Heptral tablets and ampoules: instructions for use and reviews of people. Heptral in ampoules: instructions for use Heptral instructions for use of ampoules intravenously jet

The drug Heptral (injections), the instructions for the use of which should be carefully studied before using the medication, is interpreted as a means for the treatment and prevention of liver diseases. In addition, the drug is a strong antidepressant that helps to normalize the human psyche. Heptral injections and tablets have a wide spectrum of action. The drug is used for the treatment of diseases of internal organs and in psychiatry to prevent suicides and bring patients out of a state of deep depression. Depending on the stage and form of the disease, Heptral is used intramuscularly, intravenously or in tablets. The medicine has excellent compatibility with antibiotics and analgesics, which allows it to be used in complex therapy. The duration of the course of taking the medicine, its dosage and the form of administration into the body are determined by the attending physician. Self-medication is categorically contraindicated, since the side effects of the drug can be dangerous to health and are fraught with serious consequences.

The mechanism of action of the drug

The human body is constantly exposed to toxins from the inside and outside. This is facilitated by unfavorable environmental conditions, hazardous production, poor nutrition, alcohol abuse and smoking. Under the influence of toxins, the conductivity of the membranes of the cells of the liver tissue deteriorates. This leads to the accumulation of bile acid inside the cells, which destroys them, and then connective tissue grows in place of hepatocytes. This pathology, if not stopped, inevitably leads to cirrhosis of the liver and the appearance of malignant tumors.

After the introduction of heptral intravenously, a gradual restoration of the normal state of cell membranes occurs, and the transport of bile acids improves. Already on the second day of treatment, the process of formation and proliferation of connective tissue cells is suppressed. This leads to the relief of liver cirrhosis at any stage of the disease. The therapeutic effect is enhanced by relieving the patient's psychological stress, fear and anxiety for his health. By administering the medicine intravenously, the doctor achieves the desired result quickly and without complications.

It is also recommended to take Heptral to enhance the protective functions of the body. The active components of the drug, administered intravenously, penetrate the liver, prevent the penetration of free radicals, alcohol and elements of food additives into its tissues. The active components of the drug help to activate the process of regeneration of liver cells.

The dropper of this medication is used to remove alcohol victims from a state of severe intoxication. Intravenous in such cases, the drug is introduced gradually so as not to cause side effects associated with the onset of euphoria and a sharp increase in blood pressure.

Heptral has a high penetrating ability to cross the blood-brain barrier. The active component of the drug ademetionine from the bloodstream enters the brain cells directly. As a result, biochemical processes are restored, the state of neurons is normalized. Even in a small amount, Heptral improves the conduction of nerve impulses, activates the activity of the entire central nervous system. In a few days, the patient completely gets rid of depression.

Prescribing the drug

Heptral is indicated for the treatment of diseases that cause liver congestion. The medicine has excellent compatibility with natural cells of the digestive tract and vascular tissues of the circulatory system.

Ampoules and tablets are used for the prevention and treatment of such diseases:

fatty degeneration of the liver;

chronic and acute hepatitis;

liver damage with various toxins;

chronic cholecystitis without stone formation;

cholangitis;

cirrhosis of the liver;

intrahepatic cholestasis;

liver failure;

withdrawal syndrome.

Quite often, Heptral is used as a stand-alone medication in the treatment of depression. Unlike most antidepressants, this drug has good compatibility with almost any similar and unrelated medications.

Patients should be aware that Geptral and alcohol should not be consumed at the same time. This combination gives strong complications, regardless of how much alcohol was drunk and pills taken.

Application methods

Treatment with Heptral is prescribed after the doctor examines the patient's health and determines the compatibility of the drug with his body. The course of treatment can last from two weeks or more. In order for the effect on the damaged organ or central nervous system to begin faster, the drug is first introduced into the veins by drip. The contents of the ampoule are diluted only with distilled water to avoid liquid coagulation and the formation of a solid precipitate. When the drug is administered, the patient's condition is monitored for the timely detection of allergic reactions and side effects. Depending on the patient's weight and age, one or two injections are given per day.

Since the liquid is poorly absorbed into soft tissues, the patient is prescribed a concomitant course of vitamin B12 intake. It is recommended to give an injection in the part of the body with the thinnest skin. The shoulder and hip work best for this. If the drug is administered intravenously, the droplet falling speed should be minimal. Regardless of the patient's condition, it should not exceed 20 drops per minute.

After the patient's condition stabilizes, such a form as ampoules is no longer used. Instead of injections, pills are prescribed. The dose is calculated by the patient's weight. If there are no contraindications, then the daily dose is 6-12 mg per 1 kg of the patient's body weight. The average dose is 300-900 mg (1-2 units). Taking the pills should last at least 2 weeks. To achieve the best therapeutic effect, a course of treatment up to 2 months is recommended. Before starting therapy, the doctor explains to the patient how to take the pills, specifies what side effects Heptral can give, the procedure for taking them. In order for the medicine to be well absorbed, it must be drunk after a meal. The tablets should not be chewed or pre-crushed. They must be swallowed whole with plenty of water to prevent them from sticking to the esophagus.

Side effects

Heptral is a powerful medicine. In addition to the regenerative function, the drug can cause disturbances in the functioning of internal organs and the brain.

In the course of treatment, patients may experience the following side effects:

Indigestion... Patients experience abdominal pain, nausea, and dry mouth. Bloating, diarrhea, and vomiting are not uncommon.

Complications in the work of the brain... They are expressed in weakness and dizziness, severe headache and clouding of consciousness. Loss of coordination of movements and numbness of the limbs are possible.

Impaired motor function... There are pains in the joints and muscle tissue. Even at rest there are seizures.

Weakened immunity... This disorder manifests itself in the development of inflammatory processes in the urinary tract. The risk of cystitis, candidiasis and bladder grit is increased.

Skin lesions... Patients suffer from excessive sweating, spots and rashes appear on the skin. In the most severe cases, necrosis develops.

Common complications are a slight increase in body temperature, deterioration in well-being and decreased performance.

Contraindications for admission

Heptral and alcohol are incompatible concepts. With the regular use of alcoholic beverages, the active components of the drug are neutralized. The therapeutic effect is not achieved, but the disease continues to progress.

The medicine in the form of injections and tablets is contraindicated in the following cases:

Poor heredity, in particular, a violation of the methionine cycle, homocysteinuria or hyperhomocysteinemia.

Individual intolerance to the drug as a whole or to one of its components. It is detected at the stage of developing a course of treatment.

Low levels and poor absorption of vitamin B12 by the body.

Age under 18.

The first 2 trimesters of pregnancy.

Lactation period.

In the presence of such restrictions, the attending physician prescribes similar drugs to treat the liver or relieve depressive syndrome.

Drug release form

Geptral is manufactured in the United States at the Abbott pharmaceutical company. For each product, the manufacturer encloses detailed instructions with recommendations for the use of the medicine. However, it is allowed to use the medication for its intended purpose only after an examination and consultation with a specialist.

The basis of the drug is the synthetic substance ademetionine. To enhance its action and complex effect on diseased organs, substances of different spectrum of action are added to all dosage forms.

The medication contains the following auxiliary components:

colloidal silicon dioxide;

microcrystalline cellulose;

sodium carboxymethyl starch;

magnesium stearate;

methacrylic acid;

ethyl acrylate;

macrogol;

polysorbate;

simethicone;

sodium hydroxide;

distilled water.

Heptral tablets are available in the form of a volumetric oval. They are covered with a white hard shell, which dissolves under the influence of gastric juice. Each tablet contains 400 mg ademetionine. The tablets are packed in blisters containing 20 units. Blisters are packed in a cardboard box that does not allow light to pass through.

The injections are marketed as a set of powder vials and glass ampoules with a solvent. The powder is a pure synthetic ademetionine. The active ingredient weighs 400 mg. Ampoules contain purified water in which lysine and sodium hydroxide are dissolved. These substances are a stabilizer for the ready-to-use solution. Injections are delivered to pharmacies in cardboard boxes containing 5 vials and ampoules.

The medicine is sold freely without a doctor's prescription.

Storage conditions

Store the medicine in a tightly closed box. The temperature in the room or place of storage should not go beyond + 5… +25 ºС. Storage conditions should ensure that there is no access to it for animals, children and persons with mental disabilities. If there is a drinking person in the house, then the drug must be hidden so that it would be impossible to find it. In a state of severe intoxication, a person can use anything to maximize the feeling of euphoria.

The date of manufacture and shelf life of the medicine are indicated on the package. After the expiration date, the drug must be disposed of.

Active ingredient: ademetionine 1,4-butanedisulfonate 760 mg (corresponding to 400 mg ademetionine ion) in 1 ampoule

Release form

Lyophilisate in a colorless glass bottle. Solvent 5 ml in glass ampoules. 5 vials and 5 ampoules in a carton box.

pharmachologic effect

Ademetionine belongs to the group of hepatoprotectors, and also has antidepressant activity.

