Ophintine Aspartate dissociates to the components of the orninitin components and aspartate, which are absorbed in the small intestine by active transport through intestinal epithelium. Both amino acids have a short half-life of 0.3-0.4 hours. It is displayed with urine through the urine cycle.

Pharmacodynamics

In vivo The effect of L-ornithine-L-aspartate is carried out through two key methods of deoxication of ammonia: the synthesis of urea and synthesis of glutamine by means of amino acids - ornithine and aspartate.

The synthesis of urea occurs in the aircraft hepatocytes, where the ornithine acts as an activator of two enzymes: ornithinecarbamoyltransferase and carbamoylphosfatsenthase, as well as a substrate for urea synthesis.

The synthesis of glutamine occurs in the columnsic hepatocytes. With pathological conditions, aspartate and other dicarboxylates, including ornithine metabolic products, are absorbed in cells and are used there in the form of glutamine to bind ammonia.

Glutamate serves as an amino acid binding ammonia both in physiological and pathological conditions. The resulting amino acid glutamine is not only a non-toxic form for the removal of ammonia, but also activates the important cycle of urea formation (intracellular glutamine exchange).

In physiological conditions, ornithine and aspartate do not oppress the synthesis of urea.

The drug reduces the elevated level of ammonia in the body, in particular, with diseases of the liver. The effect of the drug is associated with its participation in the orthernity cycle of Krebs (the formation of urea from ammonia). Promotes insulin production and somatotropic hormone. Improves protein exchange for diseases requiring parenteral nutrition.

Hep-Merz is a German original hepatoprotector used to treat sharp and chronic liver pathologies, as well as hepatic encephalopathy.

Over the past few decades, the incidence curve of hepatic pathologies strongly rushed upwards. It cannot be said that modern medicine sits at the same time, folded: a thorough study of the mechanisms of liver lesions of viral, alcohol and autoimmune etiology made it possible to significantly move into their diagnosis and treatment. Nevertheless, liver disease continue to remain one of the main reasons for the acquisition of disability, disability of the population and mortality. The preparation of Hep-Merz includes two active amino acids: diaminicarian (ornithine) and asparty (aspartate), determining the pharmacological properties of this drug. Most often, Hep-Merz is prescribed with hepatic encephalopathy, which complicates the flow of liver diseases (as a rule - cirrhosis) and worsens their forecast. As is known, the 5-year survival rate of patients with liver cirrhosis, complicated by hepatic encephalopathy, is only 25%. The main factor in the development of hepatic encephalopathy is a high level of ammonia blood, which has a direct impact on the central nervous system and potentiates a number of other negative factors. The high level of ammonia is established due to the impairment of the balance between its formation and disposal. Ammonia is formed in the body as a result of removal of amino groups from amino acid molecules, urea decay and other nitrogen compounds in the thick intestine. The utilization of ammonia occurs, for the most part, in the reactions of the Krebs-Henzel cycle (so-called ornithine cycle) in the liver and through the synthesis of glutamine in the liver and muscles. Liver diseases largely limit its capabilities in ammonia neutralization.

In this regard, her duties have to take the muscles. The use of the preparation of Hep-Merz leads to the activation of enzymes involved in the utilization of ammonia in the liver and muscles, an increase in protein resistance, which allows the patient to keep the patient a normal power mode and prevent muscle loss. In addition, Hep-Merz contributes to the normalization of the protein biosynthesis process in the liver. As is known, to perform the liver of its protein-synthetic function, it needs amino acids and nucleic acids. Hep-Merz increases the contents and other plus stimulates the protein biosynthesis itself. As shown by clinical tests of the drug, it increases the protein synthesis in the muscles of patients suffering from cirrhosis of the liver. Therefore, the purpose of Hep-Merz is justified with any all hypercatabolic states, incl. chronic liver diseases, protein deficiency of any etiology, exhaustion, chronic infections. In addition, ornithine and aspartate are a substrate for the Krebs-Henzel cycle, during which ammonia neutralizes. This cycle is associated with a cycle of tricarboxylic acids (the alternative name is the Krebs cycle, only without a hatzel), which is the main energy supplier in the human body.

Thus, hepa-Merz has a versatile pharmacological effect: improves the portability of the protein, has an anabolic effect, nourishes the cells by energy, and aspartate, which is included in its composition, in addition to all other things, the permeability of the magnesium cell membrane, thereby turning the membrane-stabilizing, and therefore antioxidant act. The latter is especially important for patients with chronic liver disease alcoholic etiology.

Pharmacology

Hypoammonemic drug. Reduces an elevated ammonia level in the body, in particular, with liver diseases. The effect of the drug is associated with its participation in the ornithine cycle of the urea formation of Krebs (urea formation from ammonia).

Promotes insulin production and somatotropic hormone. Improves protein exchange for diseases requiring parenteral nutrition.

Pharmacokinetics

Ornithine Aspartate dissociates the components of the components - the amino acids of ornithine and aspartate, which are absorbed in the small intestine by active transport through intestinal epithelium. It is displayed with urine through the urine cycle.

