Hepatoprotectors - drugs for treating the liver, the best drugs, tablets

Medicines for the liver are hepatoprotectors that are prescribed by a doctor for various liver dysfunctions, hepatitis (viral, toxic, alcoholic hepatitis), for liver damage when taking drugs that have a negative effect on its cells (antitumor drugs, painkillers, anti-tuberculosis drugs, broad spectrum antibiotics). spectrum of action, oral contraceptives, etc.). What medicine for the liver is considered the best, good, effective and not expensive? What medicine restores the liver, is used for prevention, to support the liver? Today, the pharmaceutical industry offers a lot of tablets supposedly to restore the liver:

• amino acid derivatives
• phospholipids
• bile acids
• herbal remedies
• preparations of animal origin
• dietary supplements
• homeopathic medicines

but an ideal medicine for treating the liver that quickly and effectively restores its tissue has not yet been created. As prescribed by a doctor, hepatoprotectors are taken throughout the adverse effects of provoking factors, as well as after their influence ends. It should be noted that a one-time use of medications for the liver after alcohol, a heavy meal, overeating, or taking toxic drugs does not give any effect.

What it is?

Hepatoprotectors are 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.

General information

Hepatoprotectors are medications that doctors prescribe to patients with impaired liver function and various liver diseases. Hepatoprotector drugs are also prescribed for hepatitis C , for other toxic, viral and alcoholic hepatitis , for damage caused by taking certain medications, in particular painkillers, antitumor drugs, antibiotics , etc.
Currently, the proposed list of hepatoprotector drugs for the liver is very wide, so it is often difficult for the patient choose the best drugs for liver treatment. Often the determining factors are the price of the medicine, the fact that it is of plant origin, etc. The main goal of patients is to find hepatoprotectors with proven effectiveness. But in this case, the most important rule is the following: liver treatment with medications should only be prescribed by a doctor.

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.

Causes of liver diseases

People test their liver’s strength every day, indulging in harmful delicacies, freaking out about it or not, drinking all sorts of medications, in search of a magic elixir. All this negatively affects the main gland. But we can still highlight four main points, which with an 85% probability can lead to complex liver disease:

• viral infections and harmful bacteria. They become the sources of all forms of hepatitis and cause severe inflammation of the liver. Timely treatment can cope with the disease, and advanced cases end in cirrhosis;
• imbalance of fat metabolism. The level of fat in the liver begins to increase and the organ simply ceases to perform its functions normally. Fat metabolism is disrupted due to poor nutrition, diseases (pancreatitis, diabetes), thyroid dysfunction, and prolonged use of medications;
• alcohol abuse and alcoholism. Even the most natural alcohol harms the body in general and the liver in particular. It is harmless to health to consume no more than 20-50 ml of vodka, 150-300 ml of wine per day;
• intoxication. This most often occurs after serious treatment with antibiotics, which significantly poison the liver, causing the appearance of chronic diseases.

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 hepatosis (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. For viral hepatitis. Medicines are prescribed if antiviral drugs do not show the expected effect or for any reason antiviral therapy is impossible.
4. For liver cirrhosis 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.

Indications for use

You should start taking medications if:

• You have cirrhosis of the liver (usually due to excessive alcohol consumption).
• You have liver hepatosis (people with obesity and a sedentary lifestyle suffer).
• Used antibiotics or hormonal drugs for a long time. Medicines will help restore the liver and immune system and restore homeostasis.
• You suffer from hepatitis A, B, C. During the disease, the liver is exposed to foreign influences and works at double speed.

List of popular hepatoprotectors for 2021

The list of hepatoprotectors with proven effectiveness for 2021 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:

A drug	Price from
Berlition	594 rub.
Gepabene	461 rub.
Hepa-mertz	769 rub.
Hepatrin	320 rub.
Heptor	1022 rub.
Heptral	1612 rub.
Karsil	372 rub.
Legalon	283 rub.
Ovesol	172 rub.
Octolipen	359 rub.
Rezalut Pro	1332 rub.
Thiogamma	223 rub.
Tykveol	278 rub.
Urdoxa	741 rub.
Ursosan	191 rub.
Ursofalk	210 rub.
Phosphogliv	540 rub.
Hepel	366 rub.
Hofitol	372 rub.
Essentiale Forte	715 rub.
Essliver	315 rub.

