The best hepatoprotectors with proven effectiveness. Tablets for the liver: a list of effective hepatoprotectors Ursofalk or Karsil

The list of new generation hepatoprotectors is compiled by the doctor for each patient individually. Hepatoprotectors are drugs for treating or restoring liver function. Their use is not considered an official drug treatment for liver problems.

Indications for use

The list of hepatoprotectors is long, so these drugs are ineffective if uncontrolled. Indications for the use of hepatoprotectors:

• alcoholic hepatitis and alcoholic cirrhosis of the liver. It is important to completely avoid drinking alcoholic beverages. Then treatment with hepatoprotectors will bring results;
• medicinal (toxic hepatitis). Hepatoprotectors are prescribed only with systemic therapy;
• viral hepatitis. If the effect of viral drugs is low, hepatoprotectors are prescribed;
• prevention of liver cirrhosis;
• fatty liver disease, which is not caused by alcoholic beverages. With diabetes or obesity, a pathological layer of fat develops, which destroys the liver. Hepatoprotectors are prescribed in combination with systemic drugs. It is important to follow a healthy diet and lead an active lifestyle.

Hepatoprotectors are often taken together with complex, systemic treatment of the disease. These drugs are used only in the CIS countries and Russia. The reason for this is the unproven healing effect of hepatoprotectors. In other countries they are used as dietary supplements (BAS). Classification of medical products based on composition:

• animal origin;
• plant base.

Preparations based on animal liver

This group includes 2 types - Hepatosan and Sirepar. These medications are dispensed in pharmacies with a doctor's prescription and are used to treat liver problems. The raw material for Hepatosan is pig liver cells, and for Sirepar it is hydrolyzed cattle liver. The work of these hepatoprotectors (drugs based on animal liver) is aimed at the regeneration of human liver tissue.

The main disadvantage of these drugs is the lack of evidence of their effect. The effect on the human body has not yet been studied. For active forms of hepatitis, these drugs are not prescribed to avoid complications of the patient's condition. Also, this type of hepatoprotector can cause allergies. Before taking it, it is important to do safety tests for the main components of the medicine.

Treatment with amino acids

Heptral is a fast-acting drug for removing excess fat from the liver. Used for fatty hepatitis, withdrawal syndrome, chronic hepatitis. Germany, Italy and Russia use Heptral in human therapy, while in Australia it is considered a drug for animals. Other countries register it as a dietary supplement. When taken orally, the drug is only partially absorbed. For a complete and quick effect, doctors prescribe Heptral intravenously.

Hepa-Merz is a drug to reduce ammonia levels in the body. Used for damage to the performance of the brain, liver, fatty degeneration and toxic hepatitis. It is an expensive medicine, so it is practically not taken for the prevention of diseases. Effective for hepatic coma. Hepa-Merz is not used for alcoholic liver damage.

Milk thistle is the main active component of the list of herbal hepatoprotectors. They are highly effective and are popular among both patients and doctors. You can find many medicines containing milk thistle in the pharmacy. The products are safe to use. The effectiveness of these hepatoprotectors for liver damage by alcohol and acute hepatitis has not been proven. Before taking it, it is important to consult with your doctor about the advisability of using the herb and drugs developed on its basis.

Medicines to treat hepatitis C

When treating viral hepatitis, the use of new generation hepatoprotectors is indicated. The main active ingredient in their composition is milk thistle. The following herbs may also be included in the medicine:

• Chophytol;
• bonjitar;
• pumpkinseed;
• eplier;
• katergen;
• Liv-52.

New drugs of organic synthesis are considered the safest for the human body.

They are good in treating various pathologies. They are used after antibiotic therapy for acute diseases, as they reduce the symptoms of intoxication in patients.

The main function of the new generation of hepatoprotectors is to stabilize the condition of the liver and reduce the load on this organ.

They quickly restore damaged liver cells and tissues and improve the body's metabolic processes.

Modern medicines

Before taking the medications listed below, you should consult your doctor about their effectiveness and possible allergic reactions.

The classification of these drugs is quite broad. Hepatoprotectors are gaining popularity due to their effectiveness, fast action and wide selection of drugs.

List of modern hepatoprotectors:

1. Ademetionine (Heptral) – increases the ability of the liver to take components for bile from the blood, increases cell potential, and increases the synthesis of thiols. Indications for use: viral hepatitis, liver damage from drugs (antibiotics, antiviral and anti-tuberculosis drugs), alcoholic hepatitis and cirrhosis, liver failure. Contraindicated during pregnancy, breastfeeding and if you are sensitive to the active ingredients. Possible heartburn when taken orally, allergic reactions.
2. Hofitol is the best hepatoprotector for stimulating bile formation. Has choleretic and diuretic functions. The active ingredient is artichoke leaf extract combined with other herbs. Available in tablets, ampoules and solutions. It is used for flatulence, heaviness in the liver, belching and nausea. Strictly contraindicated in cases of bile duct obstruction and liver failure.
3. Ursosan is a new generation hepatoprotector to reduce the amount of bile in the blood that circulates by the liver. Prevents the toxic effect of blood on cell membranes, reduces autoimmune processes. The active substance is ursodeoxycholic acid. Available in capsule form. Indications for use: uncomplicated cholelithiasis, chronic hepatitis, cholestatic liver diseases, fatty liver disease (non-alcoholic), cirrhosis, alcoholic hepatitis, reflux esophagitis. Contraindications – acute inflammation of the biliary tract, non-functioning gallbladder, impaired liver and kidney function. Side effect: diarrhea.
4. Essentiale, Essentiale forte N – the active substance is essential phospholipids. It has an antioxidant effect, restores membranes and cellular organelles, reduces inflammation and pain in the liver. Indications: chronic hepatitis, liver cirrhosis, fatty liver disease, impaired liver function in other diseases. The drug is contraindicated for children under 12 years of age. There are practically no side effects.
5. Silimar - against the manifestations of agents harmful to it, activates the synthesis of proteins in hepatocytes, normalizes the permeability of liver cells. The active ingredient is dry purified silymar extract. Indicated for hepatitis and liver cirrhosis. Contraindicated in case of individual sensitivity to the components of the drug.
6. Karsil – has an antitoxic effect in the treatment of liver diseases. It is one of the best new generation hepatoprotectors. It is used for cirrhosis and inflammation of the liver as a maintenance treatment. It is well tolerated. Itching, diarrhea, and alopecia are possible when taking a hepatoprotector. Contraindicated in children under 5 years of age, during pregnancy and breastfeeding.

