Liver - important gland, performing many functions. The parenchymal organ synthesizes various substances, participates in the processes of hematopoiesis, retains reserves of some vitamins and energy substances, neutralizes and removes toxins. But alcohol abuse, long-term use of medications, poor diet, stress and genetic diseases disrupt the functioning of the gland. Various drugs are used to restore the functioning of the organ.

The best medicines for the liver are hepatoprotectors. Today, products such as Liv 52 or Karsil are often used. To determine which of these drugs is better, you need to familiarize yourself with the characteristics of the medications.

The hepatoprotector is produced in the form of tablets. The leading components of the drug are plant extracts (chicory, yarrow, nightshade, cassia). Substances protect the gland membrane and promote its restoration.

This drug is used for liver dysfunction:

• Hepatitis
• Cirrhosis
• Hepatosis
• Cholecystitis.

Liv 53 tablets are taken orally 30 minutes before meals. For the purpose of prevention, the medicine is taken twice a day, 2 pills.

When treating children, the dosage does not change. If adult patients are being treated, take up to 3 tablets three times a day.

After taking a hepatoprotector, it is possible to develop adverse reactions in the form of allergies and disruption of the gastrointestinal tract.

Contraindications to taking Liv 52 are blood diseases, hypersensitivity, pregnancy and lactation.

Dragees differ in plant composition. The main component of the hepatoprotector, milk thistle, has an antioxidant, detoxifying and regenerating effect.

Can be used to treat cirrhosis, with toxic lesions And chronic inflammation, occurring in the liver.

Instructions for use:

• 1 tablet three times a day.
• The average treatment time is 30 days.

Possible adverse reactions Karsila – frequent urination, digestive disorders, shortness of breath, allergies, vestibular disorders. Contraindications – age under 12 years, acute poisoning.

Comparison

It is difficult to make a choice between the drug Karsil and Liv 52. Both drugs are equally effective at protecting the liver from harmful substances.

But hepatoprotectors have some differences. Thus, the therapeutic effect of Liv 52 may decrease with its joint use with a number of medications. The advantage of Karsil is that the tablets can be combined with any medications.

However, Karsil increases the effectiveness of Diazepam. Therefore, before combining drugs, you need to consult your doctor.

There are many analogues that can replace Liv 52 and Karsil. These are Maksar, Hofitol, Heptral, Legalon, Essentiale, Rezalut, Gepabene, Ursofalk, Phosphogliv, Ursosan. To understand which of these hepatoprotectors is better, it is necessary to compare them.

To find out what doctors think is better, Maxar or Heptral, you need to read the doctors’ reviews. The opinions of hepatologists vary. The drug Maxar is a strong hepatoprotector, but it is not sold in pharmacy chains. You can order the medicine only on the Internet, which raises doubts among many doctors about the therapeutic effect of the drug.

When choosing between Heptral or Essentiale, it is worth considering the fact that hepatoprotectors belong to different categories. The first remedy is used to treat severe illness liver. Due to the powerful effect of the medicine, it is prohibited to use it before the age of 18.

Essentiale has a milder effect. The main functions of the tablets are restoration and maintenance of the gland. Therefore, the drug can be prescribed from the age of three.

Doctors know which is better: Heptral or Phosphogliv. Hepatologists prefer the latter drug, which not only restores hepatocytes, but also relieves inflammation. When choosing between Phosphogliv or Heptral, it is worth considering that the latter remedy has many more contraindications and adverse reactions.

When comparing Gepabene or Essentiale, doctors say that the latter drug is better. Essentiale has a much larger list of indications. In view of this, gastroenterologists consider the medicine more effective means than Gepabene.

When comparing Heptral or Ursosan, hepatologists draw attention to the fact that the drugs have different active ingredients - S-adenosylmethionine and ursodeoxycholic acid. The first drug is contraindicated for children, and the second can be taken from the age of three.

