Recently, the number of people suffering from liver disease has increased significantly. Fortunately, modern pharmacology offers many ways to, if not completely cure, then at least alleviate these diseases. Hepatoprotectors are one of the groups of drugs that perform this function.
- What functions does the liver
- Processing of vitamins and microelements
- Other Functions
- Causes of Liver Disease
- Liver disease prevention
- Indications for use of drugs for the treatment of liver diseases
- Alcoholic Hepatitis
- Fatty hepatosis of the liver
- Drug or toxic hepatitis
- Viral Hepatitis
- Which tool to choose?
- Liver treatment medications based on animal components
- Herbal preparations
- Milk Thistle
- Pumpkin Seeds
- Essential Phospholipids
- Essentiale Forte
- Amino Acids
- Lipid Peroxidation Inhibitors
- Ursodeoxycholic Acid
- Combination Drugs
- Under which diseases which hepatoprotectors is best to use
- Viral Hepatitis
- Toxic Hepatitis
- Hepatic obesity
- Which hepatoprotectors can be used to treat children?
- Is it possible to combine the administration of liver-protecting agents and antibiotics?
- Principles for Using Liver Protecting
- Which liver medications have a firmly established positive effect
What functions does the liver
The liver is one of the most important organs in the human body. In fact, it is a huge gland that takes part in many processes of the body – the metabolism of various substances, including those coming from outside, in the production of bile, which is involved in the digestive process
The main functions of the liver:
- Processing of vitamins and microelements,
First of all, the liver is designed to split and remove toxins from the body. Toxins can come directly from the environment, where chemicals or medications can be their source, or they can be formed during digestion. Such compounds include phenol, acetone, ketone compounds.
Processing of vitamins and microelements
The liver receives various vitamins, both fat-soluble and water-soluble (D, E, K, B, PP, A), and also trace elements – copper, iron, folic acid. In the liver, they are metabolized and become available to the body.
A special fluid is produced in the liver – bile. It enters the gallbladder and then into the duodenum through the bile ducts and participates in the digestive process, splitting complex fats and proteins.
Also the liver is responsible for functions such as:
- hormone regulation,
- glucose accumulation,
- cholesterol and lipid production,
- regulation of blood coagulation and its volume,
- metabolic regulation,
- synthesis of antibodies and immunoglobulins,
- blood formation (during fetal development and early childhood).
Causes of Liver Disease
The load on the liver is very high. And for this reason, the liver needs protection. Especially the liver suffers if the body is poisoned by some chemicals or alcohol. In this case, the liver cells can not cope with their functions and liver diseases, such as cirrhosis, appear. Infectious hepatitis affecting the liver can also be added to these problems.
What factors may adversely affect the work of the liver:
- drug use,
- bad environment,
- drug treatment,
- genetic factors,
- insufficient physical activity.
A class of drugs called hepatoprotectors is intended to protect the liver from such complications. Of course, they will not replace drugs that combat the causes of liver diseases, for example, antiviral drugs, but can improve the functioning of liver cells.
Liver disease prevention
The prevention of liver diseases is the most reliable guarantee that you will not have to spend huge amounts on hepatoprotectors.
Prevention includes the following measures:
- refusing alcohol;
- proper nutrition, rejection of spicy and fatty foods;
- hygiene to prevent viral hepatitis;
- hepatitis vaccination;
- avoiding the uncontrolled use of drugs;
- high physical activity;
- control of excess weight, sugar, cholesterol in the blood;
- timely treatment of diseases that can affect the functioning of the liver – cardiovascular, infectious.
Indications for use of drugs for the treatment of liver diseases
Hepatoprotectors are used in case of the following diseases:
- alcoholic liver damage,
- liver damage of drug nature,
- viral hepatitis,
- cirrhosis and hepatosis of various etiologies,
- fatty liver disease in diabetes and obesity,
- alcoholic liver damage.
If excessive alcohol intake has led to severe liver dysfunction, turning into cirrhosis, then many doctors prescribe hepatoprotectors to patients. However, this type of drugs is not a miraculous elixir and cannot by itself cure a sick liver. First of all, the patient needs to get rid of addiction. Otherwise, the use of any medication is meaningless.
