Hepa Merz is a hepatoprotector and detoxifier. It acts on two main pathways of ammonia detoxification - urea synthesis and glutamine synthesis - through the amino acids ornithine and aspartate.
Aspartate (L-aspartate) and ornithine (L-ornithine) are two amino acids that are directly involved in the conversion of ammonia to urea and glutamine.
Ornithine acts as a catalyst for the enzymes ornithine carbamoyltransferase and carbamoylphosphate synthetase. In addition, this substance is the basis for the synthesis of urea.
The use of Hepa-Merz promotes the activation of the ornithine cycle of urea formation, thereby reducing ammonia levels. The drug helps optimize protein metabolism, and its active components take part in the production of insulin and growth hormone.
The half-life is 30-50 minutes and is excreted in the form of metabolites mainly by the kidneys.
Indications for use
What does Gepa Merz help with? According to the instructions, the drug is prescribed in the following cases:
- detoxification for cirrhosis, hepatitis (including toxic), other liver diseases, as well as for overeating and alcohol abuse;
- hepatic encephalopathy (at the stage of precoma and coma).
Granulate for the preparation of solution for oral administration:
- violation of the detoxification function of the liver (due to overeating and alcohol consumption);
- treatment of associated complications, in particular hepatic encephalopathy.
Instructions for use of Hepa Merz, dosage
The drug in the form of granules must be dissolved in water: 1 sachet per 200 ml. The solution is taken orally 2-3 times a day after meals.
The concentrate is administered intravenously, dissolved in 500 ml of infusion solution up to 40 ml (4 ampoules) per day. In the case of hepatic encephalopathy (depending on the severity of the condition), up to 80 ml (8 ampoules) per day is administered intravenously. The doctor prescribes dosage and treatment period based on clinical indications individually.
The maximum permissible infusion rate is 5 g per hour. It is recommended to dissolve no more than 60 ml (6 ampoules) of the drug in 500 ml of infusion solution. The drug concentrate is dissolved in 5% glucose solution, Ringer's solution or saline.
If nausea or vomiting occurs, the rate of administration of the drug should be reduced.
The duration of treatment is determined by the doctor individually for each patient. This parameter depends on the type of disease, its severity and the condition of the patient as a whole. In cases with severe liver dysfunction, strict monitoring of the patient's condition and, if necessary, adjustment of the rate of drug administration is required. This is necessary to prevent nausea and vomiting.
Side effects
The instruction warns about the possibility of developing the following side effects when prescribing Hepa Merz:
- allergic reactions to the components of the drug,
- sometimes - nausea and vomiting.
Symptoms are short-lived and do not require discontinuation of the drug.
Contraindications
It is contraindicated to prescribe Hepa Merz in the following cases:
- hypersensitivity to L-ornithine-L-aspartate or any component of the drug;
- lactation;
- renal failure severe (serum creatinine level 3 mg/100 ml).
During pregnancy, the drug should be taken only under strict medical supervision.
Overdose
When taking the drug in accordance with the instructions, an overdose is unlikely. Sometimes gastrointestinal disorders are possible.
If symptoms associated with overdose occur, the drug should be stopped and treated symptomatic treatment.
Analogs of Hepa Merz, price in pharmacies
If necessary, you can replace Gepa Merz with an analogue active substance- these are drugs:
- Ornilatex,
- Ornithine,
- Ornitsethyl.
When choosing analogues, it is important to understand that the instructions for use of Hepa Merz, the price and reviews of drugs with similar effects do not apply. It is important to consult a doctor and not independent replacement drug.
Price in Russian pharmacies: Hepa-Merz granules 3 g 10 pcs. – from 708 to 839 rubles, granules 3 g 30 pcs. – from 1693 to 1792 rubles, according to 538 pharmacies.
Keep away from children. Store at temperatures up to 25 °C. Shelf life – 5 years. In pharmacies, granules are sold without a prescription, concentrate is available with a prescription.
One ampoule of concentrate for preparing Hepa-Merz solution contains 5 g. ornithine aspartate, and also up to 10 ml. water for injection (auxiliary compound).
Release form
Granulate(a mixture of Hepa-Merz granules white and orange flowers) to prepare the solution, package it in sachets of 5 g each. One cardboard package contains 30 sachets.