It has choleretic and cholekinetic effects, has detoxifying, regenerating, antioxidant, anti-fibrosing and neuroprotective properties.

Indication for use

• Intrahepatic cholestasis in pre-cirrhotic and cirrhotic conditions, which can be observed in the following diseases:
  • fatty degeneration of the liver;
  • chronic hepatitis;
  • toxic liver damage of various etiologies, including alcoholic, viral, medicinal (antibiotics; anticancer, anti-tuberculosis and antiviral drugs, tricyclic antidepressants, oral contraceptives);
  • chronic acalculous cholecystitis;
  • cholangitis;
  • cirrhosis of the liver;
  • encephalopathy, incl. associated with liver failure (alcoholic, etc.).
• Intrahepatic cholestasis in pregnant women.
• Depression symptoms.

Methods of administration and doses

Intravenous and intramuscular.

The lyophilisate must be dissolved in a specially supplied solvent immediately before administration. The rest of the drug must be disposed of.

The drug must not be mixed with alkaline solutions and solutions containing calcium ions.

If the lyophilisate has a color different from almost white to white with a yellowish tinge (due to a crack in the bottle or exposure to heat), the Heptral drug is not recommended to be used.

When administered intravenously, the drug Heptral is administered very slowly.

Therapy with Heptral can be started with intravenous or intramuscular administration, followed by the use of Heptral in the form of tablets or immediately with the use of Heptral in the form of tablets.

Contraindications

• Genetic disorders affecting the methionine cycle and / or causing homocystinuria and / or hyperhomocysteinemia (deficiency of cystathionine beta-synthase, impaired cyanocobalamin metabolism);
• hypersensitivity to any component of the drug;
• age up to 18 years (experience of medical use in children is limited)

special instructions

Given the tonic effect of the drug, it is not recommended to take it before bedtime.

When using the drug Heptral in patients with cirrhosis of the liver against the background of hyperazotemia, systematic monitoring of the nitrogen content in the blood is necessary. During long-term therapy, it is necessary to determine the content of urea and creatinine in the blood serum.

Patients with depression have an increased risk of suicide and other serious adverse events, therefore, during treatment with ademetionine, these 11 patients should be under constant medical supervision to assess and treat symptoms of depression. Patients should inform the doctor if their symptoms of depression do not diminish or worsen with ademetionine therapy.

There are also reports of a sudden onset or increase in anxiety in patients taking ademetionine. In most cases, withdrawal of therapy is not required; in several cases, the anxiety disappeared after dose reduction or drug withdrawal.

Since a deficiency of cyanocobalamin and folic acid can reduce the content of ademetionine in patients at risk (with anemia, liver disease, pregnancy or the likelihood of vitamin deficiency, due to other diseases or diet, for example, in vegetarians), the content of vitamins in the blood plasma should be monitored. If a deficiency is found, it is recommended to take cyanocobalamin and folic acid before starting treatment with ademetionine or concurrently with ademetionine. In immunological analysis, the use of ademetionine can lead to false determination of the indicator of high levels of homocysteine \u200b\u200bin the blood.

For patients taking ademetionine, it is recommended to use non-immunological assays to determine the level of homocysteine. One bottle of the drug Heptral lyophilisate for the preparation of a solution for intravenous and intramuscular administration, 400 mg / 5 ml contains 6.61 mg of sodium, which is equivalent to the amount of sodium in 16.8 mg of table salt and is 0.3% of the recommended maximum daily sodium intake for an adult.

Some patients may experience dizziness while taking Geptral. It is not recommended to drive a car and work with mechanisms while taking the drug until patients are sure that the therapy does not affect the ability to engage in this type of activity.

Storage conditions

In a dark place at a temperature of 15 ° C to 25 ° C. Keep out of the reach of children.

Antioxidant, cholekinetic, antidepressant, choleretic, hepatoprotective, detoxifying, neuroprotective drug is Heptral. Instructions for use recommends taking tablets, injections in 400 mg ampoules for intravenous and intramuscular injection for toxic liver damage, hepatitis, cirrhosis, encephalopathy.

Release form and composition

Heptral is sold in the form of tablets and lyophilisate.

The active ingredient ademetionine (INN) is a part of the tablets.

The dosage of ademetionine in one vial of lyophilisate is 400 mg. An ampoule with a solvent contains: L-lysine, Na hydroxide, water d / i.

pharmachologic effect

Heptral has choleretic (increases the amount of bile acids in bile), cholekinetic (promotes the secretion of bile into the intestine), regenerating, detoxifying (removes toxins from the body), antifibrinolytic (reduces the ability of blood to spontaneously dissolve blood clots), antioxidant, antidepressant and neuroprotective (eliminates disturbances in the nervous cells) properties.

The active component of the drug is ademetionine, which is a substance that is necessary for almost all tissues.

The use of Heptral allows not only to make up for the lack of ademetionine, but also to stimulate its production in the liver, spinal cord and brain, and other organs.

Ademetionine plays an important role in the metabolic processes of the body, participates in such important biochemical reactions as transmethylation, transsulfation, transamination, and increases the protective functions of liver cells.

Medicinal properties

The use of the drug allows you to normalize the production of bile acids, their entry into the biliary tract, as well as improve the motility of the digestive tract by eliminating the stagnation of bile in the liver cells. Hepatoprotective (cleansing and restoration of the liver) and choleretic effects of Heptral are observed for another 3 months after the end of the drug intake.

The level of ademetionine decreases with age, and the concentration of this substance is also below normal in people with depressive syndrome. The use of the agent allows you to increase the content of ademetionine in the body, in particular in the brain tissue, which helps to stabilize the transmission of nerve impulses and prolong the functioning of nerve cells.

Clinical studies and reviews of Heptral confirm the antidepressant effect of the drug, which develops quite quickly, and reaches its maximum efficiency on the 5-7th day of the drug use.

What does Heptral help from?

Indications for use of the medication include:

• encephalopathy, incl. associated with liver failure (including alcoholic);
• cirrhosis of the liver;
• depression (including secondary);
• chronic acalculous cholecystitis;
• withdrawal symptoms (including alcohol);
• chronic hepatitis;
• fatty degeneration of the liver;
• intrahepatic cholestasis;
• cholangitis;
• toxic liver damage of various etiologies (including alcoholic, viral, medicinal / antibiotics, antineoplastic agents, anti-tuberculosis and antiviral drugs, tricyclic antidepressants, oral contraceptives /).

Instructions for use

Heptral in ampoules

The lyophilisate is intended for the preparation of a solution that is administered to the patient intramuscularly and intravenously (very slowly). The optimal daily dose is 400-800 mg (1-2 vials) during the first 2-3 weeks of treatment.

Immediately before administration, the lyophilized powder is dissolved with the supplied L-lysine solution. The duration of therapy is set individually for each patient. This takes into account the severity and course of the disease.

How do I take the pills?

Designed for oral administration. The tablets should be drunk whole, with the required amount of liquid, between main meals (preferably in the morning). This requirement is associated with the ability of Geptral to cause nervous excitement. The recommended daily dose is 800-1600 mg (2-4 tablets). The course of maintenance treatment is prescribed by a doctor. On average, it lasts 2 to 8 weeks.

In elderly patients, treatment should be started with the minimum recommended dose, taking into account the presence of concomitant pathological conditions, decreased cardiac, renal or hepatic function and the use of other drugs.

Contraindications

• hypersensitivity to ademetionine and other constituent components;
• the patient's age up to 18 years;
• the period of bearing a child (in particular, I and II trimesters);
• lactation period;
• genetic disorders that cause hyperhomocysteinemia and / or homocystinuria (impaired metabolism of cyanocobalamin, lack of cystathione beta synthetase) and affecting the methionine cycle.

Side effects

In rare cases, you may experience:

• vomiting;
• headache;
• dyspepsia;
• dry mouth;
• insomnia;
• peripheral edema;
• weakness;
• superficial phlebitis;
• muscle cramps;
• confusion of consciousness;
• hepatic colic;
• chills;
• asthenia;
• hyperthermia;
• dizziness;
• flatulence;
• hyperhidrosis;
• rashes on the skin;
• hot flashes;
• esophagitis;
• arthralgia;
• gastrointestinal pain;
• bleeding from the digestive tract.

Children, during pregnancy and breastfeeding

Contraindicated in children and adolescents under the age of 18.

special instructions

Patients with depressive disorders need to be under close medical supervision. They also need constant psychiatric help when using ademetionine (in order to monitor the effectiveness of therapy).

Deficiency of folic acid and vitamin B12 can lead to a decrease in ademetionine concentrations. In this regard, their concomitant use in usual doses is recommended.

Drug interactions

No known drug interaction of the drug Heptral with other drugs was observed.