Hepatoprotectors have different compositions, so their use should be supervised by the attending physician. Each type of hepatoprotector has its own contraindications and a list of diseases for which they can be used.

Hepatocytes are easily restored under the influence of hepatoprotectors. Dead liver cells that clog its membrane membrane are removed from the organ.

They also help get rid of discomfort when the body is intoxicated by toxic enzymes of various drugs.

Hepatoprotectors significantly improve biochemical markers of the liver.

Dear friends, hello!

The topic of today's conversation is hepatoprotective drugs. Your colleague and my co-author Anton Zatrutin helped me figure them out.

We will discuss:

• How are hepatoprotectors divided?
• When are they used?
• How do drugs that belong to the same group of hepatoprotectors differ from each other?
• When is it best to offer what?

How are hepatoprotective drugs divided?

All hepatoprotector drugs can be divided into 4 groups:

1. Essential phospholipids.
2. Amino acids.
3. Sequestrants (that is, “isolators”) of fatty acids.
4. Hepatoprotectors of plant origin.

Let's look at each group.

Essential phospholipids

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

To create drugs, they are obtained from soybeans.

Various damaging factors (alcohol, hepatotoxins, etc.) destroy phospholipids in hepatocyte membranes, as a result of which intracellular metabolism is disrupted and the cells die.

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

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

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

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

Another important point.

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

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

What do phospholipids do?

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

But here there are two catches

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

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

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

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

For example:

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

When are essential phospholipids used?

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

Let's look at popular drugs in more detail.

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

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

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

Children - from 12 years old.

Pregnant, lactating Can.

Rezalut Pro

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

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

Children from 12 years old, pregnant, lactating- carefully.

And this is strange, given the similar composition of Rezalut Pro with Essentiale Forte, where there are no such restrictions.

But the first is the original, the second is a copy, and that says it all. We talked about this in detail.

Essliver forte

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

With love to you, Marina Kuznetsova and Anton Zatrutin

The largest organ of the human body, the liver performs a number of vital functions, including ensuring the impeccable functioning of other organs and systems. It is the condition of the liver that largely determines how we feel, and therefore there is nothing surprising in the general desire to support the organ and help it in difficult work. To do this, consumers resort to a variety of methods and measures: from very dubious and categorically rejected by official medicine methods of “cleansing” the liver using dubious tablets to officially approved and widely used drugs of the group hepatoprotectors.

It should also be recognized that the liver is indeed susceptible to a number of diseases. It is very vulnerable to infection, suffers from the accumulation of toxins in the bloodstream, and is damaged by some strong drugs and alcohol. Therefore, it is not surprising that hepatoprotectors, drugs designed to protect liver cells, are so widely popular. However, it should immediately be noted that drugs of this pharmacological group are not recognized in all countries of the world. Moreover, the group of hepatoprotectors itself does not exist as such in the West. But in the CIS countries, many “liver protectors” reach the TOP of sales.

So what are the actual properties of hepatoprotectors? What are these drugs that many doctors do not recognize as drugs? How do they work, and do they work at all? We will try to find answers to these and many other questions about hepatoprotectors in tablets and ampoules in our article. And we will begin with a description of the pathological conditions for which drugs are prescribed to treat the liver.

The liver is in danger

“Something is wrong with my liver...” This alarming remark is heard quite often. Almost every adult from time to time, especially after a heavy dinner or a large feast, experiences heaviness in the right hypochondrium and nausea. It is these signs that may indicate the development of one of the most common chronic liver diseases, fatty hepatosis, or steatosis. So, what is hepatic steatosis? This is a non-inflammatory disease in which liver cells and hepatocytes change, degenerating into adipose tissue.

As a rule, steatosis develops as a result of overeating, excess weight, poor nutrition with an excess load of fatty foods. Another common cause of fatty hepatosis is alcohol abuse, and the likelihood of developing the disease is not always directly proportional to the doses of alcohol. It happens that even periodic intake of small amounts of alcohol leads to liver steatosis. In addition, the disease can develop while taking medications that adversely affect the liver.

Much less common cholestatic hepatosis, in which the formation and outflow of bile is disrupted, as a result of which bile pigment accumulates in hepatocytes. Its cause may be the negative impact of toxins or stress on the liver, for example, during pregnancy. With cholestasis, severe itching of the skin, darkening of the color of urine and discoloration of feces, as well as biochemical blood parameters, are observed.

Speaking about common liver diseases, one cannot fail to mention liver inflammation and hepatitis. It can develop either as a result of intoxication with alcohol, drugs or poisons, or against the background of a viral infection. The most common are hepatitis B (about 350 million people per year), hepatitis A (more than 100 million) and hepatitis C (140 million patients per year). Hepatitis C has the most aggressive course, which, if left untreated, is complicated by liver cancer in a large number of cases. Hepatitis D and E viruses are also known. Infection with hepatitis B and C viruses has been proven to be the main cause of liver cancer. All about chronic hepatitis.

Principles of treatment of liver diseases

The treatment tactics for liver pathologies are based on two main approaches:

1. The so-called etiotropic therapy, which is aimed at the cause of the disease. A clear example of such treatment is the fight against the virus in viral hepatitis. However, it should be noted that not all viral hepatitis requires elimination therapy. So, with hepatitis A it is not needed - the virus dies on its own. But for hepatitis, which is transmitted through blood and sexual contact, antiviral treatment is really necessary.
2. Pathogenetic therapy, which involves influencing various stages of the disease process.

