Intravenous Milk Thistle (Silibinin-Legalon) for Hepatic Failure Induced by Amatoxin/Amanita Mushroom Poisoning

This study is currently recruiting participants. (see Contacts and Locations)
Verified September 2015 by Madaus Inc
Information provided by (Responsible Party):
Madaus Inc Identifier:
First received: June 4, 2009
Last updated: September 21, 2015
Last verified: September 2015
Legalon® SIL will be administered to patients with amatoxin poisoning diagnosed by history, gastrointestinal symptoms, elevated liver enzymes, and/or diagnostic assay (should one become available). Patients may or may not also demonstrate abnormalities in bilirubin and/or creatinine. Treatment consists of a 5 mg/kg loading dose followed by 20 mg/kg/day via continuous infusion. The treating physician is expected to administer supportive therapy of his/her choosing but consistent with best practices. Legalon® SIL will be stopped when coagulopathy is no longer present, and when liver function tests have returned significantly towards the normal range. Patients will be followed 7-14 days after the end of Legalon® SIL therapy with follow up lab studies.

Condition Intervention Phase
Amatoxin Poisoning
Amanita Poisoning
Mushroom Poisoning
Liver Failure
Drug: Legalon SIL (Silibinin)
Phase 2
Phase 3

Study Type: Interventional
Study Design: Endpoint Classification: Safety/Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: Prevention and Treatment of Amatoxin Induced Hepatic Failure With Intravenous Silibinin ( Legalon® SIL): An Open Multicenter Clinical Trial

Resource links provided by NLM:

Further study details as provided by Madaus Inc:

Primary Outcome Measures:
  • prevention of severe morbidity (liver transplantation) and death [ Time Frame: 1 month ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Improvement in presenting abnormalities as evaluated by time to normality for hepatic and renal function tests (AST, ALT, bilirubin, PT/INR, creatinine). [ Time Frame: 1 month ] [ Designated as safety issue: No ]
  • cutaneous reactions [ Time Frame: 1 month ] [ Designated as safety issue: Yes ]
  • sodium [ Time Frame: 1 month ] [ Designated as safety issue: Yes ]
  • hemoglobin [ Time Frame: 1 month ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 50
Study Start Date: February 2010
Estimated Study Completion Date: December 2015
Estimated Primary Completion Date: December 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Legalon SIL
Legalon SIL
Drug: Legalon SIL (Silibinin)
20 mg/kg/day IV


Ages Eligible for Study:   2 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • History of eating foraged mushrooms
  • Gastrointestinal symptoms suggestive of amatoxin poisoning (cramping abdominal pain, nausea, vomiting, and / or watery diarrhea) within 48 hrs of mushroom ingestion
  • Liver function tests suggestive of amatoxin poisoning: AST or ALT above the upper limit of normal within 48 hrs after mushroom ingestion
  • Gender: male or female
  • Age: > 2 yr
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT00915681

Contact: Todd Mitchell, MD 831-479-7916
Contact: Joe Veilleux 412-279-8808

United States, California
Dominican Santa Cruz Hospital Recruiting
Santa Cruz, California, United States, 95065
Contact: Todd Mitchell, MD    831-479-7916   
Contact: Alan Buchwald, MD    831-761-0260   
Principal Investigator: Todd Mitchell, MD         
United States, Pennsylvania
Recruitment Hot Line for the United States Recruiting
Pittsburg, Pennsylvania, United States
Contact: Todd Mitchell, MD    866-520-4412      
Contact: Alan buchwald, MD    866-520-4412      
Principal Investigator: Todd Michell, MD         
Sub-Investigator: Alan Buchwald, MD         
Sponsors and Collaborators
Madaus Inc
Principal Investigator: Todd Mitchell, MD Dominican Santa Cruz Hospital
  More Information

No publications provided

Responsible Party: Madaus Inc Identifier: NCT00915681     History of Changes
Other Study ID Numbers: SB16A1.07 
Study First Received: June 4, 2009
Last Updated: September 21, 2015
Health Authority: United States: Food and Drug Administration

Keywords provided by Madaus Inc:
mushroom poisoning
hepatic failure
milk thistle

Additional relevant MeSH terms:
Liver Failure
Mushroom Poisoning
Chemically-Induced Disorders
Digestive System Diseases
Foodborne Diseases
Hepatic Insufficiency
Liver Diseases
Molecular Mechanisms of Pharmacological Action
Pharmacologic Actions
Physiological Effects of Drugs
Protective Agents processed this record on February 09, 2016