Plaquex® / Phosphatidylcholine (PTC) IV

Full ingredient list

Exact amounts delivered in each size. Formulas are compounded per patient and can be adjusted by your provider.

Supporting studies

• 1

  Phosphatidylcholine is the most abundant phospholipid in every human cell membrane, and the balance of membrane phospholipids directly governs energy metabolism, liver fat handling and lipoprotein export.

  This authoritative review from the University of Alberta group that defined phosphatidylcholine (PC) biology describes PC and phosphatidylethanolamine (PE) as the two most abundant phospholipids in all mammalian cell membranes. The authors show that the cellular PC/PE ratio is not a passive structural detail but an active regulator: it modulates energy metabolism, membrane integrity, mitochondrial function and lipid droplet dynamics, and adequate hepatic PC is required for normal lipoprotein secretion and healthy liver fat handling. This is the mechanistic foundation for supplying phosphatidylcholine therapeutically.

  Mechanistic review (biochemistry / membrane biology) van der Veen JN, Kennelly JP, Wan S, Vance JE, Vance DE, Jacobs RL The critical role of phosphatidylcholine and phosphatidylethanolamine metabolism in health and disease. Biochimica et Biophysica Acta - Biomembranes. 2017. PMID 28411170 ↗

• 2

  Choline — the head group of phosphatidylcholine — was formally recognized as an essential nutrient by the Institute of Medicine in 1998, yet most Americans fall well short of the recommended intake.

  Zeisel and da Costa's review documents that the Institute of Medicine designated choline an essential nutrient in 1998, setting Adequate Intakes of 550 mg/day for men and 425 mg/day for women, based in part on the liver damage observed at lower intakes. Because choline supports everything from cell membrane structure to neurotransmitter synthesis, inadequate intake is linked to liver disease and atherosclerosis. The authors note that mean intakes for older children, men, women and pregnant women fall far below the IOM's adequate intake, and call for dietary guidance to increase consumption of choline-rich foods.

  Narrative review / nutritional requirement analysis Zeisel SH, da Costa KA Choline: an essential nutrient for public health. Nutrition Reviews. 2009. PMID 19906248 ↗

• 3

  Essential phospholipids measurably increase the fluidity of human liver cell membranes, protect those cells from programmed cell death, and boost the activity of the membrane pumps cells use to export waste.

  In a controlled laboratory study using three human hepatocyte cell lines (HepG2, HepaRG and fat-loaded steatotic HepaRG), essential phospholipids, polyenylphosphatidylcholine and phosphatidylinositol were added directly to the cultures. All three phospholipids significantly increased membrane fluidity in HepG2 cells and significantly reduced tamoxifen-induced apoptosis. Activity of multiple membrane export transporters rose as well — BCRP and P-glycoprotein across cell types, MRP-2 in HepaRG lines, and the bile salt export pump BSEP in HepG2 and steatotic cells. This is direct human-cell evidence for the membrane-repair mechanism attributed to phosphatidylcholine.

  Mechanistic / in vitro study in human hepatocyte cell lines Wupperfeld D, Fricker G, Bois De Fer B, et al. Essential phospholipids decrease apoptosis and increase membrane transport in human hepatocyte cell lines. Lipids in Health and Disease. 2022. PMID 36153592 ↗

• 4

  Phosphatidylcholine makes up roughly 95% of the phospholipid in bile, where it forms the mixed micelles that carry fat and cholesterol and shield the bile ducts from bile salt injury.

  This review of biliary lipid physiology explains that the ABCB4 transporter on the hepatocyte canalicular membrane secretes phosphatidylcholine into bile, where PC accounts for approximately 95% of biliary phospholipid. There, phosphatidylcholine combines with bile salts and cholesterol to form mixed micelles, which both keep cholesterol in solution (preventing crystallization) and strongly reduce the cytotoxic detergent effect of bile salts on the cells lining the biliary tree. The authors state plainly that 'the function of biliary phospholipid secretion is to protect the membranes of cells facing the biliary tree against bile salts.'

  Mechanistic review (hepatobiliary physiology) Morita SY, Terada T Molecular mechanisms for biliary phospholipid and drug efflux mediated by ABCB4 and bile salts. BioMed Research International. 2014. PMID 25133187 ↗

• 5

  In a randomized double-blind trial, polyenylphosphatidylcholine improved every major cholesterol number at once — LDL fell 17%, total cholesterol 16%, triglycerides 9%, and HDL rose 12%.

