"Heptral": manufacturer, composition, instructions for use

A body cleansed of toxins is the key to well-being and health. Any doctor will tell the patient this when prescribing medications to support the liver. After all, it is this organ that passes liters of blood through itself, cleansing them of dangerous substances. For a number of liver problems, the drug Heptral is effective. The manufacturer claims that, given the current indications, it can be taken even by pregnant women. Therefore, it is easy to imagine how widely this remedy is used as part of complex therapy. In the article we will note the most necessary information about Heptral: manufacturer, release forms, indications and contraindications.

What is better and more effective in comparison with Heptral, what is the difference

An analogue of Heptral in tablets and injections containing ademetionine is Heptor. The remaining drugs listed below have hepatoprotective activity of varying degrees and consist of other active ingredients. For a comparative assessment, you should take into account not only the composition, but also reviews, as well as the price.

Heptor

Heptor is a Russian drug manufactured by JSC Veropharm. The active substance is contained in the form of S-adenosylmethionine in an amount of 400 mg. The difference between Heptral and Heptor is in the auxiliary composition, as well as in the substances of the tablet shell. This should be taken into account in case of allergic reactions to some components.

It is difficult to determine from reviews of patients and doctors which is better Heptral or Heptor due to approximately the same number of positive responses to both drugs (83%).

Drug Heptor

Ursosan

A medicine containing ursodeoxycholic acid is Ursosan. In addition to its hepatoprotective effect, it has a beneficial effect on the composition and properties of bile, preventing the appearance of cholesterol stones and dissolving small stones. Applicable for:

• hepatitis, including alcoholic;
• cholelithiasis;
• fatty degenerative processes in the liver;
• dyskinesia;
• reflux gastritis.

Contraindicated in decompensated cirrhosis and X-ray positive calcium stones in the gallbladder. This should be taken into account when deciding which is better Heptral or Ursosan.

Essentiale

The preparation of essential phospholipids Essentiale has a regenerating effect on liver cells, since its active components are the main components of cellular structures. In addition to various liver pathologies, the medicine is used for psoriasis and radiation syndrome. Essentiale is well tolerated, and contraindications include hypersensitivity and age under three years.

In any case, the attending physician must decide whether Heptral or Essentiale is better. With long-term use, phospholipids themselves can lead to the development of fatty hepatosis, that is, to the deposition of lipids in liver cells.

Phosphogliv

The Russian drug Phosphogliv is a combination product that includes phospholipids and glycyrate, which has anti-inflammatory and virus-suppressing effects. This is especially true in the treatment of viral hepatitis. Indications for use are also:

• fatty hepatosis;
• alcoholic and toxic hepatitis;
• cirrhotic degeneration of the liver;
• psoriasis.

Deciding which is better is Heptral or Phosphogliv, taking into account contraindications (pregnancy and breastfeeding, children under twelve years of age, antiphospholipid syndrome, intolerance to drug components), as well as side effects (allergies, edema, increased blood pressure, dyspepsia).

Hepa-mertz

The German-made drug Hepa-Merz is hypoammonemic, that is, it reduces the amount of ammonia in cells. Thanks to the medicine, detoxification of the body occurs, which is hepatoprotection. When choosing which is better than Hepa-merz or Heptral, you need to take into account that the hepatoprotective activity of the latter is more pronounced, which determines the breadth of its use. Hepa-merz is recommended for use in hepatic encephalopathy, including comatose states. Due to excretion through the kidneys, it is contraindicated in renal failure.

Lyophilisate for injection

According to the instructions for use, Heptral ampoules contain a sterile solvent necessary for preparing the medicine from the lyophilized white powder contained in the bottles. The active ingredient is ademetionine in the amount of 400 mg.

This substance promotes:

• restoration of liver cells;
• removal of toxins;
• reducing the proliferation of connective tissue;
• improving the functioning of brain cells due to antioxidant and neuroprotective activity.

Composition of the bottle and ampoules

The lyophilisate is contained in glass bottles and is a white dry powder. The bottle is tightly sealed with a stopper. The powder contains ademetionine 1,4-butane disulfonate 760 mg, which corresponds to 400 mg of pure substance. Heptral solvent in ampoules is a clear liquid in an amount of 5 ml. It contains:

• L-lysine – 324.4 mg;
• sodium hydroxide – 11.5 mg;
• water for injections up to 5 ml.

In what cases are injections prescribed?

Heptral injections are used to achieve results more quickly, because with intravenous or intramuscular administration, the maximum amount of the therapeutic substance in the bloodstream is achieved after 45 minutes.

The injection form is prescribed for:

• depressive disorders;
• intrahepatic cholestatic phenomena resulting from pathologies of the liver and biliary tract (hepatitis of various origins, chronic cholecystitis, cholangitis, cirrhosis, fatty hepatosis and degeneration of liver tissue).

How to administer

Heptral injections are performed after the powder is mixed with a solvent. To do this you should:

1. Draw the contents of the ampoule into a five-milliliter syringe.
2. Remove the cap from the bottle and, after piercing the stopper, slowly introduce the solvent.
3. After the lyophilized powder is completely dissolved, the medicine is drawn into a syringe.
4. Before performing the injection, the needle is changed to a new sterile one.
5. If not all of the dose is used, the remainder must be discarded.

For intravenous administration, the medicine is injected from a syringe into a bottle of 250 ml of saline solution or 5% glucose. After this, an infusion is given for at least an hour.

At the initial stages, the dosage of the drug is based on 5-12 mg/kg per day. If well tolerated, the dose is adjusted to the therapeutic dose, that is, 500-1600 mg per day.

In elderly patients who have other pathologies besides the liver, you should start with minimal dosages so as not to cause adverse events.

Liver steatosis

Contraindications

Contraindications to the use of Heptral:

• genetically determined anomalies associated with amino acid methionine metabolism, including metabolic disorders of cyanocobalamin (vitamin B12);
• bipolar affective disorder;
• children under 18 years of age (no clinical trials required);
• individual intolerance to the active substance or auxiliary components.

In the first trimester of pregnancy and during the lactation period, the medicine is used with caution, taking into account the preponderance of beneficial effects over possible negative consequences. In women after 26 weeks of pregnancy, no undesirable effects on the fetus were observed during treatment

Concomitant use with antidepressants of all groups in large doses should be carried out under the strict supervision of a doctor to monitor the side effects of Heptral and antidepressant drugs (serotonin syndrome). In people with bipolar disorder, the medication can invert the emotional state, that is, provoke the development of mania.

Caution in use must be observed when renal failure is detected, since the drug is excreted by the kidneys

Side effects

Side effects of Heptral:

• intolerance reactions (anaphylaxis, urticaria, erythema, Quincke's edema);
• insomnia;
• the appearance or intensification of anxiety;
• restlessness;
• confusion;
• dizziness;
• a feeling of “goosebumps” crawling throughout the body;
• taste disturbance;
• hot flashes throughout the body;
• headache;
• drop in blood pressure;
• inflammation of the veins;
• stomach ache;
• dry mouth;
• dyspeptic symptoms (nausea, bloating, diarrhea, flatulence, vomiting);
• bleeding from the stomach or intestines;
• inflammation of the esophagus;
• itching of the skin;
• increased sweating;
• pain in the joints of the limbs;
• muscle spastic pain;
• asthenia;
• general malaise;
• increased body temperature;
• local reactions at injection sites, including necrotic ones.

The drug was tested during clinical trials, and when compiling a list of side effects, all spontaneous data recorded by doctors when prescribing this drug were taken into account.

Side effects

If the specialist's instructions are not followed and the therapeutic dose is exceeded, side effects may occur. These include:

• gastrointestinal disorders (diarrhea, nausea, epigastric pain, vomiting);
• swelling and ulcers at the injection site;
• fever;
• sleep disorders (insomnia);
• migraine;
• dizziness;
• arthralgia;
• muscle spasms.

3% of patients experience slight hair loss. It is possible to develop additional allergic reactions in the form of itching, burning, redness of the skin and rash.

Effect on driving

You are not allowed to drive during therapeutic treatment. Ademetionine causes dizziness.

You are not allowed to drive during therapeutic treatment.

Possible negative effects

Referring to reviews of Heptral (the instructions for use list all the negative consequences of treatment that patients have ever experienced), we can confidently say that it is very well tolerated. Most patients write in the comments that even long-term use of the medicine did not negatively affect their well-being. However, we still need to educate readers about the problems they may encounter during treatment.

The manufacturer claims that Heptral causes increased sweating, itching and skin rashes. Sometimes patients experience dizziness, sleep problems, headaches and causeless anxiety.

In some patients, the gastrointestinal tract reacts sharply to taking the drug. This results in bloating, diarrhea, pain and bleeding.

