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What is the suggested medication to reduce bilirubin levels?

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General & Family Physician
Practicing since : 2008
Answered : 3624 Questions
Hello, I have beta thalassemia trait, and probably gilbert syndrome since my elevated bilirubin levels, i also have mild fatty liver and mild jundice, specially in my eyes. I know there are some medicine that can reduce amount of free bilirubin in the blood, like phenobarbital, I am looking for the best one with less side effects, what would you suggest? Thanks.
Posted Fri, 14 Feb 2014 in General Health
Answered by Dr. Raju A.T 37 hours later
Brief Answer: Not advisable Detailed Answer: Hi, Thanks for your query. Sorry for the delay in my response. I am medical doctor, an associate in Department of Gastroenterology, working with an experienced Hepatologist. I answer on his behalf. Phenobarbitone is known to reduce the bilirubin levels but its efficacy and use is limited to neonates only. It is indicated in neonatal jaundice where the most of the bilirubin is unconjugated. Phenobarb is usually not indicated for jaundice in adults. Liver protectives like Silybum marianum with strict fat and spice restricted diet would surely help to get the bilirubin levels down. Also the cause for the increased bilirubin has to be made to prevent further worsening. You may have to get complete blood check up done to rule out hemolysis. Wish you good health. Regards,
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Follow-up: What is the suggested medication to reduce bilirubin levels? 3 minutes later
I have mainly unconiugated bilirubin. And yes i have emolisys and gilbert syndrome. Why is it not advisable to use phenobarbital? What about UDCA? Any other medicine can lower bilirubin?
Answered by Dr. Raju A.T 6 hours later
Brief Answer: Silybum is effective with least side effects Detailed Answer: Hi, Thanks for writing back. Phenobarbital is considered as third line drug in treating the jaundice in adults as the side effect profile is bad. It acts by increasing the work by the liver which is not good, also it inhibits metabolism of many several drugs which can further cause liver damage. Silybum is considered safest and the next in line is Ursodeoxycholic Acid (UDCA). UDCA is considered when the Silybum treatment remains unresponsive. Only when the UDCA fails Phenobarb is considered in adults. Regards,
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