Form release

Granules for the preparation of a solution for intakes in the form of a mixture of orange and white granules.

	1 pack. (5 g)
L-Ornithine L-Aspartate	3 g

Auxiliary substances: anhydrous lemon acid, aroma lemon, flavoring orange, sodium saccharinate (saccharin sodium), sodium cyclamat, dye Sunny sunset yellow, polyvinylpyrrolidone (pose), fructose (lewleza).

5 g - bags (10) - cardboard boxes.
5 g - bags (30) - cardboard boxes.

Dosage

The drug is prescribed inside 1 sachet of granules dissolved in 200 ml of liquid, 2-3 times / day after meals.

Overdose

Symptoms: Strengthening the severity of side effects.

Treatment: washing the stomach, receiving activated carbon, conduct symptomatic therapy.

Interaction

Medicinal interaction of the drug Hep-Merz is not described.

Side effects

From the digestive system: in some cases - nausea, vomiting.

Others: Allergic reactions.

Indications

acute and chronic liver diseases accompanied by hypertronmiamia;
hepatic encephalopathy (latent or pronounced).

Contraindications

renal failure of severe (serum creatinine\u003e 3 mg / 100 ml);
lactation period (breastfeeding);
increased sensitivity to the components of the drug.

Caution should be prescribed a drug during pregnancy.

Features of application

Application in pregnancy and breastfeeding

The drug should be used with caution during pregnancy.

The drug is contraindicated to use during breastfeeding period.

Application with violations of liver function

The drug is applied by testimony.

Application with violations of the kidney function

The drug is contraindicated in renal failure, severe degree (creatinine indicator 3 mg / 100 ml).

special instructions

Impact on the ability to driving vehicles and control mechanisms

In case of hepatic encephalopathy, care must be taken when driving vehicles and the occupation of other potentially hazardous activities that require increased concentrations and speed of psychomotor reactions.

Granules for the preparation of the solution for intake - 5 g:

active substance: L-ovinitine-L-aspartate - 3 g
auxiliary substances: lemon anhydrous acid - 0.55 g; Aromatizer lemon - 0.02 g; Orange flavoring - 0.2 g; Sodium Sacharinat (Sakharin Sodium) - 0.0045 g; Sodium cyclamat - 0.0405 g; Dye "Sunny Sunset" Yellow - 0.0005 g; Polyvinylpyrrolidone (Pisidone) - 0.05 g; fructose (levulose) - 1,1345 g

Granules for the preparation of a solution for intake, 3 g. 10 or 30 packs. (5 g) The granules for the preparation of a solution for receiving inside containing 3 g of L-ornithine-L-aspartate are packaged in a cardboard box.

Description of the dosage form

Granules for the preparation of a solution for intake: a mixture of orange and white granules.

pharmachologic effect

Pharmacological action - hepatoprotective.

Pharmacokinetics

L-Ornithine-L-Aspartate quickly dissociates to ornithine and aspartate and begins to operate for 15-25 minutes, having a short T1 / 2. It is displayed with urine through the urine cycle.

Pharmacodynamics

It has a detoxification effect, reducing the elevated level of ammonia in the body, in particular with the diseases of the liver. The effect of the drug is associated with its participation in the ornithin cycle of Krebs urea formation (activates the operation of the cycle, restoring the activity of liver cell enzymes: ornithine carbamoyltransferase and carbamoyl phosphatetase). Promotes insulin production and somatotropic hormone.

Improves protein exchange for diseases requiring parenteral nutrition.

It helps to reduce asthenic, dyspeptic and pain syndromes, as well as normalization of increased body weight (with steatosis and steatohepatite).

Indications for the use of Hep-Merz

acute and chronic liver diseases accompanied by hypertronmiamia;
hepatic encephalopathy (latent and pronounced);
steatosa and steatohypatitis (different origin).

Contraindications for the use of Hep-Merz

hypersensitivity to the components of the drug;
pronounced renal failure with creatinine indicator more than 3 mg / 100 ml;
lactation period;
children's age (due to data failure).

With caution: pregnancy.

Medical Instructions

Drug

Hep-Merz.

Tradename

Hep-Merz.

International non-proprietary title

Dosage form

Concentrate for the preparation of the solution for infusion, 10ml

Structure

10 ml of concentrate contain

active substance- L-Ornithine-L-aspartate 5.00g,

auxiliary- water for injections

Description

Transparent solution from colorless to pale yellow

Pharmacotherapeutic group

Preparations for the treatment of liver disease and biliary tract. Preparations for the treatment of liver diseases.

ATH Code A05va

Pharmacological properties

Pharmacokinetics

Ophintine Aspartate has a short period of elimination - 0.3-0.4 hours.

It is displayed with urine through the urine cycle.

Pharmacodynamics

Reduces an elevated ammonia level in the body, in particular, with liver diseases. The effect of the drug is associated with its participation in the orthernity cycle of Krebs (the formation of urea from ammonia). Promotes insulin production and somatotropic hormone. Improves protein exchange for diseases requiring parenteral nutrition.