There are cases of patient complaints of chills, fever and developed urinary tract infection.

Side effects and overdose

Side effects of the body can be of various types: from the gastrointestinal tract, local allergic reactions, the body's immune system, infections, convulsions and problems with blood vessels. Most often, allergies manifest themselves at the site of drug administration and body reactions in the form of itching, rash and redness of the skin. In some cases, this only goes away when the medication is stopped, but most often it goes away on its own over time when the body gets used to the medicine.

Side effects from the blood vessels and respiratory system include hot flashes, phlebitis, swelling of the larynx and tongue, and hypotension. Disruption of the gastrointestinal tract manifests itself in problems such as diarrhea, bloating, vomiting, nausea, dryness and bitterness in the mouth, and less commonly, gastrointestinal bleeding and disorders. The patient's immune system may manifest itself in hypersensitivity to the components of the medication, bronchospasms, anaphylactic reactions, even shock. If your back or chest hurts, then this also applies to the body’s immune reactions.

Muscle pain, arthralgia and cramps may also be a concern. In rare cases, swelling at the injection site, redness of the skin and discomfort have been observed. As a rule, such manifestations do not require replacement or discontinuation of the drug. Dizziness, infection starting in the genitourinary system, or changes in heart rate such as tachycardia or bradycardia may occur. Malaise, weakness, chills and a general deterioration in the person’s health were also noted in extremely rare cases.

Properties of the drug

Heptral is actively used to treat the liver after drinking alcohol. With its help, it is possible to improve the performance of this organ in chronic hepatitis, alcohol damage, and fatty hepatosis. This medicine also perfectly treats withdrawal symptoms. The drug has the following characteristics:

• antidepressants – increases the viability of neurons, restores the transmission of nerve impulses;
• antioxidant – stimulates the synthesis of amino acids that are required for the restoration of liver cells;
• regenerating – increases the rate of hepatocyte division, which significantly accelerates recovery processes in the liver;
• cholekinetic – ensures the removal of bile from the gallbladder;
• neuroprotective – reduces the risk of developing liver encephalopathy.

pharmachologic effect

Heptral is an antioxidant, antidepressant, neuroprotective, hepatoprotective, choleretic and detoxifying drug that has proven itself to be beneficial for:

1. Strengthening the detoxification of bile acids.
2. Normalization of the functioning of transport schemes of bile acids and the removal of bile through the bile ducts. In this case, the choleretic and hepatoprotective effects last for 12 weeks after the end of the course of treatment with the drug.
3. Interruptions of recurrent depression. In these cases, the antidepressant effect increases smoothly. Stabilization of the therapeutic effect is achieved within a two-week treatment period.
4. Effective treatment of recurrent depression of an endogenous or neurotic nature that is resistant to amitriptyline.
5. Treatment of osteoarthritis, to reduce the level of painful manifestations, enhance the process of proteoglycan synthesis and improve the restoration of cartilage tissue.
6. Increased levels of cysteine ​​and taurine in the blood plasma, glutamine in the liver (with constant use). Associated positive effects of the drug are: reduction in methionine levels, normalization of metabolism and liver function.
7. Restoration and stimulation of ademetionine production in the liver.

Mechanism of action

The drug Heptral 500 contains an active component similar to Heptral 400.

In most transmethylation reactions (methyl group transfer), the element acts as a donor of the methyl group and a kind of coenzyme.

The transfer of methyl groups of the active ingredient is an important metabolic process involved in the formation of the phospholipid cell membrane. The drug has antidepressant activity. It has cholekinetic and choleretic properties. When taken regularly, a detoxifying, regenerating, antioxidant, neuroprotective, and antifibrosing effect is observed.

When taken regularly in the body, the production of ademetionine by the brain and liver is accelerated. There is an increase in glutamine levels in the liver. in blood plasma - taurine and cysteine. The medication controls the metabolism of dopamine catecholamines and is responsible for reducing methionine in the blood serum.

When taken regularly in the body, the production of ademetionine by the brain and liver is accelerated.

The production of homocysteine ​​(an amino acid produced from methionine) is slightly increased. The choleretic effect is achieved by increasing the mobility of hepatocyte cell membranes, which accelerates the release of non-sulfated bile acids into the bile ducts.

It is used as part of complex therapy as an antidepressant, antitussive, and expectorant. For mental disorders caused by long-term use of drugs and strong alcoholic beverages, the medication prevents depression and eliminates anxiety. HFZ (hydralase enzymes) under the influence of the active ingredient intensively catalyze hydrolysis.

After a single use of the recommended therapeutic dose, the maximum concentration of ademetionine in the blood is achieved after 5-6 hours. Any dosage form is 95% bioavailable. Slightly binds to blood proteins. Metabolism occurs in the liver, and excess is excreted in the urine. Does not have a harmful effect on the vascular and cardiac systems.

special instructions

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

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

It is not recommended to use ademetionine in patients with bipolar disorders. There are reports of the transition of depression to hypomania or mania in patients taking ademetionine.

Patients with depression have an increased risk of suicide and other serious adverse events, therefore, during treatment with ademetionine, such patients should be closely monitored by a physician to evaluate and treat symptoms of depression. Patients should inform their physician if their symptoms of depression do not improve or worsen with ademetionine therapy.

There are also reports of sudden onset or worsening anxiety in patients taking ademetionine. In most cases, discontinuation of therapy is not required; in several cases, the state of anxiety disappeared after reducing the dose or discontinuing the drug.

Since deficiency of cyanocobalamin and folic acid can reduce the level 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, vegetarians), the content of vitamins in the blood plasma should be monitored. If deficiency is detected, it is recommended to take cyanocobalamin and folic acid before starting treatment with ademetionine or one-day use with ademetionine.

In immunological analysis, the use of ademetionine may contribute to the false determination of high homocysteine ​​levels in the blood. For patients taking ademetionine, it is recommended to use non-immunological methods of analysis to determine homocysteine ​​levels.

Impact on the ability to drive a car and operate machinery

Some patients may experience dizziness while taking Heptral. It is not recommended to drive a car or operate machinery while taking the drug until the patient is sure that the therapy does not affect the ability to engage in such activities.

Indications and contraindications for use

It is used to protect hepatocytes (this is its main benefit), which are destroyed in the following diseases:

• fatty degeneration;
• viral, drug, alcoholic, infectious hepatitis;
• inflammation of the gallbladder or its ducts;
• use during chronic or acute liver cirrhosis;
• encephalopathy when bilirubin enters the blood and moves through the blood-brain barrier.

The drug is intended to eliminate spasms of the gallbladder and its ducts during pregnancy, the presence of depression in chronic diseases.

It is not recommended to use if the patient:

• genetic diseases causing homocystinuria, hyperhomocysteinemia;
• personality disorder;
• minor age, because there is not enough research data in this area of ​​medicine;
• hypersensitivity to one of the components of the product.

A pregnant woman can use the medicine, but only if the possible positive effect of the medicine outweighs the risk of side effects.

special instructions

Given the tonic effect of the drug, it is not recommended to take it before bed. When prescribing Heptral to patients with liver cirrhosis due to hyperazotemia, systematic monitoring of residual nitrogen is necessary. During long-term therapy, it is necessary to determine the content of urea and creatinine in the blood serum.

It is not recommended to prescribe ademetionine to patients with bipolar disorders. There are reports of the transition of depression to hypomania or mania in patients taking ademetionine.

There are also reports of sudden onset or worsening anxiety in patients taking ademetionine. In most cases, discontinuation of therapy is not required; in a few cases, anxiety resolved after dose reduction or drug discontinuation.

Since vitamin B12 and folic acid deficiency may reduce ademetionine levels in patients at risk (with anemia, liver disease, pregnancy or the possibility of vitamin deficiency due to other diseases or diet, such as vegetarians), vitamin levels should be monitored. If deficiency is detected, simultaneous administration of ademetionine with vitamin B12 and folic acid is recommended. Ademetionine interferes with homocysteine ​​immunoassay results, which may cause falsely high plasma homocysteine ​​levels. For patients taking ademetionine, it is recommended to use non-immunological methods of analysis to determine homocysteine ​​levels.

Impact on the ability to drive a car and operate machinery. Some patients may experience dizziness while taking Heptral. It is not recommended to drive a car or operate machinery while taking the drug until patients are sure that the therapy does not affect the ability to engage in this type of activity.

Nuances of the body's condition

For greater effect, it is better to administer Heptral intravenously. According to the instructions, it is recommended to combine the use of the drug with the use of folic acid and vitamin B12. Too low a concentration of the mentioned compounds may cause a decrease in the content of ademetionine, on which Heptral is based, which will make the use of the medicine less effective.