Analogues of the drug Heptral

Analogs are determined by structure:

1. Heptor N.
2. Ademetionine 1,4-butanedisulfonate.
3. S-adenosyl-L-methionine disulfate p-toluenesulfonate.
4. S-Adenosylmethionine.

Vacation conditions and price

The average price of Geptral (500 mg tablets No. 20) in Moscow is 2,031 rubles. In Kiev, you can buy a medicine for 1,460 hryvnia, in Kazakhstan - for 10,230 tenge. Pharmacies in Minsk offer tablets for 88 - 90 BYN. rubles. Dispensed from pharmacies with a prescription.

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is a drug from the group

hepatoprotectors

with antidepressant effect. The hepatoprotector has unique properties, such as the ability to improve the outflow of bile, normalize and improve the functioning of the liver, reduce the degree of damage to its cells in chronic diseases (hepatitis, cirrhosis, etc.) and organ damage (poisoning

medicines

Poisons, alcohol, etc.), as well as prevent the degeneration of the liver into connective tissue. The last ability of Heptral - the ability to prevent the degeneration of the liver into connective tissue - is, in fact, the prevention of cirrhosis and fibrosis against the background of long-term chronic diseases. The moderate antidepressant effect of the drug is used in the treatment of mild psychological disorders.

Forms of release, varieties and composition of Heptral

Currently, there is only one type of drug on the pharmaceutical market - Heptral, which, in turn, is available in two dosage forms -

tablets

for oral administration and

lyophilisate

for the preparation of a solution for intravenous or intramuscular administration. However, there is also a dietary supplement with a similar name - HeptraLight, which is available only in tablets for oral administration. This dietary supplement should not be confused with a drug, despite the very similar names.

In everyday speech, almost no one names the dosage forms of the drug completely, preferring to use certain terms and phrases to designate each option, making it easy to recognize one or another form and type of medicine. So, Heptral tablets are designated by adding numbers to the word "Heptral", reflecting the dosage of the active substance, for example, "Heptral 400" or "Heptral 400 mg".

The following terms are used to designate a lyophilisate for the preparation of a solution for intramuscular and intravenous administration - "Heptral ampoules", "Heptral injections" and "Heptral injections." Such capacious terms allow you to quickly understand what is meant by all participants in the conversation - both pharmacists and doctors , and patients.

The composition of all varieties and dosage forms of Heptral as an active substance includes ademetionine in different dosages. So, Heptral tablets contain 400 mg of ademetionine. The lyophilisate contains 400 mg of active substance per bottle.

Heptral tablets contain the following excipients:

Colloidal silicon dioxide; Microcrystalline cellulose; Sodium carboxymethyl starch; Magnesium stearate; Copolymer of methacrylic acid and ethyl acrylate; Macrogol 6000; Polysorbate; Simethicone; Sodium hydroxide; Talc; Water. The lyophilisate powder does not contain any auxiliary components. However, the solvent for the lyophilisate contains, in addition to deionized water, lysine and sodium hydroxide, which are necessary to stabilize the finished solution.

Heptral tablets have an oval, biconvex shape, enteric coated pure white or white-yellowish color and are available in packs of 20 pieces.

Lyophilisate Heptral is a white or white-yellowish powder without any impurities, poured into glass vials. The vials with lyophilizate are accompanied by sealed ampoules with a solvent, which is a transparent liquid of colorless or light yellow color. The ready-to-use solution obtained by mixing the lyophilisate with a solvent is transparent, colored in colorless or light yellow, without visible sediment or suspended particles. Heptral for injections is available in packs of 5 vials with lyophilisate, which are supplied with 5 ampoules with a solvent.

Therapeutic effects of Heptral

The therapeutic effects of Heptral are as follows:

Detoxifying action; Cholekinetic action; Choleretic action; Neuroprotective action; Hepatoprotective action; Antidepressant action; Antioxidant action. All of these therapeutic effects are provided by the properties of the active component of Heptral - ademetionine. This substance is normally produced and contained in all cells of the human body, but its greatest amounts are found in the brain and liver. That is why Heptral has the most pronounced therapeutic effects on the liver and brain.

The hepatoprotective effect is to increase the resistance of liver cells to various negative factors. Under the influence of Heptral, the liver cells become stronger and more resistant to any damage, as a result of which the functional activity and structure of the organ improve. In addition, the influence of the drug improves the process of growth and multiplication of liver cells, which replace dead cellular elements. The process of replacing dead cells with new, functionally active ones prevents the development of cirrhosis and liver fibrosis in chronic diseases (cholangitis, hepatitis, etc.).

Choleretic and cholekinetic action is to increase the production of bile with a simultaneous intensification of its outflow from the gallbladder into the duodenum. Due to the choleretic effect, bile does not stagnate in the liver and does not expand its ducts, which contributes to the better functioning of the organ and the prevention of chronic inflammatory process. In addition, the cholekinetic effect normalizes the outflow of bile from the gallbladder, which prevents and eliminates cholestasis, and also prolongs the duration of the remission period in cholecystitis. Choleretic and cholekinetic effects persist for at least three months after stopping the course of therapy.

The detoxifying effect is to reduce the production and neutralization of various toxic substances that have entered the body from the outside or synthesized by various organs and tissues. Heptral improves the functioning of the liver, which detoxifies toxic substances much faster and more intensively, which is what a detoxifying effect is achieved.

The neuroprotective effect of Heptral is to increase the resistance to negative factors of brain cells and nerve fibers. Thanks to this effect, even with severe poisoning and intoxication, the development of encephalopathy is prevented. In addition, Heptral stimulates the growth and reproduction of nerve cells, thereby replacing dead cellular elements and preventing fibrosis and hardening.

The antioxidant effect is to increase the resistance of all cells of the human body to the damaging action of free radicals.

The antidepressant effect develops from 6-7 days of treatment and reaches its maximum severity by the end of the second week of taking the drug. Heptral effectively relieves depression, not amenable to therapy with amitriptyline, and interrupts the recurrence of this disorder.

In osteoarthritis, the drug reduces the intensity of pain and improves the restoration of cartilage tissue. With cirrhosis and hepatitis, Heptral reduces the strength and intensity of itching, and also maintains the level of bilirubin, the activity of alkaline phosphatase, AST, ALAT, etc. within the normal range. In case of toxic damage to the liver (poisoning with poisons, drugs, taking drugs, etc.) Heptral reduces withdrawal symptoms ("withdrawal symptoms") and improves the functioning of the organ.

Heptral - indications for use

Heptral is indicated for use in diseases that cause stagnation of bile in the liver, such as:

Fatty liver disease; Chronic hepatitis; Toxic liver damage by various factors, such as alcohol, viruses, drugs (antibiotics, antineoplastic agents, antiviral and anti-tuberculosis drugs, tricyclic antidepressants, oral contraceptives); Chronic cholecystitis without liver stones; Cholangitis; Cirrus ; Intrahepatic cholestasis (stagnation of bile in the hepatic ducts) in pregnant women; Encephalopathy associated with liver failure; Withdrawal syndrome (alcoholic, narcotic); Depression.

Instructions for use

Consider the rules of application, dosage and treatment regimen with tablets and Heptral solution.

Heptral tablets - instructions for use

The tablets should be taken orally, swallowing whole, without chewing, biting or crushing in other ways, but with a small amount

The drug must be taken between meals, preferably in the morning, since Geptral has a tonic effect.

You should not take the tablets out of the blister in advance and transfer them to any box or jar, as this may negatively affect the properties of the drug. It is necessary to remove the tablets from the blister immediately before taking.

After the required number of tablets is removed from the blister, you should carefully look at them and evaluate the color. If the tablets are not white or white-yellowish, but painted in any other colors and shades, then they cannot be taken.

For various diseases, Heptral should be taken in a daily dosage of 800 - 1600 mg (2 - 4 tablets). Usually, the daily dosage is divided into 2 - 3 doses per day, the last of which is carried out up to a maximum of 18-00 hours. It is optimal to take Geptral twice a day - in the morning after waking up, and between lunch and dinner.

The duration of the course of therapy with Heptral is individual, and is determined by the doctor based on the rate of normalization of the condition. On average, the course of therapy lasts from 2 to 4 weeks. Re-treatment with Heptral can be performed at intervals of 1 - 2 months after the end of the previous course of therapy.

Instructions for the use of Heptral injections (in ampoules)

Packaging for injection contains vials of Heptral lyophilisate and ampoules with solvent. It is this supplied solvent that should be used to dilute the lyophilisate and obtain a solution ready for intramuscular or intravenous administration.

For various diseases and pathologies of the liver, Heptral is administered intramuscularly or intravenously at 400 - 800 mg per day (1 - 2 vials of lyophilisate) daily for two weeks. Then, if necessary, you can continue therapy by switching to taking Heptral in the form of tablets of 800 - 1600 mg (2 - 4 tablets) per day. The duration of taking tablets after Geptral injections should not exceed 4 weeks.