To protect the liver, drugs of various pharmacological groups can be prescribed, including:

• vitamins, amino acids and other substances that improve metabolism;
• drugs that increase the detoxification capabilities of the liver (for example, adsorbents);
• agents that stimulate the formation and excretion of bile (choleretic);
• antiviral drugs;
• agents that stimulate the immune response (immunomodulators). Play an important role in the complex therapy of hepatitis C;
• painkillers and anti-inflammatory drugs (NSAIDs);
• antioxidants that bind free radicals and thus prevent organ damage;
• hepatoprotectors, which differ in structure, origin, and mechanism of action.

Classification of hepatoprotectors

There is no universal classification of hepatoprotectors today - among specialists, even domestic ones, there are quite serious disagreements about which drugs should be included in them. However, they can be conditionally divided into at least five pharmacological groups:

1. Herbal preparations that contain milk thistle flavonoids. These include Gepabene, Karsil, Silibor and others.
2. Other herbal remedies, which include Hofitol, Liv-52.
3. Hepatoprotectors of animal origin, in particular, Sirepar.
4. Products containing essential phospholipids. The most famous drug in this group is Essentiale.
5. Drugs belonging to various pharmacological groups.

It should be noted that, although the classification and the very concept of hepatoprotectors do not exist in the world today, scientists have nevertheless come to a common denominator on the question of what the ideal, best drug that restores liver function should be. Basic requirements for it:

• high bioavailability;
• ability to bind toxins, free radicals;
• anti-inflammatory effect;
• stimulation of liver self-healing;
• high safety profile.

Unfortunately, despite the fairly impressive list of modern hepatoprotectors that fill the shelves of Russian pharmacies, not one of them meets the above requirements.

In modern world medicine, it is believed that there are simply no drugs that can “start” the process of liver regeneration. And why start it if the liver itself is recovering perfectly, it is enough to create appropriate conditions for it, reducing the load of fatty foods and toxins to a minimum.

About liver regeneration

This section is more intended for those who like to “clean” the liver, which is “clogged” with toxins and other industrial waste, using tablets. Many of our compatriots sincerely believe that over the years of working for the benefit of our body, the liver “wears out” and requires a restart - cleaning. For this, hepatoprotectors are used, which also have a choleretic effect, thermal procedures and folk remedies, for example, vegetable oil with lemon juice. Some particularly zealous citizens, after the procedures, find strange-looking calculi in the feces, which they sincerely regard as “stones, slag and compressed waste” that left the long-suffering organ under the influence of effective hepatoprotective drugs and other active measures. In fact, these stones are formed due to the processing of oil and lemon juice, which act as home-grown “cleansers”. “Well, what about the liver? - the reader will ask, “doesn’t it really need to be restored?” Of course not!

The liver is the only organ that has a truly remarkable ability to regenerate. It is known that only 25% of the original liver mass can be restored to its full normal size.

Restoration of the organ occurs due to replication, that is, the multiplication of liver cells, hepatocytes, as well as bile epithelial and some other cells. In this way, the liver regenerates its own damaged tissue, thereby preventing its damage. But let’s return to the drugs, which, in essence, should stimulate liver regeneration and help it “self-heal”, and we will try to dwell in detail on the most famous of them.

Milk thistle flavonoids

And let's start with popular herbal remedies containing milk thistle flavonoids, which include Karsil, Karsil forte, Legalon, Silimar, Silymarin and Silibinin.

Milk thistle is a plant widely distributed in the Mediterranean and Middle East. Milk thistle fruits, which contain flavonoid compounds, in particular, silymarin, have medicinal properties - it is this that supposedly has a hepatoprotective effect.

Mechanism of action

Silymarins contained in milk thistle fruits interact with free radicals formed in the liver and stop their destructive effect. In addition, in damaged liver cells they stimulate the synthesis of various proteins and phospholipids - components of the cell membrane that ensure the functioning of cells (in this case, hepatocytes). Silymarin also accelerates the regeneration of liver cells and prevents the penetration of certain toxic substances into them.

It is believed that silymarin preparations help improve the condition of liver diseases, normalize laboratory parameters and even increase the survival rate of patients with cirrhosis.

When is it prescribed?

Indications for the use of Karsil and other hepatoprotectors based on silymarin are toxic liver damage (due to exposure to alcohol, various poisons and medications), chronic hepatitis, fatty infiltration of the liver, cirrhosis.

Advantages

The positive aspects of medicines based on milk thistle extract include their safety: they have virtually no contraindications, and side effects from their use are recorded extremely rarely.

A review of research data on the effectiveness of milk thistle preparations for alcoholic hepatitis, hepatitis B and C showed that they do not have a significant effect on the course of these diseases and the condition of the liver, and, especially, mortality.

Despite the fact that some studies have demonstrated the possible positive effect of silymarin on liver damage from industrial toxins, Western medicine is extremely reserved about its use.

Other herbal preparations

The possibilities of herbal medicine in protecting the liver with milk thistle extract, of course, are not limited to, and on the domestic market there are a number of herbal preparations based on other natural extracts that are in great demand.

These include:

1. Preparations based on artichoke extract - Hofitol, Cholebil, Artichoke extract
2. Combined herbal preparations - Gepabene, Sibektan, Gepafor, Dipana, Liv-52.

Let's get to know them better.

Hepatoprotective drugs based on artichoke

The medicinal properties of the field artichoke are due to the content of a chemical compound called cynarin in its leaves. The highest concentrations of cynarin are found in fresh, unprocessed foliage, and significantly lower concentrations are found in dry plant materials.

Mechanism of action

Presumably, artichoke extract exhibits a choleretic effect, stimulating the production and secretion of bile by the liver; in addition, artichoke preparations are credited with a hypolipidemic effect - they help reduce the level of “bad” cholesterol in the blood.

When is it prescribed?

According to the instructions for the use of hepatoprotective drugs Hofitol and other artichoke-based drugs, they are used for conditions associated with impaired bile formation, in particular, heaviness in the epigastric region, flatulence, nausea, and belching.

In practice, the range of prescriptions for these drugs is much wider. Thus, Hofitol is often used in obstetrics to reduce the severity of toxicosis during pregnancy, as well as to support the liver in hepatitis, fatty liver hepatosis, atherosclerosis, liver cirrhosis, chronic intoxication, obesity, chronic renal failure. In addition, Hofitol is prescribed for such a very controversial disease, which does not exist in most developed countries of the world, as.