Against the background of bipolar psychosis, the medication in question is not recommended. There are isolated cases of transformation of depressive syndrome into hypomania, mania due to the use of the drug.

Effectiveness in treating depressive syndrome has been proven in a number of short-term official studies. The programs lasted three to six weeks and the drug was administered intravenously. In the instructions for Heptral there is no information about the effectiveness of depression if it is prescribed for a course exceeding six weeks - officially there is simply no such information.

The patient should know: if the symptoms of depression do not improve or the condition worsens, the treating doctor must be immediately warned about this. Depressive syndrome is a reason for classifying a patient as a patient whose condition is associated with a particular risk. It is believed that for such persons the risk of a suicide attempt is higher, which means that it is necessary to constantly monitor the person’s condition and provide him with qualified assistance as needed. This approach helps monitor the effectiveness of the therapeutic course.

Release form and composition

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

Composition of tablets:

• 400 mg ademetionine ion (as ademetionine 1,4-butane disulfonate);
• Excipients: sodium carboxymethyl starch, colloidal silicon dioxide, magnesium stearate, microcrystalline cellulose;
• Shell composition: polysorbate 80, macrogol 6000, copolymer of methacrylic acid and ethyl acrylate (1:1 ratio), simethicone (30% emulsion), talc, sodium hydroxide, water.

Tablets are sold in packs of 10. in blisters packed in cardboard boxes.

1 bottle of Heptral solution contains 400 mg of ademetionine ion (in the form of ademetionine 1,4-butane disulfonate).

The composition of the solvent included in the kit: injection water, sodium hydroxide and L-lysine.

Features of using the product

Most often, doctors prescribe intravenous administration of Heptral, this is done through a dropper. For any diagnosis, the drug in the form of injections is used only at the very beginning of treatment, then it is replaced with tablets.

The course of treatment lasts no more than two weeks, the dosage these days is about 0.8 grams of the drug. This scheme is relevant in the treatment of liver diseases.

Depressive syndrome requires a lower dosage. No more than 0.4 grams of Heptral is administered to a person (one or two ampoules of the drug per day). Injections are given over three weeks. Then the patient’s condition is assessed by the doctor, and he decides to cancel the injections and replace them with the tablet form of the drug.

It is recommended to drink the capsules before lunch. This is due to the tonic effect it has on the patient’s nervous system. There is no need to chew the tablets, otherwise the shell will be damaged and ademetionine 1,4-butane disulfonate will begin to be absorbed before it reaches the duodenum. This will reduce the effectiveness of the product and may cause digestive upset.

Usually the doctor prescribes the minimum dosage to see how the patient responds. It cannot exceed the limit of twenty milligrams per kilogram of weight per day. Then the dose is adjusted by the doctor depending on the diagnosis and the person’s well-being. For example, for intrahepatic cholestasis and depression, the drug we describe is taken in a dosage of eight hundred milligrams for twenty-four hours. The maximum concentration cannot exceed one thousand six hundred milligrams of the drug. The patient can take from 2 to 4 tablets per day.

Composition and release form of Heptral 500

The medication is available in the form of tablets and lyophilisate (lyophilized powder for injection). Tablets of regular oval shape, white or yellowish in color, coated with a film. There are no chamfers or risks.

The medication is available in the form of tablets and lyophilisate (lyophilized powder for injection).

The dosage form contains active and additional (auxiliary) elements. The main ones include ademetionine butane disulfonate, the permissible content of which is 949 mg, which is equivalent to 500 mg of ademetionine ions. The auxiliary ones include:

• pyrogenic silicon dioxide;
• MCC (microcrystalline cellulose);
• sodium carboxymethylcellulose;
• magnesium salt of stearic acid.

The enteric coating consists of the following elements:

• methylolated methacrylamide copolymers;
• ethyl acrylate;
• macrogol;
• ethoxylated sorbitan;
• simethicone;
• caustic soda;
• silicate mineral (talc).

The active ingredient in the lyophilisate is the same as in the pills. The dosage form includes some additional components:

1. Purified water.
2. Nitrogen.

The package contains bottles with powder and ampoules with solution. The lyophilisate is a homogeneous white mass without foreign particles.

The package contains bottles with powder and ampoules with solution. The lyophilisate is a homogeneous white mass without foreign particles. The solution is transparent, yellowish, without a specific odor. Pills and bottles are arranged in blister packs. The blisters are placed in cardboard boxes with the necessary markings (batch number, dosage form, expiration date, information about the manufacturer).

Each cardboard box must contain instructions for use.

How to use Heptral

The treatment regimen, dosage and rules for using Heptral differ depending on the type of pathology and the form of release of the drug.

In tablets

Heptral tablets are taken orally, without chewing and with a small amount of water. The medication is taken between meals, and it is advisable that the last dose be no later than 18.00, because the drug has a tonic effect.

The duration of taking the tablets is determined individually and depends on the course of the disease and the speed of normalization of the condition, but on average the course takes from two to four weeks. The medication can be re-taken 1-2 months after the previous course.

In ampoules

Vials with Heptral lyophilisate are supplied with a special solvent, with which a solution is prepared for intramuscular or intravenous administration.

The solvent is diluted with the lyophilisate immediately before use; storing and leaving unused medicine until the next time is prohibited. The finished solution should have a white-yellowish tint, be free of impurities and suspended particles - if the color of the drug is different and there are impurities of unknown origin, the medicine should be thrown away.

How to use Heptral intravenously and intramuscularly:

• For liver diseases - 400-800 mg (1-2 bottles of lyophilisate) daily for 2 weeks. If necessary, after this period, therapy can be continued with Heptral tablets.
• For depressive conditions - 400-800 mg every day for 15-20 days, after which you can continue treatment with Heptral using tablets.

When administered by injection, it should be taken into account that Heptral is incompatible with drugs containing calcium ions and alkaline solutions.

Use by pregnant women and children

The use of this drug by children is not advisable.
The use of this drug by children is not advisable, since there are no clinical trials and it is impossible to predict the reaction of the child’s body to the medication. Therefore, it is not recommended to use it before the age of 18. It is also not recommended to take Heptral during pregnancy in the first semester, as in the most unstable one. In the second case, you should also not use it, since there is no information about the penetration of the active substance into the fetus. During pregnancy in the third semester, the use of Heptral is allowed provided that the pregnant woman's condition worsens. Most often, it is prescribed only in cases where the risk of worsening the condition without the medicine is higher than the risk of taking it without the necessary consequences for the fetus. Some studies have been conducted, they ended successfully and did not reveal negative consequences.

Features of storing medicine

The shelf life of this medicine is thirty-six months from the date indicated on the package. It is recommended to store the product in a dark, dry place at room temperature, and also away from children’s hands. Under no circumstances should the medication be frozen. Please note that improper storage conditions will not only significantly shorten its shelf life, but can also harm your health.

You can buy Heptral ampoules (analogs, reviews are listed later in this article) only if you have a prescription from your doctor. Please note that this drug is a very serious medication, so you should definitely not self-medicate.

Contraindications

- genetic disorders affecting the methionine cycle and/or causing homocystinuria and/or hyperhomocysteinemia (cystathionine beta synthase deficiency, impaired metabolism of vitamin B12);

- age under 18 years (experience of medical use in children is limited);

- hypersensitivity to the components of the drug.

The drug should be prescribed with caution for bipolar disorders; in the first trimester of pregnancy and during breastfeeding (use is possible only if the potential benefit to the mother outweighs the possible risk to the fetus and child); simultaneously with selective serotonin reuptake inhibitors (SSRIs); tricyclic antidepressants (such as clomipramine); herbal preparations and preparations containing tryptophan; elderly patients with renal failure

Are there any contraindications for use?

Like any other drug, Heptral also has contraindications.
First of all, this medicine should not be taken by patients who have hypersensitivity to any components included in this medicine. Also, the medication should not be taken if there are genetic disorders that have a significant impact on the methionine cycle. In no case should the drug be prescribed to persons under the age of majority.

In some cases, the drug is prescribed with extreme caution under the strict supervision of the attending physician. You can take the product very carefully in the following cases: - in the first three months of pregnancy, as well as during breastfeeding;

- in the first three months of pregnancy, as well as during breastfeeding;

- the product should be used by elderly people under the strict supervision of specialists;

- when using certain types of antidepressants, as well as homeopathic medicines;

- in case of serious kidney pathologies;

- in the presence of bipolar disorders.

Pharmacodynamics

Ademethionine belongs to the group of hepatoprotectors, which has antidepressant activity. It has choleretic and cholekinetic effects, has detoxification, regenerating, antioxidant, antifibrosing and neuroprotective properties. Replenishes the deficiency of S-adenosyl-L-methionine (ademetionine) and stimulates its production in the body; it is found in all environments of the body. The highest concentration of ademetionine was observed in the liver and brain.

