Carsil, Carsil Forte: instructions for use,indications, dosage, composition

Update: October 2018

Liver disease and dysfunction are a real scourge.
modernity. This is due to many factors: inaccuracies in
nutrition, adherence to certain diets, alcohol abuse,
long-term drug therapy and other causes that
negatively affect liver function and cause metabolic disorders

Karsil is a popular drug, the hepatoprotector, which
appointed with various liver diseases. Is an
medicinal product of medicinal origin. Acting
the base is represented by the natural compounds of the thistle fruit
spotted, which is traditionally and for a long time applied when
treating the liver.

Фармгруппа: гепатопротекторы.

Composition, physico-chemical properties, price

The drug is available in two dosage forms for internal
Reception: Kars and Kars forte. The composition of these carsil forms is different.
on the group of auxiliary components and the dose of the current


Karsil форте

Main substance Silymarin – 22.5 mg Silymarin – 90 mg
Excipients Povidone K 25, lactose monohydrate, microcrystalline
cellulose, wheat starch, magnesium stearate, polysorbate 80, mannitol
(E 421), talc, sodium bicarbonate, crospovidone, acetyl phthalate
cellulose, glycerin, sucrose, diethyl phthalate, acacia, titanium dioxide
(E 171), gelatin, macrogol 6000, Opalyuks AS 26586 brown

Lactose monohydrate, wheat starch, cellulose
microcrystalline, mannitol, povidone K25, polysorbate 80, dioxide
silicon, crospovidone, sodium bicarbonate, magnesium stearate.

Shell: black, red and yellow iron oxide, titanium dioxide,

Physicochemical properties Brown coated dragee biconvex
Светло-коричневые твердые gelatinовые капсулы. Content –
light yellow or yellow-brown powdered mass with
specific smell.

10 pills in 1 blister, 8 blisters in one carton
a bundle

По 6 капсул в блистере, по 5 блистеров в a bundle картонной

Price № 80 – 370-499 rub. No. 30 – 360-400 rubles.

pharmachologic effect

Therapeutic effects of the drug are associated with the action of silymarin.
– the only natural substance that is proven today
involved in the repair of liver cells. This is a vegetable matter
of nature, derived from the fruits of milk thistle, representing
a mixture of different flavonolignans: silibinin, silicristin,
isosilybinin, silidianin. The strongest of them is
silibinin. Silymarin:

  • has choleretic and cholekinetic actions that
    leads to choleretic effect;
  • stimulates intracellular metabolism;
  • activates the formation of phospholipids, functional and
    structural proteins (in fact, building materials) in
    hepatocyte cells that are damaged;
  • normalizes lipid metabolism;
  • prevents the destruction of cell membranes and stabilizes them
  • prevents toxins from entering the liver cells, binding them and
    turning into less aggressive compounds. This interrupts the reaction.
    fat peroxidation and no further destruction
    cellular structures.

Liver cell protection is associated with competing
interaction of the active substance with toxins for receptors,
which are located on the liver cell membrane. Regulation
metabolic and other processes in hepatocytes is carried out
by adjusting the permeability of cell membranes, inhibition
5-lipoxygenase flux and interaction with free
reactive oxygen radicals.

The drug has a complex effect, providing
restoration, protection of hepatocytes and improvement of microcirculation.
It is also characterized by antioxidant and detoxification
actions. The combined effects of the drug
suspend or significantly slow down stearosis and fibrosis
the liver.

Clinically, the effect of Kars is shown to decrease in severity.
symptoms of the disease, both subjective and objective,
stabilization of the activity of bilirubin, transaminases and other
функциональных показателей the liver. Patients after treatment
They note a significant improvement in their condition, including
functions of digestion and assimilation of food. Some patients note
improvement in appetite after a prolonged absence. At the same time
the ultrasound picture also improves – the size of the liver is normalized,
echogenicity decreases.


After taking slowly absorbed in the digestive tract. The peculiarity of the drug –
this is the enterohepatic circulation without accumulation in the body.
Distributed in tissues and organs quite intensively: the greatest
active ingredient concentrations are found in the liver,
a small amount gets into other internal organs – kidneys,
heart, lungs.

Метаболизм (реакции конъюгации) происходит в the liver. Products
metabolism, which are found in bile – these are glucuronides and
sulfates. The average half-life is 6 hours
parts (up to 90%) are excreted in the bile in the form of the above
metabolites. Small part is excreted in the urine.