Concentrate Available in dark glass ampoules with a nominal volume of 10 ml. One cardboard package contains 10 ampoules.
pharmachologic effect
The medicine has a hepatoprotective effect on the human body pharmacological effects. Hepa-Merz belongs to the hypoazotemic pharmacotherapeutic group of drugs.
Pharmacodynamics and pharmacokinetics
Active compound ornithine aspartate , contained in Hepa-Mertz, participates in biosynthesis from urea ammonia (ornithine Krebs cycle) , and also promotes the production STG And insulin , accelerates protein metabolism , improves liver function ( detoxification effect ) and reduces the level ammonia in blood.
The drug is quickly absorbed in the stomach and enters the blood through intestinal epithelium and excreted from the body in urine.
Indications for use of Gepamerza
Indications for the use of Hepa-Merz are:
- liver diseases , including chronic or acute form, accompanied hyperammonemia ;
- hepatic encephalopathy .
Included complex therapy the drug is used for treatment disturbances of consciousness ( or condition precoms ). In addition, Hepa-Merz acts as corrective additive in the therapeutic diet of patients with protein deficiency .
The medicine can be used to relieve alcohol poisoning .
Contraindications
The medicine is contraindicated in renal dysfunction (at a blood level of 3 mg/100 ml. creatine ).
Side effects
It is worth noting that such possible side effects of the drug as nausea, on skin And vomit appear extremely rarely.
Hepa-Merz, instructions for use (Method and dosage)
In accordance with the instructions for use of Gepamerza, it is recommended to take the medicine after meals. To prepare a single dose of the drug, mix 200 ml. water (better room temperature) with one sachet containing 5 g granulate powder .
Hepa-Merz solution for infusion, it is administered intravenously at a dose of 20 g (i.e. 4 ampoules of the drug) per day. Recommended average daily therapeutic dose medicine can be increased to a maximum of 8 ampoules (40 g) per day.
The drug Hepa-Merz is not available in tablet form.
Overdose
Gain side effects the drug may signal an overdose of Hepa-Mertz. In this situation, first of all, stop using this drug. Patients have their stomach washed, given symptomatic treatment and prescribed.
Interaction
There is currently no information about drug interactions Hepa-Merz with other drugs.
Terms of sale
Over-the-counter release from pharmacies.
Storage conditions
Store out of reach of children, at a temperature not exceeding 25°C.
Best before date
special instructions
Before direct intravenous administration of the Hepa-Merz solution, you should not dissolve more than 6 ampoules (500 ml of solution for infusion) of the drug at a time. In order to exclude vomiting And nausea the rate of drug administration should be optimized.
While using the drug for treatment hepatic encephalopathy Patients are advised to refrain from driving vehicles, as well as not to work with potentially dangerous mechanisms and not to engage in activities that require increased concentration attention, and also a quick mental reaction.
Analogues of Hep-Merz
Level 4 ATX code matches:Structural analogues of Hepa-Merz a are considered Ornitsetil , and Ornithine .
Synonyms
During pregnancy and lactation
Reviews about Hepa-Mertz
People who took the drug, for the most part, leave positive reviews on forums about the drug, noting its effectiveness and the small number of contraindications and side effects. Judging by the reviews of Hepa-Mertz, this drug is suitable for a wide range of patients, including children and the elderly.
Hepa-Merz price, where to buy
The cost of Gepamerz varies by region and form medicinal release. You can buy this drug in pharmacies without a doctor's prescription.
average price Gepamerza in ampoules(pack of 10 pieces, 10 ml each) is 3000 rubles.
Package granulates(10 sachets, 5 mg each) will cost approximately 650-700 rubles.
- Online pharmacies in Russia Russia
- Online pharmacies in Ukraine Ukraine
- Online pharmacies in Kazakhstan Kazakhstan
ZdravCity
Hepa-merz gran.sol. 3g/5g n10 Merz
Hepa-merz gran.sol. 3g/5g n30Cloquet Pharma-Service/Merz Pharma
Hepa-merz conc.d/inf. 500mg/ml 10ml n10Maerz Pharma GmbH & Co.KGaA./B.Brown Melsungen AG
In this article you can read the instructions for use of the drug Hepa-Merz. Feedback from site visitors - consumers - is presented of this medicine, as well as the opinions of specialist doctors on the use of hepatoprotector Hepa-Merz in their practice. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Hepa-Merz analogues in the presence of existing structural analogues. Use for the treatment of liver diseases in adults, children, as well as during pregnancy and lactation. Composition of the drug.