Plays a key role in the metabolic processes of the body, takes part in important biochemical reactions:

• transmethylation;
• transsulfation;
• transamination.

In transmethylation reactions, ademetionine donates a methyl group for the synthesis of cell membrane phospholipids, neurotransmitters, nucleic acids, proteins, hormones, etc. In transsulfation reactions, ademetionine is a precursor of cysteine, taurine, glutathione (providing a redox mechanism for cellular detoxification), acetylation coenzyme (included in biochemical reactions of the tricarboxylic acid cycle and replenishes the energy potential of the cell).

Increases the content of glutamine in the liver, cysteine ​​and taurine in plasma; reduces the content of methionine in serum, normalizing metabolic reactions in the liver. After decarboxylation, it participates in aminopropylation reactions as a precursor of polyamines - putrescine (stimulator of cell regeneration and hepatocyte proliferation), spermidine and spermine, which are part of the ribosome structure, which reduces the risk of fibrosis. Has a choleretic effect.

Ademetionine normalizes the synthesis of endogenous phosphatidylcholine in hepatocytes, which increases membrane fluidity and polarization. This improves the function of bile acid transport systems associated with hepatocyte membranes and promotes the passage of bile acids into the biliary system. Effective for intrahepatic (intralobular and interlobular) variants of cholestasis (impaired synthesis and flow of bile). Ademetionine reduces the toxicity of bile acids in hepatocytes by conjugating and sulfating them. Conjugation with taurine increases the solubility of bile acids and their removal from the hepatocyte. The process of sulfation of bile acids facilitates their elimination by the kidneys, facilitates their passage through the hepatocyte membrane and excretion in the bile. In addition, sulfated bile acids themselves additionally protect liver cell membranes from the toxic effects of non-sulfated bile acids (present in high concentrations in hepatocytes during intrahepatic cholestasis).

In patients with diffuse liver diseases (cirrhosis, hepatitis) with intrahepatic cholestasis syndrome, ademetionine reduces the severity of skin itching and changes in biochemical parameters, incl. level of direct bilirubin, alkaline phosphatase activity, aminotransferases, etc. The choleretic and hepatoprotective effect lasts up to 3 months after cessation of treatment.

It has been shown to be effective against hepatopathies caused by various hepatotoxic drugs. Prescription to patients with opioid addiction accompanied by liver damage leads to regression of clinical manifestations of withdrawal, improvement of the functional state of the liver and microsomal oxidation processes.

Antidepressant activity appears gradually, starting from the end of the first week of treatment, and stabilizes within 2 weeks of treatment. Effective for recurrent endogenous and neurotic depressions resistant to amitriptyline. Has the ability to interrupt relapses of depression.

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

Indications for prescribing the drug

Reviews of the use of Heptral allow you to get an idea of ​​the list of health problems for which it is advisable to use this drug.

It is indispensable in therapy for detecting hepatitis. Moreover, the genesis of the disease is unimportant. "Heptral" is effective against toxic, drug-induced and other types of hepatitis.

The drug is also prescribed for liver cirrhosis, as well as conditions close to this disease. It is worth considering that fatty liver can also be treated with Heptral. Doctors know that this problem usually precedes cirrhosis.

Taking large amounts of drugs over a long period of time causes serious liver damage. The body will not be able to cope with them on its own. Therefore, if a viral, alcoholic, drug or other type of lesion is detected, it is necessary to begin treatment with Heptral.

For pregnant women, the drug is prescribed for intrahepatic cholestasis. This disease is very insidious and threatens problems not only for the mother, but also for the fetus. The drug effectively relieves unpleasant symptoms and reduces the risk of premature birth.

Depression is also an indication for taking the drug. In this case, it is used as part of complex therapy.

Review of reviews from patients and doctors

Reviews from patients who took Heptral are positive in 83% of cases. They reflect the beneficial effect of the drug on the body as a whole and the improvement of biochemical parameters. Negative reviews relate to unpleasant side effects (headache, allergic reactions, decreased blood pressure, nausea), due to which treatment was stopped at the initial stages. The positive effect in this case was not noticeable, since it did not have time to occur.

Doctors have a positive attitude towards the drug, considering it an effective tool in the fight against liver pathologies of various origins. The reviews also take into account good tolerability and beneficial effects on the central nervous system of patients with encephalopathy and/or depressive symptoms.

Continuing the course

According to reviews, Heptral is prescribed intravenously only for the first few days or weeks of treatment, after which the patient is transferred to the tablet form. Using the tablets is quite simple. The manufacturer warns that each pill must be swallowed whole without violating the integrity of the shell. The outer layer is designed to protect the active substance from the gastric environment and aggressive chemical compounds contained in the body. The coating dissolves as it passes through the intestinal tract, and this is where the main compound is released, quickly rushing through the intestinal lining.

In order for absorption to be as effective as possible, and the drug to show the strongest possible effect, it is wise to use it between meals. The tablet is removed from the blister shortly before consumption. If the shade of the drug has changed, the product is discarded - it should not be used, it may be unsafe.

Brief instructions for use of tablets 400 and 500 mg

The tableted drug is available in two versions: 400 and 500 mg of active substance. The instructions for using Heptral clearly stipulate how many milligrams a patient should be given for various pathologies. Treatment should not be carried out without consultation with a specialist.

Compound

Ademetionine is the active ingredient included in Heptral. It belongs to the coenzymes that are necessary for biochemical processes associated with the synthesis of proteins and lipids. The medicine helps to compensate for the deficiency of ademetionine, thereby improving the condition of liver tissue and the functioning of brain cells.

Manufacturer

Manufacturer Heptral is German. Depending on the series, the drug is produced at factories in Italy or France. The main substance – ademetionine – is produced in Switzerland.

Indications

Indications for use of Heptral:

• chronic viral hepatitis;
• liver damage due to alcohol intake;
• fatty degeneration of the liver tissue;
• drug-induced damage to hepatocytes;
• chronic inflammation in the gallbladder and ducts;
• cirrhotic degeneration of liver tissue;
• hepatic encephalopathy;
• cholestasis of the intrahepatic ducts in pregnant women;
• depressive states.

How to use

According to the instructions for use of the tablets, Heptral is prescribed in a daily dose of 500 to 1600 mg. A dose of 400 mg is 2-4 tablets per day.

How long to take Heptral depends on the patient’s health condition. On average, maintenance therapy lasts 2-4 weeks.

Before or after meals

Heptral does not need to be taken before or immediately after meals. It is recommended to swallow the tablet whole with water between breakfast and lunch, that is, in the first half of the day. The shell is designed to dissolve in the intestines, from where the active ingredient enters the blood.

Dosage

The dosage of ademetionine in Heptral tablets is 400 and 500 mg. The medicine is prescribed according to the instructions for use after a course of injections or immediately at a dose of 500 mg per day.

When is Heptral prescribed?

Heptral is prescribed for any pathology of the liver and biliary tract, except for cholelithiasis, in which an increase in bile production can lead to blockage of the renal ducts with stones.

The medicine is especially effective for cirrhosis, which develops against the background of liver intoxication with drugs, alcohol, medications, etc. Heptral also helps with viral hepatitis (even chronic), because slows down the process of destruction of liver cells.

With long-term use, there is an increase in glutamine in the liver, cysteine ​​and taurine in plasma, a decrease in the amount of methionine in the blood serum, which suggests normalization of metabolic processes in the liver and improvement of its function

In cases of depression, the drug improves the metabolic processes of brain neurons, stimulating their activity and thereby relieving the depressive syndrome.

Doctors usually do not prescribe Heptral as a prophylactic agent to prevent liver disease. But in some cases, for example, with long-term use of medications that have a destructive effect on the liver (hormonal, antibacterial, immunosuppressive drugs, chemotherapy), Heptral is recommended for use.

The main indications for prescribing the drug are:

• Cirrhosis of the liver;
• Fatty liver degeneration;
• Chronic hepatitis;
• Toxic liver damage;
• Chronic cholecystitis;
• Depressive states;
• Intrahepatic cholestasis.

When withdrawn from alcohol or drugs, a patient who has a persistent physical dependence on these substances develops withdrawal syndrome. In this condition, liver function is impaired, because It is this organ that is responsible for neutralizing toxic substances, and severe intoxication of the body occurs. The drug Heptral neutralizes toxic substances, thanks to which it is possible to significantly improve a person’s condition.

Depending on the severity of the pathology and the degree of damage, Heptral is prescribed for use orally, intramuscularly or intravenously.

