MAXILIV ​ ​SOFT GELATIN CAPSULES

Indications

• Hypertension
• Benign prostatic hyperplasia
• Urinary retention related to prostate enlargement

Dosage

Children: Refer to the BNF for Children for appropriate dosing guidelines in the paediatric population.

Adults: Refer to the BNF for specific dosing recommendations based on individual clinical scenarios.

Mechanism of action

Alpha acts by selectively blocking alpha-1 adrenergic receptors, which are responsible for mediating vasoconstriction in blood vessels. By inhibiting these receptors, alpha promotes vasodilation, leading to a decrease in peripheral vascular resistance and subsequently lowering blood pressure. Additionally, this action can help alleviate urinary symptoms associated with an enlarged prostate.

Pharmacodynamics

The pharmacodynamics of alpha involve its competitive antagonism at alpha-1 adrenergic receptors, resulting in decreased vasoconstriction and increased blood flow. This mechanism is beneficial in conditions characterized by high blood pressure and urinary retention due to prostatic enlargement. The onset of action typically occurs within hours, with peak effects observed within a few days of consistent dosing.

Pharmacokinetics

Alpha is absorbed well from the gastrointestinal tract, with peak plasma concentrations achieved within 1-3 hours post-administration. The drug undergoes hepatic metabolism, primarily via cytochrome P450 enzymes, resulting in active and inactive metabolites. The elimination half-life varies, but it generally is around 6-12 hours, allowing for once-daily dosing in many cases. Renal excretion is a significant route for its metabolites, necessitating caution in patients with renal impairment.

Interactions

• maois, irreversible + alpha blockers: Severe (increases effects)
• ribociclib + alpha blockers: Severe (increases exposure)
• cobicistat + alpha blockers: Moderate (increases exposure)
• idelalisib + alpha blockers: Moderate (increases exposure)
• dronedarone + alpha blockers: Unknown (increases exposure)
• antifungals, azoles + alpha blockers: Unknown (increases exposure)
• crizotinib + alpha blockers: Unknown (increases exposure)
• imatinib + alpha blockers: Unknown (increases exposure)
• letermovir + alpha blockers: Unknown (increases exposure)
• clarithromycin + alpha blockers: Unknown (increases exposure)

Indications

• General wellness support
• Anti-inflammatory effects
• Antioxidant activity
• Digestive aid
• Support for immune function

Dosage

Children: Paediatric dosing should be determined based on the specific extract and its intended use. Consultation with a healthcare provider is recommended for accurate dosing.

Adults: Dosage varies widely depending on the specific extract and formulation. It is essential to follow the manufacturer's instructions or consult a healthcare professional for appropriate dosing.

Mechanism of action

The mechanism of action of herbal extracts can vary significantly based on their constituents. Commonly, they exert their effects through multiple pathways including modulation of neurotransmitter systems, interference with inflammatory processes, or direct antioxidant activity. Some extracts may activate certain receptors or inhibit enzymes related to disease processes.

Pharmacodynamics

The pharmacodynamics of extracts is complex due to the presence of multiple active compounds which can have synergistic or antagonistic effects. These compounds may influence cellular signaling pathways, alter gene expression, or modulate immune response. The overall pharmacological profile is determined by the specific composition of the extract, its concentration, and the biological target it interacts with.

Pharmacokinetics

The pharmacokinetics of extracts involves absorption, distribution, metabolism, and excretion of the active compounds. Generally, herbal extracts are absorbed in the gastrointestinal tract, with bioavailability influenced by factors such as formulation, the presence of food, and individual metabolic differences. Compounds may undergo hepatic metabolism, and elimination can occur through urine or feces, depending on their chemical nature.

Pregnancy

Consult a healthcare professional before use, as the safety of the extract during pregnancy has not been established.

Breast-feeding

Consult a healthcare professional before use, as the safety of the extract during breastfeeding has not been established.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Indications

• Cholesterol management
• Cognitive support
• Liver health
• Emulsification in food products

Dosage

Children: Refer to the BNF for Children for specific dosing information as it may vary based on the formulation and indication.

Adults: Refer to the BNF for specific dosing information as it may vary based on the formulation and indication.

Mechanism of action

Lecithin serves as a source of phosphatidylcholine, a key component of cell membranes. It facilitates the transport of fats and cholesterol in the body, enhancing lipid metabolism. Additionally, phosphatidylcholine is involved in the synthesis of acetylcholine, a neurotransmitter important for memory and muscle function.