Indications for use

The use of Karsil is advisable in the following cases:

  • complex therapy of liver cirrhosis;
  • alcoholic and nonalcoholic liver stearosis;
  • toxic liver damage;
  • chronic hepatitis non-viral nature;
  • history of acute hepatitis (recovery period);
  • prevention of liver damage with long-term medication
    therapy, chronic, incl. professional intoxication,


The instructions for use of Kars are the following:

  • hypersensitivity to the main or auxiliary
  • children up to 12 years (capsules) and up to 5 years (pills);
  • galactosemia or galactose / glucose malabsorption syndrome;
  • lactase deficiency;
  • celiac disease (gluten intolerance).

special instructions

Not recommended for use in pregnant and lactating women, and
if appointed, then under strict medical supervision.

It is prescribed with caution to patients with various hormonal
disorders (prostate carcinoma, endometriosis, uterine myoma,
carcinoma of the breast, uterus and ovaries), since it is possible
implementation of the estrogen-like action of silymarin.

People with impaired function of the vestibular apparatus should
be careful during treatment because the vegetative
manifestations may intensify.

Does not affect the reaction rate.


Karsil tablets:

Accepted before meals, without chewing (except when
swallow a pill is difficult), drinking water.

  • Adults and children from 12 years for the treatment of mild liver pathologies
    or moderately prescribed 1-2 tablets 3 times a day.
  • In severe cases, adults and children from 12 years old are prescribed 2-4.
    tablets 3 times a day.
  • Children 5-12 years old drug is prescribed in terms of actual
    Weight: 3 mg per 1 kg of body weight. The dose received is a daily and
    divided into 2-3 doses per day.

The duration of therapy is determined individually and on average.
is 3 months.


The instructions of Kars forte indicated that they take the drug
inside, before eating, drinking water. It is impossible to open the capsule.

  • Adult patients and children over 12 with severe lesions
    liver drug is prescribed with an initial dose of 1 capsule 3 times a
  • In moderate and mild cases, therapeutic dose
    составляет 1 капсула 1-2 раза в day.
  • To prevent liver damage on the background of various
    chemical intoxications take 1-2 capsules per day for 3

The duration of treatment is determined by the doctor depending on the condition.
patient and severity of pathology.

No cases of overdose have been reported.

Side effects

All thistle preparations are in the low-toxic group.
medicines. In rare cases, the following occur
side effects:

  • dyspepsia, nausea, diarrhea;
  • headache (a side effect of glycerin in the composition
  • allergic skin reactions – rash, itching, alopecia;
  • strengthening of existing vestibular disorders, which disappears
    after discontinuation of treatment.

Drug interactions

Joint appointment with oral hormonal
contraceptives and drugs used for replacement
hormone therapy leads to a decrease in therapeutic action

In combination with both diazepam, alprazolam, ketoconazole,
Lovastatin and Vinblastine Kars results in enhanced effects
of these drugs.

Karsil или эссенциале: что лучше?

Both drugs have antihepatotoxic properties, have
similar indications, however, are fundamentally different in composition and
on the mechanism of action.

Essentiale and other drugs based on essential
phospholipids derived from soy – widely practiced medicinal
средства в «помощь» больной the liver. Acting основа препарата
affects the state of hepatocyte cell walls, but direct
does not participate in the recovery of cells. On the background of long
treatment for at least six months there is a decrease
energy consumption of the liver, an increase in enzyme activity and
improving the physico-chemical properties of bile. According to research
American scientists essential phospholipids cause stagnation
bile, and therefore provoke further development of the inflammatory
process. In addition, the greatest effect from the essential
phospholipids is achieved only when administered intravenously.
Given that the drugs are not cheap, and they need to take a long time,
to achieve at least some effect (injection method of administration
many do not accept), the appropriateness of treatment is controversial.

Karsil и его аналоги не только поддерживают, но и
restore damaged liver cells, stimulate the growth of new
hepatocytes. Apply a course of shorter duration, but require
treatment in an adequate dose, best of all, in the form of a forte.


Analogues on the active substance are:

Legalon 140 No. 60: 650-760 rubles; Gepabene number 30: 400-500 rubles; Silimar tablets number 30: 100-120 rubles; Thistle tablets № 30: 140-160 rub. Thistle meal Milk thistle syrup

Автор: врач-гигиенист, эпидемиолог

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