Milk Thistle fruit

Cardui mariae fructus, milk thistle fruit.  

Milk thistle fruit consists of ripe seed of Silybum marianum (L.) Gaertner [Fam.  Asteraceae], freed from the pappus, and its preparations in effective dosage.  

The drug contains silibinin, silydianin, and silychristin.  

Uses

Crude drug:

• Dyspeptic complaints.  

Formulations:*

• Toxic liver damage; for supportive treatment in chronic inflammatory liver disease and hepatic cirrhosis.  

Contraindications

None known.  

Side Effects

Crude drug:

• None known.  

Formulations:

• A mild laxative effect has been observed in occasional instances.  

None known.  

Unless otherwise prescribed:

Average daily dose of drug:

• 12 - 15 g;
• Formulations equivalent to 200 - 400 mg of silymarin, calculated as silibinin.  

Powdered drug for making infusions and other galenical formulations to be taken by mouth.  

Silymarin acts as an antagonist in many experimental liver-damage models: phalloidin and -amanitin (death-cap toxins), lanthanides, carbon tetrachloride, galactosamine, thioacetamide, and the hepatotoxic virus FV3 of cold-blooded vertebrates.  

The therapeutic activity of silymarin is based on two sites or mechanisms of action:

(a) it alters the structure of the outer cell membrane of the hepatocytes in such a way as to prevent penetration of the liver toxin into the interior of the cell;

(b) it stimulates the action of nucleolar polymerase A, resulting in an increase in ribosomal protein synthesis, and thus stimulates the regenerative ability of the liver and the formation of new hepatocytes.  

*[Ed.  note:"Formulation" refers to an extract standardized to at least 70 percent silymarin, the collective name for the three compounds listed in theComposition of Drug section.]