Classification of liver drugs by type of active substances:

Active Ingredients	Drugs
Animal liver cells	Hepatosan, Sirepar, Progepar
Milk Thistle Extract (Silymarin)	Karsil, Gepabene, Galstena, Legalon, Fosfontziale, Gepatrin, Livesil Forte
Artichoke extract	Hofitol, Hepatrin
Pumpkin seed extract	Tykveol, Peponen
Other herbal ingredients	Hepel, Liv 52, Ovesol
Phospholipids	Essentiale Forte, Phosphogliv, Antraliv, Essliver, Phosphonciale, Rezalut Pro, Hepatrin, Livesil Forte
Ursodeoxycholic acid	Ursofalk, Urdoxa, Ursosan, Livodexa
Thioctic acid	Octolipen, Thiogamma, Berlition
Ademetionine	Heptral, Heptor
Ornithine	Hepa-Merz

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:

Essentiale N, Essentiale forte N Composition: essential phospholipids. Side effects: well tolerated, sometimes diarrhea and abdominal discomfort are possible. Contraindicated for children under 12 years of age. Average price in pharmacies 2021: 30 pcs. 660 RUR, 5 amp. 950 rub. 90 pcs. 1300 rub.

Essliver Forte Ingredients: essential phospholipids (less than in Essential), vitamins (B1, B2, B6, E, PP, B12) Side effects: possible diarrhea, pain in the upper abdomen. With caution for children under 1 2 years old, pregnant and lactating women. Price: 30 caps. 300 rub, 50 caps. 420 rub.

Phosphonziale Composition: Lipoid C100 and Silymarin Price: 30 caps. 420-480 rub.

Gepagard Active Ingredients: essential phospholipids, vitamin E Price: 30 caps. 300 rubles, 120 drops.. 900-950 rubles.

Phosphogliv Ingredients: phospholipids, trisodium salt of glycyrrhizic acid (antiviral and immunomodulatory effects) Price: 50 caps. 450-500 rub. powder for injection 5 pcs. 1300-1500 rub.

Rezalut PRO Ingredients: Lipoid PPL 600, which contains: medium chain triglycerides, phospholipids, glycerol mono/dialconate, soybean oil, vitamin E. Price: 30 caps. 450 rub., 100 caps. 1300 rub.

Doppelhertz active essential phospholipids Composition: Essential phospholipids, Vitamin B1, B2, B6 Price: 60 caps. 460 RUR, 5 amp. 640 rub.

Eslidin Composition: phospholipids + methionine Indicated: For liver diseases, diabetes mellitus, psoriasis, dystrophy and exhaustion, atherosclerosis of the coronary arteries and cerebral vessels. Contraindicated: children under 3 years of age, pregnant and breastfeeding women with caution. Price: 580 -720 rub.

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 detoxification 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.

They contain amino acids, low molecular weight metabolites, cyanocobalamin. The disadvantages include:

• 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 the 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.

Hepatosan Ingredients: dried liver cells from a donor pig. Contraindicated in: children under 1 year of age, acute hepatitis, pregnancy, lactation, hypersensitivity. Price: 10 caps. 400-520 rub.

Hepatamine Composition of a biological food additive - cattle liver. Price: 40 pcs 440 rub.

Progepar Complex drug, contraindicated for children. Price: 50 tablets 1400 rub.

Why does the pharmaceutical class “hepatoprotectors” exist only in Russia and the CIS countries?

Hepatoprotectors as a class of drugs are sold exclusively in the countries of the former USSR, since they are simply not registered in countries with strict registration of pharmaceuticals (European Union, USA, Australia). To be included in the list of drugs for the treatment of the liver, it is necessary to prove therapeutic effectiveness and confirm clinical significance.