In case of depression, Heptral is also administered intravenously or intramuscularly at 400 - 800 mg (1 - 2 bottles) per day every day, for 15 - 20 days. After completing the course, you can continue taking Heptral in the form of tablets of 800 - 1600 mg (2 - 4 tablets) per day for another 2 - 4 weeks.

For the administration of the solution, intravenous injection is preferable compared to intramuscular injection, since the risk of complications is much lower.

The lyophilisate is always diluted with a solvent immediately before administration, and not beforehand. The prepared solution should be used immediately and should not be stored even for several hours. If after the injection any part of the drug remains, then it must be thrown away and not left until the next time.

Heptral should not be mixed in the same syringe or vial with solutions containing calcium ions. The drug is compatible with other solutions for infusion (for example, glucose, saline, etc.).

So, immediately before the injection, the lyophilisate should be diluted with a solvent from the ampoule. To do this, the end of the ampoule is filed and carefully broken off, after which the solvent is collected with a sterile syringe. Remove the aluminum cover of the soft cap from the vial with the lyophilisate. Then the needle of the syringe with the solvent collected in it is introduced into the vial with the lyophilisate, piercing the soft lid through and through. The solvent is carefully released into the vial, avoiding a sharp push of the piston so that the lyophilisate particles do not scatter along the walls. Then, to completely dissolve the lyophilisate, without removing the needle, gently swing the bottle from side to side, without turning it upside down.

When all the lyophilisate is dissolved, the finished solution should be free of impurities and suspended particles and painted in a white or white-yellowish color. If the solution contains particles or its color differs from white-yellowish, then the drug cannot be used, it should be discarded.

The finished solution, subject to its normal appearance, is drawn into a syringe, which is removed from the cork. Then the solution is injected with the same syringe intravenously or intramuscularly. You can add the solution from the syringe to the dropper and administer the drug as an intravenous infusion.

How to give Heptral intravenously (dropper)

For the jet injection of Heptral, immediately before the injection, the lyophilisate is diluted and drawn into a syringe. Then a thin needle is put on the syringe for intravenous injection. The syringe is held in an upright position with the needle up and tapped with a finger on the wall towards the needle holder so that all air bubbles accumulate in one place. Then the plunger of the syringe is pressed and a small amount of solution is released, which allows air to be removed to the outside.

Next, the skin in the area of \u200b\u200bthe injection is wiped with a swab moistened with an antiseptic, and the needle is carefully inserted into the vein. Then the solution is slowly injected from the syringe (the ampoule is injected for at least 2 - 3 minutes). After that, the needle is removed from the vein and the puncture site is again wiped with a swab moistened with an antiseptic.

For infusion administration, first the lyophilisate in a vial is diluted with a solvent from an ampoule. The finished Heptral solution is poured into the infusion solution. At the same time, the ratio is observed - one bottle of lyophilisate per 250 ml of infusion solution. As an infusion solution, physiological saline or 5% glucose is usually taken. The prepared infusion solution is installed in the system and 15-25 drops per minute are introduced.

How to inject Heptral intramuscularly

For intramuscular administration of Heptral, immediately before performing the manipulation, the lyophilisate should be diluted with a solvent. The prepared solution is drawn into a syringe, a relatively long and thick needle is attached to it, designed specifically for intramuscular injection. Care should be taken to ensure that there is no thin needle on the syringe for intravenous or subcutaneous administration of solutions, as they can slide off the holder and go deep into the soft tissues. Such needles trapped in the muscles can be in them for years, periodically causing pain attacks in a person.

After dialing the solution into the syringe, it is held vertically, with the needle up, and lightly tapped on the wall with a finger in the direction from the piston to the needle so that air bubbles gather in one place. Then the plunger is pressed, releasing some of the solution into the air, which removes all gas bubbles from the syringe.

A syringe prepared for the production of an injection is put on a sterile napkin or bandage. Then the injection site is wiped with a swab moistened with an antiseptic. It is optimal to inject into the lateral upper third of the thigh or the upper external third of the shoulder, since in these areas the muscles are close to the skin. The solution should not be injected into the buttock, as the muscles lie deep and there is a high risk of subcutaneous injection.

Having prepared the injection site, take the syringe again and insert the needle deep into the tissue vertically to the skin surface. Then slowly push down on the piston, releasing all the solution into the tissue. After the injection of the solution, the syringe is removed, and the injection site is again wiped with a swab moistened with an antiseptic.

To produce an injection, each time you should deviate from the previous one by at least 1 cm to minimize the risk of bruising and abscess.

special instructions

Elderly people (over 65 years of age) tolerate Heptral well, so they do not need to reduce the dosage. However, older people are advised to start taking Heptral with minimal dosages, gradually increasing them if necessary.

During treatment, a person may experience anxiety, which usually disappears after a decrease in the dosage of the drug. Such anxiety is not an indication for discontinuation of Heptral.

Since Geptral has a tonic effect, you should not enter or take the drug in the evening, shortly before going to bed.

When using Heptral for liver cirrhosis, the concentration of residual nitrogen, urea and creatinine in the blood should be periodically determined. Also, against the background of drug therapy, it is recommended to take B vitamins, especially B12 and folic acid, since Heptral is poorly absorbed with a lack of these vitamins.

The drug should not be used to relieve depression in people suffering from mania.

Influence on the ability to control mechanisms

Heptral can provoke

dizziness

Overdose

Cases of overdose with Geptral were not recorded during the entire observation period for the clinical use of the drug.

Interaction with other drugs

Confirmed and reliably established interaction of Heptral with other drugs has not been identified. However, there are data from individual observations about the appearance of an excess

serotonin

antidepressants

Selective serotonin reuptake inhibitors and drugs containing tryptophan.

Side effects of Heptral

Heptral tablets and injections can provoke the same side reactions, among which the most common are

nausea, stomach pain

In addition to them, Heptral in any dosage form can provoke the following side effects from various organs and systems:

1. The immune system:
Laryngeal edema; Allergic reactions (Quincke's edema, skin reactions, shortness of breath, bronchospasm, back pain, tachycardia, bradycardia, etc.). 2. Skin covering:
Rash; Itching; Sweating; Erythema; Irritation at the injection site. 3. Nervous system:
Dizziness; Headache; Paresthesia (feeling of running creeps, etc.); Feeling of anxiety and anxiety; Confusion of consciousness; Insomnia. 4. The cardiovascular system:
Hot flashes; Phlebitis of superficial veins. 5. Digestive tract:
Bloating; Abdominal pain; Diarrhea; Dry mouth; Esophagitis; Flatulence; Bleeding from the digestive tract; Nausea; Vomiting; Hepatic colic; Liver cirrhosis. 6. Musculoskeletal system:
Arthralgia (joint pain); Spasms in the muscles. 7. Others:
Asthenia; Chills; Flu-like syndrome; Malaise; Edema; Fever. 8. Infections

urinary tract.

Contraindications for use

Lyophilisate and Heptral tablets are contraindicated for use if a person has the following diseases or conditions:

Genetic disorders that cause disruption of the methionine cycle, homocysteinuria or hyperhomocysteinemia; Violation of vitamin B12 metabolism; Increased individual sensitivity to the components of the drug; Age under 18 years; I and II trimesters of pregnancy (up to the 27th week of gestation inclusive); Breastfeeding period.

Heptral - analogues

There are synonyms and analogues of Heptral on the pharmaceutical market. Synonyms are drugs that contain the same active substance as Heptral. Other drugs from the group of hepatoprotectors that contain other active substances, but have the most similar spectrum of therapeutic effects, are considered analogs.

Synonyms for Heptral

Heptor tablets and lyophilisate; Heptor H tablets. Analogues of Heptral are the following medications:
Brenziale forte capsules; VG-5 tablets; Hepa-Merz granules and concentrate for preparation of solution for injections; Hepatosan capsules; Hepaphor capsules; Heptrong solution for injection; Histidine solution for injection; Glutargin concentrate and solution for injection; Glutamic acid tablets and granules for preparation of a solution for oral administration; Dipana tablets; Potassium orotat tablets and granules for syrup preparation; Carnitene solution and tablets; Carnitine capsules, solution and concentrate; Carsil dragee; Carsil forte capsules; Cryomelt MN solution for subcutaneous administration; Laennec injection solution; Legalon 140 and Legolon 70 capsules; Liv 52 tablets and drops; Livolin Forte capsules; Lipostabil capsules and solution; Maxar tablets; Methionine tablets; Metrop GP injection solution; Peponen capsules; Prohepar capsules; Rezalut Pro capsules; Remaxol injection solution; Ropren drops ; Rosilimarin tablets; Silymarin sediko granules for suspension preparation; Thiotriazolin tablets and injection solution; Tykveol capsules, rectal suppositories ositoria and oil; Phosphatidylcholine capsules; Phosphogliv capsules; Fosfoncial capsules; Cholenol capsules; Elcar solution and tablets; Essel forte capsules; Essentiale, Essentiale N, Essentiale forte, Essentiale forte N capsules and injection; Essliver forte capsules.

