Milk Thistle (Herbs/Suppl)

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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

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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