Indications for use

hepatic encephalopathy (latent and pronounced)

Method of application and dose

Intravenously administered up to 40 ml (4 ampules) per day, dissolving the contents of the ampoules in 500 ml of an infusion solution.

With the initial symptoms of the disturbance (prema) and darkening of consciousness (coma), depending on the severity of the state, up to 80 ml (8 ampoules) per day are introduced.

The duration of infusion, frequency and duration of treatment is determined individually.

The maximum rate of intravenous administration is 5 g per hour (corresponds to the contents of 1 ampoule).

Do not dissolve more than 60 ml (6 ampoules) in 500 ml of infusion solution!

An isotonic solution is used as an infusion solution, a solution of glucose or a ringer solution.

Side effects

Sometimes (≥1 / 1000,<1/100)

Nausea

Rarely (≥1 / 10000,<1/1000)

- Vomot

These side effects are transient and do not require the cancellation of the drug. During their occurrence, a dose and the rate of administration of the drug should be reduced.

Contraindications

Hypersensitivity to L-Ornithine-L-Aspartate

Renal failure with creatinine clearance of more than 3 mg / 100ml.

Medicinal interactions

Not installed

special instructions

At high doses of the concentrate for the preparation of infusion solutions of Hep-Merz, the level of urea in serum and urine should be monitored.

With a significant violation of the liver function, it is necessary to individually select the infusion rate in order to avoid nausea and vomiting.

Pediatrics

There are no reliable data of the use of the drug in children's practice.

Pregnancy and lactation

With caution to apply during pregnancy, taking into account the benefit / risk ratio for mother and fetus.

If it is necessary to appoint the drug during the lactation period, it is necessary to resolve the issue of cessation of breastfeeding.

Features of the influence of the drug on the ability to control the vehicle or potentially hazardous mechanisms.

Depending on the course of the disease, the ability to control the vehicle or potentially hazardous mechanisms may deteriorate.

Overdose

Symptoms: Strengthen side effects.

Treatment: symptomatic.

Release form and packaging

10 ml of the drug is placed in ampoules of brown with color marking rings and a white point. 5 ampoules are inserted into the plastic pallet. 2 pallet along with instructions for use in public and Russian are placed in a pack of cardboard.

Storage conditions

Store at a temperature not higher than 30 ° C, in the place protected from light.

Keep out of the reach of children!

Storage term

Do not use after the expiration date.

Conditions of vacation from pharmacies

On prescription

Manufacturer

Merz Pharma GmbH and Co. Kigaa

D- 60318, Frankfurt am Main, Germany

Tel: +49-69-1503-0, Fax: + 49-69-1503-200, e-mail: [Email Protected]

Owner of the registration certificate

MERC Pharma GmbH, Germany

The address of the organization hosting on the territory of the Republic of Kazakhstan complaints from consumers for product quality (product)

Representation of the company in RK Pharma Garant GmbH in RK

050002, Almaty, ul. Zhibek-Zholy 64, office 305

According to the World Health Organization (WHO), various liver diseases occur in 2 billion people and every year this figure increases. Beep fatty disease, viral, alcohol, medicinal hepatitismany people are familiar with many people.

The development of these diseases leads permanent action of adverse factors.

To prevent the transition of liver disease in more serious stages, it is necessary to start treatment in time.

Hep-Merz in granules is a hepatoprotector-denoxicant *, which can provide a versatile effect on the operation of the liver and metabolism, and apply for the treatment of various liver diseases, starting from the earliest stages.

Often with various diseases of the liver can increase the level of toxic ammonia 1. Increased ammonia level can manifest themselves with nonspecific symptoms - lethargy, sleep impairment, inability to focus, even some inhability. In this case, the detoxification of the entire body may be needed, since ammonia has a toxic effect primarily on the cells of the brain, and to other organs, including the liver itself.
As a detoxicant drug for therapy in this case, hepa-measurements can be recommended in granules. When taking a course, the drug binds and removes toxins, having a beneficial effect of both the liver cells and on the cells of the brain and the entire body as a whole.

1 Clinical perspectives of gastroenterology, hepatology, publishing house: Publishing House M-News (Moscow), ISSN: 2079-9667
*CM. Weaver, "L-Ornithine L-Aspartate as a universal hepatoprotector-detoxicant with playiotropic effects."
** Ivashkin V.T., Drapkina O.M., Maev I.V., Trukhmanov A.S., Blinov D.V., Kalgin L.K., Tsukanov V.V., Ushakova T.I.
"Prevalence of non-alcohol liver disease in patients of outpatient polyclinic practice in the Russian Federation: the results of the study of Direg 2."
*** Alekseenko S.A., Ageev E.A. "Experience in the use of oral form of L-ornithine-L-aspartate with hypertionmonimia in patients with chronic liver diseases on a dochydrotic stage."
**** S.G. Burkov, A.G. Harutyunov et al. The effectiveness of L-Ornithine-L-Aspartate granules in the treatment of non-alcoholic liver disease. Consilium Medicum Gastroenterology, 2010, №8: 3-6.