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Silymarin (Milk Thistle)

    Brands

    DEA Class; (Herb/Suppl)

    Common Brand Names; carduus marianum, holy thistle, lady’s thistle, legalon, Marian thistle, Mary thistle, silibinin, silybin, silybum marianum, silymarin, St Mary thistle

    • Gastrointestinal, Herbals

    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

    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

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

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

    • Abdominal bloating/pain
    • Allergic reactions
    • Anaphylaxis
    • Anorexia
    • Diarrhea
    • Dyspepsia
    • Flatulence
    • Nausea
    • Pruritus
    • Rash

    Concurrent CYP3A4 substrates, CYP2C9 substrates

    Silymarin has poor oral bioavailability & is sparsely water-soluble

    Pregnancy Category: N/A

    Lactation: N/A

    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

    Silymarin (Milk Thistle)

    Syrup:

    • 100mg/5ml