Milk Thistle (Herbs/Suppl)

Brand and Other Names:carduus marianum, holy thistle, more...lady's thistle, legalon, Marian thistle, Mary thistle, silibinin, silybin, silybum marianum, silymarin, St Mary thistle
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Suggested Dosing

140 mg silymarin PO TID

Hepatitis, Chronic Active

Silibinin constituent: 240 mg PO BID

Hepatic Cirrhosis

Silymarin 70-80% extract: 420 mg/d PO

Dyspepsia

1 mL PO TID (Iberogast, Medical Futures, Inc)

Diabetes

Silymarin 200 mg PO TID in combination with conventional treatment

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Suggested Uses

Alcoholic liver disease, appetite stimulant, gallbladder problems, hepatic cirrhosis, hepatitis (chronic), hepatotoxicity (chemical/drug-induced), jaundice, pleurisy, prostate cancer, spleen diseases

Efficacy

Possibly effective in diabetes and dyspepsia

Extensively studied; effective in treatment of cirrhosis, hepatitis, chemical- or alcohol-induced fatty liver

Effective in mushroom (Amanita phalloides) poisoning, if treatment begun early

IV form of silibinin approved in Europe for Amatoxin poisoning

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Adverse Effects

Frequency Not Defined

Abdominal bloating/pain

Allergic reactions

Anaphylaxis

Anorexia

Diarrhea

Dyspepsia

Flatulence

Nausea

Pruritus

Rash

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Warnings

Contraindications

Hypersensitivity to Asteraceae/Compositae plants, chrysanthemums, daisies, marigolds,

Breast cancer, endometriosis, hormone sensitive conditions, ovarian cancer, uterine cancer, uterine fibroids

Cautions

Concurrent CYP3A4 substrates, CYP2C9 substrates

Silymarin has poor oral bioavailability & is sparsely water-soluble

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Pregnancy & Lactation

Pregnancy Category: N/A

Lactation: N/A

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

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Pharmacology

Metabolism: N/A

Excretion: N/A

Mechanism of Action

Active constituents: silymarin; silibinin

Antioxidant, protects hepatocyte membranes, enhances liver parenchyma regeneration, increases glutathione levels

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