Phosphogliv or Karsil, which is what hepatologists know best. Doctors recommend choosing the first medicine. Phosphogliv effectively treats liver diseases, relieves inflammation, restores the organ and prevents the development of diseases in the future.

Rezalut or Heptral are also often compared. Both drugs are quite effective, so the choice must be made by the attending physician based on the patient’s particular body.

Ursosan or Essentiale: which is better to take? Most people with liver disease are convinced that ursodeoxycholic acid is much more effective than herbal components. Therefore, patients prefer Ursosan, the price of which is much lower than Essential.

Doctors do not know which is better than Legalon and Phosphogliv, since the drugs have almost the same effectiveness. In this regard, doctors often recommend taking these drugs alternately.

Hofitol and Karsil have a plant composition. But the artichoke-based drug has many more contraindications. The cost of drugs is approximately the same.

People suffering from cirrhosis or hepatosis and their treating doctors do not know which is better than Hepabene or Essentiale Forte. Both hepatoprotectors are effective and safe, which makes them one of the the best means in the fight against liver diseases.

Ursofalk and Heptral: which is better for the treatment of cirrhosis and severe gland pathologies? Reviews say that the first drug is much more effective, but it can only be taken as prescribed by a doctor. Heptral is a less effective remedy, and its cost is too high.

If we talk about which is better Phosphogliv or Liv 52, then doctors pay attention to different groups drugs. The first remedy is an essential phospholipid, and the second is a plant hepatoprotector. In terms of effectiveness, Phosphogliv is considered stronger, which allows it to be used to treat advanced forms of liver diseases. Liv 52 is prescribed for mild disorders of the gland. It is also used as a support agent when taking toxic medications.

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

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

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

• enhance the antitoxic functions of hepatocytes - the main cells of the liver;
• inhibit oxidative processes in the organ;
• have an anti-inflammatory effect;
• prevent the production of connective tissue components, preventing the development of fibrosis;
• stimulate the restoration of hepatocytes.

Therefore, the effects of hepatoprotectors vary.

Conflicting opinions about hepatoprotectors

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

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

There is still no ideal drug with the properties listed in the work of Preisig R. However, interest in the topic does not wane. The pharmaceutical market is flooded with drugs claiming to be hepatoprotectors, but:

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

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

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

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

If there is none, then in descending order of importance:

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

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

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

1. With proven effectiveness.
2. With questionable (debatable) effectiveness.
3. With proven ineffectiveness.
4. Hepatoprotectors without reliable studies.

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

Hepatoprotectors with proven effectiveness

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

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

Ademetionine and alcoholic liver disease

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

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

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

Under the influence of alcohol, drugs, drugs, ademetionine is consumed very intensively, its resources are depleted, and a deficiency of this active occurs. chemical substance. As a result, the production of other enzymes necessary to maintain life is disrupted and their activity decreases. The liver can no longer cope with neutralizing toxins and cannot perform protective functions. The restoration of its main cells, hepatocytes, is also disrupted.

Taking ademetionine medications compensates for the lack of the substance and stimulates its production in the body, primarily in the liver and brain. Clinical researches confirm that the use of ademetionine in the treatment of alcoholic liver disease increases the concentration of glutathione in organ tissue, and also has a positive effect on patient survival, especially in severe forms diseases.

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

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

Ademetionine and chemotherapy

Almost all drugs against malignant tumors are activated and degraded in the liver. Toxic breakdown products affect her. When the liver is damaged by medications, the effect “ feedback“when, due to the destruction of hepatocytes in the blood plasma, the concentration of the chemotherapy drug increases, and this in turn increases the toxic effect on the liver. The most toxic drugs include fluorouracil, methotrexate, cyclophosphamide, epirubicin, doxorubicin.

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

Ademetionine and depression

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

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

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

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

Hepatoprotectors requiring additional evidence of effectiveness

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

Ursodeoxycholic acid (UDCA)

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

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

Ursodeoxycholic acid is indicated in three cases:

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

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

Ursodeoxycholic acid and cholelithiasis

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

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

However, cholelithiasis is not a liver disease.

