Hepatoprotectors for the liver

The treatment of liver pathology is not without the prescription of drugs that provide the restoration of damaged hepatocytes, the protection of viable cells, the activation of lost functions.

Hepatoprotectors for the liver do not replace drugs. The list of drugs for liver therapy includes antibacterial, antiviral agents, hormones, complex vitamins, immunomodulators, homeopathic medicines.

To determine the best of more than 200 drugs is difficult. We will be based only on proven facts from the database of evidence-based medicine. It includes only those medications that have been tested in sufficient numbers of cases, have reliable efficacy results compared to the group of patients to whom they were not assigned.

To whom are hepatoprotectors indicated?

Some think that hepatoprotectors are necessary only for various diseases that occur with cell damage, but this is not so. The most effective action they have as a means of prevention.

Conditions for the need for support and protection of hepatic cells arise:

• in violation of the usual regime and quality of nutrition on holidays, when it is impossible to avoid overeating delicious but difficult for digestion food, alcohol intake;
• after acute infectious diseases and their treatment( ARVI, influenza, intestinal infections, food poisoning);
• if they moved to another locality where the ecology has changed, the quality of drinking water.

Hepatoprotective drugs are necessarily included in the treatment regimen for acute and chronic liver diseases:

• for inflammation( hepatitis) of viral origin, toxic, alcoholic, alimentary;
• hepatoses caused by altered metabolic processes( fatty, cholestatic, pigmentary) that occur in diabetes mellitus, alcoholic hepatitis, broken bile compartment, enzymatic hereditary pathologies of bilirubin metabolism;
• at the stage of initial cirrhotic or fibrotic changes in the hepatic tissue;
• for patients with liver damage caused by forced long-term use of drugs in systemic lupus erythematosus, Bekhterev's disease, Wilson-Konovalov, with tuberculosis;
• in case of development of cardiac cirrhosis during decompensation of myocardium.

Classification of

There is no single classification of drugs from the list of hepatoprotectors. It is accepted to divide them by origin and base basis. The mechanism of action is often the same. The pharmacological group includes products made from plant material, animal liver, synthesized artificially, combined with polyvitamins.

In the form they are presented by tablets, capsules, ampoules for injection, drops

Depending on the origin, 6 groups of hepatoprotectors are distinguished:

• essential phospholipids;
• preparations from the hepatic tissue of animals;
• derivatives of amino acids;
• medicinal protectors from bile acids;
• herbal remedies( herbages, extracts of medicinal plants);
• biological active food supplements( BAA) and homeopathic preparations.

As a means for treatment, hepatoprotectors are used in Russia and CIS countries. Doctors in Europe and the US do not consider them medicines because of insufficient evidence base for effectiveness. The situation even evolves in such a way that the country produces the drug, but sends it not to its pharmacy network, but to Russia and the CIS( like the French company Sanofi Essentiale).

Which medications are best to apply in a particular case is decided by the attending physician. It is not recommended to choose drugs on your own. They have their own characteristics and optimal options for action. It is impossible to completely exclude the negative impact. We will consider examples of the most popular means, testimony to their purpose, we will give the opposite views for and against.

Essential phospholipids

There is no consensus among researchers on the mechanism of action of drugs.

"For"

In accordance with the Instruction, we are invited to believe that the essential phospholipids obtained from soybeans are of the same composition as the components of the cell membrane of hepatocytes. Getting into the fat layer of the damaged hepatocyte wall, they are able to restore the functions of cells, improve their functions.

It is proved that in patients on the background of phospholipid intake: the energy costs of hepatic cells decrease, the activity of enzymes increases, the properties of the produced bile are improved, and the probability of an active response to the introduction of α-interferon increases in the treatment of hepatitis C.Most effective in injections.

To obtain the result, it is necessary to take medications of this type for half a year and longer, are not recognized by the doctors of most countries

"Against"

Studies have been published that refute the effect of phospholipids on liver function. Negative action is the provocation of inflammation in chronic forms of hepatitis, which is associated with the lack of choleretic properties, congestion of bile.

