For approved drug preparations and parenteral applications in the treatment of Amanita mushroom poisoning, the water-soluble silibinin-C-2',3-dihydrogensuccinate disodium salt is used.

In 2011, the same compound also received Orphan Medicinal Product Designation for the prevention of recurrent hepatitis C in liver transplant recipients by the European Commission.

[2] Silibinin is available in many EU countries for treatment of toxic liver damage (e.g., as an intravenous formulation used in death cap poisoning) or as adjunctive therapy in chronic hepatitis and cirrhosis.

[citation needed][3][4] There is limited evidence to support use of silibinin-containing products as a supplement in people with chronic liver disease.

[6] There is little evidence to support a meaningful antiviral effect of milk thistle in chronic hepatitis C.[7][8] Silibinin is under investigation to see whether it may have a role in cancer treatment (e.g., due to its inhibition of STAT3 signalling).

[12] Due to its immunomodulatory,[13] iron-chelating, and antioxidant properties, this herb has the potential to be used in beta-thalassemia patients who receive regular blood transfusions and suffer from iron overload.

[25][26] A phase I clinical trial in humans with prostate cancer designed to study the effects of high dose silibinin found 13 grams daily to be well tolerated in patients with advanced prostate cancer with asymptomatic liver toxicity (hyperbilirubinemia and elevation of alanine aminotransferase) being the most commonly seen adverse event.

[27] Silymarin can be produced in callus and cell suspensions of Silybum marianum and substituted pyrazinecarboxamides can be used as abiotic elicitors of flavolignan production.