  Thirty non-insulin-dependent diabetic patients with secondary hyperlipidemia were randomized double-blind to 2.7 g/day of 3-sn-polyenylphosphatidylcholine (PPC) or placebo for two months (oral route in this trial). After 56 days the PPC group showed a 17% fall in LDL cholesterol (191 to 159 mg/dL, p = 0.0174), a 16% fall in total cholesterol and a 9% fall in triglycerides, while HDL cholesterol rose 12%. Differences in LDL, total cholesterol and triglycerides between treatment groups were statistically significant; placebo values were unchanged.

  Randomized double-blind placebo-controlled trial Kirsten R, Heintz B, Nelson K, et al. Polyenylphosphatidylcholine improves the lipoprotein profile in diabetic patients. International Journal of Clinical Pharmacology and Therapeutics. 1994. PMID 8004358 ↗

• 6

  In 100 patients with high cholesterol and coronary artery disease, six months of essential phospholipids (Lipostabil) matched prescription niacin for lowering cholesterol, cut oxidized LDL, raised the protective HDL2b subfraction, reduced angina attacks and improved exercise capacity — with better tolerability.

  Klimov and colleagues randomized 100 patients with diet-resistant type IIb hyperlipoproteinemia and ischemic heart disease to six months of nicotinic acid (n=50) or essential phospholipids/Lipostabil (n=50). Both produced significant reductions in serum total cholesterol, LDL cholesterol and triglycerides (p < 0.001). Uniquely, the phospholipid arm significantly reduced LDL hydroperoxides (p < 0.05) — a marker of the oxidized LDL that drives plaque — and increased the cardioprotective HDL2b subfraction. Both groups had fewer angina attacks (p < 0.05), but only Lipostabil improved working capacity, and the nicotinic acid group had more dropouts and side effects, leading the authors to favor the phospholipid.

  Randomized comparative clinical trial Klimov AN, Konstantinov VO, Lipovetsky BM, et al. "Essential" phospholipids versus nicotinic acid in the treatment of patients with type IIb hyperlipoproteinemia and ischemic heart disease. Cardiovascular Drugs and Therapy. 1995. PMID 8850382 ↗

• 7

  Loading HDL particles with extra phosphatidylcholine makes them more than four times more efficient at pulling cholesterol out of cells — the first step of reverse cholesterol transport.

  Phosphatidylcholine is the essential cholesterol-binding component of lipoproteins and the acyl donor that the enzyme LCAT uses to esterify cholesterol on HDL. Tchoua and colleagues developed a method to increase HDL phosphatidylcholine content more than tenfold without losing apolipoprotein A-I, producing 'superphospholipidated' HDL. These enlarged, PC-rich particles improved cholesterol efflux kinetics dose-dependently, raising catalytic efficiency by more than 400%. The authors concluded that phospholipid enrichment of plasma HDL is a viable way to enhance reverse cholesterol transport.

  Mechanistic study (human hdl, cell-based efflux assays) Tchoua U, Gillard BK, Pownall HJ HDL superphospholipidation enhances key steps in reverse cholesterol transport. Atherosclerosis. 2010. PMID 19892352 ↗

• 8

  Adding phosphatidylcholine to human serum converts HDL into the small pre-beta particles that are the body's most active cholesterol scavengers, markedly increasing cholesterol removal from cells.

  Working with fresh human serum, Jian and colleagues at the Medical College of Pennsylvania showed that enriching serum with phosphatidylcholine vesicles substantially increased its ability to promote cholesterol efflux from cells. The mechanism was a compositional remodeling of HDL: alpha-migrating HDL particles were converted into larger pre-beta-migrating particles containing apolipoprotein A-I. Among all isolated lipoprotein fractions tested, only interaction with HDL produced this enhancement — confirming that phospholipid works through the HDL pathway specifically.

  Mechanistic study (human serum, cell-based cholesterol efflux) Jian B, de la Llera-Moya M, Royer L, Rothblat G, Francone O, Swaney JB Modification of the cholesterol efflux properties of human serum by enrichment with phospholipid. Journal of Lipid Research. 1997. PMID 9144088 ↗

• 9

  Intravenous soy phosphatidylcholine nanoparticles doubled the cholesterol-removal power of HDL and protected arteries from atherosclerosis as effectively as a statin or fibrate.