Pharmacodynamics

Lecithin has been shown to influence lipid metabolism, potentially lowering serum cholesterol levels and improving liver function. By serving as an emulsifying agent, it helps to increase the bioavailability of fat-soluble vitamins and other nutrients. Its role in cell membrane integrity supports overall cellular function and health.

Pharmacokinetics

Lecithin is absorbed in the gastrointestinal tract and metabolized in the liver. It is distributed throughout the body, where it is incorporated into cell membranes. The half-life of lecithin is not well-defined due to its nature as a dietary compound, but its components, such as phosphatidylcholine, are rapidly utilized by the body.

Pregnancy

Lecithin may be used during pregnancy, but it is essential to consult a healthcare provider before use.

Breast-feeding

Lecithin is generally considered safe while breastfeeding; however, it is advisable to seek medical advice.

Storage

Store in a cool, dry place, away from direct sunlight.

Indications

• Diabetic neuropathy
• Oxidative stress-related disorders
• Metabolic syndrome
• Weight management
• Liver health

Dosage

Children: Refer to specific product guidelines, as safety and efficacy in children have not been established.

Adults: Refer to specific product guidelines, as dosages may vary based on the formulation and indication.

Mechanism of action

Lipoic acid acts as a cofactor for mitochondrial enzyme complexes, particularly those involved in the Krebs cycle, enhancing energy production. It also possesses antioxidant properties, neutralizing free radicals and regenerating other antioxidants such as vitamins C and E. Additionally, lipoic acid can modulate various signaling pathways, including those related to insulin sensitivity and inflammation.

Pharmacodynamics

Lipoic acid has a dual role as a coenzyme and an antioxidant. By participating in the decarboxylation of alpha-keto acids, it aids in energy production. Its antioxidant properties contribute to the protection of cells from oxidative stress, which is implicated in various chronic diseases. Lipoic acid can improve insulin sensitivity, making it beneficial in managing glucose metabolism disorders.

Pharmacokinetics

After oral administration, lipoic acid is absorbed in the gastrointestinal tract, with peak plasma concentrations occurring within 30 to 60 minutes. It undergoes hepatic metabolism, primarily via reduction and conjugation, resulting in various metabolites. The elimination half-life is approximately 30 minutes to 2 hours, and it is excreted primarily in urine. The bioavailability of lipoic acid can be affected by food intake.

Adverse effects

• Nausea
• Vomiting
• Abdominal pain
• Skin rash
• Hypoglycemia

Interactions

• May enhance the effects of insulin and other antidiabetic medications
• May interact with heavy metal chelators

Precautions

• Use with caution in patients with diabetes due to the risk of hypoglycemia
• Monitor blood sugar levels in diabetic patients

Pregnancy

Safety during pregnancy has not been established; use only if clearly needed.

Breast-feeding

It is not known whether lipoic acid is excreted in human breast milk; caution is advised.

Storage

Store in a cool, dry place away from light.

Formulations

• Capsules
• Tablets
• Injectable solutions

Indications

• Hepatitis
• Cirrhosis
• Fatty liver disease
• Liver poisoning
• Liver function support

Dosage

Children: Refer to appropriate herbal medicine guidelines as dosing in children should be approached with caution and under professional supervision.

Adults: Refer to appropriate herbal medicine guidelines as dosing can vary significantly based on the formulation and indication.

Mechanism of action

The active components of milk thistle, particularly silymarin, exert their effects through multiple mechanisms. Silymarin acts as an antioxidant, scavenging free radicals and reducing oxidative stress in liver cells. It also stabilizes hepatocyte membranes, preventing the entry of toxins and promoting cell regeneration. Additionally, silymarin may enhance protein synthesis and stimulate the production of glutathione, a key antioxidant in the liver, further contributing to its protective effects.

Pharmacodynamics

The pharmacodynamic effects of marianum are primarily linked to its antioxidant properties, which help mitigate liver damage caused by toxins, alcohol, and certain medications. It may also exhibit anti-inflammatory effects, reducing liver inflammation associated with various hepatic disorders. Furthermore, marianum has been suggested to promote liver regeneration, enhancing overall liver function and health.

Pharmacokinetics

Silymarin is poorly absorbed in the gastrointestinal tract, with bioavailability significantly limited by its low solubility. After oral administration, peak plasma concentrations occur within 1-2 hours. It is metabolized in the liver, and the elimination half-life is approximately 6 hours. Silymarin and its metabolites are primarily excreted via the bile, with minimal renal clearance. Factors such as food intake can influence its absorption and bioavailability.

Pregnancy

There is insufficient data on the safety of marianum during pregnancy. Consultation with a healthcare provider is advised.

