Drug-induced liver injury: silymarin
Vovk E.I.

Moscow State Medical Stomatological University named after A.I. Evdokimov

The prevalence of drug-induced liver injury (DILI) - clinico-morphological variants of liver damage caused by medication intake - reaches 5-20% in different countries, which according to some data corresponds to 10% of all adverse reactions of the human body associated with the use of medications. This article examines in detail the predictors of DILI, the pathogenesis of primary, genetically-dependent and toxic drug reactions, clinico-morphological forms of DILI, the algorithm of medical care depending on the type of side effect. The drugs of the first choice for the DILI treatment are hepatoprotectors, which increase the ability of hepatocytes to resist toxic effects, withstand the development and progression of chronic inflammation in the liver, and inhibit the development of liver fibrosis. The publication reflects the properties of standardized silymarin, Legalon®, which is approved by international agencies - the FDA and EMEA in the US and Europe. The effectiveness of the use of silymarin for the prevention of DILI has been demonstrated in a number of experimental and clinical studies for patients receiving anti-tuberculosis, cytostatic therapy, as well as drugs for the control of Alzheimer's disease. The main mechanisms of hepatoprotective action of silymarin are antioxidant, anti-inflammatory, regenerative, membrane-stabilizing and antifibrotic.

Key words: drug-induced liver injury, side effect, silymarin, Legalon®, antioxidant.
For citation: Vovk E.I. Drug-induced liver injury: silymarin // RMJ. 2017. № 10. P. 750–753.