  Researchers incubated human blood plasma with phospholipid nanoparticles made of soybean polyunsaturated phosphatidylcholine and observed dose-dependent lipidation of every HDL subfraction. When these remodeled HDLs were tested against cholesterol-loaded human THP-1 macrophages, cholesterol efflux capacity — the best-validated functional measure of reverse cholesterol transport — doubled compared with native plasma. Given intravenously to cholesterol-fed rabbits, the same phospholipid particles restored the lipid profile and protected the vessel wall from atherosclerosis progression, performing comparably to fenofibrate and atorvastatin.

  Mechanistic / preclinical (human plasma ex vivo plus intravenous administration in rabbits) Kudinov VA, Torkhovskaya TI, Zakharova TS, et al. High-density lipoprotein remodeling by phospholipid nanoparticles improves cholesterol efflux capacity and protects from atherosclerosis. Biomedicine & Pharmacotherapy. 2021. PMID 34328100 ↗

• 10

  In a 2026 multicenter phase 4 randomized placebo-controlled trial, essential phospholipids significantly reduced liver fat, improved fatigue and improved blood sugar control — with a clean safety profile.

  This double-blind, placebo-controlled, multicenter phase 4 trial randomized 193 patients with metabolic dysfunction-associated steatotic liver disease (MASLD) plus type 2 diabetes, hyperlipidemia and/or obesity to essential phospholipids or placebo alongside standard of care for six months. The phospholipid group had a significantly greater reduction in hepatic steatosis measured by controlled attenuation parameter (CAP), with benefit visible by month three and persisting after treatment ended. Patients also reported notable improvement in fatigue and showed better glycemic control. No safety concerns were identified. This is the most rigorous modern trial of essential phospholipids to date.

  Randomized double-blind placebo-controlled phase 4 clinical trial Stefan N, Hartleb M, Fan J, et al. Effect of Essential Phospholipids in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Randomised Phase 4 Clinical Trial. Liver International. 2026. PMID 41889076 ↗

• 11

  A systematic review and network meta-analysis found that adding essential phospholipids to standard care lowered liver enzymes, triglycerides and total cholesterol, and raised the odds of overall improvement by 50%.

  Dajani and Popovic pooled ten studies (n = 22-324 per study, treatment 4 to 72 weeks) in adults with nonalcoholic fatty liver disease alongside type 2 diabetes and/or obesity. In the direct meta-analysis of four randomized controlled trials, essential phospholipids added to antidiabetic therapy produced significantly greater reductions than therapy alone in ALT (mean difference -11.28 U/L, 95% CI -17.33 to -5.23, p = 0.0003), triglycerides (-49.33 mg/dL, 95% CI -66.43 to -32.23, p < 0.0001) and total cholesterol (-29.74 mg/dL, 95% CI -38.02 to -21.45, p < 0.0001). Overall disease improvement was 50% more likely (RR 1.50, 95% CI 1.26-1.79, p < 0.0001).

  Systematic review and network meta-analysis Dajani AI, Popovic B Essential phospholipids for nonalcoholic fatty liver disease associated with metabolic syndrome: A systematic review and network meta-analysis. World Journal of Clinical Cases. 2020. PMID 33269259 ↗

• 12

  In a real-world study of 6,052 patients across 264 hospitals, injectable polyene phosphatidylcholine steadily lowered liver enzymes — and higher doses worked better.

  This is the largest real-world evaluation of injectable polyene phosphatidylcholine (PPC, 232.5 mg per vial) as a hepatoprotective agent, covering 6,052 patients with liver injury across 264 Chinese hospitals, including 471 with hepatitis B. PPC produced steady daily declines in liver enzymes: in chronic hepatitis B patients ALT fell 3.7 U/L per day (95% CI -6.0 to -1.5) and AST 2.4 U/L per day; in non-hepatitis B patients ALT fell 5.2 U/L per day, AST 3.5 U/L per day and GGT 4.9 U/L per day. A clear dose-response was seen — high-dose PPC (4 or more vials/day) reduced ALT substantially faster than low-dose (-6.5 vs -4.2 U/L per day).