Ursodeoxycholic acid and alcoholic liver disease

In France, in 2003, a randomized controlled trial was conducted in people with alcoholic cirrhosis and jaundice. The goal is to determine how ursodeoxycholic acid affects human survival.

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

At intent-to-treat, the likelihood of 1-month survival among those taking ursodeoxycholic acid was lower than among those taking placebo (69% vs. 82%, respectively). According to the main clinical and biological parameters, bilirubin levels were higher in those who took ursodeoxycholic acid.
Later it was possible to prove that ursodeoxycholic acid for alcoholic liver pathology is at most a placebo. There is no convincing scientific evidence that this drug has a positive effect on survival in this disease.

Ursodeoxycholic acid and primary biliary cirrhosis

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

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

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

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

L-ornithine-L-aspartate (LOLA)

Trade names of the drug L-ornithine-L-aspartate: Ornitox (Great Britain), Ornithine (Russia), Hepa-Merz (Germany), Hepatox (Ukraine), Lornamin (Ukraine).
L-ornithine-L-aspartate, separated into aspartate and ornithine, is actively absorbed into the intestinal epithelial tissue. small intestine. Both amino acids participate in the coordination of metabolic processes in the main cells of the liver. In addition, aspartate serves as the main medium for the production of the amino acid glutamine, neutralizes ammonia, binding it in tissues. When the liver fails to neutralize toxins, L-ornithine-L-aspartate reduces ammonia levels in the brain and other organs.

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

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

Hepatoprotectors with proven ineffectiveness

Hepatoprotectors that have been proven to be ineffective include essential phospholipids and preparations based on milk thistle flavonoid extract.

Essential phospholipids

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

The effects of hepatoprotective agents based on essential phospholipids were studied by Charles Lieber. The American scientist conducted research with a high degree of evidence - randomized, double-blind, placebo-controlled. Charles Lieber was an employee at a US Army veterans' treatment center. In 1994, he conducted research on monkeys and there were good achievements in this area of ​​work. Essential phospholipids prevented fibrosis as well as cirrhosis in baboons.
To evaluate the effect of essential phospholipids on the development of liver fibrosis in alcoholic pathology, in 2003 the scientist conducted a study on humans. The study included 789 patients and was conducted in 20 medical centers US Veterans Affairs. The average age of the subjects was 48.8 years. Before the experiment, participants drank about 16 servings of alcohol per day (one serving contains 10 grams of pure alcohol).

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

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

Since 2003, essential phospholipids have not been used either in the United States of America or in the European Union. On the world market they are sold exclusively as biologically active additives (BAS). They are registered as medicinal products only in the post-Soviet space. A few studies demonstrate that essential phospholipids help improve the well-being of patients and some biochemical parameters.
Disadvantages of the drug:

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

The basis of any hepatoprotector, pharmacological action which are essential phospholipids - soybeans:

• • • Essentiale forte N – phospholipids from soybeans;
    • Esslidin – soy + methionine;
    • Essliver forte – soy + vitamins B, PP, E;
    • Phosphonciale – soy + milk thistle;
    • Rezalut – soy lecithin;
    • Livolin Forte – soy lecithin + B 1, B 2, B 6, B 12, PP, E;
    • Phosphogliv – soy + glycerrizinic acid.

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

Milk thistle preparations

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

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

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

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

Meta-analysis involves studying all studies on a relevant problem. The final conclusion is that for alcoholic liver disease and hepatitis B and C, silymarin has little effect on sick people compared to the placebo group. The incidence of complications when taking milk thistle extract did not decrease, nor did the fatal outcome of the disease.
Milk thistle is a placebo - a substance without obvious medicinal properties. The only plus of the research is that we can say with confidence that the drug is safe to use.