There is an opinion that the vitamins present in the composition can not be taken at the same time, it is better to replace them with separate medications. Some authors believe that the composition of the tablets reaches the liver in a very small dosage, because it is distributed throughout the body.

The main drugs of the group:

• Essentiale H, Essentiale Forte N - composed only of phospholipids;
• Essley Forte - includes phospholipids + vitamins B, E, PP;
• Phosphontsiale is an active ingredient of silymarin in combination with lipoid C;
• Hepagard - phospholipids + vitamin E;
• Phosphoglue - phospholipids in combination with the trisodium salt of glycyrrhizic acid;
• Resolyut - phospholipids + triglycerides + glycerol + soybean oil + vitamin E.

The most expensive are Essential Forte N and Resalute. In Russia, they are prescribed for fatty hepatosis, toxic hepatitis, toxicosis in pregnant women, before the forthcoming operation on the biliary tract, liver cirrhosis, metabolic disorders.

Means from animal liver

Two types of drugs are distinguished by origin: Hepatosan - from pig liver, Sirepar - from liver tissue of cattle. Contain cyanocobalamin, growth factor, amino acids in combination with low-molecular metabolites.

Due to a significant number of negative moments of exposure, drugs are not used for the purpose of prevention, only for treatment. They are prescribed for cirrhosis of the liver, fatty hepatosis, hepatitis, hepatomegaly.

Causes increased sensitivity in many patients

"For"

The instruction points out the pronounced antioxidant properties, the possibility of eliminating intoxication and stimulating the healing of the liver parenchymal tissue. The progepar that enters the group activates the blood flow in the affected organ, blocks the formation of connective tissue( cirrhosis), accelerates the elimination of toxins with diuresis, and therefore improves all liver functions.

Recommended in the complex therapy of cirrhosis, chronic hepatitis, fatty degeneration, with drug intoxication, the consequences of chemotherapy.

"Against"

The action of this group of hepatoprotectors on the liver and the body as a whole is the most controversial. Moreover, the safety of the proposed drugs has not been proven. Very high ability of drugs to cause an allergic reaction. Therefore, the use of hepatitis in the acute phase is considered dangerous.

There is an opinion that the pharmaceutical industry does not exclude the risk of infection with prion infection( small protein substrates similar in effect to viruses) with the development of incurable encephalopathy. The drugs of the group also include BAD Gepatomin. Funds are categorically contraindicated for children.

Hepatoprotectors from amino acids

Depending on the protein composition, the agents are distinguished with:

• ademethionine( representatives of Heptor and Heptral);
• ornitoaspartate( Hepa-Merz).

"For"

We know that amino acids are necessary for the body to synthesize all active substances, enzymes, including phospholipids. Through the formed compounds they participate in the processes of regeneration of the liver tissue, remove intoxication.

Heptral - has the ability to split and remove accumulated fats, purifies the liver, has an antidepressant property. Assign in the therapy of fatty hepatosis, hepatitis, withdrawal syndrome and depression in alcoholism, drug addiction.

Ademetionine derivatives have an antioxidant effect, stimulate the production of bile and its release, protect the nervous system, liver parenchyma from fibrosis. Hepa-Mertz - effective for removing ammonia compounds from the blood, so the only indication is toxic hepatitis with kidney failure, hepatic coma.

The drug is effective for intravenous administration, it is believed that use in tablets is limited to low absorption in the digestive tract

"Against"

Heptral, unlike other protectors, is registered, except in Russia, in Germany and Italy. Australians use it in veterinary practice. In other countries it is listed as a BAD with dubious properties. Hepa-Mertz does not give results for alcohol intoxication.

Drugs from bile acids

The basic substance of this group of protectors is ursodeoxycholic acid. Preparations( Ursosan, Ursofalk, Urdoksa, Exhole, Livedoksa, Ursodez, Holudexan, Urosliiv) are widely used in the treatment of diseases of the gallbladder and biliary tract, cholelithiasis.

They possess choleretic and hypoglycemic action, reduce the concentration of cholesterol, are effective for stagnant phenomena, have a stimulating effect on immunity. These drugs are indicated for biliary cirrhosis, biliary reflux gastritis, acute hepatitis in pregnant women, toxic effects of alcohol and drugs.