What is better than Heptral?

In medical practice, there is no concept of "best" in relation to various drugs. Practitioners prefer to use the term "optimal", which means a drug that suits a particular person in the current situation in the best way. That is, for different people, depending on individual characteristics, for the same pathology, different drugs will be optimal. Moreover, for the same person suffering from a chronic disease, different drugs may be optimal at different stages of life. It is the drug that is optimally suitable for a particular person in a given situation that will be the best for him.

Thus, it is impossible to single out any best drug that would be consistently and equally effective for different diseases in different people. And in each situation, one or another drug may be the best. Therefore, it is not possible to single out a number of drugs that would be "better" Heptral.

When choosing between Heptral and other hepatoprotectors, you should focus only on your own feelings. If Heptral is subjectively better suited and tolerated by someone, then it should be considered the "best" drug. If the same person at another moment of time is more suitable, for example, Essentiale, then this particular drug will be the "best", etc.

If we compare Heptral with synonyms that also contain ademetionine as an active substance, then at the present time on the pharmaceutical market of the CIS countries all the drugs presented are worse than Heptral, since they often cause side effects and are more difficult to tolerate. From this position, there is nothing better than Heptral.

Reviews

Most of the reviews about Geptral (from 80 to 90%) are positive, to some extent even enthusiastic, due to the visible clinical effects of the drug. People note that the course of Heptral therapy significantly improved overall health, led to normal biochemical

blood test

(AsAT, ALT, alkaline phosphatase, etc.), and also healed some problems associated with liver damage, such as

pimples

plaque on the tongue

and dyspeptic symptoms (

belching heartburn

Bloating

flatulence

The disadvantages of the drug include its high cost, which, however, according to people, is justified, since Geptral really effectively restores the normal functioning of the liver. Many people who have tried various hepatoprotectors consider Heptral one of the best medicines.

There are few negative reviews about Heptral, and they are due to the development of any side effects that were difficult for people to tolerate and required discontinuation of the drug. In reviews, people indicated that they developed swelling, absent-mindedness, flu-like symptoms, and severe headache. These side effects were so strong and difficult to tolerate that people were forced to stop taking Geptral. This situation quite naturally caused disappointment and irritation in people, which became the emotional basis for writing a negative review. However, when deciding to start therapy with Heptral, it should be borne in mind that such a reaction of the body is quite possible, and during its development it is not necessary to perceive this fact emotionally so as not to increase the already strong enough tension.

Heptral - reviews of doctors

The doctors' comments about Heptral in most cases are positive, since this drug is one of the most effective and effective hepatoprotectors on the pharmaceutical market. Heptral has an excellent and pronounced effect on the liver, relatively quickly normalizing its functioning and eliminating the phenomena that, with long-term existence, cause fibrosis and cirrhosis. That is, in the opinion of practicing hepatologists and gastroenterologists, Heptral is an effective drug for maintaining liver functions and preventing cirrhosis for many years (sometimes several dozen).

However, among doctors there are adherents of Heptral and supporters of its careful use, who believe that the drug has a very powerful effect, which is not always necessary for a person with liver diseases. Adherents of Heptral believe that the drug can be used for any liver damage, since the clinical effect occurs in almost 100% of cases.

And supporters of the careful use of Heptral believe that the drug should be used only in case of severe liver dysfunction and under constant monitoring of blood tests (ASAT, ALT, urea and creatinine). If a person has relatively mild liver damage, then a very powerful Heptral should not be used, it is better to replace it with another hepatoprotector with a milder effect, for example, Essentiale, Phosphogliv, Ursosan, etc.

Heptor or Heptral?

Heptor and Heptral are synonymous drugs, since they contain the same active substances. However, Heptral is the original Italian-made drug, and Heptor is its Russian

generic

Unfortunately, in terms of effectiveness, severity of therapeutic action, speed of normalization of the condition and frequency of side effects, Geptral is much superior to the Russian Heptor. This means that Heptral is more effective than Heptor and causes fewer side effects.

Therefore, when choosing between Heptral and Heptor, it is recommended to prefer the first drug. However, Heptral is much more expensive than Heptor, therefore, it can be taken, especially with long courses, only if there is a sufficient reserve of funds. If Heptral is financially unavailable, then it is quite possible to replace it with Heptor.

Many people who have experience with both drugs claim that they did not feel any difference between the effectiveness and severity of the side effects of Heptral and Heptor. Therefore, you can try to take both drugs, and if the difference is not felt, then stop the final choice on Heptor, which will be much cheaper than Heptral.

Essentiale or Heptral?

Essentiale and Heptral are hepatoprotectors, but contain different active substances. Both drugs protect the liver from the negative effects of various factors, and also help maintain its normal functioning in chronic diseases. But Essentiale has only a hepatoprotective effect, and Heptral also has a choleretic and antidepressant effect. Therefore, in the presence of stagnation of bile or diseases of the gallbladder, it is recommended to choose Heptral.

With hepatitis C, in order to maintain normal liver function and prevent cirrhosis, it is recommended to take Heptral, and not Essentiale, before starting antiviral therapy. This is due to the fact that Geptral in this clinical situation is more effective, since it normalizes liver function and the activity of AST and ALAT faster and more powerfully.

In other cases, Geptral and Essentiale have approximately the same therapeutic effects, so you can choose and use any drug that you like more for any subjective reasons. However, you should always remember that each person is individual, and therefore Heptral is perfect for someone, and Essentiale for another.

More about Essentiale

Heptral (tablets and ampoules) - price

Heptral is produced in Europe or the USA, and is imported to the countries of the former USSR, so the differences in its cost are not due to reasons reflecting the quality of the drug. This means that there is no difference in the quality of drugs sold at higher and lower prices. Therefore, you can purchase the drug at the lowest price offered.

Currently, the cost of Heptral tablets and ampoules in the domestic pharmaceutical market varies within the following limits:

Heptral tablets 400 mg, 20 pieces –1618 - 1786 rubles; Heptral lyophilisate, 400 mg per vial, packaging of 5 vials and 5 ampoules with a solvent - 1572 - 1808 rubles.

One ampoule of Heptral contains five milliliters of the drug. To date, this pharmaceutical agent has managed to find its widespread use in medicine, and all because it tends to restore metabolism in the region in a fairly short period of time.

Regenerate tissues and have a beneficial effect on cells

brain

The list of pathologies in the fight against which you can use the help of this drug is huge. So, for example, they turn to him for help with fat

dystrophies

liver, cholestasis,

liver cirrhosis

Cholangitis, chronic and viral

intoxication

alcoholic beverages, drugs, pharmaceuticals, food.

I would like to draw the readers' attention to the fact that, despite the fact that this medication is considered one of the least dangerous, in some cases it tends to cause the development of certain side effects. So, for example, against the background of its use, heartburn or an allergic reaction can make itself felt. Heptral can also cause very excruciating pain in the abdomen. Dyspeptic symptoms have also been noted in some patients, so they are also referred to as possible side effects of this drug. In general, you need to be extremely careful with Heptral. You should not use it without first consulting a specialist, so as not to aggravate the general state of affairs.

Osteoarthritis

it is considered to be a degenerative pathology of the joints, in which there is a constant progression of wear of the articular cartilage. This disease occurs due to the lack of balance between the synthesis and degradation of cartilaginous proteoglycans. In most cases, this ailment is observed in elderly people, but sometimes it also affects young people. In young people, this ailment can occur immediately for several reasons, namely because of congenital defects of the joints, as a result of injuries, or against the background of any chronic inflammatory pathology. As a rule, osteoarthritis affects the proximal and distal interphalangeal joints of the hands, knee joints, lumbar or cervical spine.

spine

or hip joints. Pain in the affected area is strong enough, which significantly interferes with the patient to lead his normal life.

In the fight against this pathology, a number of drugs are used, including hepatoprotectors. More recently, scientists have come to the conclusion that a drug such as Heptral should be used to treat this disease. The fact is that in the course of a study conducted by British scientists, it was possible to establish the fact that Heptral has a tendency to have a restorative effect on the affected areas. As a result, there is a significant improvement in the general condition of patients. Without a doubt, Heptral in such cases is used along with numerous other pharmaceuticals, but its therapeutic effect is not superfluous.

For the first time, the etiology of viral

hepatitis

began to be studied by specialists back in one thousand nine hundred and sixty-five. Despite this, specialists still fail to prevent the development of these pathologies. In fact, viral hepatitis is very common in modern medical practice. According to statistics, this kind of disease affects about three hundred to four hundred million people from year to year. The figure is amazing. It should also be noted that about two million inhabitants die from these ailments every year. Even if a person manages to save his life, very often viral hepatitis causes the development of extremely serious complications, which in any case undermine the general condition of the patient.