Advantages

Of course, as is the case with many other herbal hepatoprotectors, products based on artichoke extract are highly safe. They are prescribed to children, pregnant and lactating women, which, of course, is comprehensive evidence of their excellent tolerability.

NB! Since Hofitol and other hepatoprotectors containing artichoke extract stimulate the formation of bile, they are strictly contraindicated for. Therefore, before taking these medications, you should make sure that there are no stones in the biliary tract! In addition, artichoke extract is not recommended for use in acute diseases of the kidneys, liver, biliary tract and urinary system.

Efficiency from the point of view of evidence-based medicine

While in the instructions for artichoke preparations we see many indications, covering the widest range of diseases of the hepatobiliary system and even hyperlipidemia (increased cholesterol levels in the blood), clinical studies have not confirmed virtually any of the declared effects of these plant hepatoprotectors. To date, there is not a single comprehensive medical evidence demonstrating the positive effect of drugs containing artichoke extract on blood cholesterol levels and bile formation. In Western medicine, artichoke is not used at all.

Combined herbal remedies for liver diseases

Gepabene is one of the leaders among choleretic and hepatoprotective drugs. It contains two active components:

• milk thistle extract;
• fumaria officinalis extract.

The first active substance, as we have already said, exhibits a hepatoprotic effect in acute and chronic intoxication conditions. The second component, fume extract, works due to the content of the alkaloid fumarin, which has a choleretic effect and reduces spasm of the bile ducts, which facilitates the flow of bile from the liver into the intestines.

Indications for the use of Gepabene are chronic liver damage of various origins and dyskinesia of the excretory tract. The drug should not be used for acute diseases of the liver and biliary system (acute cholecystitis, acute hepatitis), as well as for children under 18 years of age due to the lack of tests on this category of patients.

Sibektan is a complex combined herbal preparation of domestic development. It contains extracts of tansy, milk thistle, St. John's wort, and birch. It protects liver cells, cell membranes of hepatocytes, and exhibits an antioxidant and choleretic effect. A contraindication to the use of these tablets is cholelithiasis, and the indications are various chronic lesions of the liver and biliary tract.

Another Russian drug, Gepafor, along with milk thistle extract, contains bifidobacteria and lactobacilli, designed to restore the intestinal flora and thereby normalize intestinal function.

Dipana, Liv-52- products produced by Indian pharmaceutical companies, containing many herbal components used in Ayurvedic medicine. Both medications, according to the instructions for use, have a hepatoprotective effect, restoring liver function, stimulating the regeneration of its cells, exhibiting a choleretic effect, and protecting the organ from the effects of toxins.

Efficiency from the point of view of evidence-based medicine

A certain evidence base has been accumulated regarding some herbal hepatoprotective drugs, in particular, Gepabene and Liv-52. The first has been studied for the most part in Russian studies, the second - including Western ones. Evidence of the beneficial effects of these hepatoprotectors on liver function has been obtained, but many Western experts do not consider it conclusive. This opinion is confirmed by data from some studies demonstrating the lack of effectiveness of Liv-52 in alcoholic hepatitis.

NB! Liv-52 is associated with a scandalous study involving patients with alcoholic hepatitis. It showed that survival in the group of patients receiving Liv-52 was 12% lower than in the group of patients taking dummy pills (74% compared to 86%). 22 of 23 deaths in the Liv-52 group were associated with acute liver failure. The results of this work became a compelling reason for the immediate withdrawal of the product from the American market.

Thus, the effectiveness of combined herbal hepatoprotectors from the point of view of evidence-based medicine remains extremely doubtful. Nevertheless, in domestic practice, drugs of this group are widely used and are very popular.

Hepatoprotectors of animal origin

Only two hepatoprotectors of animal origin are registered in Russia - Sirepar and Hepatosan.

Sirepar contains hydrolyzed liver extract enriched with vitamin B12. According to the manufacturer, the drug helps restore liver tissue and exhibits a detoxification effect. It is administered only intravenously or intramuscularly; there is no oral form. At the same time, Sirepar is strictly contraindicated for acute liver diseases and is used only in the remission stage for chronic hepatitis and other pathologies.

The second hepatoprotector, Hepatosan, contains dried liver cells from a donor pig. They are assumed to be biologically compatible with macromolecules of the human body. According to the manufacturer, Hepatosan has a hepatoprotective and detoxifying effect, and also exhibits adsorbing properties and stabilizes cell membranes. Indications for the use of Hepatosan include cirrhosis, hepatitis, liver failure, liver damage from drugs and alcohol, and so on.

Efficiency from the point of view of evidence-based medicine

There is no evidence that drugs of animal origin have any beneficial effect on liver function. But they definitely pose a potential danger. First of all, these drugs should absolutely not be used during the acute period of the disease, as this can lead to activation of the pathological process.

NB! It is important to consider the allergenicity of hepatoprotectors of animal origin. To exclude hypersensitivity reactions, an allergy test should be performed before starting treatment to ensure that the drug does not cause an allergy.

In addition, some experts believe that the use of cattle liver hydrolysates increases the risk of contracting prion infection, which is associated with fatal Creutzfeldt-Jakob disease.

Rich and Famous: Essential Phospholipids

Phospholipids are an important component of every cell membrane, ensuring its integrity and function. The body's need for them increases sharply with increased loads and damage to some organs, in particular the liver. At the same time, a defect is formed in the wall of hepatocytes, liver cells, which can be filled with drugs containing essential phospholipids.

A number of hepatoprotectors with this active ingredient are registered on the modern market:

• Essentiale forte N;
• Result Pro;
• Essliver;
• Phosphonciale;
• Phosphogliv;
• Brenziale forte;
• Livolife forte;
• Antraliv;
• Livenciale and others.

All of them are of natural origin: essential phospholipids are obtained from soybeans by processing their oil.

