Carsil Forte, 90 mg capsules 30 pcs

Carsil Forte belongs to the group of hepatoprotective drugs. It contains a dry extract of milk thistle fruits (equivalent of silymarin), which is a mixture of 4 isomers of flavonolignans: silybinin, isosilybinin, silydianin and silycristin.

The mechanism of action of the drug is still not well elucidated. It is established that the hepatoprotective effect of silymarin is conditioned by competitive interaction with toxins for corresponding receptors in membrane of hepatocytes, i. e. by membrane stabilizing action.

Silymarin has metabolic and cell-regulating effects, influencing cell membrane permeability by inhibiting the 5-lipoxygenase pathway, especially LT B₄, and by binding to free reactive oxygen radicals. Stimulates the synthesis of proteins (structural and functional) and phospholipids in the affected hepatocytes, accelerating regenerative processes. The action of flavonoids, to which belongs silymarin, is also due to their antioxidant and improving microcirculation effects. Clinically, these effects are expressed in the improvement of subjective and objective symptoms and normalization of liver function parameters (transaminases, γ-globulin, bilirubin). This leads to improvement of general state, reduction of digestive complaints, and in patients with poor digestion due to liver disease leads to increase of appetite and body weight gain.

Pharmacokinetics

Absorption is low and slow. Subject to intestinal-hepatic recirculation. Does not cumulate.

In studies of C¹⁴-labeled silibinin, the highest concentrations are found in the liver and very small amounts in the kidneys, lungs, heart and other organs.

It is metabolized in the liver by conjugation. Glucuronides and sulfates are found as metabolites in bile.

T_1/2 is 6 hours. It is excreted mainly with the bile (about 80%) as glucuronides and sulfates and to a small extent (about 5%) with the urine.

Indications

In the complex therapy of the following conditions and diseases:

Active ingredient

Composition

1 capsule contains:

the active ingredient:

milk thistle fruit extract dry 163.6-225 mg (equivalent to 90 mg of silymarin)

excipients:

Lactose monohydrate – 38.2-7.5 mg;

MCC (type 101) – 38.2-7.5 mg;

Wheat starch – 15.5 mg;

Povidone K25 – 3.7 mg;

Polysorbate 80 – 3.7 mg;

Colloidal anhydrous silica – 3.4 mg;

Mannitol – 80 mg;

Crospovidone – 14 mg;

sodium hydrocarbonate – 6 mg;

magnesium stearate – 3.7 mg,

capsule:

iron oxide black – 0.02%;

iron oxide red – 0.03%;

titanium dioxide – 0.6666%;

iron oxide yellow – 0.35%;

gelatin – up to 100%.

How to take, the dosage

Ingestion with plenty of water.

Adults and children over 12 years of age: Treatment of severe liver damage should start with a dose of 1 capsule. 3 times a day.

In milder and moderate cases, the dosage is 1 capsule 1-2 times a day.

For the prevention of chemical intoxications, 1-2 capsules a day.

The course of treatment is at least 3 months.

Interaction

When using Silymarin together with oral contraceptives and drugs used in hormonal replacement therapy, it is possible to reduce the effects of the latter.

Silymarin may increase the effects of such drugs as diazepam, alprazolam, ketoconazole, lovastatin and vinblastine due to its inhibitory effect on the cytochrome P450 system.

Special Instructions

Impact on the ability to drive motor transport and operate machinery.

The use of the drug in monotherapy does not affect the ability to drive and operate machinery.

Contraindications

With caution: patients with hormonal disorders (endometriosis, uterine myoma, breast, ovarian and uterine carcinoma, prostate carcinoma) – possible effects of estrogen-like silymarin.

Side effects

The drug is well tolerated. The following side effects are rarely observed.

Gastrointestinal disorders: nausea, dyspepsia, diarrhea.

Skin disorders: in single cases there may be skin allergic reactions – itching, rash, alopecia.

Others: rarely it is possible to observe aggravation of existing vestibular disorders.

The side effects are transient and disappear after stopping the drug.

Overdose

There are no data on overdose of the drug.

Treatment in case of accidental ingestion of a high dose: induction of vomiting, gastric lavage, use of activated charcoal, symptomatic therapy if necessary.

Pregnancy use

The drug is not recommended during pregnancy and while breastfeeding.

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