Legalon SIL

**Legalon SIL** is an intravenous formulation of silibinin-C-2',3-dihydrogensuccinate disodium salt, a flavonolignan derivative from milk thistle (Silybum marianum) standardized to deliver 350 mg silibinin per vial. It acts primarily by inhibiting OATP1B3-mediated uptake of amatoxins into hepatocytes, blocking enterohepatic recirculation of the toxin, and exhibits antioxidative, anti-inflammatory effects that mitigate TNF-mediated hepatocyte apoptosis in amatoxin-induced hepatic failure from Amanita phalloides poisoning. Administered as a 5 mg/kg loading dose followed by 20 mg/kg/day continuous IV infusion, it is registered in over a dozen European countries and has shown mortality reduction to <10% in nearly 1,500 documented cases compared to >20% with historical treatments; a Phase II trial (NCT00915681) assessed its efficacy in preventing liver transplantation/death.

Brand names

Legalon SILLegalon

Other names

Silibinin-C-2',3-dihydrogensuccinate disodium salt