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Explaining Uncertain Hepatoprotective Effects: When Silibinin Co-Administered with Other Drugs
Dong Pu1, Qinwei Sun1, Zengxiang Zhao1
1China Pharmaceutical University School of Basic Medical Sciences and Clinical Pharmacy, Department of Clinical Pharmacy, Nanjing, China.
Medeniyet Medical Journal
|June 26, 2025
Summary
Silibinin
Area of Science:
- Pharmacology
- Hepatology
- Drug Interactions
Background:
- Silibinin is a compound found in milk thistle.
- Carbamazepine (CBZ) is an anticonvulsant medication.
- Herb-drug interactions can lead to adverse drug reactions (ADRs).
Purpose of the Study:
- To investigate the herb-drug interaction between silibinin and carbamazepine (CBZ).
- To assess the risk of ADRs when silibinin is co-administered with other drugs.
Main Methods:
- Primary fresh hepatocytes were cultured for in vitro testing.
- Methylthiazolyldiphenyl-tetrazolium bromide (MTT) assay was used to determine cell viability.
- A retrospective analysis of the Food and Drug Administration Adverse Event Reporting System (FAERS) database was conducted.
Main Results:
- Silibinin's liver-protective effects against CBZ were not dose-dependent.
- At 25μM, silibinin increased hepatocyte viability with CBZ (p<0.05), but at 50μM, it decreased viability (p<0.05).
- FAERS data showed a significant increase in ADRs and hepatotoxicity reports associated with silibinin co-administration.
Conclusions:
- Silibinin's liver protective effects in combination with CBZ are uncertain.
- Co-administration of silibinin is linked to increased risks of ADRs and hepatotoxicity.
- Vigilance is necessary to prevent unexpected herb-drug interactions.
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