Toxic liver damage: for maintenance therapy in patients with chronic inflammatory liver disease or liver cirrhosis.

Hypersensitivity to the active substance or any component of the preparation. acute poisonings of various etiologies.

With individual increased sensitivity, the following side effects are possible.

From the digestive system: diarrhea due to increased liver and gallbladder function, nausea, dyspepsia, vomiting, decreased appetite, flatulence, heartburn.

From the side of the immune system: allergic reactions (perhaps delayed type); hypersensitivity reactions, including skin rashes, itching, anaphylactic shock.

On the part of the organs of hearing and the labyrinth: strengthening of existing vestibular disorders.

From the side of the respiratory system: shortness of breath.

From the urinary system: increased diuresis.

From the side of the skin and skin appendages: increased alopecia.

Side effects are temporary and disappear after stopping the preparation without taking special measures.

Treatment with the preparation Karsil for liver damage will be effective if you follow a diet and abstain from alcohol.

If jaundice develops, it is necessary to consult a doctor to correct the therapy.

Due to the possible estrogen-like effect of silymarin, it should be used with caution in patients with hormonal disorders (endometriosis, uterine fibroids, carcinoma of the breast, ovaries and uterus, carcinoma of the prostate gland). In such cases, a doctor's consultation is required.

The medicinal product contains wheat starch as an auxiliary substance. Wheat starch may contain gluten, but only in small amounts, and is therefore considered safe for patients with celiac disease (gluten enteropathy).

The auxiliary substances of the preparation include lactose. Patients with rare hereditary galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption should not take the preparation.

The preparation contains sucrose in the composition of the shell. Patients with rare hereditary fructose intolerance, glucose-galactose malabsorption syndrome or sucrase-isomaltase deficiency should not take the preparation.

The composition of the preparation shell includes methyl parahydroxybenzoate (E 218), propyl parahydroxybenzoate (E 216), which can cause allergic reactions (perhaps delayed type).

The period of pregnancy and breastfeeding. There are no data on the safety and effectiveness of the preparation during pregnancy and breastfeeding, so it should not be prescribed during this period.

Children. It is not recommended to use the preparation in children under 12 years of age.

The ability to influence the speed of reaction when driving a motor vehicle or working with mechanisms. Karsil does not affect these functions. Patients with vestibular disorders should use the preparation with caution when driving vehicles and working with other mechanisms.

With the simultaneous use of silymarin and oral contraceptives and preparations used in estrogen therapy, tamoxifen treatment may reduce the effectiveness of the latter.

By inhibiting the cytochrome P450 system, silymarin enhances the effect of antiallergic preparations (fexofenadine), anticoagulants (clopidogrel, warfarin).

Silymarin can enhance the effects of such preparations as diazepam, alprazolam, ketoconazole, lovastatin, atorvastatin, vinblastine, due to its inhibitory effect on the cytochrome P450 system.

Plant products containing silymarin are widely used as hepatoprotectors in oncology practice at the same time as cytostatics. Clinical studies show a slight risk of possible pharmacokinetic interactions of silymarin as an inhibitor of the CYP3A4 and UGT1A1 isozymes and cytostatics, which are substrates of these enzymes.

There are no reports of overdose. in case of accidental ingestion of a high dose, it is necessary to induce vomiting, wash the stomach, take activated charcoal and, if necessary, carry out symptomatic treatment.

In the original packaging at a temperature not higher than 25 °C.