Indications

In all situations where the functioning of an organ is disrupted:

• in the presence of chronic hepatitis C;
• cholecystitis of any form;
• onset of cholestasis;
• encephalopathy;
• with cirrhosis;
• withdrawal syndrome;
• toxic hepatitis;
• metabolic disorder.

Heptral is prescribed for the treatment of various liver diseases

Heptral has indications for diseases of a wide variety of etiologies: both for patients with cirrhosis and fatty hepatosis, and for any long-standing problems and diseases of the liver. Heptral helps gradually against liver diseases, helping the organ to recover. It does not cure cancer, but it helps to cope with hepatitis C and gradually returns the ability to recover on its own. For metastases to the liver, no drug will help, only a transplant is possible. But until this moment, the doctor prescribes Heptral to keep the organ in working condition.

It is also important to monitor ALT and AST levels - liver indicators; they should not be allowed to fall to critical values. Patients are also often sent for liver ultrasound to detect the onset of hepatomegaly in time. Such enlargement of the liver is pathological and requires special treatment.

General characteristics of the drug

Heptral is an effective medicine for the restoration and prevention of liver diseases. In addition, it perfectly increases the defenses of the entire body. This drug is prescribed for the treatment of cirrhosis. Sometimes it is also used to eliminate hepatitis and cholecystitis. Only a doctor should prescribe Heptral - any self-medication options can lead to negative consequences.

How many days does therapy last? It is usually recommended to take Heptral for about 2 months. However, the specific period is determined by the doctor - it all depends on the characteristics of the body.

Preparations of similar action with a different composition

When it is not possible to buy Heptral, you can find cheaper analogues of the drug that are similar in terms of therapeutic action. The list of such drugs is quite large, and there are analogues of Heptral in tablets and ampoules. The dosage of the selected drugs should be determined by a doctor. It is forbidden to increase the dose on your own.

Please pay attention to the following:

Gepadif. The main components are represented by the antitoxic fraction, carnitine orotate, riboflavin, pyridoxine hydrochloride. The product combined with hepatoprotective action is produced in the form of capsules and powder. Treatment with Gepadif is carried out in the presence of acute and chronic hepatitis, cirrhosis, fatty degeneration, and intoxications of various origins. The medicine is also used in surgery before and after anesthesia. Gepadif is not prescribed to patients with intolerance to the components. Tablets are taken regardless of food intake, 2 capsules per day. Dosage for children: 1-2 capsules, depending on age. For the little ones, the contents of the capsule are diluted in water or juice. Geptrong. Russian analogue of Heptral, double action. The drug is available in ampoules. Heptrong has antiviral, adaptogenic and immunomodulatory properties. The active component of the drug is a solution of low molecular weight sugars obtained from honey. The medicine is used in complex therapy of drug and toxic intoxication, alcoholic liver disease, cirrhosis, toxicosis during pregnancy. If the patient is hypersensitive to bee products, Geptrong is contraindicated. Prescription of the drug for pregnant and lactating women is carried out on an individual basis. The method of administering the solution from the ampoule is intramuscular. The injection is placed in the buttock area. The dosage depends on the pathology, but 6 milliliters are always administered first

Caution should be exercised if you have diabetes. Phosphogliv

It is a representative of the group of hepatoprotective agents made on a plant basis. The effect of using the drug is due to the presence of antiviral, anti-inflammatory, immunostimulating and antioxidant properties. The action of Phosphogliv is aimed at restoring the structure of the membrane membrane of hepatocytes and normalizing the liver’s ability to neutralize toxins. The medicine is used to combat hepatosis, toxic liver damage, cirrhosis, and viral hepatitis. Release form: capsule. Phosphogliv is contraindicated for use in cases of excessive sensitivity to the components, when carrying a baby, breastfeeding and in adolescents under 12 years of age. It is recommended to take 2 capsules three times a day. Treatment can last up to 6 months. Hepa-Merz. The German medicine helps restore liver function. It has 2 forms of release - bags with granules and ampoules with a solution for injection. Hepa-Merz is prescribed to patients suffering from acute and chronic liver pathologies, which are accompanied by hyperammonemia. The drug is also prescribed for hepatic encephalopathy, including the latent form.

The list of contraindications includes renal failure, individual intolerance to components, and lactation. During pregnancy, Hepa-Merz can be prescribed if absolutely necessary.

The granules should be dissolved in water before use. For 200 milliliters it takes 1 sachet of medicine. Take the drug 2-3 times a day after meals.

The selection of medications that have the same therapeutic effect as Heptral should be carried out by a specialist. We should not forget about existing contraindications and the danger of overdose.

Is it possible to drink alcohol during and after a course of Heptral?

Recommendations for use

For each stage of pregnancy, there are certain dangers in using Heptral:

• 1st and 2nd trimester - it is recommended to use the drug only if the effect provided significantly exceeds the risk of side effects that occur in the body of the pregnant woman and the fetus;
• 3rd trimester - the risk of negative reactions during pregnancy is significantly reduced, so the medicine is freely prescribed to perform a hepatoprotective function.

In some women, after childbirth, the inflammatory reaction with cholestasis persists, so the medication continues to be taken in the future. Heptral is allowed during lactation, but only on the strict recommendation of a doctor. The effect must be significantly higher than the risk of side effects. If there is a possibility of harm to the baby, breastfeeding is interrupted for the duration of therapy.

Properties of Heptral

The high effectiveness of the drug is due to its components. The main component is the substance ademetionine, which plays an important role in the body's metabolism. It also performs several other functions, such as increasing the protective function of liver cells. A decrease in this substance in the body can occur due to age-related changes. A decrease in ademetionine often occurs due to the presence of a depressive state in the patient. The use of Heptral is aimed not only at replenishing this substance in the body, but also at stimulating its production in the liver, brain and other organs.

Thus, due to the composition of the drug, it contains the following properties:

• enhances bile secretion;
• promotes the release of bile into the intestines;
• removes toxins from the body;
• restores liver function;
• protects body cells from aging and damage;
• has a pronounced antidepressant effect.

How to use

Heptral should be taken after a doctor's prescription. Heptapral tablets are taken 1 piece 3-4 times a day, and it is recommended to do this in the first half of the day between meals. The tablets should be taken with a small amount of water without chewing. Treatment usually lasts a month.

Heptral is also available in the form of an injection solution. The daily dose of the drug in this case is 400-800 ml. It is administered via a dropper or intramuscular injection. Intensive treatment with the drug is carried out for 2-3 weeks, after which maintenance therapy is carried out for 2-4 weeks.

Description of the drug Heptral

Heptral belongs to the group of hepatoprotectors - drugs that restore the activity of liver cells. The active component of the drug is ademetionine. Additional substances enhance the therapeutic effect of the drug - magnesium stearate, silicon dioxide, etc.

Heptral is presented on the pharmaceutical market in 2 forms - tablets and lyophilisate for the preparation of solution for injection.

Conditions for dispensing from pharmacies

Dispensed by prescription.

Answer

Lies...ReplyReply

No, it does not replace.ReplyReply

Despite the fact that the manufacturer presents it as a hepatoprotector, and as an antiviral agent, and as an immunomodulator, the effect of the drug is not enough for it to be used as the main therapy; it is usually prescribed in combination with stronger drugs. Some experts classify Geptrong as a drug with an unknown effect. Reply

Rave. This is the first time I’ve heard of hepatitis C virus and cirrhosis being treated with sugar and interferon. Everything has been known for a long time, Yandex can help. Medicine hucksters are scamming you for moneyReply

How to use Heptral

Typically, therapy with Heptral begins with parenteral administration, followed by a transition to tablet forms, but in some cases the use of tablets without preliminary infusions and intramuscular injections is allowed.

Pills

When administered parenterally, a single dose should not exceed 400 mg, and a daily dose should not exceed 800 mg. The course of intravenous infusions is 20 days if the patient is being treated for a depressive state. When treating liver pathology, the duration of treatment is 14 days.

The tablets are taken morning and evening, one pill (daily dose 800 mg). Sometimes the dosage is increased to 1600 mg per day.

Approximate scheme for using Heptral tablets:

• The first pill should be taken early in the morning, before meals. In this case, the interval between meals should be at least half an hour.
• The second pill is taken before lunch , at the same interval.
• If a gastroenterologist prescribes a third appointment , then this medicine must be taken no later than 18:00. This is best done before a meal (dinner).

If Heptral is used by injection, its effect is more effective and prolonged.

After diluting the dry lyophilized powder, it should be used immediately before administration. To dilute it, a solvent is included in the package, which does not contain calcium. You can also use Sodium chloride (saline) or Glucose.