Mechanism of action

The properties of essential phospholipids are due to their similarity to phospholipids in the human body. They are easily integrated into the cell membrane, providing a comprehensive therapeutic effect. Hepatoprotectors of this group stimulate the restoration of liver cells and protect them from the effects of toxins, including alcohol, chemicals, aggressive drugs, and so on. According to some data, essential phospholipids also help reduce the level of “bad” cholesterol and, as a result, reduce the risk of developing atherosclerosis. In addition, their use helps prevent the formation of cholesterol stones in the gall bladder.

When is it prescribed?

Hepatoprotectors containing essential phospholipids are used for various liver diseases, both in the acute period and in remission. Indications for their use include acute and chronic hepatitis, fatty liver disease, regardless of its origin, alcoholic lesions, cirrhosis, poisoning, including drugs, and liver dysfunction in other pathologies.

It should be borne in mind that the effectiveness of treatment with essential phospholipids largely depends on the duration of the course: according to the instructions for use, these hepatoprotectors are prescribed in high doses (600 mg up to three times a day) for at least three months. If necessary, the course of therapy is repeated and extended up to several years of continuous use.

NB! Clinicians believe that parenteral therapy with essential phospholipids shows the best results. Thus, Essentiale Forte N and its generics are prescribed intravenously as a bolus, after diluting the drug with the patient’s blood in a 1:1 ratio.

Efficiency from the point of view of evidence-based medicine

Over the years, essential phospholipids and their effectiveness have been studied in many clinical studies. However, the conclusions of experts regarding the advisability of their appointment remain ambiguous.

However, on the other hand, neither Essentiale nor any other drug containing essential phospholipids is included in the pharmacopoeia of the developed countries of the world. In the USA and some European countries they can be purchased as dietary supplements and nothing more.

Accordingly, essential phospholipids are also not included in official international protocols for the management of patients with liver diseases. The position of Western colleagues is also supported by some domestic doctors. Thus, the formulary committee of the Russian Academy of Sciences included Essentiale in the list of drugs with unproven effectiveness.

Unfortunately, today the situation with drugs in this series remains controversial: studies demonstrating their effectiveness, as a rule, do not meet the requirements of evidence-based medicine and are not perceived by specialists as evidence that the drug really works.

And at the same time, Essentiale and its more inexpensive analogues remain the most prescribed hepatoprotectors, enjoying enormous popularity both among doctors and among consumers, and occupy leading positions in the top sales of drugs.

Hepatoprotectors of various pharmacological groups

All other drugs are difficult to systematize according to any general characteristic, so they are considered separately.

Heptral

Heptral, a drug from the Italian company Abbot, as well as its generics (Heptor, Ademethionine) contain an amino acid, a derivative of methionine, ademetionine.

Mechanism of action

Presumably, the drug has a complex effect on the body.

1. Prevents bile stagnation by stimulating phospholipids in liver cells and thereby improving their function.
2. Binds free radicals, preventing oxidative damage to the liver, as well as toxins.
3. Stimulates liver regeneration.
4. It has an antidepressant effect, including in long-term depression that is resistant to the action of amitriptyline.

In patients with cholestasis (impaired excretion of bile, accompanied by the release of bile acids into the blood and painful itching), ademetionine reduces the severity of itching and helps normalize liver parameters, including the concentration of direct bilirubin, alkaline phosphatase activity, and so on. Moreover, according to the instructions for use, the hepatoprotective effect of Heptral persists for three months after the end of treatment.

When is it prescribed?

Heptral or its analogues are used for liver damage of various origins, including toxic, alcoholic, viral, medicinal, and liver failure. An important indication for the drug is intrahepatic cholestasis.

Due to its antidepressant properties, Heptral is used to treat withdrawal symptoms in alcoholism and drug addiction, especially in patients with liver damage.

NB! The bioavailability of the oral form of hepatoprotectors containing ademetionine is low. Therefore, most clinicians prefer intravenous injections of Heptral, which have a more pronounced effect.

Efficiency from the point of view of evidence-based medicine

The situation with the evidence base for Heptral is somewhat reminiscent of that with regard to essential phospholipids. Again, several studies have demonstrated positive effects of the drug on the liver. And in the same way, neither Heptral nor any other drug containing ademetionine is registered in the USA and most European countries (with the exception of Italy, where it is produced). But it is successfully sold in pharmacies in Malaysia, India, Bulgaria, Argentina, Georgia, Ukraine, Mexico and the Czech Republic. And yes, it is registered as a veterinary medicine in Australia and New Zealand.

Thus, the Western world did not accept Heptral and did not introduce it into the standard treatment of liver diseases, based, again, on the lack of reliable clinical studies confirming its effectiveness. And this is against the background of the wide popularity of the drug in Russia and other CIS countries, where ademetionine is used both for the treatment of outpatients and in hospitals.

Hepa-Merz is an original drug containing the complex compound L-ornithine-L-aspartate. In the body, it quickly turns into two independent active substances - ornithine and aspartate. Hepatoprotectors of this group are produced in the form of granules for the preparation of a solution for oral administration, as well as ampoules for intramuscular and intravenous injections. Along with Hepa-Merz, its analogues Ornitsetil, Larnamin and Ornilatex are registered in the Russian Federation.

Mechanism of action

The drug works due to the ability of amino acids formed during its dissolution to reduce the concentration of ammonia in the blood plasma, normalize the acid-base composition of the body, thus providing a detoxifying effect. In addition, Hepa-Merz helps reduce pain and dyspeptic syndrome in case of poisoning, as well as normalize the mass of the case (for example, with).

When is it prescribed?

Hepatoprotectors containing this active substance are prescribed for acute and chronic liver pathologies, in which the ammonia content in the blood increases. Indications for Hepa-Merz also include fatty liver degeneration of various origins.

Efficiency from the point of view of evidence-based medicine

The situation with evidence in the case of Gepa-Merz and his analogues is as vague as with our previous heroes. On the one hand, several studies have demonstrated its effectiveness in liver cirrhosis, accompanied by an increase in the concentration of ammonia in the blood. On the other hand, the results of using this hepatoprotector for hepatitis, alcoholic liver damage and other pathologies remain very doubtful. And again, in Western medicine, a hepatoprotector that includes L-ornithine-L-aspartate does not exist.