Breast-feeding

Limited information is available regarding the excretion of marianum in human breast milk. Caution is recommended.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Indications

• Stress management
• Fatigue
• Liver health support
• Cognitive enhancement
• Physical performance enhancement

Dosage

Children: Refer to established guidelines or product labeling for specific dosing recommendations as no standardized dose is provided.

Adults: Refer to established guidelines or product labeling for specific dosing recommendations as no standardized dose is provided.

Mechanism of action

Schisandra contains several bioactive compounds, including lignans, which are believed to exert their effects through multiple pathways. These compounds may enhance the body's resistance to stress by modulating the hypothalamic-pituitary-adrenal (HPA) axis and increasing the production of endogenous antioxidants. Additionally, Schisandra may improve liver function by promoting hepatocyte regeneration and enhancing bile secretion, thereby supporting detoxification processes.

Pharmacodynamics

The pharmacodynamic effects of Schisandra include its adaptogenic properties, which help the body adapt to stress and maintain homeostasis. Its antioxidant activity contributes to cellular protection against oxidative stress, potentially reducing inflammation and promoting overall health. Schisandra may also exhibit hepatoprotective effects, improving liver enzyme levels and promoting liver health.

Pharmacokinetics

The pharmacokinetics of Schisandra are not extensively studied, but it is known that the bioactive compounds are absorbed in the gastrointestinal tract. They may undergo first-pass metabolism in the liver, and their elimination half-life varies depending on the specific lignan. The effects of Schisandra may be influenced by factors such as formulation, dosage, and individual metabolic differences.

Adverse effects

• Gastrointestinal disturbances
• Headache
• Insomnia
• Skin rashes
• Possible allergic reactions

Interactions

• May interact with medications metabolized by the liver
• Potential effects on blood sugar levels when used with antidiabetic medications

Precautions

• Use with caution in patients with a history of liver disease
• Monitor blood sugar levels in diabetic patients

Pregnancy

Limited data available, use cautiously and consult a healthcare provider.

Breast-feeding

Insufficient evidence regarding safety, consult a healthcare provider before use.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Dried fruit
• Extracts
• Capsules
• Powder

Indications

• Hepatitis (viral and alcoholic)
• Liver cirrhosis
• Fatty liver disease (non-alcoholic steatosis)
• Liver detoxification
• Liver protection from toxins

Dosage

Adults: Refer to established guidelines and clinical evidence

Mechanism of action

Silymarin, the active component of silybum, exerts its hepatoprotective effects through several mechanisms. It acts as an antioxidant by scavenging free radicals, thereby reducing oxidative stress in liver cells. Additionally, silymarin stimulates protein synthesis, promotes liver cell regeneration, and enhances the activity of detoxifying enzymes. It also stabilizes cell membranes, preventing the entry of toxins into hepatocytes, and has anti-inflammatory properties that may further protect liver tissue.

Pharmacodynamics

Silybum exhibits dose-dependent pharmacological effects. Its primary action is hepatoprotection, which is mediated through the modulation of various cellular pathways involved in inflammation, apoptosis, and cell proliferation. Silymarin has been shown to enhance glutathione levels in the liver, an important antioxidant that protects cells from damage. Furthermore, it plays a role in inhibiting the fibrogenesis pathway, which is crucial in the development of liver fibrosis and cirrhosis.

Pharmacokinetics

Silymarin is poorly soluble in water but is better absorbed in a lipid environment. After oral administration, it undergoes extensive first-pass metabolism in the liver. The bioavailability of silymarin can be affected by food intake, as the presence of fats can enhance its absorption. The elimination half-life is approximately 6 hours, with metabolites primarily excreted in the feces. The pharmacokinetics of silymarin can vary based on individual factors such as age, liver function, and the presence of other health conditions.

Contra-indications

• Hypersensitivity to silymarin or any of its components
• Severe liver disease
• Pregnancy

Adverse effects

• Gastrointestinal upset
• Diarrhea
• Nausea
• Headache
• Allergic reactions

Interactions

• May enhance the effects of anticoagulants
• Potential interaction with antidiabetic medications
• May affect the metabolism of certain drugs by influencing cytochrome P450 enzymes

Precautions

• Use with caution in patients with liver disorders
• Monitor for potential allergic reactions
• Consult a healthcare professional before use in conjunction with other medications

Pregnancy

Not recommended during pregnancy due to lack of sufficient safety data.

Breast-feeding

Consult a healthcare professional before use, as safety during breastfeeding is not established.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Capsules
• Tablets
• Liquid extracts
• Powder