Injections

Step-by-step instructions for preparing a solution for intramuscular injection:

1. It is necessary to administer the medicine slowly, this will avoid the subsequent formation of an abscess.
   Remove the aluminum cap from the bottle containing the powder. Open the solvent by sawing off the top of the ampoule. Add the solvent drawn into the syringe into the bottle with the lyophilisate.
2. Shake the bottle until the powder is completely dissolved. The solution should be clear and free of particles of undissolved medication.
3. If the powder does not dissolve , this may mean that the medicine has expired and cannot be used.
4. The injection is made deep into the gluteal muscle , having previously treated the injection site with alcohol. The medication must be administered slowly to avoid subsequent abscess formation.

To achieve positive dynamics from the use of Heptral, you need to use drip administration of this drug.

To carry out this manipulation, a diluted Hepatral solution is introduced into a bottle with Glucose or saline solution (250 or 500 ml) in a ratio of 250 ml of Glucose per bottle of dissolved lyophilisate powder.

Use of Heptral for depressive conditions

Treatment of depressive conditions with Heptral begins with the introduction of its injectable forms.

Prescribed from 400 to 800 mg per day. The duration of the course is determined by the attending physician; usually it does not exceed 20 days.

Upon completion, the patient can switch to tablet forms and take this medicine 2 or 4 pills (800, 1600 milligrams) per day. This type of treatment continues for another month.

Heptral during pregnancy

The first 2 trimesters of pregnancy exclude the possibility of using this medicine. In subsequent trimesters of pregnancy, this drug is prescribed individually, after consultation with a doctor.

When breastfeeding occurs, Heptral can be prescribed only if its action will have a positive effect on the health of the mother and will not lead to negative consequences on the development of the baby.

Use in childhood

This dosage form has not been sufficiently tested in early childhood and adolescence. Therefore, there is no clinical data on the benefits or harms of this drug.

This medication is prescribed only after reaching 18 years of age.

Old age and Heptral

There are no differences in the use of this dosage form in young or elderly people. But one should take into account the fact that older people, due to their age, have a number of pathologies (in the cardiovascular, nervous system, kidneys).

Therefore, the drug is prescribed in small doses and with great caution.

Use for liver and kidney diseases

Let's consider cases of using Heptral for liver and kidney diseases:

• In case of pathological processes in the liver (hepatitis of various etiologies, cirrhosis of the liver), the use of Heptral gives a positive effect, restores liver tissue, and warns against its further destruction.
• In severe forms of renal failure, the use of this medicine is not recommended. But if it is prescribed, it is necessary to carry out systematic laboratory tests of blood and urine. Monitor nitrogen, urea, and creatinine levels.

Alcohol compatibility

The first thing you need to understand at the very beginning of treatment is that heptral and alcohol do not mix. The consequences can be extremely disastrous, and this is not due to the effect of the medication. The problem is that alcohol negatively affects human health, especially the liver.

Damaged liver cells become more and more difficult to restore with each alcohol consumption, and the disease only worsens with each liter of beer or shot of vodka. In addition, the level of alcohol in the blood interferes with the normal effects of the drug. Therefore, it is not advisable to use Heptral and drink it with alcohol on the same day.

Reviews from doctors are also adamant - no alcohol should be combined with therapy or prevention of liver treatment. In some cases, even a small amount of alcohol can be harmful to a person. In addition, the person is prescribed a strict diet, which does not include the consumption of fatty, fried, spicy and alcoholic foods. And the meals themselves should be more frequent and smaller in volume. Heptral and alcohol do not imply compatibility. Reviews speak about this very eloquently. If you do not follow this rule, then either the medication will not help, or the patient will become much worse. The medicine will not act on the body while intoxicated.

Heptral and Heptor

Both of these drugs are produced on the basis of Ademetionine, which, in the normal functional state of the liver, produced by the body, participates in metabolic processes, promotes the synthesis of liver cell membranes, and promotes the production of important biological compounds. In addition, hepatoprotectors promote normal outflow of bile, reduce the degree of liver damage in chronic diseases, and prevent the degeneration of liver tissue into connective tissue. In case of cholecystitis, cholestasis, fatty degeneration, chemical, alcohol poisoning, cancer processes and other pathological conditions of the liver, the production of Ademethionine is disrupted.

By using Heptral or Heptor, you can compensate for the deficiency of Ademethionine by improving the functioning of hepatocytes. As a result, the liver’s resistance to harmful factors increases, cells are renewed, new ones appear, and the outflow of bile improves. Heptor or heptral, which is better, doctors' opinions can be found online. Both drugs have a similar mechanism of action, range of indications and contraindications. Contraindications include:

hypersensitivity to the components of the drug; children under 18 years of age; pregnancy and lactation.

Possible side effects:

nausea; heartburn; stomach ache; allergic reactions; rash, itching; dizziness, headache; arthralgia.

Pharmacological properties

When using Heptral, the following positive properties can be identified:

• Antitoxic effect.
• Cholekinetic.
• Cholergic.
• Antidepressant.
• Antioxidant.
• Hepatoprotective.
• Choleretic.

Thanks to its numerous positive qualities, Heptral stimulates the production of Ademethionine (it is synthesized in the brain and liver cells) and increases its concentration in the bloodstream.

This leads to the activation of hepatocytes, liver cells and enhances the choleretic effect, eliminating the problems of cholestasis.

As a result of the use of this drug, liver cells increase their functional activity, they quickly grow, multiply and replace dead cell elements. Therefore, this drug is often prescribed for hepatitis and cirrhosis.

Heptral is able to have antitoxic and detoxifying effects on the body. Because of these qualities, it is used for various forms of poisoning, to relieve their negative consequences (poisoning with drugs and poor-quality food, relieving alcohol withdrawal syndrome).

The reduction in free radical activity is based on the antioxidant effect of Heptral.

A week after using this drug, its antidepressant activity begins to appear , the patient’s psycho-emotional state improves if therapy with Aminatreptyline does not lead to positive dynamics.

In addition, Heptral affects the biochemical parameters of the blood, helps normalize the levels of bilirubin, liver transaminase and creatinine.

Peak concentrations in the circulatory system are observed 6 hours after consuming Heptral. Its bioavailability when administered orally is 5%, and when administered parenterally 95%. At the same time, its connection with protein fractions remains at a low level.

It is excreted from the body along with urine through the kidneys.

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Heptral during pregnancy - reviews on the use of the drug

According to reviews, Heptral is most often prescribed after the 30th week of gestation, although, in the presence of elevated liver test titers already in the second trimester, treatment is started earlier.

• Anna: “I took a lot of medications due to the threat of pregnancy failure. At the 32nd week, a sharp increase in biochemistry indicators began. The doctor stopped all medications, leaving only Nefidipine. Ursosan and Heptral were prescribed for the liver. Within a week, liver enzymes dropped by almost a third. Treatment continued until delivery. She gave birth on her own."
• Lyudmila: “From the 26th week, problems with the liver began. The doctor insisted on performing a caesarean section. Labor began spontaneously at 32 weeks. The child appeared healthy, but with low weight.”
• Vera: “From the 22nd week, the biochemistry numbers began to increase. Therapy using Heptral did not help either. When ALT reached 1000, the decision was made to perform an emergency cesarean section. The child is alive, but very weak. The birth took place at 26 weeks.”
• Anastasia: “At the 30th week, severe itching began in the area of ​​​​the palms and soles. After taking tests, the doctor diagnosed hepatosis. After a course of Heptral in combination with a strict diet, the numbers returned to normal. She gave birth on time, on her own.”

Prices and analogues

In pharmacies in St. Petersburg, Moscow, Novosibirsk and Ufa, the average price for a package of 20 tablets is 1,500 rubles. For ampoules you will have to pay from 1600 to 1900 rubles. The same tablets in Ukraine are sold for 756-1175 hryvnia. For a pack of ampoules they will ask for 670-755, and one bottle - 210-215 hryvnia. In Belarus, the price for Heptral tablets and ampoules is approximately the same, it varies from 675 to 925 thousand rubles.

To make treatment cheaper, patients and doctors resort to cheaper options - analogues of Heptral in structure, function and composition.

Heptor with ademetionine

Heptor costs only 645 rubles, and also activates the activity of the liver and increases its stability. The composition of the tablets and the mass for reconstituting the solution includes ademetionine. Moreover, it is contained in the same amount as in the original drug. Heptral and Heptor are almost completely similar drugs; they can be freely replaced with each other. If the price of the product is very important, then it is better to purchase a cheaper analogue, because you can save up to 1 thousand rubles.

Essentiale Forte or N

Essentiale is produced with the additions “Forte” and “N”. In both cases, this hepatoprotector is based on soybean phospholipids. They actively restore hepatocytes, which is why heaviness in the liver area disappears, appetite increases and fatigue decreases - the patient’s overall well-being improves.