Homeopathic remedies and dietary supplements

The mechanism of action of drugs with a “hepatoprotective effect” belonging to this category remains extremely vague. Homeopathic medicines have such an inexplicable effect from a medical point of view that homeopaths themselves often cannot explain it.

With regard to dietary supplements, the situation may theoretically be more transparent, but their composition is not subject to pharmacological control. What they contain, in what dosages, is a closely guarded secret.

From the point of view of evidence-based medicine, homeopathy is a big soap bubble. A lot of large studies indicate the complete failure of homeopathic medicines. There is no need to talk about dietary supplements at all, because even their composition is unreliable.

Consumers who prefer to support the liver with homeopathic hepatoprotectors (Hepel, Galstena, etc.) or dietary supplements should understand that they are playing roulette. If they are lucky, as those who experience the placebo effect are, for example, they may experience relief. If you're unlucky, they won't feel it. But we must not lose sight of the possibility that the effect may be negative, because allergic reactions or side effects (especially in the case of dietary supplements with questionable composition) have not been canceled.

UDCA is the black sheep among hepatoprotectors

And now, finally, the turn has come to talk about the drug, which occupies a special place among hepatoprotectors. Let's make a reservation right away so as not to bore the reader - especially on the positive side.

Ursodeoxycholic acid is a bile acid that is produced in small quantities in the human body. The drug was first obtained from bear bile, but today it is obtained synthetically.

In domestic pharmacies, this hepatoprotector is represented by a galaxy of trade names, including:

• Ursofalk, the most expensive, original drug
• Urososan
• Ursodez
• Livodex
• Urdoxa
• Ursoliv
• Grinterol
• Holudekasan
• Ursodex and others.

Mechanism of action

Ursodeoxycholic acid (UDCA) exhibits a complex immunomodulatory, hepatoprotective, and choleretic effect. In addition, it reduces cholesterol levels in the blood and prevents bile stagnation.

The properties of the hepatoprotector are due to its ability to stabilize liver cell membranes and protect the hepatocytes themselves. It inhibits the absorption of cholesterol in the intestine, as a result of which its content in bile decreases, and also increases the solubility of cholesterol. This quality allows UDCA preparations not only to protect the liver, but also to promote the dissolution of existing cholesterol stones in the gall bladder and bile ducts and prevent the formation of new ones.

When is it appointed?

Hepatoprotectors containing ursodeoxycholic acid are used for cholelithiasis (only in the case of confirmed cholesterol stones, which is observed in 80-90% of cases of the disease), as well as acute and chronic hepatitis, toxic liver damage, regardless of the type of toxic substance that provoked the disease, alcoholic illness liver, biliary dyskinesia. In addition, ursodeoxycholic acid is used as part of combination therapy for cystic fibrosis.

Hepatoprotective drugs UDCA are also used for cholestasis, including in pregnant women - their safety profile allows them to be prescribed to the most vulnerable categories of consumers, including young children.

Efficiency from the point of view of evidence-based medicine

Hepatoprotectors containing UDCA are almost the only representatives of this pharmacological group that have no disagreements with evidence-based medicine. Numerous studies indicate that this medicine really works effectively for liver damage of various origins, intrahepatic cholestasis, alcoholic cirrhosis (improving the prognosis of the disease), steatosis and other liver pathologies.

And no less compelling evidence that UDCA-based hepatoprotectors are truly effective is their worldwide recognition. The funds of this group are registered and widely used in developed countries of the world, including Switzerland, Italy, France, Japan, Germany and others. True, it is worth noting that they are included in the group of choleretics, which promote the dissolution of gallstones, and not hepatoprotectors. But in the end, this aspect has no influence on the result.

Thus, if you are looking for an answer to a question that often arises among consumers - which hepatoprotector is the most powerful, the most effective and generally the best - the answer will be unambiguous: the one that has proven effectiveness that cannot be doubted even with the most skeptical attitude. And only one active ingredient meets this requirement - ursodeoxycholic acid.

“What about the other hepatoprotectors? - the reader will doubt, - after all, the doctor said (it’s written in the article, they said on TV) that their effectiveness has also been proven? Yes, indeed, such situations do occur. And that's why.

Clinical Research: All that glitters is not gold

By uploading our conversation about modern hepatoprotectors, we will dot the i’s on an issue that confuses many consumers (and, unfortunately, even doctors) and gives them false ideas about the effectiveness of these drugs.

The fact is that the results of various drug studies are not always reliable. To eliminate the possibility of obtaining false data, work must be carried out in accordance with certain requirements formulated in the basic principles of evidence-based medicine. Thus, the most reliable studies are those in which participants are divided into several groups taking the study drug and dummies or other means of comparison (randomized trial). No patient should know whether he is receiving a drug or a placebo (blind study), and it is better if even the doctor does not know about it (double-blind study). An important condition for reliability is the inclusion of a large number of participants in the work - in large works we are talking about thousands of volunteers. And these are not all the requirements for modern research.

Such experiments require both time and enormous material costs. In addition, no pharmaceutical company will carry them out if there are serious doubts about the results, because the goal of the work is to confirm the effectiveness, register the product in the maximum number of markets, increase sales and get maximum profits.

In order to get out of the situation and present at least some “evidence of effectiveness,” companies producing drugs with questionable effectiveness resort to a trick: they initiate studies with almost certainly positive results. These experiments are carried out, at best, with several dozen patients, and the requirements of evidence-based medicine are reshaped in their own way. The obtained data, which satisfies the interests of the manufacturer, is used to promote the drug - they appear in advertising, decorate booklets and confuse consumers.

Alas, a similar situation in the CIS countries is the rule rather than the exception. And therefore, in the matter of choosing over-the-counter drugs, the law of the cruel market must apply: not all that glitters is gold. Especially when it comes to hepatoprotectors.

