug reduces the concentration of cholesterol, so it can also be used in the treatment of atherosclerosis. It is very effective in combating diseases such as steatohepatitis and hepatosis, while it can be prescribed for various types of hepatitis. The drug is often included in the complex therapy of diabetes mellitus, psoriasis and atherosclerosis.

Contraindications : strictly prohibited for children under 3 years old, can be used with caution during pregnancy and for children from 3 to 7 years old.

7. Karsil, Karsil forte, Legalon and Silimar. The main component of the listed preparations is of plant origin, it is milk thistle fruit extract. It promotes the restoration of liver cells, tk. stimulates protein synthesis. These drugs are indicated for problems with digestion that are caused by liver disease. Most often, drugs are very well tolerated by the body and stimulate appetite.

Contraindications: should not be taken by children under 12 years of age.

8. Phosfonciale, Phosphogliv and Phosphogliv Forte. They have a unique complex of active substances - a combination of phospholipids and silymarin, which are combined with a plant extract of milk thistle fruits. As a result, it has positive properties similar to the action of drugs based on phospholipids and plant hepatoprotectors.

Possible side effects: very rarely, abdominal pain and nausea may occur.

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

Indications for the use of liver protector drugs

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

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

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

Classification of hepatoprotectors

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

List of essential phospholipids

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

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

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

List of amino acid hepatoprotectors

Preparations with aminocarboxylic acids may contain:

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

Therapy with extracts from the liver of animals

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

Inexpensive drugs:

Hepatosan - contains an extract from the liver cells of pigs. It has a therapeutic effect in fatty hepatosis and non-infectious cirrhosis. It is taken for two weeks, 2 capsules three times a day.
Sirepar is an analogue of Hepatosan, enriched with vitamin B12, which contributes to normal hematopoiesis. Available in the form of a solution for intravenous administration.
Prohepar - contains bovine liver extract. It is prescribed for any lesions of the gland, with the exception of -. It is sold in tablets that take 1-2 pcs. 3 times a day for 2-3 months.

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

Modern hepatoprotectors with bile acids

They are made using chenodeoxycholic and ursodeoxycholic acid. The first gives a lot of side effects (nausea, biliary colic, allergies, diarrhea). Contained in the preparations Henofalk, Henosan, Henohol. They are taken to destroy cholesterol.

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

Ursosan;
Ursodez;
Ursofalk;
Livodex;
Ursoliv and others.

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

Plant-based preparations of natural origin

Commonly prescribed herbal hepatoprotectors:

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

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

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

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

Hofitol;
Holiver;
Febihol.

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

Combined medicines for the gallbladder and liver

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

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

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

Dietary supplements and homeopathic medicines

Products and herbs-hepatoprotectors

seaweed;
pumpkin pulp;
low-fat dairy products;
dried apricots, prunes, raisins;
olives, olive oil;
meat and fish of dietary varieties;
oatmeal, millet, buckwheat.

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

Lifestyle

It is important for people with a diseased liver to lead an active lifestyle, but at the same time, the body should not be subjected to heavy loads. In a person who does not move much, the processing of animal fats slows down. They are deposited in hepatocytes, which can provoke. The same thing happens with the liver of people who periodically exercise intensively, for example, in order to lose weight. For a quick recovery, doctors recommend daily hour-long walks in the fresh air. Smokers should give up bad habits.