Heptar and Essentiale have a similar list of indications for use. The analogue is prescribed for liver intoxication, cirrhosis, psoriasis, hepatitis or steatohepatosis. It helps for rehabilitation after surgery and can be used as a means of combating depression and encephalopathy. Despite the similar purpose, the drugs are based on the action of different substances. An intelligent choice can only be made by the attending physician, who is aware of the patient’s health characteristics and the form of his disease.

Antiviral Phosphogliv

Phosphogliv not only has a protective effect on the liver, but also fights viruses. Glycyrrhizic acid and phospholipids are the main components of the drug.

Phosphatidylcholine helps restore the structure and function of damaged cell membranes. The substance also normalizes the liver’s independent ability to remove toxins. Under its influence, lipid, protein and fat metabolism is restored in the organ, and connective tissue stops growing. This is a good remedy for the prevention of cirrhosis and liver fibrosis.

Exposure to glycyrrhizic acid protects hepatocytes from infection and prevents viruses from forming new structural components. Phosphogliv is prescribed for cirrhosis, hepatitis, hepatosis and liver intoxication, and is often used to treat eczema, psoriasis, neurodermatitis and other skin diseases.

Pharmacokinetics of the drug

The therapeutic concentration of the main component of the drug is achieved after 6 hours. The half-life of the product takes 1.5 hours. A dropper will allow you to achieve higher bioavailability. To improve the functioning of the organ, the drug can be administered intravenously or intramuscularly. Then the injections are replaced by the use of the drug in tablets. Intravenous injections of the drug ensure bioavailability of the drug at a level of 95%. If you take the drug in tablets, this figure is only 5%.

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Popular analogues in tablets

There is no completely identical analogue of Heptral in tablets, but pharmacies offer medications that are classified as hepatoprotectors and have one therapeutic direction - they are used in the treatment of liver pathologies.

Essentiale Forte N

Essentiale forte N is available in capsules and solution for injections. The active component in the medicine is phospholipids from soybeans. Medication is prescribed for the following pathologies:

• hepatitis in a chronic form of development;
• cirrhosis of the liver;
• fatty degeneration of hepatocytes;
• damage to hepatocytes by toxins;
• severe toxicosis during pregnancy.

Release form and application

The drug is also part of the complex therapy of psoriasis. The medication Essentiale is not used in therapy for the following disorders in the body:

• if you are allergic to components;
• injection solution is not used in children under 3 years of age.

No clinical studies have been conducted during pregnancy and lactation, so Essentiale can be prescribed during this period with caution and when absolutely necessary. Essentiale is intended for a long-term medication course

The duration of the course is determined by the doctor based on laboratory and instrumental diagnostic indicators, as well as positive dynamics in therapy with this drug. The daily allowable dose is from 4 to 6 capsules. The medicine must be taken while eating. Capsules must be swallowed whole without breaking

Essentiale is intended for a long-term course of medication. The duration of the course is determined by the doctor based on laboratory and instrumental diagnostic indicators, as well as positive dynamics in therapy with this drug. The daily allowable dose is from 4 to 6 capsules. The medicine must be taken while eating. Capsules must be swallowed whole without breaking.

The dosage of the solution for injections per day is 5-10 ml, the maximum allowable dosage is 20 ml. The course of intravenous treatment with medication is 10 days. After this, medication is prescribed in tablets. The course of therapy is 3-6 months.

Gepadif

Gepadif is a combination medication, the effectiveness of which is due to the active components in the composition. Carnitine is a natural component in Gepadif, which is similar in composition to vitamin complexes. The component inhibits the breakdown of protein and carbohydrate molecules, and also reduces fat metabolic processes.

Carnitine is necessary for regulating the transport of cholesterol throughout the body, correcting the process of lipid oxidation and coenzyme formation. This active component stimulates cell retention during organ hypoxia.

Effect of the drug

Gepadif is available in the form of capsules and in bottles with a dry mixture for preparing a solution. The medicine is used in therapy:

• hepatitis in chronic and acute forms of development;
• liver cirrhosis;
• liver dysfunction;
• intoxication of liver cells with alcohol or medications;
• fatty degeneration.

The medication is not prescribed for pediatric patients (up to 7 years of age) or for those with an allergy to the medication. You can take Gepadif during pregnancy, because studies have not found any effect of the drug on the intrauterine formation of the fetus.

Gepadif is prescribed 2 capsules twice. Children over 7 years old – 1 capsule twice or three times a day. Powder for intravenous solution – 1 time per day. The dry mixture is diluted in a 5% dextrose solution (500 ml). The drug is administered using a dropper.

Heptor

Heptor is available in tablet form with the active component S-adenosylmethionine. Indications for use in the treatment of the Heptral analogue are the following pathologies:

• liver cholestasis;
• cirrhosis or pre-cirrhosis of the liver;
• hepatitis of various etiologies;
• alcoholic and drug-induced hepatitis;
• encephalopathy of alcoholic etiology;
• depression;
• withdrawal syndrome.

Contraindications to treatment with Heptor are the following disorders in the patient’s body:

• sensitivity to the drug;
• 1st and 2nd trimester of pregnancy;
• during lactation;
• children under 7 years old.

Use with extreme caution in therapy in patients with hyperazotemia. In such patients, treatment is carried out in an inpatient setting and under the supervision of a physician.

During pregnancy, it is permissible to take the medicine only in the 2nd trimester, and during lactation, you can take Heptor after the child is transferred to artificial feeding.

Maintenance therapy: 800 to 1600 mg per day. The course of therapy is 14-30 calendar days. Capsules should be taken whole with a small amount of water.

Interaction

Dosage forms based on Ademethionine are not allowed for use in parallel with solutions containing alkalis and calcium.

This medicine is not used in combination with the following drugs:

• Clomipramine.
• Herbal medicines containing tryptophan.
• Serotonin inhibitors.
• Medicines of the tricyclic group.
• This dosage form should be used with extreme caution if other antidepressant drugs were previously prescribed.

Analogs

Analogues of Heptral include hepatoprotectors based on milk thistle, animal and plant components, as well as analogues of the drug containing amino acids. You should not use such drugs on your own or to maintain a healthy liver. An analogue or Heptral itself should be prescribed by the doctor himself, having examined the patient’s health status, his medical record, the possible presence of concomitant and chronic diseases, as well as the patient’s budget. Because to prescribe medications, the specialist will inquire about financial possibilities and prescribe the drug that the patient can purchase.

It is highly not recommended to replace or discontinue medications on your own, as this should only be done by a doctor. Only he, based on complaints and research results, has the right to replace one medicine with another. Unauthorized prescription and choice of drugs may not only not bring the expected result, but also significantly harm the person. Also, do not voluntarily replace prescribed drugs with analogue ones.

Side effects

The most common adverse reactions include nausea, abdominal pain, and diarrhea. Also, tablets and injections of a medicinal substance can provoke the following disturbances in the functioning of major organs and systems:

1. Immune system – hypersensitivity reactions may occur. Sometimes very life-threatening complications develop in the form of anaphylactic shock. In this case, the patient may experience a decrease or increase in blood pressure, discomfort in the chest area, back pain, shortness of breath, skin flushing, and bronchospasms.
2. Respiratory system - the main side effect is swelling of the larynx, which poses a real danger to life.
3. Skin – injections may provoke a reaction at the injection site. In rare cases, they are accompanied by skin necrosis. Also sometimes there is redness of the dermis, erythema, itching, and urticaria. Some people experience excessive sweating and even develop angioedema.
4. Infectious diseases most often affect the urinary tract.
5. Nervous system – headaches, increased anxiety, dizziness, confusion, and sleep disturbances may appear.
6. Cardiovascular system - sometimes the drug provokes the development of phlebitis of the superficial veins, so-called hot flashes, disturbances in the functioning of the heart and blood vessels.
7. Digestive system – as a result of using the product, flatulence, diarrhea, and a feeling of dryness in the mouth may occur. Pain in the abdomen, internal bleeding in the digestive organs, cirrhosis, nausea and vomiting, and dyspeptic symptoms also often occur.
8. Musculoskeletal system - side effects manifest themselves in the form of muscle spasms and arthralgia.
9. Other complications - taking the drug can provoke febrile states, the appearance of peripheral edema, malaise, chills, asthenic phenomena, and the development of influenza-like syndrome.

Pain in the abdomen - side effects of the drug

Expert opinion of the Polismed medical board

We have collected frequently asked questions and prepared answers to them

Can I take it during pregnancy or while breastfeeding?

Closer to the third trimester of pregnancy, I began to suffer from heartburn attacks. This was explained to me by the fact that the enlarged uterus puts pressure on the stomach and interferes with normal digestion. Can I take Ranitidine during pregnancy? Tatiana.