If we talk about the treatment of these pathologies, then in all cases it should be complex. The patient is prescribed a special diet, as well as a number of medications. In this case, one cannot do without the help of Heptral, since it is this medication that has a rather strong detoxifying property. It cleans the liver from toxins and other harmful substances, of course. Heptral is prescribed mainly for viral hepatitis, both moderate and severe. In addition to the hepatoprotective effect, this medication also has neuroprotective, antioxidant and regenerative properties. It is also important to note the fact that with the help of this drug, therapy is carried out not only for viral, but also for chronic forms of hepatitis. It is not recommended to use it without consulting a specialist.

Quite often, in people who have consumed a large amount of alcoholic beverages for a sufficiently long period of time, abrupt cessation of their use becomes the cause of the development of alcohol withdrawal. This pathological condition is accompanied by such signs as seizures, tremors, delirium, hallucinations. Development of some somatic or infectious pathologies is quite possible. Symptoms of this kind with alcohol withdrawal make themselves felt after three to six hours and continue to bother the patient for two to three days.

You can get rid of this kind of condition. To do this, you need to use the help of a pharmaceutical agent called Heptral, which has a fairly strong hepatoprotective property. To establish the effectiveness of therapy with this medication for alcohol withdrawal, a special clinical study was conducted in which twenty male patients, whose age ranged from thirty to sixty years, took part. They all suffered from alcoholism for six to twenty-five years. Therefore, all of them showed signs of alcohol withdrawal more than once.

All of them were prescribed one tablet of Heptral four times a day for fourteen days. In addition to this medication, they were also prescribed vitamins of the group and. The therapeutic effect of such treatment was noted within two to four days after the start of the course of therapy. The patients were no longer disturbed by fear, excessive irritability, anxiety, or tremors. The use of this pharmaceutical product has also helped to improve the patients' appetite, normalize their blood pressure and restore normal sleep duration. Craving for alcoholic beverages significantly decreased by the tenth day of therapy. Treatment with this drug was well received. They did not have any side effects or complications with the use of Heptral.

To date, a drug called Heptral is available in several pharmaceutical forms, namely in the form of tablets and solution for injection.

What are the indications for the use of this pharmaceutical product? This drug is usually prescribed for patients with chronic and acalculous forms of cholecystitis. In addition, it is also used to treat cholangitis. You cannot do without the help of this medication even in the case when a person has intrahepatic cholestasis, liver cirrhosis or chronic hepatitis. Quite often, it is prescribed in the fight against various liver damage. It can be both viral and alcoholic or drug damage. Withdrawal symptoms, chronic hepatitis, depression, including secondary, liver dystrophy - all these are also indications for the use of this drug. It is also used for encephalopathy, including those associated with liver failure.

What are the contraindications to the use of Heptral? Heptral is not recommended for use in the first and second trimester of pregnancy, as well as during lactation. Its use is categorically contraindicated even if a person has a hypersensitivity to any of its components. In no case should Heptral be given to children under the age of eighteen.

Since the use of this drug is not possible in all cases and not for all categories of patients, its use should be discussed without fail during a consultation with a specialist.

A medication called Heptral is considered to be a representative of a group of pharmaceuticals, which are not only characteristic

cleanse the body

from toxins and slags accumulated in it, but also to restore its normal performance. This drug has found its widespread use in medical practice also because, in addition to cleansing the body, it also fights against various pathologies of such a vital organ as

When using this medication, it is very important to remember the existing precautions that should be followed when taking it.

What are these precautions? At the initial stage of the course of therapy with Heptral, it is necessary to take into account the fact that this pharmaceutical preparation tends to have an invigorating effect. Therefore, its last intake is best done a few hours before bedtime. In addition, do not forget that this medication can be used by people with cirrhosis of the liver only as directed by a doctor and under his strict regular supervision. The same patients are recommended to regularly monitor the amount of nitrogen in the blood, as well as the level of creatinine and urea in the blood serum. In no case should this medication be given to children, especially if there is no good reason for this. And yet, the use of Heptral without the advice of a specialist is extremely dangerous, so it is not worth the risk once again. Self-medication in this case is inappropriate.

Intrahepatic cholestasis is a pathological condition accompanied by impaired flow of bile from the hepatocyte to the hepatic ducts. As a result, the duodenum fails to receive the required amount of bile. The reasons that tend to cause the development of this pathological process, in fact, abound. The most common of them include damage to the intrahepatic ducts, as well as a violation of the mechanisms of formation and transport of bile at the level of hepatocytes.

The processes of both production and secretion of bile are really necessary for the normal functioning of the human body. That is why the development of intrahepatic cholestasis cannot be neglected. Heptral is one of the modern hepatoprotectors, which tends to improve the permeability of the liver cell membranes. As a result, the energy potential of the cell increases and it manages to capture the greatest amount of bile from the blood. In addition to taking over the liver, it also processes it.

Heptral is especially often prescribed for canalicular and hepatocellular cholestasis. This medication is used in the fight against these pathologies for two months. The effectiveness of such treatment directly depends on the severity of cholestasis, as well as on the cause that provoked the development of this pathological condition. The use of Heptral in the fight against cholestasis is impossible only if the patient also has such a pathology as azotemia.

Heptral is one of those drugs of the hepatoprotective group, which has a fairly large number of therapeutic properties. Acting on a person, this drug is included in almost all not only biological, but also chemical processes of our body, while promoting the synthesis of endogenous ademetionine.

If we talk directly about ademetionine, then it is a biological substance that is contained in all tissues without exception, as well as body fluids. Almost no biological reaction is possible without its molecule. In addition, the ademetionine molecule is considered to be a donor of the methyl group, since it is she who takes an integral part in the methylation of phospholipids, which are part of the lipid layer of the cell membrane. She also received the title of the precursor of physiological thiol compounds and polyamines, namely taurine, glutathione, putrescine, cysteine. If we talk about putrescine, then it tends to regenerate cells in the first place.

There is ademetionine in the composition of the drug itself. In addition to ademetionine, Heptral also contains magnesium stearate, anhydrous colloidal silicon dioxide, microcrystalline cellulose, and sodium starch glycolate. The amount of ademetionine significantly exceeds the amount of all other constituent components. This is not surprising, since it is this component with special efforts that fights with such hepatic pathologies as cirrhotic and pre-cirrhotic conditions, intrahepatic cholestasis, toxic and viral hepatitis, and so on.

Heptral is a hepatoprotective drug, endowed with both antidepressant and choleretic, as well as cholekinetic properties. It also tends to make up for the lack of ademetionine in the body by increasing the synthesis of this substance in the area

brain liver

This pharmaceutical agent takes an integral part in biological transmethylation reactions. It is a kind of donor in the reactions of methylation of phospholipids of cell membranes as neutrotransmitters and hormones, as well as proteins. This drug also tends to provide the redox mechanism of cellular detoxification.

As for its choleteric properties, it is mainly due to an increase in both mobility and polarization of hepatocyte membranes as a result of increased synthesis of phosphatidylcholine in them. This fact makes it possible to use this medication in the event of a violation not only of synthesis, but also of the flow of bile. In addition, Heptral helps to protect cell membranes from the negative effects of certain toxic substances on them. In the case of the presence of any diffuse liver disease in the face of cirrhosis or hepatitis, this medication helps to reduce the severity of itching of the skin. Its use makes it possible to reduce to a minimum the changes in such biochemical parameters as the amount of direct bilirubin. Both hepatoprotective and choleretic effects are observed three months after the completion of the course of therapy with this drug.

In this article, you can read the instructions for using the drug Heptral... The reviews of site visitors - consumers of this medicine, as well as opinions of doctors of specialists on the use of Heptral in their practice are presented. A big request is 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 that may not have been declared by the manufacturer in the annotation. Analogs of Heptral in the presence of available structural analogs. Use for the treatment of liver diseases in adults, children, as well as during pregnancy and lactation.

Heptral- hepatoprotector, has antidepressant activity. It has choleretic and cholekinetic effects. It has detoxifying, regenerating, antioxidant, anti-fibrosing and neuroprotective properties.

Replenishes the deficiency of ademetionine (the active substance of the drug Heptral) and stimulates its production in the body, primarily in the liver and brain. Participates in biological transmethylation reactions (methyl group donor) - the S-adenosyl-L-methionine molecule (ademetionine) donates a methyl group in the methylation reactions of cell membrane phospholipids, proteins, hormones, neurotransmitters; transsulfation - a precursor of cysteine, taurine, glutathione (provides the redox mechanism of cellular detoxification), acetylation coenzyme. Increases the content of glutamine in the liver, cysteine \u200b\u200band taurine in plasma; reduces the content of methionine in serum, normalizing metabolic reactions in the liver. After decarboxylation, it participates in aminopropylation processes as a precursor of polyamines - putrescine (a stimulator of cell regeneration and hepatocyte proliferation), spermidine and spermine, which are part of the ribosome structure.