Only a few hepatoprotectors are used for narrow indications as biologically active food additives in developed countries (USA and Europe). Moreover, even these drugs get there no more than 5-10% of the total amount produced. For example, 99% of the volumes of the French drug Essentiale produced are sent to Russia and other CIS countries, since no one else needs it.

Since the pharmaceutical business is very profitable, it is difficult to determine the reliability of the research being conducted, especially since its funding is most often provided by an interested party.

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.

Heptral Composition: active ingredient ademetionine Has antidepressant, regenerating, antioxidant effects. Slows down the development of liver cirrhosis. Side effects: may cause heartburn, stomach pain. Price: 20 tablets or 5 fl. 1700 -1800 rub.

Heptor Composition: active ingredient ademetionine Just like Heptral, it is indicated for toxic liver damage, depression, liver cirrhosis, treatment of the consequences of alcohol abuse. Contraindicated: for children, during lactation and in the first and second trimester of pregnancy. Price: 20 tablets 800-1000 RUR, 5 fl. 1200 rub.

Tablets - bile acids

Ursodeoxycholic acid is a bile acid preparation. Used for the treatment of diseases of the biliary tract and liver, uncomplicated cholelithiasis. It has a hypoglycemic effect, a choleretic effect, therefore it is contraindicated in the presence of X-ray positive (high calcium content) gallstones (see also what you can eat with cholecystitis), reduces the saturation of bile with cholesterol (until the cholesterol stones are completely dissolved), causes an increase in pancreatic and gastric secretion. Affects immunological reactions in the liver - reduces the number of eosinophils, affects the formation of interleukin-2, the number of T-lymphocytes.

Since drugs containing ursodeoxycholic acid have a number of serious contraindications (acute inflammatory processes in the intestines, gall bladder, severe dysfunction of the pancreas, kidneys and liver, gallstones), and also have an immunomodulatory effect, their use without a doctor’s recommendation is dangerous .

These drugs are used for:

• biliary reflux gastritis,
• for symptomatic treatment of primary biliary cirrhosis of the liver,
• to dissolve cholesterol stones in the gall bladder,
• alcohol, toxic liver damage,
• acute hepatitis, with hepatopathy in pregnant women.
• UDCA is the most effective treatment for primary biliary cirrhosis and primary sclerosing cholangitis.

Pathogenetic therapy with ursodeoxycholic acid is carried out for patients with viral hepatitis with aggravating factors - during pregnancy, alcoholic viral liver damage, hemophilia, in adolescence, with oncohematological diseases, drug and substance abuse.

Ursofalk 10 caps. 250 rub, 50 caps. 1000 rub. 100 caps. 1800 rub. susp. 1200 rub.	exhol 10 pcs 200 rub. 100 pieces. 1500	Urosliv 10 capsules. 160 RUR, 100 caps. 1300 rub.	Ursodez 100 caps. 1100 rub.
Grinterol 50 pcs. 700 rub 100 pcs 1400 rub.	Urdoxa 100 caps. 1200 rub.	Livodex 50 pcs. 300 rub. 100 pieces. 900 rub.	Ursosan 10 caps. 200 rub. 100 caps. 1500 rub.

Ornithine aspartate - Hepa-Merz

Positive opinion - Ornithine helps reduce high levels of ammonia, is used for disorders of brain function 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.

Hepa-Merz Composition: active ingredient Ornithine Used in the treatment of severe liver damage. Reduces high levels of ammonia in the body. Side effects: nausea, vomiting. Contraindicated: lactation, pregnancy with caution, in severe renal failure. Price: 10 pack. 650-700 rub., 30 packs. 1600-1700 RUR, 10 amp. 2500 rub.

Thioctic acid

Action: normalizes lipid, energy, carbohydrate metabolism, has hepatoprotective and antioxidant properties. Helps reduce blood glucose levels and is used in the complex treatment of hepatitis and toxic liver damage. Contraindications: for children, can lead to a sharp decrease in blood glucose levels (especially in patients with diabetes). Side effects: nausea, vomiting, diarrhea, itching, headache.