The liver is the largest gland in the human body, an internal organ 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 environmental influences. Still, some factors can cause serious harm to her:

As you can see, diseases often arise from an incorrect lifestyle. Patients who established a healthy diet, gave up bad habits, had their liver treated, 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. Cholelitholytics aimed at dissolving 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, itching, baldness, vestibular disorders.

Women with ailments of the reproductive system that occur with hormonal disorders (endometriosis, fibroids, carcinoma of the breast, ovaries or uterus) should use the drug “Karsil” with extreme caution. 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), with drug-induced pathology that arose during long-term use of antitumor, antituberculosis, antiviral drugs.
3. Cirrhosis, fibrosis of the gland.
4. Intoxication with alcoholic beverages, narcotic substances, medicines, food.

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

However, you should be very careful with the product, as it has a large number of side effects. These may be headaches, disturbances in consciousness and sleep, allergic reactions, heart failure, nausea, 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. The medicinal effect is due to the artichoke.

The positive aspects of the drug include:

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

The disadvantages include the following:

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

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.

Hepatoprotectors for the liver: a list of effective and inexpensive drugs

Due to age-related characteristics and deterioration of digestive function, people develop polyhypovitaminosis. This affects the metabolism in the body and triggers an accelerated aging process. The main goal of hepatoprotectors is to prolong a person’s youth and life.

There are about 200 varieties of the drug, each of which has its own indications and contraindications for use.

What it is?

Hepatoprotectors- a group of diverse drugs that, in domestic practice, prevent the destruction of cell membranes and stimulate the regeneration of hepatocytes, thereby having a positive effect on liver function. They increase the liver’s resistance to pathological influences, enhance its detoxification function by increasing the activity of enzyme systems (including cytochrome P450 and other microsomal enzymes), and also help restore its functions in case of various damages (including toxic ones).

At the same time, the proven clinical effectiveness of the use of hepatoprotectors for various conditions is contradictory.

Groups of hepatoprotectors

Currently, there is the following classification of tablets, when taken, the liver is supposedly restored:

• phospholipids;
• amino acid derivatives;
• medicines of animal origin;
• bile acids;
• herbal medicines;
• homeopathic medicines;
• Dietary supplements.

But no matter how much patients ask what is the most effective drug for improving the functioning, maintaining and treating the liver, there is no ideal drug that could restore liver tissue very quickly and effectively. As a rule, such medications are taken throughout the entire period as long as there is an adverse effect of a certain factor on the human liver and there is significant harm from such an effect.

At the same time, patients who need liver protection when taking antibiotics, or those who are interested in how to support the liver when taking alcohol, should understand that a one-time use of such a drug after a person has consumed alcohol, toxic drugs, or overeated, has no effect at all . Therefore, it is better not to treat the liver yourself, because a hepatoprotective agent is only an auxiliary drug in complex therapy, and only a specialist should determine which drug is better and how to treat it.

Organ functions and drug effects

Any disease that affects the liver causes serious disruption in almost all body systems, since the organ performs a number of important functions, in particular the liver:

• responsible for protein, carbohydrate, lipid, pigment metabolism;
• neutralizes the harmful effects of toxins and drugs;
• stores vitamins and microelements;
• produces cholesterol and lipids;
• regulates blood clotting;
• responsible for the production of bile acids and their transport to the gallbladder;
• stimulates intestinal function;
• synthesizes and inactivates some hormones, including sex hormones;
• produces enzymes;
• is a blood repository.

Nature, having endowed the liver with so many functions, took care of its integrity. This is the only organ that can recover even after partial removal. But the body cannot always cope with some factors on its own, namely:

• obesity;
• alcohol;
• medications;
• genetic factors;
• drug use;
• poor environment;
• diabetes mellitus;
• physical inactivity;
• improper nutrition.

Although the liver is capable of recovery, prolonged excessive stress sooner or later disrupts its activity. Hepatoprotectors are designed to protect the liver from such factors. They, of course, will not replace basic therapy, but will complement the effect of prescribed medications and can improve the function of liver cells.

In case of liver pathologies (hepatitis, hepatosis, fibrosis, cirrhosis, liver failure, cancer, etc.) and forced prolonged use of certain medications (anticonvulsants, antitumor, painkillers), the doctor must prescribe hepatoprotectors.

Recently, a myth has formed that this class of drugs is just an invention of “greedy” pharmacists who want to profit from the grief of patients and produce drugs with dubious effectiveness. Opponents of these drugs rely on the fact that in Europe and the USA, liver treatment is not carried out with such medications, since they do not exist in the list of pharmacological agents.

When are drugs from this group prescribed?

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

1. For (fatty liver). Hepatoprotectors are used as part of complex therapy, which includes: a low-fat diet, antidiabetic drugs, and regular exercise.
2. After chemotherapy. The hepatoprotective agent helps to gradually restore the liver.
3. . Medicines are prescribed if antiviral drugs do not show the expected effect or for any reason antiviral therapy is impossible.
4. When caused by alcoholism. In this case, the main step towards recovery is to stop drinking alcohol, otherwise hepatoprotectors will be absolutely useless.
5. For toxic hepatitis (after taking antibiotics). Hepatoprotectors are effective in combination with other drugs to restore the liver, diet, and giving up bad habits.
6. With enlarged liver (hepatomegaly). For rapid regeneration of organ cells and normal functioning of the organ, hepatoprotectors are used.

List of popular hepatoprotectors for 2019

The list of hepatoprotectors with proven effectiveness for 2019 is not that long. First of all, it is ursodeoxycholic acid, as well as amino acids. However, the effect of amino acids in most cases manifests itself only with injections, and ursodeoxycholic acid is used for liver diseases to treat only certain manifestations and cannot be considered as a universal drug.

List of inexpensive and effective hepatoprotectors:

Classification of liver drugs by type of active substances:

Hepatoprotectors with essential phospholipids

According to statistics, these drugs are most common in post-Soviet regions. They are obtained from soybeans. Phospholipids are products of lipid metabolism, which are kind of building blocks for the construction of cells. These substances are involved in the transport of nutrients, cell division and differentiation, and they activate various enzymatic systems.

