Carsil Forte
Carsil Forte: instructions for use and reviews
- 1. Form of release and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. Drug interactions
- 12. Analogs
- 13. Terms and conditions of storage
- 14. Terms of dispensing from pharmacies
- 15. Reviews
- 16. Price in pharmacies
Latin name: Carsil Forte
ATX code: A05BA03
Active ingredient: Milk thistle fruit extract (Silybi mariani fructuum extract)
Manufacturer: Sopharma AD (Bulgaria)
Description and photo update: 2018-23-10
Prices in pharmacies: from 300 rubles.
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Carsil Forte is a hepatoprotective herbal remedy.
Form of release and composition
Dosage form of Karsila Forte - capsules: size No. 0, hard gelatinous, light brown; content - powdery mass from light yellow to yellow-brown color with agglomerates. Packing: blisters - 6 pcs., 5 blisters in a cardboard box.
Composition of 1 capsule:
- active substance: dry extract of milk thistle fruit - 163.6-225 mg, which is equivalent to 90 mg of silymarin;
- auxiliary components: lactose monohydrate, anhydrous colloidal silicon dioxide, magnesium stearate, mannitol, wheat starch, povidone K25, crospovidone, polysorbate 80, sodium bicarbonate, microcrystalline cellulose (type 101);
- capsule composition: gelatin, titanium dioxide, red iron oxide, yellow iron oxide, black iron oxide.
Pharmacological properties
Pharmacodynamics
As an active ingredient, Karsila Forte contains milk thistle fruit extract. Its main active ingredient is a mixture of 6 isomers of flavonolignans (silymarin), such as silidianin, silicristin, silibinin A and B, isosilybinin A and B, the most active of which is silibinin.
The mechanism of the hepatoprotective action of these substances is not fully understood. The available data allow us to state that there are several main mechanisms of action.
Antioxidant action
Silymarin interacts with free radicals in the liver, transforms them into less toxic compounds and interrupts the process of lipid peroxidation. It regulates the intracellular content of glutathione and prevents the destruction of cellular structures.
Depending on the concentration, it suppresses microsomal peroxidation caused by NADPH-Fe 2+ -ADP.
Suppresses the peroxidation of linolenic acid catalyzed by lipoxygenase. Affects enzyme systems associated with superoxide dismutase and glutathione. Protects liver microsomes and mitochondria from the formation of lipid peroxides caused by various agents.
Anti-inflammatory action
According to experimental studies, silybin (silibinin) at a certain concentration inhibits the synthesis of LT B4 (leukotriene B 4 / LTB 4) in isolated Kupffer cells of animals.
In the course of in vitro studies carried out on human polymorphonuclear leukocytes, it was established that one of the mechanisms of anti-inflammatory action is the ability of silybin to suppress the formation of hydrogen peroxide.
Silybin, silymarin, silicristin and silydianin in vitro inhibit the activity of prostaglandin synthase and lipoxygenase.
Membrane stabilizing action
This action of silymarin is explained by its competitive interaction with receptors for the corresponding toxins on the membrane of hepatocytes, and the effect on membrane permeability is due to quantitative and qualitative changes in membrane lipids - phospholipids and cholesterol.
Silymarin stabilizes cell membranes and regulates their permeability. As a result of this action, hepatotoxic agents do not enter the hepatocytes.
The substance activates the synthesis of phospholipids, functional and structural proteins (ribosomal synthesis of RNA, protein and DNA), as a result of which it stimulates regeneration processes in the liver, i.e., promotes the restoration of damaged hepatocytes.
In experimental studies, it was found that silymarin is also able to suppress the transformation of stellate liver cells into myofibroblasts, a process that is responsible for the arrangement of collagen fibers.
Clinically, the pharmacodynamic properties of silymarin are manifested by an improvement in the objective and subjective symptoms of the disease, as well as the normalization of indicators of the functional state of the liver (bilirubin, gamma globulin and transaminases).
Pharmacokinetics
After oral administration, silymarin is not completely absorbed from the gastrointestinal tract (23–47%). The maximum plasma concentration reaches 4-6 hours after taking one dose.
Reaches the highest concentrations in the liver, stomach, pancreas, lungs. In small amounts, it is determined in the heart, kidneys and other organs.