Hepa-Merz- hypoammonemic drug. Has a detoxifying effect, reducing increased level ammonia in the body, in particular in liver diseases. The effect of the drug is associated with its participation in the ornithine Krebs urea cycle (activates the cycle, restoring the activity of liver cell enzymes: ornithine carbamoyltransferase and carbamoyl phosphate synthetase). Promotes insulin production and growth hormone. Improves protein metabolism in diseases that require parenteral nutrition. Helps reduce asthenic, dyspeptic and pain syndromes, as well as normalization of increased body weight (with steatosis and steatohepatitis).
Compound
L-ornithine L-aspartate + excipients.
Pharmacokinetics
Ornithine aspartate dissociates into its constituent components - the amino acids ornithine and aspartate, which are absorbed into small intestine by active transport through the intestinal epithelium. It is excreted in urine through the urea cycle.
Indications
- spicy and chronic diseases liver, accompanied by hyperammonemia;
- hepatic encephalopathy (latent or severe), incl. as part of complex therapy for disorders of consciousness (precoma and coma);
- steatosis and steatohepatitis (of various origins);
- as a corrective additive to preparations for parenteral nutrition in patients with protein deficiency.
Release forms
Granules for the preparation of a solution for oral administration 3 g (sometimes mistakenly called tablets or granules).
Concentrate for the preparation of a solution for infusion (injections in injection ampoules) (sometimes mistakenly called powder).
Instructions for use and usage diagram
Granules
The drug is prescribed orally, 1-2 sachets of granules dissolved in 200 ml of liquid, 3 times a day, after meals. The course of treatment ranges from 10 to 30 days and depends on the severity of the disease.
Ampoules
Up to 40 ml (4 ampoules) per day is administered intravenously, dissolving the contents of the ampoules in 500 ml of infusion solution.
For hepatic encephalopathy (depending on the severity of the condition), up to 80 ml (8 ampoules) per day is administered intravenously.
The duration of infusion, frequency and duration of treatment are determined individually. Maximum speed infusion - 5 g/hour.
Side effect
- nausea, vomiting;
- abdominal pain;
- flatulence;
- diarrhea;
- pain in the limbs;
- allergic reactions.
Contraindications
- severe renal failure (serum creatinine more than 3 mg/1 dl);
- lactation period (breastfeeding);
- children's age (due to insufficient data);
- hypersensitivity to the components of the drug.
Use during pregnancy and breastfeeding
The drug should be used with caution during pregnancy.
The drug is contraindicated for use during breastfeeding.
special instructions
If nausea or vomiting occurs, the rate of administration of the drug should be reduced.
Impact on the ability to drive vehicles and operate machinery
In case of hepatic encephalopathy, care must be taken when driving vehicles and engaging in other potentially dangerous species activities that require increased concentration and speed of psychomotor reactions.
Drug interactions
Drug interactions with Hepa-Merz have not been described.
Analogues of the drug Hepa-Merz
Structural analogues according to active substance:
- Ornitsethyl.
Analogues pharmacological group(hepatoprotectors):
- L-Methionine;
- S-Adenosylmethionine;
- Antraliv;
- Berlition;
- Bonjigar;
- Brenziale forte;
- Vitanorm;
- Gepabene;
- Hepatosan;
- Hepatofalk planta;
- Hepaphor;
- Heptor;
- Heptral;
- Geptrong;
- Glutargin;
- Glutargin alkocline;
- Dipana;
- Cawehol;
- Karsil;
- Karsil Forte;
- Kedrostat;
- Cryomelt MN;
- L-ornithine-L-aspartate;
- Laennec;
- Legalon;
- Liv 52;
- Livodex;
- Livolife Forte;
- Lipoic acid;
- Lipoid;
- Maxar;
- Methionine;
- Metro;
- Mylife;
- Molixan;
- Octolipen;
- Prohepar;
- Result Pro;
- Ropren;
- Sibektan;
- Silegon;
- Silibinin;
- Silimar;
- Silymarin;
- Sirepar;
- Thiolipon;
- Thiotriazolin;
- Tykveol;
- Urdoxa;
- Urso 100;
- Ursodez;
- Ursodeoxycholic acid;
- Ursodex;
- Ursolive;
- Ursor;
- Ursosan;
- Ursofalk;
- Phosphogliv;
- Phosphogliv forte;
- Phosphonciale;
- Hepabos;
- Choludexan;
- Exhol;
- Erbisol;
- Eslidin;
- Essentiale N;
- Essentiale forte N;
- Essential phospholipids;
- Essliver;
- Essliver forte.