  Multicenter real-world observational study (injectable/parenteral route) Xu J, Fan Y, Yu Y, et al. A Multicenter Real-World Study Evaluating the Hepatoprotective Effect of Polyene Phosphatidylcholine Against Chronic Hepatitis B. Frontiers in Medicine. 2022. PMID 35814776 ↗

• 13

  In a landmark primate study, phosphatidylcholine completely prevented liver fibrosis and cirrhosis — none of the supplemented animals developed either.

  Lieber and colleagues fed baboons virtually pure phosphatidylcholine for up to 6.5 years alongside alcohol. Ten of twelve baboons given alcohol without phosphatidylcholine developed septal fibrosis or cirrhosis, whereas none of the eight animals given alcohol with phosphatidylcholine developed either. Phosphatidylcholine also corrected the alcohol-induced fall in liver phospholipids. The authors identified dilinoleoylphosphatidylcholine — the principal active species in soy-derived polyenylphosphatidylcholine — as the active component, working by stimulating collagen-degrading (collagenase) activity in liver cells.

  Controlled long-term primate study (mechanistic/preclinical) Lieber CS, Robins SJ, Li J, DeCarli LM, Mak KM, Fasulo JM, Leo MA Phosphatidylcholine protects against fibrosis and cirrhosis in the baboon. Gastroenterology. 1994. PMID 8276177 ↗

References

• 1van der Veen JN, Kennelly JP, Wan S, Vance JE, Vance DE, Jacobs RL. The critical role of phosphatidylcholine and phosphatidylethanolamine metabolism in health and disease. Biochimica et Biophysica Acta - Biomembranes. 2017. PMID 28411170 ↗
• 2Zeisel SH, da Costa KA. Choline: an essential nutrient for public health. Nutrition Reviews. 2009. PMID 19906248 ↗
• 3Wupperfeld D, Fricker G, Bois De Fer B, et al. Essential phospholipids decrease apoptosis and increase membrane transport in human hepatocyte cell lines. Lipids in Health and Disease. 2022. PMID 36153592 ↗
• 4Morita SY, Terada T. Molecular mechanisms for biliary phospholipid and drug efflux mediated by ABCB4 and bile salts. BioMed Research International. 2014. PMID 25133187 ↗
• 5Kirsten R, Heintz B, Nelson K, et al. Polyenylphosphatidylcholine improves the lipoprotein profile in diabetic patients. International Journal of Clinical Pharmacology and Therapeutics. 1994. PMID 8004358 ↗
• 6Klimov AN, Konstantinov VO, Lipovetsky BM, et al. "Essential" phospholipids versus nicotinic acid in the treatment of patients with type IIb hyperlipoproteinemia and ischemic heart disease. Cardiovascular Drugs and Therapy. 1995. PMID 8850382 ↗
• 7Tchoua U, Gillard BK, Pownall HJ. HDL superphospholipidation enhances key steps in reverse cholesterol transport. Atherosclerosis. 2010. PMID 19892352 ↗
• 8Jian B, de la Llera-Moya M, Royer L, Rothblat G, Francone O, Swaney JB. Modification of the cholesterol efflux properties of human serum by enrichment with phospholipid. Journal of Lipid Research. 1997. PMID 9144088 ↗
• 9Kudinov VA, Torkhovskaya TI, Zakharova TS, et al. High-density lipoprotein remodeling by phospholipid nanoparticles improves cholesterol efflux capacity and protects from atherosclerosis. Biomedicine & Pharmacotherapy. 2021. PMID 34328100 ↗
• 10Stefan N, Hartleb M, Fan J, et al. Effect of Essential Phospholipids in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Randomised Phase 4 Clinical Trial. Liver International. 2026. PMID 41889076 ↗
• 11Dajani AI, Popovic B. Essential phospholipids for nonalcoholic fatty liver disease associated with metabolic syndrome: A systematic review and network meta-analysis. World Journal of Clinical Cases. 2020. PMID 33269259 ↗
• 12Xu J, Fan Y, Yu Y, et al. A Multicenter Real-World Study Evaluating the Hepatoprotective Effect of Polyene Phosphatidylcholine Against Chronic Hepatitis B. Frontiers in Medicine. 2022. PMID 35814776 ↗
• 13Lieber CS, Robins SJ, Li J, DeCarli LM, Mak KM, Fasulo JM, Leo MA. Phosphatidylcholine protects against fibrosis and cirrhosis in the baboon. Gastroenterology. 1994. PMID 8276177 ↗