Heptral, 400 mg 20 pcs

Pharmacotherapeutic group Other drugs for gastrointestinal tract and metabolism, amino acids and their derivatives

ATC code A16AA02

Pharmacological properties.

Pharmacodynamic

Ademetionine belongs to the group of hepatoprotectors, also has antidepressant activity. It has choleretic and cholokinetic effect, has detoxifying, regenerating, antioxidant, antifibrotic and neuroprotective properties.

It replenishes the S-adenosyl-L-methionine (ademetionine) deficiency and stimulates its production in the body, contained in all body fluids. The highest concentration of ademetionine is found in the liver and brain. Ademetionine plays a key role in the metabolic processes of the body and takes part in major biochemical reactions: transmethylation, transsulfurization and transamination.

In transmethylation reactions ademetionine donates methyl groups for the synthesis of cell membrane phospholipids, neurotransmitters, nucleic acids, proteins, hormones and others. In transsulfurization reactions ademetionine is a precursor of cysteine, taurine, glutathione (providing redox mechanism of cellular detoxification), coenzyme A (is included into biochemical reactions of tricarboxylic acid cycle and fills the cell energy potential).

Increases glutamine content in the liver, plasma cysteine and taurine, decreases methionine content in the serum, normalizing metabolic reactions in the liver. After decarboxylation it participates in aminopropylation reactions as a precursor of polyamines – putrescine (promoter of cell regeneration and hepatocyte proliferation), spermidine and spermin, included in the structure of ribosomes, which reduces the risk of fibrosis.

It has choleretic action. 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 membranes of hepatocytes and contributes to bile acid passage to biliary tracts.

Effective with intradolocular variant of cholestasis (disorders of bile synthesis and flow). Ademetionine reduces the toxicity of bile acids in the hepatocyte by performing their conjugation and sulfation. Conjugation with taurine increases solubility of bile acids and their excretion from the hepatocyte. The process of sulfation of bile acids promotes the possibility of their elimination by the kidneys, facilitates the passage through the hepatocyte membrane and excretion with bile. In addition, sulfated bile acids themselves additionally protect liver cell membranes from toxic effects of nonsulfated bile acids (in high concentrations present in hepatocytes with intrahepatic cholestasis).

In patients with diffuse liver diseases (cirrhosis, hepatitis) with intrahepatic cholestasis syndrome, ademetionine reduces the severity of skin itching and changes of biochemical parameters, including the concentration of direct bilirubin, alkaline phosphatase activity, aminotransferases and others. Choleretic and hepatoprotective effect persists up to 3 months after discontinuation of treatment. It is shown to be effective in hepatopathies caused by various hepatotoxic drugs. Antidepressant activity appears gradually from the end of the first week of treatment and stabilizes during 2 weeks of treatment.

Several studies have confirmed the effectiveness of ademetionine in treatment of increased fatigability in patients with chronic liver disease. A pooled analysis of data from patients with pre-treatment symptoms of fatigue proved the effect of ademetionine treatment in reducing symptoms of increased fatigue in conjunction with a number of other symptoms, such as depression, hiccuria of the skin and mucous membranes, malaise and skin itching.

Ademetionine treatment significantly improved mood in patients with alcoholic liver disease who had a simultaneous positive response from symptoms of increased fatigue. In addition, in patients with alcoholic liver disease and nonalcoholic fatty liver disease with achieved response to ademetionine treatment on the side of fatigue symptoms there was also observed a significant reduction in such symptoms as acidity of the skin and mucous membranes, malaise and skin itching.

Indications

Active ingredient

Composition

How to take, the dosage

– Heptral tablets® 400 mg should be taken whole, without chewing, preferably in the morning between meals. Heptral tablets ® 400 mg should be taken out of the blister immediately before drinking because ademetionine, the active ingredient of Heptral ®, is sensitive to light.

Age for use: From 18 years of age.

Interaction

Special Instructions

Influence on the ability to drive and operate machinery

In some patients dizziness may occur while taking Heptral®. It is not recommended to drive a vehicle or operate machinery while taking this medicine until the patient is sure that the therapy does not affect the ability to perform this type of activity.

Synopsis

Heptral® is a source of active amino acid, which is involved in more than 100 vital reactions in the liver. Heptral® triggers the process of natural liver cell repair from within, working in several ways at once:

– Restoring cell structure: participates in the synthesis of building components of the cell wall.

– Excretion of toxins: provides the redox mechanism of cellular detoxification as a precursor of glutathione, the most active antioxidant of the liver.

– Bile acid excretion: improves the function of transport channels and promotes the transport of bile acids into the biliary tract.

– Replenishment of cells energy potential: participates in the synthesis of energy molecules in the mitochondria of liver cells.

– Regeneration of liver cells: stimulates the “multiplication” of healthy liver cells, helping liver repair.

The intake of Heptral® also helps reduce the increased fatigue that often accompanies patients with chronic liver disease. Already after the 1st week of use Heptral® helps restore liver function, reducing fatigue signals and restoring vigor.

Heptral® tablets 400 mg easy to take: can be taken once a day, between meals. The effects of taking Heptral® can last for 3 months after the end of treatment.

Contraindications

Pregnancy (first trimester) and the period of breastfeeding (use is possible only if the potential benefit to the mother exceeds the possible risk to the fetus or baby).

Simultaneous use with selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (such as clomipramine), and herbal and tryptophan preparations.

Elderly age.

Renal insufficiency.

Side effects

Overdose

Pregnancy use

Similarities