Fatty hepatosis of the liver
This disease is diagnosed in many people with diabetes and obesity. Also, the disease can occur as a result of malnutrition, eating large amounts of spicy and fatty foods. The disease is expressed in the fact that a fatty layer begins to form in the liver, as a result of which the efficiency of the liver decreases. As in the case of alcoholic cirrhosis, in this case it will not be enough alone. The patient must simultaneously follow a diet and begin to lose weight, increase physical activity, take drugs to lower cholesterol or blood sugar.
Drug or toxic hepatitis
Taking certain drugs or ingesting toxic substances can lead to severe liver dysfunctions. In this case, the doctor may also prescribe drugs that help to restore tissue and liver function.
There are several types of hepatitis, differing from each other in their pathogens. These diseases are distinguished from each other by the letters A, B, C, D, E. The disease can be transmitted through infected people as well as occur as a result of a weakened immunity and non-compliance with the rules of personal hygiene. Most hepatitis is a serious illness whose treatment is difficult and expensive. Of course, hepatoprotectors will not replace standard antiviral drugs and diets. However, in many cases they will be able to reduce the effect caused by viral tissue damage.
Which tool to choose?
The list of drugs for the treatment of liver diseases is very long, and often the patient does not know which remedy is suitable for his case.
There is no unequivocal answer to the question which medicine is the most effective. To choose the necessary remedy for the treatment of liver diseases, you need to consult a doctor so that he would pick up good medicine and say that he needs to drink. Also, the doctor will help to make a choice between two drugs that are close in their properties and suggest, for example, which is better – Hepatrine or Ovesol, Liv 52 or Karsil, Hofitol or Karsil. The fact is that so many drugs for the liver are contraindicated. In addition, in order to determine the liver disease, it is necessary to undergo some diagnostic procedures – ultrasound, tests. Hepatoprotectors should not be taken just for the sake of prevention – protection of a healthy liver is not required. Each preparation for the liver is aimed at solving one particular problem.
Acquire tablets to restore the liver should be based on the evidence, effectiveness and availability. Many patients hesitate, not knowing what to buy and are wondering, for example, Gepamerts or Essentiale – which is better for the price? Although such a question can hardly be considered appropriate, as it is necessary to choose drugs, focusing not so much on the price, but on their properties. In addition, it is worth remembering that inexpensive and effective drugs do not exist, cheap drugs are often ineffective, and even are just empty spaces.
Preparations for the treatment of liver diseases can be made from both herbal and synthetic components. There are drugs for the liver, which are available only in tablet form, there are injectable drugs, and there are drugs that have both dosage forms.
There are several types of remedies for the treatment of liver diseases:
- drugs for the liver, based on animal ingredients;
- drugs for the liver, based on herbal ingredients;
- amino acids;
- drugs based on ursodeoxycholic acid;
- amino acids;
- dietary supplements;
- essential phospholipids;
- lipid peroxidation inhibitors.
Liver treatment medications based on animal components
In preparations based on animal components, ingredients derived from the liver of farm animals – pigs, cattle, are used.
According to the manufacturers of this type of drugs, they have a detoxification and antioxidant effect, stimulate the regeneration of the parenchyma.
These remedies for the liver have many contraindications and side effects. For example, they can cause severe allergic reactions, and can also cause infections with intractable infectious diseases. Therefore, before entering the drug, it is recommended to make a check of the individual tolerance of the drug by the patient. Examples of such drugs are Hepatosan, Prohepar, Syrepar.
Medicines for the liver of this group are available on prescription. Used in the treatment of:
- fatty hepatosis,
- medicinal and toxic hepatitis,
The disadvantage of this group of drugs is that they can be used only with chronic hepatitis, and not with their active form.
In folk medicine, various plants have long been known that helped people with diseased liver. Some extracts from these plants are now used in preparations designed to support the liver. Compared with other types of drugs, preparations based on herbal ingredients have a minimum number of contraindications. Herbal preparations have a choleretic effect, improve digestion, normalize protein synthesis.
Among the herbal ingredients, the following extracts should be noted.
- thistle fruit,
- pumpkin seeds,
Preparations for maintaining the liver based on them have long been used in traditional medicine and have worked well.
Also in herbal, homeopathic preparations and dietary supplements can be found the components of the following plants:
- dymyanka medicinal,
- Dandelion officinalis,
The most widely used drugs based on the fruits of milk thistle. These plants contain a unique complex of vitamins and microelements. There are more than 200 various biologically active substances in a plant. Among them it is worth noting:
- polyunsaturated fatty acids.
