Hepatoprotective Effects of a Combination of Three Medicinal Plants on Carbamazepine-Induced Liver Injury: A Case Report

Abstract

Introduction: The global incidence of liver disease has increased, and some drugs can cause adverse effects, underscoring the need for alternative medicine approaches. This report evaluated the hepatoprotective effects of a combination of three medicinal plants, Silybum marianum, Cichorium intybus, and Ziziphus vulgaris, in a patient with elevated levels of liver injury marker enzymes. Case Presentation: The patient was a 27-year-old man with tonic-clonic seizures who had been receiving chronic carbamazepine treatment and had elevated liver injury marker enzyme levels. The results showed that the combination of Silybum marianum, Cichorium intybus, and Ziziphus vulgaris significantly reduced the elevated serum levels of aspartate transaminase, alanine aminotransferase, and alkaline phosphatase in the patient (P < 0.05), decreasing to 34.0 ± 3.16, 40.5 ± 3.83, and 370.5 ± 4.76 U/L, respectively. These findings suggest that total flavonoid and phenol doses of 200.84 and 149.00 mg/day, respectively, could alleviate carbamazepine-associated side effects. Conclusions: Based on this case report, the combination of Cichorium intybus, Silybum marianum, and Ziziphus vulgaris may exert hepatoprotective effects, as reflected by improved liver enzyme levels following herbal therapy.