The article discusses topical issues of hepatotropic therapy in the context of over-the-counter drug dispensing in the pharmacies of the Russian Federation. The risks associated with an increase in cases of self-medication with hepatoprotectors and choleretics, especially in chronic diseases of the liver and biliary tract, are analyzed. It is noted that hepatotropic therapy is of an auxiliary pathogenetic nature, does not replace etiotropic treatment and requires strict differentiation depending on the clinical situation. The lack of a universal hepatoprotector is emphasized: most drugs in this group have a limited evidence base, whereas ursodeoxycholic acid remains the only drug with a high level of evidence (level A–B) and belongs to prescription drugs. Due to the availability of medical information on the Internet and the active advertising of over-the-counter drugs, the role of a pharmacist in the prevention of unjustified use of hepatotropic drugs is increasing. Based on the synthesis of expert opinions and analysis of the regulatory framework, algorithms have been developed for pharmaceutical information to pharmacy visitors during the dispensing of hepatoprotectors and choleretics. The algorithms include the collection of medical history, assessment of indications and contraindications, information about the dosage regimen, possible adverse reactions and drug interactions, as well as recommendations for lifestyle correction and the need for medical monitoring. The conclusion is made about the undesirability of using hepatotropic drugs without a doctor's prescription. When requesting the selection of an over-the-counter drug, it is advisable for the pharmacist to focus on the developed algorithms and, if necessary, refer the patient to a specialist.
Alina V. Aydova – аssistant department of pharmacy, Kazan (Volga Region) Federal University, Kazan, Russia.
Dilyara Kh. Shakirova – head of the department of pharmacy, professor, doctor of pharmaceutical sciences, Kazan (Volga Region) Federal University, Kazan, Russia.
Sayar R. Abdulhakov – head of the department of internal medicine, аssociate рrofessor, candidate of medical sciences, Kazan (Volga Region) Federal University, Kazan, Russia.
Kamilya F. Zaripova – аssistant, department of pharmacy, Kazan (Volga Region) Federal University, Kazan, Russia.
Adelina R. Garaeva – аssistant, department of pharmacy, Kazan (Volga Region) Federal University, Kazan, Russia.
1. International Classification of Diseases 10th Revision (ICD-10). Аvailable at: https://mkb-10.com/. Accessed: 28 Mar 2026. (In Russ).
2. Physiology of bile secretion. Physiological anatomy of bile secretion. Available at: https://meduniver.com/Medical/Physiology/1148.html. Accessed: 28 Mar 2026. (In Russ).
3. Mekhtiev SN, Mekhtieva OA, Ibragimova ZM. Functional gall-bladder disorders and non-alcoholic fatty liver disease: clinical features and new approaches to therapy. Medical Council. 2020;(15):54-4. (In Russ.) https://doi.org/10.21518/2079-701X-2020-15-54-64.
4. Ivashkin VT, Mayev IV, Shulpekova YuO, et al. Diagnostics and treatment of biliary dyskinesia: clinical guidelines of the Russian gastroenterological Association. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2018;28(3):63-80. (In Russ.) DOI: 10.22416/1382-4376-2018-28-3-63-80
5. Okovityi SV, Raikhelson KL, Akhmedov VA, et al. Hepatotropic therapy for drug-induced liver injury (expert meeting). Permskij medicinskij zhurnal. 2025;3:58-74. (In Russ). DOI: 10.17816/pmj42358-74
6. Clinical recommendations of the Ministry of Health of the Russian Federation, 2025. «Lekarstvenny`e porazheniya pecheni (LPP). Vzrosly`e». Available at: https://endoexpert.ru/dokumenty-i-prikazy/kr-lpp2027/. Accessed: 12 Apr 2026. (In Russ).
7. Tkachenko PE, Ivashkin VT, Mayevskaya MV. Klinicheskie rekomendacii po korrekcii gepatotoksichnosti, inducirovannoj protivoopuxolevoj terapiej. Zlokachestvenny`e opuxoli. 2022;12(3s2):64-77. (In Russ). DOI: 10.18027/2224-5057-2022-12-3s2-64-77
8. Clinical recommendations of the Ministry of Health of the Russian Federation, 2024. «Nealkogol`naya zhirovaya bolezn` pecheni u vzrosly`x». Available at: https://diseases.medelement.com/disease. Accessed: 12 Apr 2026. (In Russ).
9. Clinical recommendations of the Ministry of Health of the Russian Federation, 2024. «Alkogol`naya bolezn` pecheni». Available at: https://diseases.medelement.com/disease. Accessed: 12 Apr 2026. (In Russ).
10. Clinical recommendations of the Ministry of Health of the Russian Federation, 2024. «Xronicheskij virusny`j gepatit В». Available at: https://diseases.medelement.com/disease. Accessed: 12 Apr 2026. (In Russ).
11. Clinical recommendations of the Ministry of Health of the Russian Federation, 2024. «Xronicheskij virusny`j gepatit С». Available at: https://diseases.medelement.com/disease. Accessed: 12 Apr 2026. (In Russ).
12. Stel'makh VV, Bakulin IG, Kovalenko AL, Kozlov VK. Efficiency of remaxol in alcoholic liver disease patients. Experimental and Clinical Pharmacology. 2022;85(6):25-31. DOI: 10.30906/0869-2092-2022-85-6-25-31
13. Prikhodko VA, Okovityi SV. Perspectives for the use of morpholinium thiazotate as a pharmacotherapy for hepato-cardiac continuum states. Medical Council. 2024;23:94-103. DOI: 10.21518/ms2024-xxx
14. Achufusi TGO, Safadi AO, Mahabadi N. Ursodeoxycholic Acid. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. Updated 2023 Feb 12. Available from: https://pubmed.ncbi.nlm.nih.gov/31424887/. Accessed:14 Apr 2026.
15. Kovaleva NB. Ursodeoxycholic Acid is a Multifunctional Agent in Gastroenterology. Ural Medical Journal. 2025;24(5):116-32. DOI: 10.52420/umj.24.5.116
16. Gosudarstvenny`j Reestr lekarstvenny`x sredstv Rossii. Available at: https://grls.rosminzdrav.ru/. Accessed: 28 Mar 2026. (In Russ).
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DOI: 10.14489/lcmp.2026.02.pp.008-015
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