Undergoes enterohepatic recirculation. The metabolic process takes place in the liver by conjugation with glucuronic acid and sulfates. Metabolites - sulfates and glucuronides - are found in bile.
The half-life of unchanged silymarin is 1–3 hours, its metabolites is 6–8 hours.
Does not cumulate. About 80% of the substance is excreted in the bile in the form of active metabolites, about 5% - by the kidneys unchanged.
Indications for use
Karsil Forte is used as part of complex therapy:
- toxic liver damage;
- liver steatosis, including alcoholic;
- chronic hepatitis of non-viral etiology;
- conditions after acute hepatitis;
- cirrhosis of the liver.
Also, the drug is prescribed for the prevention of liver damage in chronic intoxication (including professional), prolonged use of drugs, alcohol abuse.
Contraindications
- celiac disease (celiac disease);
- galactosemia, glucose / galactose malabsorption syndrome, lactase deficiency;
- age up to 12 years;
- individual intolerance to any component of the drug.
Karsil Forte should be used with caution in the treatment of patients with hormonal disorders, for example, in the presence of uterine fibroids, endometriosis, prostate carcinoma, uterine, ovarian or breast carcinoma.
Instructions for the use of Karsila Forte: method and dosage
The capsules are taken orally.
For mild and moderate liver lesions, 1 capsule is prescribed 1 or 2 times a day, for severe lesions - 1 capsule 3 times a day.
For preventive purposes, it is recommended to take 1 capsule of Carsil Forte 1 or 2 times a day.
The duration of therapy is individual, but not less than 3 months.
Side effects
Carsil Forte is well tolerated. Side effects are very rare. As a rule, they are expressed slightly and are transient.
- from the gastrointestinal tract: rarely (> 1/10 000 - <1/1000) - diarrhea; unknown frequency (it is not possible to assess these side effects due to insufficient data) - flatulence, decreased appetite, nausea, dyspepsia, vomiting;
- from the immune system: very rarely (<1/10 000) - allergic skin reactions (itching, rashes); unknown frequency - anaphylactic shock;
- on the part of the organ of hearing and labyrinth disorders: rarely - an increase in the existing vestibular disorders.
Overdose
There is no data on overdose.
In case of accidental intake of too large a dose, vomiting should be induced, the stomach should be flushed, activated charcoal should be taken, and symptomatic therapy should be carried out if necessary.
special instructions
Influence on the ability to drive vehicles and complex mechanisms
According to the instructions, Carsil Forte does not affect concentration, mental and motor reactions.
Application during pregnancy and lactation
The use of Carsila Fortea is not recommended for pregnant and lactating women.
Pediatric use
Karsil Forte is contraindicated in children under 12 years of age.
Drug interactions
Silymarin has no significant effect on the pharmacodynamics of other concurrently used drugs.
In the case of taking oral contraceptives or drugs used for hormone replacement therapy, there may be a decrease in their effect.
Silymarin has an inhibitory effect on the cytochrome P 450 system, therefore, the possibility of an increase in the plasma concentration of drugs such as lovastin, alprazolam, vinblastine, ketoconazole and diazepam, with their combined use, is possible.
Analogs
The analogues of Carsila Forte are: Carsil, Legalon 70, Legalon 140, Silimar, Silibinin.
Terms and conditions of storage
Store no more than 3 years out of the reach of children, protected from light, in a dry place at temperatures up to 25 ° C.
Terms of dispensing from pharmacies
Available without a prescription.
Reviews about Carsil Fort
Reviews of Carsil Forte are positive: the drug restores liver cells well, is effective for hepatitis, steatosis, chronic cholecystitis and gallbladder dyskinesia, in the case of taking hepatotoxic drugs and alcohol, as well as in case of errors in nutrition.
The disadvantages of some patients include the relatively high price, the large size of the capsules (making it difficult to swallow) and the duration of the course of treatment.
Price for Carsil Forte in pharmacies
The price for Carsil Forte is 308–390 rubles for a pack of 30 capsules.
Carsil Forte: prices in online pharmacies
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Drug name Price Pharmacy |
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Carsil Forte 90 mg capsules 30 pcs. RUB 300 Buy |
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Carsil Forte capsules 90mg 30 pcs. 308 RUB Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