Literature

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Dietology / Ed. A. Yu. Baranovsky - Ed. 5th - St. Petersburg: Peter, 2017. - 1104 p.: ill. - (Series "Doctor's Companion")
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Schiff, Eugene R. Introduction to Hepatology / Eugene R. Schiff, Michael F. Sorrel, Willis S. Maddray; per. from English. ed. V. T. Ivashkina, A. O. Bueverova, M.V. Maevskaya. - M.: GEOTAR-Media, 2011. - 704 p. - (Series "Liver diseases according to Schiff").
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Radiology (radiation diagnostics and radiation therapy). Ed. M.N. Tkachenko. - K .: Book-plus, 2013. - 744 p.
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Schiff, Eugene R. Cirrhosis of the liver and its complications. Liver transplantation / Eugene R. Schiff, Michael F. Sorrel, Willis S. Maddrey: trans. from English. ed. V.T. Ivashkina, S.V. Gotye, Ya.G. Moisyuk, M.V. Maevskaya. – M.: GEOTAR-Media, 201st. – 592 p. - (Series "Liver diseases according to Schiff").
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Therapy of liver diseases is to eliminate the causes of their occurrence, for example, the neutralization of toxins. However, there is a wide range of drugs, the action of which is aimed at protecting the cells of the body from destruction. What are hepatoprotectors for the liver? This is a special type of funds that stimulate the recovery process of hepatocytes and protect them from the harmful effects of various toxic substances, fatty, smoked foods, alcohol, chemical compounds and other poisons.

When are hepatoprotectors needed?

Russian pharmacies offer a wide range of drugs for liver cleansing, which are very popular. The cost of a therapeutic course is expensive for patients, although not everyone feels the result. Discussions about the feasibility and necessity of such treatment in medical circles have been going on for a long time, in our country a doctor can prescribe hepatoprotectors in such cases:

With viral hepatitis. Medicines are prescribed if antiviral drugs do not show the expected effect or antiviral therapy is not possible for any reason.
With cirrhosis of the liver caused by alcoholism. In this case, the main step towards recovery is the refusal to take alcohol, otherwise hepatoprotectors will be absolutely useless.
With fatty hepatosis (fatty liver). Hepatoprotectors are used as part of complex therapy, which includes: a low-fat diet, antidiabetic drugs, and regular exercise.
After chemotherapy. Hepatoprotective agent helps to gradually restore the liver.
With toxic hepatitis (after taking antibiotics). Hepatoprotectors are effective in combination with other drugs for liver restoration, diet, and the rejection of bad habits.
Enlarged liver (hepatomegaly). For the rapid regeneration of organ cells and the normal functioning of the organ, hepatoprotectors are used.

Types of hepatoprotectors for the treatment and restoration of the liver

Modern medicine uses the requirements for preparations for cleansing and restoring the organ, which were created back in the 70s of the last century, but the ideal medicine that would suit all patients has never been created. There is a large list of drugs for the liver, including herbal and animal products, dietary supplements, phospholipids, vitamins, synthetic drugs, amino acids. Which hepatoprotectors for liver restoration are suitable for a particular patient and the duration of treatment is determined by the doctor.

Medicines of animal origin

Such funds are made from liver cells of a pig or cattle. Preparations for liver restoration effectively cleanse the gallbladder and biliary tract, have a hepatoprotective effect. They are prescribed for the treatment of cirrhosis, hepatitis, with alcoholic damage to the organ, liver failure. Tablets for the liver of animal origin are released strictly by prescription. These include:

"Sirepar";
"Hepatosan";
"Progepar";
"Gepadif".

Herbal hepatoprotectors

This group includes preparations based on oils of different seeds, artichoke leaves, extracts of licorice root, senna, chicory, St. John's wort, nightshade, etc. The active substances in plant hepatoprotectors for the liver may differ. A commonly used drug ingredient is silymarin, which is derived from milk thistle. The substance contains natural flavonoids: silidianin, silibinin, silicristin. Their hepatoprotective properties are due to the ability to accelerate the recovery of liver cells.

Homeopathic medicines include:

"Geparsil";
"Holenzim";
"Hepel";
"Galstena";
"Karsil";
"Silegon";
"Gepabene";
"Silimar";
"Liv-52".

Synthetic drugs

Treatment of the liver with drugs of synthetic origin is considered the most effective for biliary cirrhosis, cholesterol stones, reflux gastritis, organ damage by toxins. Hepatoprotectors based on uvsodeoxycholic acid help with the first stage of sclerosing cholangitis, viral hepatitis with various aggravating factors (childhood, pregnancy, oncological diseases). Synthetic medicine helps to reduce cholesterol, improves pancreatic and gastric secretion, activates the excretion of bile.