The drug is able to reduce blood glucose

Contraindications include: large calcium stones in the bile ducts, acute inflammation of the intestine, pronounced impaired pancreatic function. Preparations of this group are most harmless for the human body. Accepted courses, depending on the patient's condition.

Vegetable preparations

The group of hepatoprotectors is an advanced folk treatment for liver diseases, since the preparations are synthesized from known medicinal plants( milk thistle, artichoke, immortelle, bearberry, oats, mint).Their action is slow, long-term treatment is required.

But they remain the optimal choice for preventive reception. Drugs from milk thistle contain active substance silymarin( Legalon, Karsil Forte, Karsil, Silimarin, Silibinin, Silimar).Actively recommended oil, capsules of milk thistle, meal.

A strong antioxidant effect is known, regeneration of cell membranes. Course treatment is carried out for 3 months. Negative information is clinically unsubstantiated treatment of viral hepatitis and alcohol damage of the liver, which lists drugs in many countries to the group of dietary supplements.

Artichoke preparations contain the active substance cimarin. It is known for its anti-inflammatory properties( with joint pains), reducing the effect on cholesterol level, a diuretic effect. Representatives of the group - Hofitol, Tsinarix, artichoke extract,

"Against" the use - the lack of clinical studies showing the results of treatment, contraindications for congestion in the bile excretory system, calculous process.

The drug is low-toxic, it is used for getting out of drinking-bout, treating atherosclerosis, cholecystitis

BADs and homeopathic preparations

To sufficiently studied drugs with proven effectiveness are:

• Halsten - contains active components of the milk thistle plant, dandelion root, May celandine in combination with phosphorus and sodium sulfate. It is prescribed by homeopaths in drops according to the scheme for the treatment of liver diseases in both acute and chronic stages, with cholecystitis, pancreatitis.
• Hepel - includes the healing properties of milk thistle, hinnovoi tree, nutmeg, celandine in combination with phosphorus and colocite. It has anti-inflammatory, analgesic, choleretic and anti-diarrheal properties. It is recommended for toxic and inflammatory diseases of the liver, flatulence, loss of appetite, acne.

Of the dietary supplements most often used Liv 52. Producers promise the effect due to the total choleretic, restorative action and moderate antioxidant effect. The drug is recommended for the treatment of children with hepatitis A, as a preventive agent.

Foreign studies have confirmed only a decrease in bilirubin in the blood and recovery of body weight. With alcoholic hepatitis, no effect was observed. Some dietary supplements have been clinically tested and successfully recommended for practical use. These include Hepatotransit, Milona 10, Gepatrin, Dipan, Ovesol.

As part of the medicine, extracts from seven plants

Can he protect the liver from alcohol with hepatoprotectors?

There are adults who are sure that after taking "liver pills" you can drink alcohol-containing drinks in any quantity and not be afraid of cirrhosis. This is completely wrong. Despite its name, hepatoprotectors up to a full-scale removal of negative influences are very slow.

They are not suitable for fast sobering, they do not guarantee prevention of liver diseases with alcoholism. It is proved that in the initial stage of cirrhosis, when only a part of the hepatocytes are damaged, there is the possibility of complete restoration of liver functions in the case of alcohol failure.

For this, in addition to suitable hepatoprotectors,

• uses a strict diet with restriction of fatty, fried, smoked food, spicy condiments;
• cholagogue preparations;
• enzymes of the pancreas( it suffers from alcohol no less than the liver);
• herbal teas;
• drugs to improve kidney function.

I'll have to see a doctor and talk about the problem. The prescribed examination and results will show the degree of impaired function of the liver and other organs. Independently to choose medicines it is impossible, probably they are counter-indicative in a concrete case.

For those people who are engaged in "cleaning" the liver with various drugs, it is desirable to take into account that the proven efficacy of the drugs have amino acids, ursodeoxycholic acid, based on silymarin.

For the essential phospholipids in pharmacology, a mild formulation of "expected efficacy" is used. The action was proven with intravenous administration. It is better not to spend the family budget on other hepatoprotectors.