Hepatoprotectors without reliable studies

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

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

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

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

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

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

In the table below of hepatoprotectors, inexpensive drugs are highlighted in bold.

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

Hepatoprotectors: full list drugs with proven effectiveness and price (inexpensive and expensive drugs)

Hepatoprotectors – These are medications used mainly for older patients who have liver problems. Due to the fact that this gland performs cleansing functions, any damage to it can lead to poisoning of the entire body.

Over time, peptic activity changes for the worse in the human stomach and intestines. This feature leaves an imprint on metabolism and a more intense withering of the human body begins. The main purpose of such drugs is to increase the vitality of the population.

IN this moment There are about two hundred products in this category on the drug market, which have their own beneficial and harmful properties for an individual organism. Use of such medicinal products permitted only on doctor's orders.

To resuscitate liver activity, it is necessary to make significant efforts during treatment using drugs of various functions. The following types of pharmacological groups are suitable for treatment:

• Dietary supplements that have immune stimulating properties and saturate the body with biologically active substances;
• Medicines that are involved in eliminating;
• Softeners painful sensations in the affected organ;
• Medicines that help drain bile and liquefy cholesterol stones;
• Means for regeneration of liver elements.

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

• If a patient has hepatitis resulting from alcohol abuse, and the disease runs the risk of developing into. 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 the 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 who lead a quiet life devoid of physical exercise or who are ill. When treating such cases, recommended liver medications must be combined with exercise and diet.

List of hepatoprotectors with proven effectiveness

The list of drugs with proven effectiveness includes the basic pharmacological category of drugs that promote rapid regeneration of individual areas of the organ. The liver remedies, the list of which is shown below, have delicate and specific applications. Before choosing the right medicine, you should definitely get a detailed consultation with your doctor.

• Rezalut Pro (Price 1500-1800 rub.)

​ The drug compensates for the organic component of the liver gland in order to reduce the destructive influence of pathogenic circumstances. A distinctive degree of usefulness of the medicine is shown by the symptoms of the hypothesis, with any modification of hepatitis, with frequent use of alcohol.

• Heptral (Price 1622-1950 rub.)

It is a compound medical substance. In addition to its basic properties, it also differs in that it is somewhat of a depressant. Ademetionine is a reactive component of the drug, which promotes the reparative functions of the body susceptible to damage. Doctors prescribe Heptral for acute forms cholestasis and during the withdrawal stage.

Ademetionine is an amino acid that is involved in the generation of phospholipids. Heptral is a remedy with proven medicinal properties exclusively in three countries: Italy, Germany and Russia. In other countries, medical institutions consider Heptral as a dietary supplement with suspicious medicinal functions. Doctors recognize the drug as effective only when administered venously. For aggravating forms, Heptral tablets are not used.

In case of rapidly developing cirrhosis, one of the types of hepatitis, long-term form of renal dysfunction, Hepatosan can serve as a very effective remedy. Hepatosan looks like a yellow tablet that helps with poisoning by toxic and harmful substances.

• Phosphogliv (Price 523-600 rub.)

Also refers to an effective medicinal substance. Main therapeutic properties The medicine appears to have a positive effect on the damaged part of the body.

The content of the amino acid ornithine aspartate in Hepa-Merz reduces the ammonia content in the human body and is intended for use to support the functioning of the liver gland and in the thinning of the fat layer of its cells. Hepa-Merz is recommended for use, but is expensive. The effectiveness of Hepa-Merz has been proven in laboratory and clinical studies.

Affordable and effective drugs for the liver

For a certain category of citizens, the main factor is that the medicine must be inexpensive and effective. Often inexpensive means, despite their cost, have immediate post-reception actions. These medications include:

• Chofitol (Price 360-750 rub.)

Chophytol with artichoke extract has a beneficial effect on. Medical experts recommend using it as an auxiliary supplement to the main therapy.

• Liv.52 (Price 363-520 rub.)