If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.
Registration number in the Russian Federation P N015093/02 dated 03/22/2007
Tradename Hepa-Merz
International nonproprietary name
Dosage form
concentrate for the preparation of solution for infusion
Compound
1 ampoule contains 5g L- ornithine-L aspartate, water for injection up to 10 ml.
Description
Transparent solution of light yellow color.
Pharmacotherapeutic group
Hypoazotemic agent ATX code: A05BA
Pharmacological properties
Reduces elevated levels of ammonia in the body, in particular in liver diseases. The effect of the drug is associated with its participation in the ornithine Krebs urea cycle (the formation of urea from
ammonia). Promotes the production of insulin and growth hormone. Improves protein metabolism in diseases requiring parenteral nutrition. Pharmacokinetics: Excreted by the kidneys.
Indications for use
Acute and chronic liver diseases accompanied by hyperammonemia. Hepatic encephalopathy incl. as part of complex therapy for disorders of consciousness (precoma and coma).
As a corrective additive to parenteral nutrition preparations in patients with protein deficiency.
Contraindications
Severe renal failure with a creatinine level of more than 3 mg/100 ml. Hypersensitivity to the components of the drug, lactation period. With caution - pregnancy.
Directions for use and doses
Up to 4 ampoules per day are administered intravenously, dissolving the contents of the ampoules in 500 ml of infusion solution. For hepatic encephalopathy, depending on the severity of the condition, up to 8 ampoules per day are administered. The duration of infusion, frequency and duration of treatment are determined individually. The maximum rate of intravenous administration is 5 g per hour. Do not dissolve more than 6 ampoules in 500 ml of infusion solution!
Side effect
Allergic reactions, in some cases nausea and vomiting are possible.
Overdose
Symptoms: increased severity of side effects.
Interaction with other drugs
Not described
special instructions
When diagnosing hepatic encephalopathy due to the underlying disease, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.
If nausea or vomiting occurs, the rate of administration should be reduced.
Release form
Concentrate for solution for infusion, 500 mg/ml, 10 ml in dark glass ampoules type I, DAB 10 with two color marking rings and
white dot. 10 ampoules each (2 plastic pallets of 5 ampoules each) with instructions for use in a cardboard box.
Best before date
3 years. Do not use after expiration date.
Storage conditions
At a temperature not higher than 25 °C. Keep out of the reach of children.
Conditions for dispensing from pharmacies
On prescription.
Manufacturing company
Merz Pharma GmbH & Co. KGaA"
D-60318, Germany,
Frankfurt am Main
Send claims to
Address: Merz Pharma LLC
123242, Moscow,
lane Kapranova, d.Z, p. 2
An effective remedy for the treatment of liver diseases is medicinal product"Hepa-Merz". This medication belongs to the group of hepatoprotectors that have a positive effect on liver cells and the body as a whole. However, like any drug, the described medication has a number of contraindications that should be taken into account before undergoing a therapeutic course to cure liver diseases with Hepa-Merz.
"Hepa-Merz" - synthetic drug for the treatment of liver diseases.
Composition of the medicine
For liver therapy, the medication “Hepa-Merz” is prescribed, containing the following components:
- ornithine aspartate;
- orange or lemon flavoring;
- dye E110;
- sodium cyclamate;
- saccharin;
- purified water;
- levulose;
- polyvinylpyrrolidone.
Release form
Available in granular form. Packaged in packs of 30 sachets, each of which contains 5 g of product. The granules are colored white and orange. It has another form of release - a concentrate from which it is prepared infusion solution. The concentrate is in 10 ml ampoules, which are made of brown glass. The cardboard package contains 10 pieces.
Hepa-Merz has a cleansing and protective effect on liver cells. pharmachologic effect
This medication has cleansing, protective and positive effects on the liver. The two amino acids present in the composition (aspartate and ornithine) convert ammonia into glutamine and urea. In addition, the described drug activates the ornithine cycle of urea production and thereby takes part in lowering ammonia levels. Secondary, but no less important properties of Hepa-Merz are the processes of optimizing protein metabolism and participation in the production of insulin and growth hormone. The components of the drug are excreted primarily by the kidneys and their half-life will require an average of 40 minutes.