List of hepatoprotectors of synthetic nature:

"Antral";
"Ursosan";
"Aeschol";
"Rezodlut";
"Cryomelt";
"Urdoksa";
"Essliver".

Essential phospholipids

Liver cells have a phospholipid layer. The action of essential phospholipids is aimed at restoring the membrane of hepatocytes by direct incorporation into it. The importance of these components for liver health cannot be overstated. Essential phospholipids are widely used by modern Russian medicine, but rarely used outside the country. They can be prescribed to a child of any age, to women during pregnancy or lactation. Side effects are extremely rare. Among the hepatoprotectors of this group include:

"Phospholip";
"Hepaforte";
"Livolin";
"Essentiale";
"Enerliv";
"Rezalut".

Amino acids

Amino acids are necessary not only for sick people, but also for healthy people - this is the opinion of many doctors. A healthy diet can saturate the body with the necessary amount of these substances, but with a deficiency of amino acids, their intake is mandatory. Amino acid hepatoprotectors are recommended for people with severe liver damage, but they have a less pronounced effect compared to other types of drugs to maintain the hematopoietic organ. Due to ademetionine, (the main active ingredient), which provides for the possibility of negative consequences, amino acids are rarely prescribed.

This group of hepatoprotectors for the liver includes:

"Heptral";
"Methionine";
"Heptor".

vitamins

Previously, the treatment of liver diseases consisted in taking vitamins; there were no other types of hepatoprotectors. In modern pharmacies, there are many vitamin products with different compositions, but not all of them are effective for restoring liver functions. Taking such drugs will not harm even a healthy body, but you should not expect a significant effect in the treatment of the organ. As a rule, the doctor prescribes a vitamin hepatoprotector in combination with other medicines.

Vitamin remedies for the treatment of liver diseases are:

"Supradin";
"Complivit";
"Undevit";
Vitrum.

Vitamin-like substances

Dietary supplements are rarely used as hepatoprotectors to cleanse and normalize the functioning of the liver, biliary tract, and gall sac, since they do not guarantee the expected therapeutic effect. Despite the doubtfulness of the effectiveness of dietary supplements, some manufacturers have recommended their drugs as effective hepatoprotectors. Among the total mass of bioadditives, it is worth highlighting:

"Ovesol";
"Dipana";
"Hypatrin";
"Milona-10";
"Hepatotransit".

List of the best new generation hepatoprotectors

The sheath of the liver has no nerve endings, so a person cannot feel pain until it enlarges so as to put pressure on neighboring organs. Therefore, liver diseases are often discovered by chance, for example, during blood donation or ultrasound examination. Pathological processes are characterized by rapid, irreversible cell death. Hepatoprotectors of a new generation are necessary for the rapid regeneration of hepatocytes, the removal of poisons, and the prevention of tumor development.

The best hepatoprotectors for chemotherapy:

"Eslidin";
"Glycyrrhizin";
"Ursosan";
"Hepaliv";
"Liver Pro";
"Adementionine";
"Silymarin".

The best liver medicine for hepatitis is:

"Liv-52";
"Lohein";
"Tykveol";
"Katergen";
"Bondijar";
"Eplir".

Hepatoprotectors for children

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

For newborns: Galstena, Hepel.
Toddlers from 3 years old:
"Essentiale", "Duphalac".
Children over 4 years of age:
"Antral", "Methionine", "Gepabene" and other preparations based on milk thistle.
From 5 to 12 years:
Ursosan, Legalon, Karsil.
Teenagers over 12:
"Holenzim".

Where to buy and how much

Modern hepatoprotectors for the liver are represented by a large assortment, which often confuses people who come to the pharmacy. Even after carefully studying the characteristics of the drugs, it is difficult to decide which one is better. Only a doctor can choose an inexpensive and effective medicine, who will prescribe the necessary dosage and duration of the course of treatment.