Doctors recognize Liv.52 as a compound medicinal substance with beneficial effects on the liver. It reduces the concentration of bile and has a restorative effect.

• Allohol (Price 12-59 rub.)

A medicine called Allochol is included in the list of drugs with proven effectiveness , since it ensures a decrease in the amount of bile, it removes waste from its activities in natural form.

Drugs suitable for treating both the pancreas and liver

Since these organs of the human body have a direct relationship, it makes sense to carry out complex therapy for them. To prevent severe symptoms Medical experts recommend the following inexpensive medicines:

• No-shpa (Price 70-480 rub.)

No-spa is a short-term medicine for the liver.

• Festal (Costs 200-670 rub.)

It is a drug in capsule form, which is recommended for enlargement of the filtering organ and pancreas. The festival presents one of the most effective ways in the fight against.

• Lochelan (Cost RUR 500)

This is a brown substance in powder form based on herbal extracts.

Anticyrosis and antihepatitis drugs

Both cirrhosis and hepatitis have protracted, long-lasting forms that are difficult to treat. Similar diseases also include thinning of the fatty tissue of the liver, since it cannot be completely cured and is characterized by periodic repetitions of symptoms. Medical workers It is recommended to immediately prevent the symptoms of these diseases when detected. Below is a list of effective medicinal products that have a quick therapeutic effect:

• Livolin Forte (Costs 454 rubles)

It is an accelerator of fat metabolism, therefore it is an effective way to combat fatty hepatosis and excess fat in the liver.

• Essentiale Forte (Price 660-1598 RUR)

Another drug that has proven itself in the fight against cirrhosis and hepatitis is Essentiale Forte. It has a mild effect and is involved in normalizing the activity of cells exposed to toxic substances. It is produced both in liquid form in ampoules and in tablet form. Take it three times a day, 2 capsules. In case of severe disease, the number of ampoules is increased to four.

Drugs for the liver of new modifications

It's no secret that what more modern medicine, the more effective they are. In case of liver dysfunction, it is necessary to use auxiliary medications so that the regeneration of the elements of the vital organ occurs at an accelerated pace. Global pharmacological companies are constantly improving their drug list, and their prices are presented for categories of citizens with different levels income. Now a great many manufacturers of new forms of drugs have appeared on the market. The list below presents the means that have proven themselves to be the best:

• Hepa-Merz (Price 772-2796 RUR)

One such medicine based on a natural granular herbal base is Hepa-Merz. He's different at a high price and high performance.

• Gepatosan (Price 300-550 rub.)

Hepatosan appears to be a fermented representative of the new generation of medicinal substances. It is produced on the basis of elements of the pork liver gland. Hepatosan copes with almost all forms of damage, except those caused by infection.

• Sirepar (Costs 150-250 rubles.)

Similar to the previous medicine medicinal properties may be considered Sirepar. Sirepar is a domestic development.

Combined medications for the gallbladder and liver

In cases where the patient is simultaneously observed, in order to avoid complications with the liver, doctors recommend that they first take a course of drugs to dissolve cholesterol formations. This approach will contribute to the accelerated process of regeneration of liver elements. TO safe drugs This category includes:

• Ursosan (Costs 200-1500 rubles)

A product that dilutes bile and also dissolves large cholesterol formations.

• Exhol (cost 161-1520 rub.)

Exchol has proven itself to be a highly productive tool for eliminating cholesterol formations. It is also effective for alcoholism.

Content

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

What are liver recovery pills?

Hepatoprotectors - a broad class medical supplies, which have a stimulating effect on liver cells, help restore its structure and functionality. Such medications are produced in the form of tablets, pills or dragees. They help maintain the integrity of hepatocytes, improve the removal of harmful substances, improve the flow of bile and restore the body’s absorption of vitamins.

