Liver therapy (local classification, «hepatoprotectors»)
ATC code: A05BA-PHOSPHOGLIV (Glycyrrhizic acid + phosphatidylcholine (Phosphogliv) – local code)
Combination of sodium glycyrrhizinate (a licorice root derivative) and phosphatidylcholine. The manufacturer claims anti-inflammatory, antiviral, and membrane-stabilizing effects. Glycyrrhizic acid at high doses in Japan is used in chronic hepatitis C — modest transaminase effects have been reported, predominantly in Japanese and Korean studies. International and hepatology guidelines do not mention Phosphogliv or its components as agents with proven clinical efficacy in liver disease.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
For alcoholic liver disease, 2018 recommends complete alcohol cessation and, in severe alcoholic hepatitis, prednisolone per Maddrey. Hepatoprotectors are not part of the recommendations.
Sources
ICD-10: K70 · ICD-11: DB94
Not recommended
– Liver 'detox' and cleansing: Phosphogliv is heavily advertised as 'liver protection and cleansing'. No international recommendations exist for this indication because 'liver cleansing' itself is absent from evidence-based medicine. Prolonged use also carries a real risk of pseudo-aldosteronism – sodium retention, potassium loss, blood pressure elevation.
Sources
Not recommended
Chronic hepatitis C is treated with direct-acting antivirals (DAAs), which achieve sustained virologic response in over 95% of patients. 2020 and 2023 guidelines recommend only DAAs. Phosphogliv is not mentioned in these documents. Prescribing a hepatoprotector for chronic hepatitis C is a missed opportunity for cure.
Sources
ICD-10: B18.2 · ICD-11: 1E51.1
Not recommended
For NAFLD, 2023 and 2021 guidelines recommend weight loss, diabetes and dyslipidaemia control, and alcohol cessation. Phosphogliv and other 'hepatoprotectors' are not included.
Sources
ICD-10: K76.0 · ICD-11: DB92
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Contraindicated in pregnancy.
Contraindicated during breastfeeding.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Glycyrrhizic acid + phospholipids is evaluated for the following indications with varying evidence strength: Body detoxification and cleansing (evidence tier F), Alcoholic liver disease (evidence tier F), Non-alcoholic fatty liver disease (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Glycyrrhizic acid + phospholipids (≥ 1 in 100): Allergic reactions, Dyspepsia, Fluid retention, edema, Blood pressure elevation. See the Safety section for uncommon and serious reactions.
FDA category N. Contraindicated in pregnancy.
Contraindicated during breastfeeding.
Glycyrrhizic acid + phospholipids is contraindicated in: Hypersensitivity to any component; Antiphospholipid syndrome; Age under 12 years; Pregnancy (insufficient data); Breastfeeding. Full list in the Safety section.
universal liver «protectors» do not exist. The only effective strategy is to remove the causative factor (alcohol, toxin, hepatotropic virus, drug).
elevated transaminases require differential workup, not a «protector». Treat the cause.