Where are hepatoprotectors sold and how much do they cost in Moscow.

The liver protects the body from the effects of all kinds of toxins, but at the same time, the destruction of its cells - hepatocytes - is possible. To restore them, enhance the detoxifying function, it is recommended to use hepatoprotectors. The list of such drugs includes drugs that increase the activity of enzyme systems, improve metabolism, antihypoxants, etc. All of them have different effects on the liver. Each of the drugs has its own characteristics of use, therefore, they are prescribed depending on the factor that destroys hepatocytes.

What are hepatoprotectors, a list of drugs

Hepatoprotectors help the liver maintain or restore its functions after exposure to toxins.

With prolonged use of various medications, narcotic substances, poisoning, hepatoprotectors are recommended. These drugs help the liver "resist" under the toxic blow. The range of such drugs is quite wide. Hepatoprotectors are:

Vegetable origin (Karsil, Legalon, etc.). Preparations are made mainly from the fruits of milk thistle. This plant contains a large amount of a special substance - silymarin, which has a hepatoprotective effect.
Animal origin (Sirepar, Erbisol). Sirepar is made from the liver of cattle. The amino acids and cyanocobalamin contained in it have a hepatoprotective effect. It is believed that the composition of the drug includes fragments of liver growth factors that contribute to the restoration of hepatocytes. Erbisol contains low molecular weight organic compounds. It is made from the embryonic tissue of animals. It enhances the ability of cells to regenerate.
Essential phospholipids (Essentiale, Lecithin). They contribute to the rapid recovery of hepatocytes due to the fact that the molecules of essential phospholipids (EPL) are directly integrated into the damaged membranes of liver cells, restoring its barrier function, and prevent the formation of connective tissue.
Amino acids and their derivatives (ornithine). This group of hepatoprotectors helps to reduce the concentration of ammonia in plasma, enhances the ability of the liver to withstand toxic effects.
Synthetic origin (Antral). These drugs have a complex effect (hepatoprotective, antioxidant, membrane stabilizing, anti-inflammatory, antitoxic and even analgesic).

The list of hepatoprotectors is quite wide. To restore the liver, prescribe:

Silymarin;
Darsil;
Legalon;
Silegon;
Karsil;
Hepatofalk Planta;
Gepabene;
Galsten;
Liv-52;
Silibor;
Simepar;
Sirepar;
Thiotriazoline;
Essentiale N/forte;
Livolakt;
Lecithin;
Ornithine oxoglurate;
Citrarginine;
Hepa-Merz granulate;
Hepa-Merz concentrate for infusions;
Antral;
Gepar compositum;
Hepel.

This is not a complete list of drugs belonging to the group of hepatoprotectors. There are many analogues. Combines all these medicines with a similar pharmacotherapeutic effect. They are:

Enhance the antitoxic function of the liver. Increase the activity of enzymes involved in the oxidation of xenobiotics (foreign substances).
Stabilize and restore damaged cellular structures. The most effective are preparations containing EFL.
They have an anti-inflammatory effect, increase the ability of the liver to neutralize harmful substances, and prevent necrosis (decay) of hepatocytes.

Despite the fact that hepatoprotectors have a similar effect, they are recommended depending on the cause of the liver malfunction, as they have their own characteristics of use. Therefore, which drug, its dose, when and how to take, the doctor prescribes, depending on the disease and the goals of treatment.

Features of the use of hepatoprotectors

With alcohol abuse, hepatoprotectors are also indispensable.

Hepatoprotectors are prescribed not only for liver pathologies (hepatitis of various origins, cirrhosis, and coma). They are recommended for long-term drug treatment, since most drugs are metabolized in the liver. They are effective for poisoning (including alcohol abuse), when the liver cannot cope with an excessive amount of toxins, and hepatocytes begin to die.

Hepatoprotectors, although they have common properties, they also have significant differences. That is why, before prescribing drugs that restore and enhance the functioning of the liver, it is necessary to take into account many factors:

the cause of liver damage;
whether the patient has cholestasis (stagnation of bile in the biliary tract);
intensity of the pathological process;
whether hepatocyte death occurs as a result of autoimmune reactions.