But the most effective component found in preparations with milk thistle is silymarin, which is a complex of flavonoid substances – silybin, silychristin and silydianin. They are believed to be responsible for the beneficial properties of milk thistle. Silymarin is also used as an antidote to poisoning by pale toadstool. It has the following properties:
It also stimulates the formation of new liver cells, enhances the synthesis of phospholipids and proteins, prevents the appearance of connective tissue in the liver, the formation of free radicals in cells and stops the destruction of cell membranes. However, for most acute or toxic hepatitis, silymarin-based drugs are ineffective and require additional therapy. The course of treatment with silymarin is usually several months.
The artichoke has also earned the fame of a liver doctor in folk medicine. It contains proteins, fats, carbohydrates, organic acids, vitamin C, P, B1, B2, B3. It has a choleretic effect, improves metabolism and reduces the level of bad cholesterol. The artichoke active substances responsible for hepatoprotective properties are cinarin and cinaridine. They allow you to increase the production of bile and bile acids, contribute to the restoration of liver cells. Artichoke extract medications are used in the treatment of hepatitis, alcohol intoxication, cholecystitis, cirrhosis.
However, it is not recommended to take artichoke-based drugs for cholestasis and acute hepatitis, gallstone disease.
Drugs based on pumpkin seed oil are also widely used as hepatoprotective agents. And this is not without reason, because pumpkin seeds contain a number of essential fatty acids for health – oleic and linoleic, as well as a number of vitamins – B, C, beta carotene and niacin, essential oils, tocopherol. There is reason to believe that pumpkin seed oil has an antioxidant effect and is capable of stopping the destruction of hepatocyte cells.
The best medicines for the liver based on herbal ingredients are Gepabene, Karsil, Hofitol, Galstena, Hepel, Legalon, Liv 52, Tykveol, Peponen.
This is another common class of drugs for the liver. As a rule, they contain soybean extract. They contain phosphatidylcholine and unsaturated fatty acids. The principle of their action is based on the fact that they contain substances that help liver cells to restore their own walls, more than half, consisting of phospholipids. In addition, phospholipids are designed to improve intracellular metabolism, enhance the detoxification ability of cells, neutralize poisons coming from the intestine, reduce liver energy costs, prevent the appearance of connective tissue in the liver, improve the efficiency of interferons and have antioxidant properties. The most famous substance belonging to the class of phospholipids is lecithin.
Phospholipids are prescribed for the following liver diseases:
- fatty tissue degeneration;
- Alcoholic, viral or toxic hepatitis, including chronic hepatitis.
The most common drug of this class is Essentiale Forte. It can be produced both in tablets and in the dosage form for injection and infusion. Of the other drugs of this class can be mentioned Phosphogliv, Anthrall.
Essential phospholipids showed the highest efficacy when used simultaneously with interferons during the treatment of viral hepatitis C.
The disadvantage of these drugs to restore the liver is that in order to feel the effect, you need to take them for a long time, not less than six months. In some cases, phospholipids can provoke bile stasis. They are also rapidly metabolized by oral administration, and only a small part of the drugs enter the liver.
In the liver, amino acids perform many functions. First of all, they participate in the synthesis of phospholipids, break down fats, have a regenerating and detoxifying effect.
The amino acid most commonly used in hepatoprotectors is ademetionine. Other amino acids, such as ornithine, are also used.
However, many agents for the treatment of the liver with amino acids have shown efficacy only when administered intravenously. When taken orally, the amino acids are quite extensively metabolized and only a relatively small part of them reaches the liver.
Among this kind of drugs can be noted Geptrala. It is a popular hepatoprotector, also used as an antidepressant. It can be used as a means to normalize metabolism in the liver. Heptral is based on ademetionine.
The Hep-Merts drug is based on ornithine aspartate. It helps reduce ammonia levels and can be used to protect the nervous system from the negative effects of products formed in the liver.
Scope of amino acids:
- fatty hepatosis,
- chronic hepatitis,
- toxic hepatitis.
Another amino acid based drug, Heptor, is also often used.
Preparations of this group can be taken in tablets, as well as administered by infusion (with the help of droppers).
In order for the liver to function normally, it is necessary to consume vitamins from different groups. First of all, these are the B vitamins (thiamine, pyridoxine, cyanocobalamin, riboflavin), and also vitamin E (tocopherol). Vitamins facilitate metabolic processes in the liver, as well as accelerate the recovery of its cells.