Groups

There are a lot of different hepatoprotectors today. Each of these drugs is generally responsible for one function - restoring the functioning of the organ and minimizing the damage caused to it, but in essence they may differ slightly from each other. Based on the active ingredient, all drugs for liver restoration can be divided into several classes:

• Phospholipids are substances obtained by special processing of soybeans. Their action is to improve the condition of cell walls at the lipid level, increase enzyme activity, and increase the likelihood of a response to α-interferon. Tablets for liver restoration based on phospholipids include: Essentiale N, Essentiale Forte N, Essliver Forte, Phosphonciale, Gepagard, Phosphogliv, Rezalut.
• Amino acid derivatives. The active components of the drugs are involved in the production of phospholipids and the processes of absorption of biologically active substances, reduce ammonia levels, and trigger the processes of self-healing of gland cells and cleansing. Medicines with amino acids: Hepa-Merz (Ornithine aspartate), Heptral, Heptor.
• Medicines of animal origin. Contains pork liver hydrolysate. Known medications: Sirepar, Progepar, Hepatosan.
• Medicines with added medicinal plants. They are used for organ damage caused by toxins, poisons or medications, for cholecystitis, hepatitis, cholelithiasis and for preventive purposes. These include products based on milk thistle (Legalon, Karsil, Gepabene, Silimar), artichoke (Tsinariks, Hofitol), pumpkin seed oil (Tykveol, Peponen), elecampane or burdock root, herb, agrimony, and corn silk.
• Homeopathic remedies. The drugs help eliminate numerous symptoms, improve the functionality of the organ, and are used to cleanse it. The best pills: Hepel, Galstena, May celandine and milk thistle.
• Dietary supplements. Biologically active food supplements help to better absorb vitamins, cleanse the liver, and restore its structure. Popular dietary supplements: Hepatamine, Hepatotransit, Artichoke extract, Hepatotransit, Milona 10, Ovesol, Dipana, Hepatrin.
• Bile acids. Medicines have a hypoglycemic and choleretic effect, reduce cholesterol levels, increase the secretion of gastric juice, and affect immunological reactions. Popular tablets: Ursosan, Urdoxa, Livodexa, Ursodez, Ursofalk, Ursoliv.

Indications for use

Treatment with hepatoprotectors is possible only after consultation with a doctor. They are prescribed when making the following diagnoses:

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

Hepatoprotectors for the liver

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

FanDetox

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

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

FanDetox is prescribed to protect the organ from the pathological effects of alcohol on it, medicinal substances, poor quality food. Before use, the contents of the sachet must be dissolved in half a glass of warm water. The drink is drunk 2 times a day after meals for a month. No side effects were recorded during treatment, but FanDetox is strictly contraindicated:

• during lactation;
• patients with intestinal disorders;
• during pregnancy;
• in case of individual intolerance to components;
• for disorders of carbohydrate metabolism.

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

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

Heptral is prescribed by doctors after diagnosing and making the following diagnoses:

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

Heptral must be taken in the first half of the day. The daily dosage is 800-1600 mg, the course of treatment is determined individually. The medication should be avoided in case of genetic metabolic disorders, patients under 18 years of age, and people with bipolar disorder. While taking Heptral, undesirable effects may occur:

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

Essentiale forte

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

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

Tablets are prescribed for recovery from toxicosis in pregnant women, chronic hepatitis, fatty liver degradation, cirrhosis, as an adjuvant therapy for psoriasis, and radiation syndrome. Essentiale Forte should be taken with meals, 2 capsules 2-3 times a day. Treatment duration is 3 months, can be repeated if necessary. Essentials are well tolerated by the body, only occasionally causing stool upset. Serious contraindications Essentiale doesn't.

Liv 52

This combination medicine to restore the functionality of the liver gland. The composition of Liv 52 consists entirely of plant materials:

• caper and chicory powder;
• iron oxide;
• black nightshade;
• terminalia arjuna;
• cassia occidentalis;
• common yarrow;
• Gallic tamarix;
• eclipta white;
• medicinal fume;
• Ceylon pig;
• medicinal emblems;
• seed radish.