Depending on them, the doctor prescribes the most optimal medicine. The dosage is selected individually.

The main features of hepatoprotectors of plant origin are:

Preparations containing silymarin contribute to increased cholestasis.
For intravenous infusions with exogenous poisoning, a solution of silymarin is used. It is effective even in case of poisoning with pale toadstool.
They should not be taken for more than one month. If further treatment is required, plant hepatoprotectors are replaced with EPL.
Hepatofalk planta contains milk thistle extract, celandine and turmeric. Along with the restoration of liver function, it also has an antibacterial, anti-inflammatory and choleretic effect. Gepabene has a similar effect, but this drug has a slight laxative and diuretic effect.
Liv-52 protects the liver parenchyma, is an antioxidant. It is prescribed for chronic and, cirrhosis, fatty degeneration of the liver,. It is effective in toxic liver damage caused by antibiotics, antipyretic and anti-tuberculosis drugs.

Hepatoprotectors of animal origin are prescribed for chronic hepatitis, cirrhosis, toxic and medicinal liver damage. At the moment, there has not been a sufficient number of studies proving their particular clinical effectiveness. But these drugs can harm, so they are not prescribed:

patients with active forms of hepatitis;
with a high probability of developing an allergic reaction.

Preparations, which include liver hydrolysates, are used with extreme caution, since their use can cause a deadly disease - spongiform encephalopathy (Crutzfeldt-Jakob disease).

EFL is advisable to appoint when:

acute and chronic hepatitis;
cirrhosis of the liver;
alcohol and drug intoxication;
radiation syndrome;

These hepatoprotectors are a highly purified soybean extract. It consists of phosphatidylcholine molecules, polyunsaturated fatty acids. The Essentiale preparation additionally contains B vitamins, nicotinic and pantothenic acid, and other biologically active substances. It normalizes protein and fat metabolism in the liver tissues, enhances its antitoxic function, restores damaged hepatocyte membranes, and increases the liver's resistance to toxins.

EPL is prescribed in the complex treatment of hepatitis C. It has been proven that they enhance the effect of alpha-interferon and reduce the likelihood of relapse after its withdrawal.

Products that contain amino acids include:

Ornithine;
Citrarginine;
Ademetionine.

They have different effects. Ornithine and Citrarginine increase ammonia metabolism. The drugs are most effective in the treatment of hepatic encephalopathy (brain damage). They are also prescribed for fatty liver, intoxication.

Ademetionine improves the detoxification function of the liver, stimulates the recovery of hepatocytes. It is used for the complex treatment of toxic liver damage, cirrhosis.

Among hepatoprotectors of synthetic origin, Antral is most often used. It not only helps to restore damaged liver tissue, but also has an antiviral, anti-inflammatory effect:

inhibits the synthesis of neuroactive substances that increase the sensitivity of pain receptors;
exhibits angioprotective activity, restores blood circulation.

In order not to worsen and harm the liver even more, you should not self-medicate. The most optimal and effective hepatoprotector will be prescribed by a doctor, depending on the causes of liver damage. In addition, in most pathologies, hepatoprotectors are additional drugs, they are prescribed in complex treatment. By themselves, they will not cure hepatitis or cirrhosis. They only contribute to a speedy recovery, restoration of hepatocytes, and help the liver to cope with toxins.

Which doctor to contact

Preparations based on silymarin are contraindicated for more than 1 month. If further treatment with hepatoprotectors is necessary, the herbal preparation is replaced with essential phospholipids.

Although the liver protects our body from the effects of toxins, it itself is under attack. To protect it, to contribute to the restoration of damaged tissue, hepatoprotectors are prescribed. The list includes drugs of various origins. Each of them has a specific effect on the liver. Only a specialist can choose which drug will be more effective and will not harm. To do this, you need to contact a gastroenterologist or hepatologist.