It has a choleretic effect due to an increase in the mobility and polarization of hepatocyte membranes, due to the stimulation of the synthesis of phosphatidylcholine in them. This improves the function of the bile acid transport systems associated with the hepatocyte membranes and facilitates the passage of bile acids into the biliary system. Effective for intralobular cholestasis (violation of the synthesis and flow of bile). Promotes detoxification of bile acids, increases the content of conjugated and sulfated bile acids in hepatocytes. Conjugation with taurine increases the solubility of bile acids and their excretion from the hepatocyte. The process of sulfation of bile acids contributes to the possibility of their elimination by the kidneys, facilitates the passage through the hepatocyte membrane and excretion with bile. In addition, sulfated bile acids protect the liver cell membranes from the toxic effects of non-sulfated bile acids (present in high concentrations in hepatocytes in intrahepatic cholestasis). In patients with diffuse liver diseases (cirrhosis, hepatitis) with intrahepatic cholestasis syndrome, it reduces the severity of itching and changes in biochemical parameters, incl. direct bilirubin level, alkaline phosphatase activity, aminotransferases.

The choleretic and hepatoprotective effect lasts up to 3 months after stopping treatment.

It has been shown to be effective in hepatopathies caused by hepatotoxic drugs.

Prescribing the drug to patients with opioid addiction accompanied by liver damage leads to a regression of the clinical manifestations of abstinence, an improvement in the functional state of the liver and microsomal oxidation processes.

Antidepressant activity manifests itself gradually, starting at the end of the first week of treatment, and stabilizes within 2 weeks of treatment. The drug is effective for recurrent endogenous and neurotic depression resistant to amitriptyline. Has the ability to interrupt relapses of depression.

Prescribing the drug for osteoarthritis reduces the severity of pain, increases the synthesis of proteoglycans and leads to partial regeneration of cartilage tissue.

The tablets are coated with a special coating that dissolves only in the intestine, thanks to which ademetionine is released in the duodenum. Serum protein binding is negligible. Penetrates the blood-brain barrier. Regardless of the route of administration, there is a significant increase in the concentration of ademetionine in the cerebrospinal fluid. Biotransformed in the liver. It is excreted by the kidneys.

chronic acalculous cholecystitis; cholangitis; intrahepatic cholestasis; toxic liver damage of various etiologies (including alcoholic, viral, medicinal / antibiotics, antineoplastic agents, anti-tuberculosis and antiviral drugs, tricyclic antidepressants, oral contraceptives /); fatty degeneration of the liver; chronic hepatitis; cirrhosis of the liver; encephalopathy, incl. associated with liver failure (including alcoholic); depression (including secondary); withdrawal syndrome (including alcoholic).

Release forms

Enteric-coated tablets 400 mg.

Lyophilisate for the preparation of a solution for intravenous and intramuscular administration (injections in ampoules for injection).

Instructions for use and dosage

The drug is administered orally in a daily dose of 800-1600 mg. The duration of maintenance therapy can be on average 2-4 weeks.

The tablets should be swallowed whole, without chewing, preferably taken in the morning, between meals.

Applied intravenously or intramuscularly.

The lyophilisate must be dissolved in a specially supplied solvent immediately before administration. The rest of the drug must be disposed of.

The drug must not be mixed with alkaline solutions and solutions containing calcium ions.

If the lyophilisate has a color different from almost white to white with a yellowish tinge (due to a crack in the bottle or exposure to heat), the Heptral preparation is not recommended.

When administered intravenously, the drug Heptral is administered very slowly.

Intrahepatic cholestasis

The drug is administered in a dose of 400 mg per day to 800 mg per day (1-2 bottles per day) for 2 weeks.

The drug is administered at a dose of 400 mg per day to 800 mg per day (1-2 bottles per day) for 15-20 days.

If maintenance therapy is required, it is recommended to continue taking the drug Heptral in the form of tablets at a dose of 800-1600 mg per day for 2-4 weeks.

Side effect

gastralgia; dyspepsia; heartburn; allergic reactions. 1st and 2nd trimester of pregnancy; lactation period (breastfeeding); age up to 18 years; hypersensitivity to drug components.

Application during pregnancy and lactation

Application in children

Contraindicated in children and adolescents under the age of 18.

special instructions

Considering the tonic effect of Geptral, it is not recommended to use it before bedtime.

When Heptral is prescribed to patients with cirrhosis of the liver against the background of hyperazotemia, systematic monitoring of the level of nitrogen in the blood is necessary. During long-term therapy, it is necessary to determine the content of urea and creatinine in the blood serum.

The solution is prepared immediately before use; if the color of the lyophilized powder is different from the proper white, you must refrain from using it.

Drug interactions

No known drug interaction of the drug Heptral with other drugs was observed.

Analogs of the drug Heptral

Structural analogues for the active substance:

S-adenosyl-L-methionine disulfate p-toluenesulfonate; S-Adenosylmethionine; Ademethionine 1,4-butanedisulfonate; Heptor; Heptor N.

In the absence of analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps and see the available analogues for the therapeutic effect.

Edited news: admin - 17-10-2016, 00:41
Cause: clarification of the instructions for the drug

Heptral is a hepatoprotective agent with antidepressant activity. The drug has choleretic and cholekenetic properties, and also has a regenerating, detoxifying, antioxidant, neuroprotective and antifibrinolytic effect.

The use of Geptral contributes to the replenishment of the lack of ademetionine in the body and its production in organs such as the brain and spinal cord, liver.

In this article, we will consider when doctors prescribe the drug Heptral, including instructions for use, analogues and prices for this drug in pharmacies. If you have already used Heptral, leave your feedback in the comments.

Release form and composition

Dosage forms of Heptral are tablets for oral administration and a lyophilisate, from which a solution is prepared for intramuscular and intravenous administration.

Composition of tablets:

400 mg ademetionine ion (as ademetionine 1,4-butanedisulfonate); Excipients: sodium carboxymethyl starch, colloidal silicon dioxide, magnesium stearate, microcrystalline cellulose.

One 400 mg bottle contains:

active substance - ademetionine 1,4-butanedisulfonate - 760 mg, which is equivalent to the ademetionine cation 400 mg.

One 500 mg bottle contains:

active substance - ademetionine 1,4-butanedisulfonate - 949 mg, which is equivalent to the ademetionine cation 500 mg.

The solvent is a clear liquid from colorless to light yellow, free from foreign particles.

What is Heptral used for?

The use of Heptral is indicated in the treatment of diseases that may be accompanied by intrahepatic cholestatic syndrome against the background of pre-cirrhotic and cirrhotic conditions, these include the following pathologies:

Cirrhosis of the liver; Chronic hepatitis; Fatty degeneration of the liver; Chronic acalculous cholecystitis; Encephalopathy; Cholangitis; Toxic liver damage of various etiologies, including drug, alcoholic, viral.

The use of Heptral is effective in the treatment of intrahepatic cholestasis during pregnancy and in the treatment of symptoms of depression.

Pharmacological properties

Hepatoprotective agent, has choleretic and cholekinetic, as well as some antidepressant effect. Replenishes the deficiency of ademetionine and stimulates its production in the body, primarily in the liver and brain. Participates in biological reactions of transmethylation (donor of the methyl group), donates the methyl group in the reactions of methylation of phospholipids of cell membranes, proteins, hormones, neutrotransmitters, etc.

It has a choleretic effect. Ademetionine normalizes the synthesis of endogenous phosphatidylcholine in hepatocytes, which increases the fluidity and polarization of membranes. This improves the function of the bile acid transport systems associated with the hepatocyte membranes and facilitates the passage of bile acids into the biliary system. It is effective for intrahepatic (intralobular and interlobular) cholestasis (impaired synthesis and flow of bile). Ademetionine reduces the toxicity of bile acids in the hepatocyte, carrying out their conjugation and sulfation. Conjugation with taurine increases the solubility of bile acids and their excretion from the hepatocyte.

In patients with diffuse liver diseases (cirrhosis, hepatitis) with intrahepatic cholestasis syndrome, it reduces the severity of pruritus and changes in such biochemical parameters as the level of direct bilirubin, alkaline phosphatase activity, "hepatic" transaminases, etc. The choleretic and hepatoprotective effect lasts up to 3 months after termination treatment.

Instructions for use

The drug is administered orally, the duration of therapy is determined by the doctor. The tablets should be swallowed whole, without chewing, preferably taken in the morning between meals.

The tablets of the drug Heptral should be removed from the blister immediately before ingestion. If the tablets have a color different from white to white with a yellowish tinge (due to the leakage of the aluminum foil), the Heptral preparation is not recommended to be used.