The advantages of hepatoprotectors based on essential phospholipids include:

• the ability to quickly restore hepatocytes at the molecular level;
• protection against toxins and viruses;
• improvement of the action of interferons;
• preventing the formation of scar tissue.

However, there are also negative opinions about these medications.. In particular, in 2003, a study was conducted in the United States that did not determine the positive effect of such drugs on liver function. Scientists have also found that during the treatment of hepatitis - acute and chronic, inflammation intensified, since drugs in this group do not have choleretic properties, and the bile stagnates.

If we are guided by these studies, then the choice of drugs of this type for the treatment of viral hepatitis is the wrong decision. There is also evidence that different B vitamins, which are present, for example, in Essliver Forte, are not recommended to be taken at the same time. Some sources claim that tablets like Essentiale practically do not enter the liver, being distributed throughout the body. It is advisable to take B vitamins separately in tablets; you can find out the names of the drugs from your doctor.

Therefore, treatment of liver disease with such drugs may be ineffective. At the same time, the price of hepoprotective drugs is quite high: if you take capsules for one month, the cost of treatment will be approximately 3,000 rubles. Thus, taking modern drugs of this type, the patient receives questionable effectiveness. And people with hepatitis (the active form of the disease) need to take them very carefully.

List of essential phospholipids:

Hepatoprotectors with components of animal origin

Preparations created from pork liver are capable of regenerating hepatocytes of the human liver, since they are as similar in composition as possible. Thanks to their detoxifying and antioxidant effects, they treat hepatitis, hepatosis and cirrhosis of the liver.

Among the positive qualities noted:

• the ability to remove toxins from the body;
• accelerate the regeneration of hepatocytes;
• restore lost liver functions.

• high risk of allergies;
• the risk of developing immunopathological syndromes in acute forms of hepatitis;
• they are not suitable for the prevention of liver diseases.

Cons: There is no clinical evidence that the medicine actually helps or is safe. There is also a potential danger when taking these medications: for example, they should not be taken if you have active hepatitis. Also, drugs of this type have a high allergenic potential. Therefore, before practicing such treatment, it is necessary to determine whether a person is highly sensitive to the drug.

When taking such drugs, there is a risk of the patient contracting a prion infection, which causes spongiform encephalopathy. Therefore, when determining which medicine is better, you need to take into account that there is an opinion that it is not advisable to take these tablets for the treatment of liver pathologies.

Hepatoprotectors with amino acids: Heptral, Heptor (Ademethionine)

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

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

Negative opinion— Heptral is a registered drug in Russia, Germany and Italy. It is also a veterinary drug in Australia (for dogs and other animals). In all other countries, the drug is positioned as a dietary supplement, since research results have shown dubious results.

Most doctors still claim the effectiveness of this drug, but only if it is infused intravenously, since it is poorly absorbed when taken orally.

Ornithine aspartate - Hepa-Merz

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

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

Negative opinion- in the case of alcoholic liver damage, it has practically no effect, so supporting and protecting the liver with this remedy is ineffective. A noticeable effect is observed only in hepatic coma. It is advisable to use the drug for the purpose of short-term recovery from this state.

Hepatoprotectors of plant origin

Herbal-based preparations have won the greatest confidence. Especially popular are the fruits of milk thistle, which contain many biologically active components (microelements, vitamins, organic acids).

Preparations based on milk thistle significantly reduce the toxic effect on the liver and promote the regeneration of cellular structures. In damaged hepatocytes, protein production is stimulated, cell membranes are stabilized, and the loss of trace elements stops, thereby increasing the natural regeneration of liver cells.

However, there is insufficient confirmed data on the clinical effectiveness of silymarin in the treatment of alcoholic liver tissue damage. Effectiveness in acute hepatitis C and viral hepatitis B has not been proven. In the future, studies will be conducted on the effectiveness of silymarin in the treatment of chronic liver diseases.

Milk thistle tablets are not the only herbal medicines that restore and protect the liver. Celandine, artichoke, turmeric, pumpkin seeds, and fumaria officinalis can act as active ingredients in a number of hepatoprotectors. They are distinguished by a minimal number of side effects, the ability to eliminate spasms of the gallbladder, and improve the outflow and production of bile. For example, Allochol, which is not a hepatoprotector, also consists of plant components, but causes a lot of side effects.

At the same time, medical evidence suggests that artichoke leaf extract is widely used, but it has not been clinically proven that it can provide effective help. It is not recommended to use for cholelithiasis, acute hepatitis, cholestasis syndrome.

The list of popular drugs includes:

• Liv-52, regenerating damaged intracellular processes. Prescribed for persistent disturbances of appetite, it has a healing effect on the liver due to its powerful phytocomposition.
• Pumpkin based on pumpkin seed oil. It has a pronounced antioxidant and hepatoprotective effect, normalizes the composition of bile and the condition of the bile ducts.
• Chophytol, which has a choleretic and diuretic effect, improves blood composition and promotes the rapid elimination of urea.
• Hepel, which has antispasmodic, choleretic, hepatoprotective, antidiarrheal, and anti-inflammatory effects.

Dietary supplements or homeopathic medicines

List of drugs:

1. Galstena with active plant components - milk thistle, medicinal dandelion and celandine. The drug also contains phosphorus and sodium sulfate. Prescribed for the treatment of liver pathologies occurring in acute and chronic forms, in case of impaired functioning of the gallbladder, chronic pancreatitis.

The medicine is taken after meals or 1 hour before meals. Children under one year old are prescribed ½ tablet 3 times a day, children 1-12 years old - ½ tablet (or 5 drops of the drug), children over 12 years old and adults - 1 tablet. In severe forms of the disease, the frequency of taking the drug is increased to 8 times a day.

1. Hepel. The medicine contains spotted milk thistle, components of the quinn tree, celandine, nutmeg, phosphorus and colocynth. It has anti-inflammatory, analgesic, choleretic and antidiarrheal properties. Prescribed to patients suffering from bloating, appetite disorders, eczema, acne on the body, as well as toxic and inflammatory liver diseases. Hepel is taken three times a day, one tablet. In severe forms of pathology, patients are administered 1 ampoule of the drug intramuscularly.