Tatyana, although the official instructions for Ranitidine indicate that its use is undesirable during pregnancy, recent studies have shown that this drug does not pose a danger to the fetus. Ranitidine is included in the treatment protocols for heartburn in pregnant women in many Western countries. When breastfeeding, you should refrain from taking it, as it is excreted in breast milk.

Which is better - Ranitidine or Omeprazole?

I am being treated for a peptic ulcer, doctors prescribe different medications. I would like to know which is better – Omeprazole or Ranitidine, or maybe there are more effective drugs?

A number of fairly reliable studies have shown that treatment with Omeprazole results in faster healing of duodenal and gastric ulcers. This indicates that Omeprazole is still more effective. Some peptic ulcer treatment regimens use both of these drugs.

Even more effective proton pump blockers have been created (the group of drugs to which Omeprazole belongs) - these are Lansoprazole, Esomeprazole and others.

How to give Ranitidine to children?

A four-year-old child was prescribed Ranitidine for treatment. Interested in how to properly give it to children with gastritis?

Ranitidine is approved for use in children from 3 years of age. However, only a pediatrician can prescribe it at this age, having calculated the dosage according to a special scheme. Ranitidine tablets are given to the child before meals in the morning and in the evening before bed. When hospitalized in a hospital, it is possible to administer the drug by injection.

How to take Ranitidine correctly?

The doctor prescribed Ranitidine for the treatment of gastritis. Interested in how many tablets should be taken at a time and how long can you use it, and when does its effect occur?

The dosage of any drug, as well as the duration of the course of treatment, is determined by the attending physician. The average course dose ranges from 150 to 300 mg twice a day and depends on the human constitution - people with low body weight require a dose reduction. A dose reduction is also required in patients with renal failure. The course of treatment can last from 4 to 8 weeks and depends on the effect. With a prophylactic dose, a half dose of the drug is most often prescribed once a day.

The maximum effect from taking Ranitidine is observed after 1.5-2 hours, when it is completely absorbed into the blood. The duration of action of one dose is 12-14 hours.

Prices for the drug and main analogues

The cost of similar products varies significantly and directly depends on the country of origin. The average prices of the main analogues of Heptral are shown in the table.

Compatibility of the drug and alcoholic beverages

The use of this medicine should be the basis for a complete abstinence from alcohol. First of all, to eliminate the underlying disease, it is very important to follow a special diet. It strictly prohibits the consumption of any alcoholic beverages. If you break this rule, there is a risk of developing serious health consequences. The interaction of alcoholic beverages and the drug leads to a significant decrease in the effectiveness of therapy. In some cases, all therapeutic measures completely lose all meaning. That is why before starting a course of therapy you need to stop drinking alcohol. This is especially true for cases where the disease is a consequence of complex forms of alcoholism. Often, the combination of medication with alcoholic drinks provokes an increase in heart rate, which leads to the development of hypertension. Alcohol abuse is almost always caused by the presence of emotional problems that can provoke depressive states. In turn, this disorder also leads to excessive alcohol consumption. This creates a vicious circle. This disease should be treated with antidepressants, but today they do not work for everyone. In such situations, heptral is actively used. With its help, you can restore metabolic processes in the brain and make the nervous system more active. Taking the drug helps eliminate melancholy and return a person to a full life. The duration of such therapy should be about 2 months. It is important to consider that the medicine cannot be used for manic-depressive syndrome. Under the influence of the active components of this drug, depression can transform into a manic state. It is important to consider that combining medication with alcohol can negatively affect the functioning of the nervous and circulatory systems. The functioning of the heart and pancreas often suffers. People's consciousness is impaired and insomnia appears.

The combined use of the drug with ethanol leads to the appearance of complex forms of an allergic reaction - Quincke's edema. Due to the impact of alcohol on the affected organ, side effects increase many times over. In this case, a person develops skin rashes and an itching sensation. The following disorders in the functioning of internal organs may also develop:

• phlebitis;
• increased heart rate;
• bowel dysfunction;
• cirrhosis;
• vomit;
• colic;
• kidney failure;
• internal bleeding.

Domestic analogues

For many patients, the imported drug is inaccessible due to its high price. Therefore, citizens are looking for medicines with a similar composition or effect at an affordable cost.

https://youtube.com/watch?v=o4j3uQu6mYo

The list of inexpensive structural analogues of Heptral from a domestic manufacturer includes:

1. Heptor. Regenerates, detoxifies, acts as a neuroprotector. Antifibrosing and antioxidant effects are included. Presented in the form of tablets and lyophilisate for injection. Heptor is used for intrahepatic cholestasis, cirrhosis, hepatitis of various origins, encephalopathy, and depressive syndrome. The drug is prohibited for patients with individual intolerance to the components, children under 18 years of age, and in the 1st and 2nd trimesters of pregnancy. Adverse reactions occur rarely.

According to the instructions, the tablets are swallowed without chewing. In this case, the packaging is opened immediately before using the medicine. The average course duration is 2-4 weeks.

1. Heptor N. Russian drug with the same characteristics as the previous medicine.
2. S-adenosyl-L-methionine disulfate p-toluenesulfonate. Heptral substitute with hepatoprotective properties. Available in powder form. One package contains 25 milligrams. The drug has choleretic and cholekinetic properties. Additionally, the medicine helps restore liver cells and remove toxic substances, protects against the action of free radicals. Plus, an analogue of a foreign drug helps eliminate ademetionine deficiency and stimulates its production, especially in the brain and liver.

The drug has similar indications and contraindications to Heptral. The disadvantage of the medicine is the lack of tablet form.

1. Ademethionine 1,4-butane disulfonate. It is attractive due to its inexpensive price, however, it has an inconvenient dosage form. The drug is produced in the form of a powder, packaged in bags. One contains from 1 to 10 kilograms. It is difficult for private individuals to buy such a volume at a time and is not always necessary. The drug is mainly purchased by clinics. The maximum concentration of the substance in the blood is achieved much later than in the case of previous drugs.

When using any of the existing analogues, it is important to carefully study the instructions. Ignoring contraindications and dosages results in worsening well-being

The listed drugs are potent and are available only with a doctor's prescription.

Comparison of drugs Heptral and Maxar for hepatitis

Compound

The composition of Heptral 400 includes the active compound - ademetionine in a volume of 400 mg. This applies to such types of drug as capsules and lyophilisate. Ademetionine has a liver-supporting and depressive-reducing effect on the patient. It is important to monitor values ​​such as folic acid and B12. The lack of these indicators can reduce the natural amount of ademetionine, for this reason, if indicators decrease, you need to take additional folic acid and vitamins. You also need to understand that heptral and alcohol do not mix. This is not the reason that the active ingredients cannot be combined with alcoholic beverages. Medicines such as Heptral and other hepatoprotectors are prescribed for disturbances in the functioning of the organ. In such situations, it is strictly forbidden to drink alcoholic beverages, so as not to aggravate the health condition.

Dosage for cats

Heptral is a drug intended for the treatment of humans, therefore the instructions for use are intended for such patients, and not for animals. Only a veterinarian can select the correct dosage for a cat, based on the diagnosis, clinical picture, age and weight of the animal.

The table shows the approximate doses of the drug that are prescribed to the cat during the day in 2 doses:

The course of therapy depends on the severity of the disease. Most often, an appointment is scheduled within 1 week. Then tests are taken, and based on their results, the doctor decides whether further treatment is necessary. Often it is extended for up to 1 month.

Sometimes Heptral is prescribed intravenously. But such injections are given through a catheter only in the clinic.

At home, it is easier to use Heptral in tablet form. To do this, it is recommended to crush the tablet and mix the powder with a small amount of water. You can give the medicine using an insulin syringe without a needle or teaspoon. The cat should be held tightly so that it does not escape and spill the mixture.

If the owner decides to inject himself, he should familiarize himself with how to prepare the solution:

• a solvent should be poured into the lyophilisate (the ampoule with it is included in the kit);
• mix thoroughly by shaking.

Veterinarians advise giving an injection into the femoral muscle. It rolls under your finger, so you can feel it quite easily. The needle is inserted to a depth of 1 cm at an angle of 90°. The medicinal composition must be poured in gradually, i.e., the piston should be pressed slowly. Rapid administration of the drug causes pain. It is recommended to avoid using a long needle to avoid injury to the nerve endings.

Heptral does not combine with many medications, including those of herbal origin, so you should not give your cat other medications. But if the doctor recommended any other medications, you must act in accordance with his instructions.

If your pet has pain not only in the liver, but has previously been prescribed other medications, you should tell the veterinarian about this. It is possible that you will have to stop taking other medications while taking Heptral.