Silymarin and Piperine as Co-Phytotherapeutics: A Systematic Review of Evidence for Anti-Inflammatory and Antioxidant Synergy

Abstract

Background: Oxidative or chronic inflammatory processes are significant causes of the pathogenesis of liver, metabolic, or inflammatory diseases. Integrative therapeutic potential Backpurative Therapeutic The evidencebased practice of herbal co-phytotherapy which combines antioxidant and anti-inflammatory effects of herbs and any combination of Herbal cophytotherapy derived from evidence indicates integrative therapeutic potential. Silymarin and Piper nigrum (piperine) are typically used both traditionally in Ayurveda and modern medicine with regard to its value in protecting the liver and immunoregulation. Their mixture is a prospective pattern of Rasayana Yogavahi synergy as a fusion of classic rejuvenating and bioenhancing values with the modern time pharmacological medicine. Objectives: To carry out a systematic review of preclinical and clinical data on the interaction between silymarin and piperine in terms of synergistic antioxidant and anti-inflammatory activities, as well as verbally present the findings in a framework of Ayurvedic Rasayana. Methods: Based on PRISMA 2020 guidelines, PubMed, Scopus, Web of Science, AYUSH Research Portal, and Google Scholar (2000 -2025) were used to retrieve literature. In Vitro, in Vivo, and clinical studies that determine the antioxidant and inflammatory biomarkers were eligible. Risk of bias was also determined, with the help of SYRCLE and Cochrane ROB-2. Results: A total of seventytwo studies were adopted to meet the inclusion criteria. Combined silymarin– piperine treatment enhanced antioxidant enzyme activity (↑ SOD, ↑ GSH, ↓ MDA) and suppressed inflammatory mediators (↓ TNF-α, ↓ IL-6, ↓ NF-κB). Piperine enhanced the bioavailability of silymarin by a maximum of 3-fold, increasing anti-oxidant and anti-inflammatory action. Clinical trials presented better biochemical markers both in liver, metabolic conditions with great safety. Conclusion: Radicals and antioxidant Silymarin and piperine exhibit synergistic anti-inflammatory and antioxidant effects, which follow the principles of Rasayana and Yogavahi. Such integrative synergy confirms Ayurvedic pharmacodynamics using the newer molecular evidence, as fuller clinical conversion to standardised co-phytotherapeutic formulations.