When is it appointed?
The medicine "Hepa-Merz" is indicated for hepatitis, cirrhosis of the liver, alcoholic liver disease, hyperammonemia, eating large quantity food, liver failure and encephalopathy. It is worth considering that the medication is prescribed for hepatitis of any origin, including toxic, as well as for various other liver ailments. Only a doctor should prescribe medication. Self-medication increases the risk of developing serious complications and side effects.
How does Hepa-Merz affect the liver?
Mainly, Hepa-Merz promotes the removal of toxins from hepatocytes. Medical drug has a positive effect on liver cells. Active components"Hepa-Merza" can reduce toxicity of the organ. To improve the results of therapy for hepatic encephalopathy, the drug is combined with silymarin. This complex treatment can normalize oxidative lipid metabolism with preservation of liver cell membranes against the background of a massive antitoxic effect. In addition, the process of restoration of affected tissues is enhanced.
According to the results clinical trials The drug was found to increase protein biosynthesis in muscles in patients with gradually dying liver tissue. Based on this, the medicine has fully justified itself in various chronic diseases liver, protein deficiency, exhaustion and chronic infections. Thus, Hepa-Merz has anabolic, membrane-stabilizing, antioxidant and nutritional effects.
The drug “Hepa-Merz” is also used to prevent liver diseases. However, the preventive effectiveness of the described medication will be maximum if the diet is followed. It is necessary to reduce the toxic load on the liver, which cannot cope with large amounts of harmful substances, accumulated in the body. The medication for prevention should also be prescribed by a specialist.
Instructions
"Hepa-Merz" is taken no more than a couple of packs per day, for no more than 3 weeks. The instructions for the drug indicate the following dosage for using granules:
- Dissolve the medicine in a glass of filtered water at room temperature;
- the dose per day is 1-2 sachets, which should be divided into 3 doses;
- take after a meal, but no later than 20 minutes after a meal;
- the maximum duration of the therapeutic course is 20 days;
- If necessary, a repeat course must be maintained at an interval of 2-3 months.
The release form of the drug for treating the liver allows it to be used in the form of injections. Ampoules of the drug are dissolved in 0.5 l saline solution, glucose and Ringer's solution, maintaining the maximum daily dose- 8 ampoules. Administer the medication intravenously at a rate of no more than 5 g/hour. Treatment must be continued for an average of 21 days. Repeat the therapeutic course after 2 months.
Treatment during pregnancy and lactation
If it is necessary to treat liver diseases during pregnancy, you should first consult a doctor about the safety of taking the drug Hepa-Merz. The drug is not an absolutely contraindicated drug, but it must be taken exclusively under the supervision of a specialist. As for breastfeeding, it is not recommended to take Hepa-Merz medication during this period.
Drug interactions
"Hepa-Merz" is not combined with benzodiazepines and antibacterial agents. The described drug is incompatible with the following medications:
- "Diazepam";
- "Rifampicin";
- "Sodium thiopental";
- "Vincamine";
- "Meprobamate"
- vitamin K;
- "Ethionamide";
- antibacterial agents of the penicillin series.
Contraindications and side effects
It is not recommended to use the described medication when breastfeeding, hypersensitivity to the components of the drug, children under 16 years of age, as well as severe liver failure. If these contraindications are not observed, the patient faces the following undesirable manifestations:
- painful sensations in the abdomen;
- diarrhea;
- increased gas formation in the intestines;
- nausea;
- gagging;
- joint pain;
- allergic manifestations.
special instructions
A long course with Hepa-Merz can cause caries and affect the speed of thinking reactions. The described medication has some features that should be taken into account before treating liver diseases with it. At intravenous administration When using the Hepa-Merz medication in high doses, it is necessary to monitor the level of urea in the urine and blood. If liver dysfunction is pronounced, then the rate of administration of the solution should be reduced. This will prevent nausea or vomiting. It is important to consider that Hepa-Merz infusion solution is contraindicated for injection into an artery. In addition, it contains fructose, which is undesirable when diabetes mellitus, and is also contraindicated in patients with intolerance to this substance.
Long-term use of the medicine has a negative effect on the condition of the teeth - it provokes caries. In addition, the effect of the drug on the patient’s ability to drive vehicles and other machinery should be taken into account. If the dosage is neglected, increased side effects may occur. In case of overdose, symptomatic therapy is necessary.
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