For various diseases and pathologies of the liver, Heptral is administered intramuscularly or intravenously at 400 - 800 mg per day (1 - 2 vials of lyophilisate) daily for two weeks. Then, if necessary, you can continue therapy by switching to taking Heptral in the form of tablets of 800 - 1600 mg (2 - 4 tablets) per day. The duration of taking tablets after Geptral injections should not exceed 4 weeks. In case of depression, Heptral is also administered intravenously or intramuscularly at 400 - 800 mg (1 - 2 bottles) per day every day, for 15 - 20 days. After completing the course, you can continue taking Heptral in the form of tablets of 800 - 1600 mg (2 - 4 tablets) per day for another 2 - 4 weeks.

An intravenous solution of Heptral, obtained after diluting the lyophilisate with a solvent, can be administered in two ways - jet or infusion. Jet solution is injected unchanged by simply injecting it into a vein (as in intramuscular injection). Infusion Heptral is injected slowly, drop by drop, and it is preliminarily added to 250 - 500 ml of saline. The infusion of Heptral is usually called a "dropper" because the drug does enter the vein drop by drop.

Contraindications

According to the instructions for Heptral, the use of the drug is contraindicated:

With hypersensitivity to the components; In the presence of genetic disorders that affect the methionine cycle and / or cause homocystinuria and / or hyperhomocysteinemia (for example, a violation of vitamin B12 metabolism or a deficiency of cystathionine beta synthase). Under the age of 18 years (since the experience of using the drug in pediatrics is limited). To old people; During breastfeeding; In the first trimester of pregnancy; With bipolar disorder; With renal failure.

Particular care should be taken if it is necessary to simultaneously use Heptral with tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), as well as with drugs that include tryptophan.

Side effects

Among the most common adverse reactions noted are nausea, abdominal pain and diarrhea. Below are summarized data on adverse reactions that were identified in clinical studies and with post-marketing use of ademetionine both in tablets and in an injectable dosage form.

For various organs and body systems, the following side reactions can be distinguished:

From the musculoskeletal system: joint and muscle pain. From the side of immunity: edema of the larynx tissues, allergic and anaphylactoid reactions. From the side of the cardiovascular system: a feeling of hot flashes, phlebitis. Genitourinary system: exacerbation of chronic urinary tract infections. From the side of the central nervous system: dizziness, headaches, confusion, insomnia, a feeling of numbness and paresthesia in the limbs. On the part of the skin: hyperhidrosis (increased sweating), itching, skin rash and Quincke's edema. On the part of the digestive system: flatulence, diarrhea, abdominal pain, dyspepsia, dry mouth, esophagitis, gastrointestinal bleeding, nausea, vomiting, hepatic colic.

In some cases, asthenia syndrome, local reactions (at the injection site), chills and flu-like manifestations, general malaise, edema of peripheral tissues, and fever were noted.

Application features

Impact on the ability to drive vehicles and mechanisms In some patients, dizziness may occur when using ademetionine. Patients should be aware of the need to refrain from driving vehicles or working with mechanisms during drug treatment, up to reasonable confirmation that ademetionine therapy does not cause them to disrupt the ability to engage in this kind of activity.

Interaction

Lyophilisate for preparing a solution for intramuscular and intravenous administration should not be mixed with alkaline solutions and solutions containing calcium ions. There is a report of the serotonin excess syndrome in a patient taking ademetionine and clomipramine.

Analogs

Structural analogue of Heptral: Heptor. Preparations with a similar mechanism of action: Glutamic acid, Histidine, Carnitene, Carnitine, Elkar, Epilapton.

Prices

The average price of HEPTRAL, tablets in pharmacies (Moscow) is 1600 rubles. Heptral lyophilisate, 400 mg per vial, packing of 5 vials and 5 ampoules with solvent 1808 rubles.

Use in the elderly

Clinical experience with the use of the drug Heptral did not reveal any differences in its effectiveness in elderly patients and younger patients.

However, given the high likelihood of existing violations of the liver, kidneys or heart, other concomitant pathology or simultaneous therapy with other drugs, the dose of the drug Heptral should be selected with caution in elderly patients, starting with the lower limit of the dose range.

Pregnancy

It is contraindicated to use in the I and II trimester of pregnancy, in the last trimester, the administration of the drug is possible if the expected benefit to the mother is higher than the potential risk to the fetus. During lactation, if you need to take the drug, you should consider stopping breastfeeding.

Childhood use

The use of the drug Heptral in children is contraindicated (efficacy and safety have not been established).

Heptral instructions for use of the drug

Tradename: Heptral ®
International non-proprietary name: Ademetionine
Dosage form: Lyophilized powder for preparation of a solution for intravenous and intramuscular administration of 500 mg complete with a solvent of 5 ml.

Heptral 500 mg (Ademetionine) photo

Heptral instructions for use (injections in ampoules)

Ademetionine - a drug that has moderate antidepressant, stimulating and hepatoprotective properties. Actively penetrates the blood-brain barrier, stimulates dopamine synthesis.
The effectiveness of the drug for depression has been proven in a number of studies. The results of open and double-blind trials confirmed the statistically significant superiority of S-adenosylmethionine therapy compared with placebo and comparable efficacy to standard tricyclic antidepressants, as well as a favorable side effect profile.
Wikipedia

Composition and properties Heptral injections in ampoules

One bottle contains:

• active substance: ademetionine 1,4-butanedisulfonate 949 mg (equivalent to 500 mg of ademetionine cation);
• excipients: water for injection, nitrogen;

One ampoule with a solvent contains active substances: L-lysine 428.0 mg, sodium hydroxide 14.4 mg, excipient - water for injection.

Description

• Lyophilized Powder - lyophilized mass from white to yellowish color, free from foreign particles;
• Solvent - clear liquid from colorless to light yellow;
• Prepared drug solution - a clear solution from colorless to yellow without visible precipitate.

Pharmacotherapeutic group: Other drugs for the treatment of gastrointestinal diseases and metabolic disorders. Amino acids and their derivatives. Ademetionine

ATX code: A16AA02

Pharmacological properties

Pharmacokinetics

Absorption

In humans, after intravenous administration, the pharmacokinetic profile of ademetionine is biexpotential with a rapid phase of distribution in tissues and clearance with a half-life of about 1.5 hours.

Absorption with intramuscular injection is 96%, maximum plasma concentrations are reached after 45 minutes. after application.

After a single oral administration of enteric tablets of ademetionine in doses from 400 to 1000 mg, the maximum plasma concentrations achieved are dose-dependent and amount to 0.5-1 mg / l after 3-5 hours.

Bioavailability after oral administration is increased if ademetionine is used on an empty stomach.

Plasma concentrations decline to baseline values \u200b\u200bwithin 24 hours.

Distribution

The volume of distribution is 0.41 and 0.44 l / kg for doses of ademetionine 100 mg and 500 mg, respectively.

Serum protein binding is negligible and is ≤5%.

Metabolism

The metabolic process of ademetionine is cyclic and is called the ademetionine cycle.

At the first stage of this cycle, ademetionine-dependent methylase uses ademetionine as a substrate for the production of S-adenosyl-homocysteine, which is then hydrolyzed to homocysteine \u200b\u200band adenosine by S-adenosyl-homocysteine \u200b\u200bhydralase.

Homocysteine, in turn, undergoes reverse transformation to methionine by transferring a methyl group from 5-methyltetrahydrofolate.

Ultimately, methionine can be converted to ademetionine, completing the cycle.

Withdrawal

In studies of the clearance of radioactively labeled substances with oral administration of radioactively labeled (methyl 14 C) ademetionine, in healthy volunteers, the urinary excretion of the radioactive substance was 15.5 ± 1.5% after 48 hours and the excretion with feces was 23.5 ± 3.5% after 72 hours.

Pharmacodynamics

Heptral ® (active ingredient - S-adenosyl-L-methionine (ademetionine)) is a natural amino acid that is present in all tissues and fluids of the body.

Heptral (ademetionine) primarily acts as a coenzyme and methyl group donor in many transmethylation reactions.

The transfer of methyl groups (transmethylation) of ademetionine is the basis for the construction of the phospholipid membrane of cells and plays a role in membrane fluidity.

Heptral (ademetionine) is able to penetrate the blood-brain barrier.

High concentrations of Heptral (ademetionine) affect the transmethylation processes, which are very important in the brain tissue, due to the effect on the metabolism of catecholamines (dopamine, adrenaline, norepinephrine), indoleamines (serotonin, melatonin) and histamine.

Heptral (ademetionine) is also a precursor of biochemical thiol compounds (cysteine, taurine, glutathione, coenzyme A, etc.) - in transsulfurization reactions. Glutathione, a powerful antioxidant, is essential for liver detoxification.

Heptral increases glutathione levels in patients with liver damage, both alcoholic and non-alcoholic.

Heptral instructions for use