Of course, vitamins can not be the only way to protect the liver. As a rule, they are taken as part of the complex therapy of liver diseases.
Lipid Peroxidation Inhibitors
This is an extensive group of drugs, which, however, contains the same active ingredient – thioctic acid. Examples of drugs in this group:
What is the principle of action of these drugs? It is based on accelerating the withdrawal of lactic acid from hepatocytes. This acid is formed in the liver cells when nitrogen combines with oxygen. Lactic acid has a certain toxic effect on cells, and accelerated output of acid weakens it.
Preparations based on thioctic acid are used for the following diseases:
- different types of hepatitis,
- fatty hepatosis,
Also preparations based on thioctic acid are used in diseases of the nervous system and blood vessels.
Indications for use of drugs in this area:
- diabetic neuropathy,
- the effects of a stroke
- Atherosclerosis of the small arteries.
However, the evidence base for the hepatoprotective properties of drugs based on thioctic acid is not sufficient, although these drugs have proven themselves in the treatment of diabetes.
Thioctic acid preparations can be used both in the form of tablets and in the form of injections. Another disadvantage of these drugs is their relatively high cost.
It is used to dissolve gallstones and lower cholesterol levels in bile. Ursodeoxycholic acid has the greatest evidence base among all hepatoprotectors. The scope of its application, however, is rather narrow, namely, the treatment of biliary cirrhosis, that is, cirrhosis caused by bile stasis in the liver. Also, the drug is used for hypomotor dyskinesia of the biliary tract, the presence of small sand stones in the gallbladder or inflammation of the biliary tract.
Acid stimulates the removal of bile from the liver and this has a protective effect. However, this action does not apply to other types of liver diseases that are not associated with bile stasis, for example, alcohol, toxic and viral hepatitis. Also, the acid has a hypoglycemic effect, reduces cholesterol in the bile, improves the secretion of gastric juice and pancreatic enzymes. Stimulates the formation of T-lymphocytes. The disadvantage of the substance is that it is contraindicated in certain types of gallstones, acute inflammation of the intestine, gallbladder, dysfunction of the pancreas and kidneys. Therefore, it is not recommended to take drugs based on it without a doctor’s recommendation.
The main use of drugs – biliary cirrhosis, dissolution of cholesterol stones, various alcohol, viral and toxic hepatitis, including acute, hepatopathy during pregnancy, primary cholangitis. Ursodeoxycholic acid preparations can be used in the treatment of liver diseases in children. For this purpose, suspensions of drugs are used.
Examples of preparations containing ursodeoxycholic acid:
These preparations may contain components belonging to several groups at once, for example, phospholipids and herbal preparations, phospholipids and vitamins, animal preparations and vitamins. Examples of such drugs are Phosphonciale, Essel Forte, Esliver Forte, Rezalut Pro, Sierapar, Hepatrine.
Under which diseases which hepatoprotectors is best to use
The choice of drug should depend on the specific disease and the type of liver damage. It should be remembered that universal means still do not exist, as well as tools without side effects, so you should not take the first available drug.
For viral hepatitis, drugs with phospholipids in combination with interferons are best recommended. Of course, this type of therapy cannot be considered the only possible one. The main type of drugs for viral hepatitis are antivirals.
The best type of therapy for hepatitis of this type is to stop the entry of a toxic substance into the body (for example, refusing to take any medications, drugs, alcohol). However, Heptral and Heptor are recommended for toxic hepatitis. In addition, Heptral is also an antidepressant and can be used to treat withdrawal symptoms, often accompanying alcoholism.
This disease is usually caused by non-alcohol factors. Again, hepatoprotectors cannot serve as a panacea. The best way to stop the disease is the organization of proper nutrition, diet, increased physical activity. In this case, the best fit herbal medicines or preparations of bile acids.
Cirrhosis is a severe damage to the liver tissue that is irreversible. The reason can be both toxic and viral lesions, autoimmune factors, bile stasis. In case of toxic cirrhosis, the choice can be made on preparations with amino acids, and in the biliary nature of the disease – on ursodeoxycholic acid.
Which hepatoprotectors can be used to treat children?