Berlition 30 tablets 700 rub. IV 600-800 rub.

Espa-lipon 30 tablets 640 rub. IV 750-800 rub.

Thioctacid 30 tablets 1800 rub. IV 1400 rub.

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.

Karsil and Karsil Forte Ingredients: milk thistle extract. Application: before meals, with a sufficient amount of water, course for at least 3 months. For prevention, 1 tablet 3 times a day. For children over 12 years of age and adults with severe liver damage, 4 dr. 3 r/day, then 1-2 dr. 3 r/day. Side effects: allergic reactions, diarrhea. Price: Karsil 80 pcs. 330 rub., Karsil Forte 30 pcs. 380 rub.

Legalon Ingredients: milk thistle fruit extract. Application: after eating, without chewing, with a small amount of liquid. Start of treatment 2 caps. 3 r/day, maintenance therapy 1 dr. 3 r/day. Side effects: allergic reactions, diarrhea. Price: Legalon 70 mg: 30 caps. 230 rub. 60 caps. 400 rub Legalon 140 mg: 30 caps - 340 rubles, 60 caps. 600 rub.

Gepabene (milk thistle and fumy thistle) Ingredients: herbal fumitory medicinal dry extract and milk thistle. Contraindication: children under 18 years of age, acute inflammation of the liver and biliary tract. Application: 1 capsule. 3 times a day For pain, take an additional 1 capsule. before bedtime. The maximum daily dose is 6 capsules, taken in 3-4 divided doses. Price: 30 caps. 430-570 rub.

Silymar tablets Ingredients: milk thistle fruit extract. Application: for toxic liver damage, cirrhosis, after hepatitis, chronic hepatitis, with prolonged use of alcohol and medications, with intoxication. 1-2 tablets each. 3 times a day for 30 minutes. before meals. Course 25-30 days. After 1-3 months, you can repeat the treatment. Not recommended for children under 12 years of age. Side effects: possible loose stools and allergic reactions. Price: 30 pcs. 110-150 rub.

Milk thistle tablets (extract) Ingredients: 50 mg silymarin. Application, indications, contraindications and side effects are the same as for other drugs with milk thistle extract. Price: 20 pcs. 130 rub.

Milk thistle meal (crushed plant) Application: 1 teaspoon 3 times a day with meals. Contraindications: cholelithiasis, exacerbation of gastric and duodenal ulcers, hypersensitivity, pregnant and lactating women. Side effects: pain in the right hypochondrium, diarrhea, allergies. Price: 60 rub.

Milk thistle oil in capsules Application: adults, 1 capsule. 2 times a day during meals. The course is 1 month, which can be repeated 2-3 times a year. Contraindications: acute gastrointestinal diseases, childhood. Price: 40-60 rub.

Milk thistle syrup Ingredients: milk thistle meal and extract, common thyme herb, tansy flowers. Application: 1 tbsp. spoon 1-2 times a day during meals. Course 4-6 weeks. It is possible to repeat the course up to 4 times a year. Contraindications: children under 14 years of age, pregnancy, lactation, diabetes. Price: 150 ml. 110 rub.

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, which regenerates 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.

Pumpkin seed oil

pros

Such drugs contain fatty acids, polyunsaturated and unsaturated, with a high content of linoleic and oleic acids - essential oils, vitamins, phytosterols, niacin, beta-carotene. As a result, a hepatoprotective effect is noted.

Due to the presence of carotenoids and tocopherols, an antioxidant effect is noted; due to the presence of essential phospholipids, damage to hepatocyte membranes is slowed down, and cell recovery is accelerated.

Peponen and Tykveol chronic liver diseases.

Minuses

There is no clinical evidence base regarding the effectiveness of pumpkin seed oil preparations. More research needs to be done to get accurate information.