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

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

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

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

Carsil is used to prevent damage to the liver gland due to prolonged use of alcohol or medications. As part of complex therapy, capsules are prescribed for:

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

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

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

Ovesol

The drug is one of the natural dietary supplements. Ovesol contains natural components that have anti-inflammatory, detoxifying, restorative effects - oat seed extract, turmeric, immortelle flowers, peppermint. The dietary supplement carefully “washes” the liver, reduces bile stagnation, and reduces the chance of cholelithiasis.

Tablets can cause allergies and are contraindicated for people with hypersensitivity to one or more components. Ovesol is prescribed with caution to patients with a bent gallbladder or cholelithiasis. According to the instructions, you need to take the dietary supplement for 20 days, 1 tablet twice a day. The course must be repeated 3-4 times a year.

Phosphogliv

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

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

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

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

Gepabene

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

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

The drug should be taken orally with food. To restore the functionality of the liver gland, doctors prescribe 1 capsule 3 times a day. The duration is selected individually. Hepabene can rarely provoke an allergic reaction or cause a laxative effect. It is contraindicated:

• teenagers under the age of majority;
• patients with active forms of biliary tract diseases;
• if the patient is hypersensitive to the composition of the drug.

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

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

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

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

Galstena

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

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

• For hepatitis, hepatosis or pancreatitis: children under 12 years of age are prescribed ½, adults – 1 tablet. The duration of therapy until recovery is 3 months, the frequency of use is 3 times a day.
• For chronic cholecystitis, cholelithiasis: children ½ tablet, adults - 1 tablet. Frequency of administration – 3 times/day, duration of therapy – 1 month.

Hofitol

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

Adults are prescribed 2-3 tablets. 3 times a day before meals, children over 6 years old – 1-2 tablets. The course of drug therapy is 3 months. Hophytol is well tolerated by patients, but rarely can cause minor allergic reactions or the development of diarrhea. You will have to stop taking liver restoration pills if:

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

Cyqualon

It is a synthetic drug developed on the basis of a single active ingredient - cyclone. The medicine is available in the form of tablets to restore the liver with anti-inflammatory properties. Cyclalon:

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

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

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

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

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

• digestion – diarrhea, nausea, stomach discomfort;
• hematopoiesis – menstrual irregularities in women, petechial rash;
• allergic reactions - urticaria.

Osalmid

A choleretic agent stimulates the formation and outflow of bile, has analgesic and anti-inflammatory properties, and normalizes bilirubin levels. Osalmid is available as a white or almost white, soluble in water. Take the drug orally at a dose of 250-500 mg 3 times a day for up to 20 days. Osalmide can very rarely cause diarrhea or allergies. Taking the powder is contraindicated if:

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

How to choose liver restoration pills

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

After alcohol

Drug treatment after severe alcohol intoxication is possible only after the patient completely abandons further consumption of alcoholic beverages. The safest pharmaceutical products are considered to be homeopathic medicines, herbal remedies based on milk thistle, burdock root, and elecampane. They have minimal side effects and are used as a food additive. Gepabene, Heptral have cleansing properties, while Dipana, HepatoTransit, Tykveol have restorative properties.

Hepatoprotectors for children

The list of medications that are allowed for a child is not very long. Treatment of liver diseases in childhood must be carried out under the supervision of an experienced pediatrician or attending physician. Destination:

1. From the age of one it is allowed to use Galstena and Hepel.
2. Children over three years old can be prescribed Essentiale Forte, Antral.
3. After five years, Karsil, Gepabene, Ursosan are allowed.

For cirrhosis of the liver

Hepatotropic drugs will prevent the liver from deteriorating, will restore its functionality as much as possible, and will prevent the replacement of healthy cells with fibrous tissue in cirrhosis. On initial stage Patients are prescribed a special diet and vitamin complexes. If the disease has entered the active phase, treatment is supplemented with essential phospholipids, herbal medicines with milk thistle or artichoke - these are Carsil, Lipolic acid, Phosphogliv.