The list of such drugs is small. However, drugs such as Galsthen and Hepel can be used for children, starting from infancy. Essentiale can be prescribed from the age of three. However, treatment of the liver with drugs in children can be carried out only after a doctor’s prescription.
Is it possible to combine the administration of liver-protecting agents and antibiotics?
It is believed that such agents can balance the effects on the liver of certain antibacterial drugs with high toxicity. However, no serious evidence of this effect exists. In addition, on the contrary, some drugs may affect the metabolism of antibiotics and thereby reduce their effectiveness.
Principles for Using Liver Protecting
All drugs of this type must be prescribed by a doctor. Only he can decide what to drink in case of acute or chronic liver diseases. Although currently on the market you can find a lot of dietary supplements, designed to protect the liver, however, their use is questionable, and various side effects can reduce it to nothing. In addition, it is necessary to inform the doctor about all the drugs taken, as some of them may be toxic to the liver. This is especially true for herbal medicines.
The second feature is that drugs that protect the liver, can only be taken as an adjuvant. And their use will be completely useless if the patient does not seek to recover and adheres to his habits that aggravate the course of the disease, for example, consumes alcohol in excessive doses. In viral lesions of the liver, treatment with medicinal protective agents is ineffective compared with antiviral therapy. With cirrhosis caused by obesity and diabetes, liver treatment will be useless without increasing physical activity, and reducing excess weight, reducing cholesterol, antidiabetic drugs, diet. In addition, it should be remembered about the treatment of other organs – the pancreas and gall bladder.
The next problem facing most of the funds designed to protect the liver is a weak evidence base of their effectiveness. This is expressed in the fact that very few drugs have undergone serious clinical trials. At the same time, such drugs can be found on the market for which there is no serious evidence of effectiveness, apart from the clinical practice of individual doctors, whose opinion may be subjective. There are several reasons for this situation. Of course, you should not disregard the dishonesty of individual manufacturers who do not skimp on advertising and praise their product.
However, the origins of the situation are deeper. The fact is that the domestic view on the treatment of diseases of the liver is somewhat different in opinion, which exists in Western medicine. In our country, among many doctors and the overwhelming number of patients, there is a perception that the liver needs enhanced protection from various adverse factors – products of industrial pollution, chemicals, alcohol, and medicines. Such ideas generate demand that is satisfied by pharmaceutical manufacturers.
Meanwhile, the protection of the liver can not replace the antiviral therapy of hepatitis, or the treatment of diseases associated with the biliary system, as well as the prevention of liver diseases. It is often easier for many people to take drugs than to change their lifestyles and avoid undesirable effects on the liver – not to take questionable medicines, drink alcohol, eat right, and avoid potentially harmful chemicals from entering the body. In this case, the consumer is willing to pay for good tablets of this type is quite a lot of money. This is facilitated by the fact that there are a great many people with liver diseases in our country. At the same time, in Western countries, most of the means protecting the liver refers to dietary supplements and is accepted only in a limited number of cases.
Does this mean that funds for the liver that do not have a solid evidence base are empty spaces? This is not excluded, although categorically it would hardly be right to say this.
Many drugs, such as herbal remedies, despite the lack of scientific evidence, have been used for a long time as a means of protecting the liver, and have positive reviews. Therefore, more research is needed in this area.
Which liver medications have a firmly established positive effect
The list of drugs with proven effectiveness is not so great. First of all, it is ursodeoxycholic acid, as well as amino acids. However, the effect of amino acids in most cases is manifested only with injections, and ursodeoxycholic acid is used in liver diseases for the treatment of only certain manifestations and cannot be considered as a universal preparation.
Classification of liver drugs by type of active substances
|Animal Liver Cells||Hepatosan, Syrepar, Prohepar|
|Milk thistle extract (silymarin)||Carsil, Gepabene, Galstani, Legalon, Phosphoncial, Hepatrine, Livesil Forte|
|Artichoke Extract||Hofitol, Hepatrin|
|Pumpkin Seed Extract||Tykveol, Peponen|
|Other Plant Components||Hepel, Liv 52, Ovesol|
|Phospholipids||Essentiale Forte, Phosphogliv, Anthrall, Essliver, Phosphonziale, Rezalut Pro, Hepatrine, Livesil Forte|
|Ursodeoxycholic Acid||Ursofalk, Urdox, Ursosan, Livodeksa|
|Thioctic acid||Octolipen, Thiogamma, Berlition|