Means	Compound	Price
Tykveol	Pumpkin seed oil	from 260 rub.
Peponen	Pumpkin seed oil	from 300 rub.

Reviews from people

We have selected some reviews from people who have used various hepatoprotectors:

1. Maria. I used to have serious problems with the liver, so for prevention I take a course of hepatoprotectors once a year. I’m not sure whether they help me or not, but I haven’t felt any deterioration in my health for 5 years now. When I was a teenager, I was treated with Essentiale - the drug helped a lot, and as a form of prevention I prefer something homeopathic or milk thistle decoctions.
2. Anton. I have had epilepsy since I was 21. As soon as anticonvulsant therapy was selected, the neurologist prescribed Karsil. I didn’t believe I would need it because I was taking handfuls of PEP and didn’t want to add more medication to it. But after 3 years, liver tests worsened, and I had to cleanse my liver. Since then I have been taking hepatoprotectors twice a year and following diet No. 5.
3. Egor. I underwent a two-week liver cleanse with Heptral as a preventive measure, since I often drink red wine, eat fatty meats and other “healthy” foods. There were no obvious changes in my health, but my health had never bothered me before. The only big advantage of taking the hepatoprotector that I noted was the improvement in intestinal perilstatics.
4. Veronica. She was registered with her illness and regularly donated blood. The drug Phosphogliv was prescribed to me by my attending physician. I can’t say that it somehow protected my liver and improved my condition. It happened that I did not take hepatoprotectors for years, and sometimes I drank it regularly. I didn't notice any difference. Each time I used them I felt sick and, interestingly, I got a runny nose. When the diagnosis was finally removed and the main treatment stopped, the liver tests returned to normal. This was not associated with hepatoprotectors. As soon as I stopped taking the medications, everything returned to normal. I consider these drugs to be a common money grab.
5. Alexei. When I underwent a medical examination at the enterprise, doctors strongly recommended treating my liver, as there was a possibility of developing cirrhosis. I spent three weeks in the hospital, was given a course of heptral, and after discharge I continued treatment with the hepatoprotector on my own. Two months of therapy cost me 12 thousand rubles, but my health improved. The latest examination showed a significant improvement in the condition of the organ.

Main principles of restoration of liver structures

Subject to complete abstinence from alcoholic beverages, the liver structures can be restored, which occurs in 3 stages:

1. Hepatocyte regeneration.
2. Production of new cells.
3. Active tissue replication.

If a person, despite problems with the liver, continues to drink alcohol, then the tissues begin to replace functional connective tissue - fibrosis, which subsequently turns into cirrhosis (tissue death), which cannot be treated.

Watch a video about liver restoration:

Drawing conclusions

Many patients consider herbal remedies and nutritional supplements to be completely safe and sometimes take them without the knowledge of the doctor and without restrictions. This is a big mistake. During treatment, you should tell your doctor about all dietary supplements, herbs and medications you are taking, as they may be hepatotoxic and interact with other medications you are taking.

All medicinal plants have a complex composition and contain, although minimal doses, toxic (poisonous) substances. For example, many Chinese herbs have hepatotoxic properties, leading to acute liver failure. Moreover, control over such herbal products (food additives) even in the USA, where the safety of drugs and products is strictly controlled, is not carried out to the proper extent. What can we say about Russia? Therefore, the use of any herbal remedies should be treated with caution, keeping in mind their possible hepatotoxicity.

Therefore, for 2021, hepatoprotectors are considered drugs with proven effectiveness (to varying degrees):

1. Ursodeoxycholic acid
2. Amino acid preparations (ornithine aspartate, ademetionine)
3. Silymarin preparations are hepatoprotectors with supposed but unproven effectiveness, used for certain conditions
4. Essential phospholipids - the effectiveness of their use in capsules remains controversial; intravenous administration is more preferable

Cattle liver hydrolysates should not be used due to the potential danger to the human body. Other herbal remedies cannot yet be recommended for widespread use in chronic liver diseases, since their effectiveness has not been properly proven.