For hepatitis

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

• Ursoliv;
• Chophytol;
• Gepabene;
• Essentiale.

For fatty liver disease

Treatment fatty liver disease necessarily includes following a diet, taking vitamin complexes and drugs with an antifibrotic effect:

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

Hepatoprotectors when taking antibiotics

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

Price

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

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

Good to know

The liver has amazing properties. Few human organs are capable of actively regenerating. Patients who have had three quarters of the gland removed have every chance of having it restored to its original size.

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

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

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

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

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 effects environment. Still, some factors can cause serious harm to her:

As you can see, diseases often arise from an incorrect lifestyle. Patients who have established healthy eating, gave up bad habits, performed liver tests, and were able to completely heal the organ.

Classification of drugs

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

1. Hepatoprotective drugs. They are aimed at improving metabolic processes in the organ, increasing resistance to various pathogenic influences, and accelerating the restoration of its functions after damage. This group includes many effective drugs for treating the liver. List of the most popular drugs: “Essentiale Forte”, “Karsil”, “Ovesol”, “Progepar”, “Hepatamin”, “Hepel”.
2. Choleretic drugs. Such medications increase the secretion of bile, thereby facilitating its release into the cavity of the duodenum. For these purposes, the drugs “Allohol” and “Cholenzim” are effectively used.
3. Cholelitholytic aimed at dissolution gallstones. These include ursodeoxycholic acid and chenodeoxycholic acid.

Let's look at the most effective and popular medications for treating the liver.

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.

The drug "Legalon"

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

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

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

Medicine "Karsil"

When considering the best drugs for treating the liver, it is impossible to ignore this excellent remedy. It is widely used to restore gland function. It is often prescribed for prophylactic purposes to prevent the pathological development of changes in liver cells.

This drug is based on the fruit extract of spotted milk thistle. Indications for use are liver ailments, such as steatosis, hepatitis, cirrhosis of completely different etiologies (drug-induced, viral, toxic). The medicine is an excellent prophylactic for long-term use of hepatotoxic drugs.

Children over 12 years of age are allowed. Almost always well tolerated. It is extremely rare that side effects may develop.

However, the drug also has disadvantages. Do not take this medication during pregnancy and lactation. Sometimes side effects may occur such as nausea, diarrhea, itchy skin, baldness, vestibular disorders.

Women should use the drug "Karsil" with extreme caution if they have ailments of the reproductive system that occur with hormonal disorders(endometriosis, fibroids, breast, ovarian or uterine carcinoma). Men who have been diagnosed with a prostate tumor should also be careful.

The drug "Heptral"

It should be remembered that only a doctor can recommend the best livers. 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), in drug-induced pathologies 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. Patients whose liver pathology is combined with other serious illnesses (encephalopathy, depression, joint and bone diseases), this medicine fits best.

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, diarrhea, intestinal and stomach bleeding, joint and muscle discomfort.

The drug "Gepabene"

Many effective drugs are widely used to treat liver diseases. The medicine "Gepabene" is one of them. The combined herbal remedy is based on the fruits of milk thistle and 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.

The drug "Galstena"

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

Galstena drops and tablets for liver treatment have many advantages:

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

Like any drug, the product also has disadvantages:

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

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. Medicinal effect due to artichoke.

TO positive aspects drugs 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.

The drug "Rezalut Pro"

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

The drug is used for:

• hepatitis;
• hepatosis;
• cirrhosis;
• toxic organ damage;
• fatty gland degeneration;
• atherosclerosis;
• hyperlipidemia;
• ailments of blood vessels and heart;
• psoriasis, eczema, neurodermatitis.

In case of antiphospholipid syndrome, this drug is contraindicated. It is not intended for children under 12 years of age. The product should be used very carefully by pregnant and lactating women.

Conclusion

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

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