Used "intravenously or intramuscularly" Heptral "in the form of an injection, as well as tablets produced under this name - an effective tool for cleaning the body. The medicine belongs to the class of liver protectors and is used for cirrhosis, against the background of depressive syndrome or alcohol poisoning. The number of indications includes cholestasis inside the liver during the period of bearing a child, as well as a similar pathology that accompanies or precedes cirrhosis.
Indications and contraindications
The drug is indicated for the following pathologies and symptoms:
- fatty liver disease;
- cholangitis;
- chronic hepatitis;
- encephalopathy;
- toxic liver lesions of various etiologies, including alcoholic, viral, medicinal;
- cirrhosis of the liver;
- chronic stoneless cholecystitis ;
- symptoms of depression.
- intrahepatic cholestasis in pregnant women;
Contraindications:- Genetic disorders affecting the methionine cycle and / or causing homocystinuria and / or hyperhomocysteinemia.
- Sensitivity to any of the components of the medication;
- Age to 18 years.
Application rules
Following the instructions to Heptral, intravenous drip of the drug is prescribed only to adults. Typically, injections are given only in the first period of treatment, then the patient is transferred to a tablet version of the drug.
With liver diseases, the drug is prescribed for two weeks in an amount of 0.4-0.8 g per day. To maintain a stable state, the patient is shown continued treatment with tablets: from two to four pieces per day.
If the appointment is associated with depressive syndrome, the first two to three weeks the drug is administered in an amount of 0.4 g per day into a muscle or vein, after which the patient is transferred to a tablet version of the medication. A day will be prescribed a dose of 2-3 tablets. The duration of the course of treatment depends on the symptoms, the severity of the condition. In each case, the doctor individually determines how long the therapy will last and how much medication the patient needs.
The nuances of some cases
So far, no scientific studies have been conducted to determine how effectively it is prescribed to patients of advanced age, produced in Heptral ampoules. Intravenous drip may not always be prescribed for older people. There are no official volumetric clinical observations on such medical practice. If it is necessary to select a course for an elderly person, it is reasonable to start with the lowest possible dosage. In this case, it is important to consider concomitant pathologies, diseases of the liver, kidneys and heart. Formulating a course of drug therapy, you need to pay attention to other drugs used by patients.
How to apply correctly?
Before administering the Heptral diluted in saline solution by the intravenous drip method, it is necessary to familiarize yourself with the instructions supplied by the manufacturer with the product. It is important to prepare the substance for administration. The powder contained in sterile ampoules is diluted immediately before use. All release options include not only powder, but also a special liquid in which you need to dilute it. The prepared drug must be injected into the patient in drops into a vein. The procedure is long, the speed is very small.
According to the accompanying Heptral ampoule instructions for use, only freshly prepared product can be used intravenously. If some of the solution remains unused, it is disposed of. Keeping the medicine is strictly prohibited. Do not use the product if the color of the powder during storage has changed. It is not allowed to mix medicinal substance and alkaline solutions, as well as liquids with calcium ions.
Continuing the course
According to reviews, Heptral is administered intravenously only for the first few days or weeks of a course of treatment, after which the patient is transferred to the tablet form. Using pills 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 membrane dissolves as it passes through the intestinal tract, and it is here that the main compound is released, quickly breaking through the mucous intestines.
So that absorption is as effective as possible, and the drug shows the most powerful of the possible effects, it is reasonable to use it between meals. The tablet is removed from the blister shortly before eating. If the shade of the drug has changed, the product is disposed of - it should not be used, it may be unsafe.
Negative consequences: what is possible
According to the instructions for use and reviews of Heptral, intravenous administration of the drug can cause an unwanted response from the body. In order to clarify such effects, 22 official studies were organized. On average, the incidence of an adverse reaction is estimated at 7.2%. Nausea and stool disturbance, pain in the abdomen were more often noted.
There is an assumption that "Heptral" may be the cause of some other undesirable responses of the body, but when conducting an official study, it was not possible to establish for certainty the relationship between the condition and the drug course. Among these answers are infection of the urinary system, sleep disturbance, confusion, headaches and dizziness, paresthesia. Presumably, the medication may be the cause of hot flashes, phlebitis, flatulence, dry mouth, bleeding and gastrointestinal tract dysfunction. In a number of cases, there were reasons to suggest a connection between the drug and cirrhosis, rash, itching of the skin, muscle cramps. There is a risk of flu-like symptoms, swelling, fever, chills.
More often negative reactions are observed local, at the point of injection. They are most pronounced if you use the medication sloppy, not following the rules of intravenous administration of Heptral.
Strongly impossible!
The introduction of "Heptral" intravenously, intramuscularly, as well as the tablet form of the drug is strictly prohibited if the patient has revealed an increased sensitivity to any of the substances present in the composition of the drug. You can not use the composition if any of its components provokes an allergic response to the body.
The drug is prohibited if the characteristics of the patient's condition include genetic defects that provoke hyperhomocysteinemia, homocystinuria - either of these syndromes or both at the same time.
"Interesting" position
Tests were conducted with the appointment of the medication in question to pregnant women. The use of a substance in the third part of the term, even at a high dosage, did not cause an unwanted response from the body. In the first two trimesters, the composition should be used only if there is vital evidence.
During lactation, the use of "Heptral" intravenously, in muscle tissue or orally is allowed only when the obvious benefit of the drug course is higher than the potential dangers for the baby.
Special cases
Experiments were conducted with the participation of volunteers, as well as persons suffering from chronic hepatic pathologies. Studies of the results showed: the pharmacological kinetics of the drug does not differ in patients and healthy patients. If hyperammonemia is established at the stage preceding cirrhosis, as well as at the cirrhotic step, it is indicated to regularly check the content of ammonia in the body. This is especially important when taking the tablet form, but with injective administration, accuracy will not hurt.
With caution, the use of "Heptral" intravenously against the background of renal failure is allowed. So far, no official trials have been organized to confirm the effectiveness and safety of the active compound for patients of this category. Presumably, the remedy is quite safe, so the failure of the kidneys is not an absolute contraindication, but requires monitoring the patient's condition.
So far, official statistics on the use of medicines by people of advanced age have not been collected, but the medicine is strictly contraindicated for children.
The nuances of the state of the body
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 these compounds may cause a decrease in the content of ademetionine, on which Heptral is based, which will make the use of the drug less effective.
Against the background of bipolar psychosis, the medication in question is not recommended. Isolated cases of transformation of the depressive syndrome into hypomania, mania against the background of the use of the drug are known.
The effectiveness of depressive syndrome has been proven in a number of short-term official studies. The programs lasted from three to six weeks, while the drug was administered intravenously. In the instructions to Heptral, there is no information on the effectiveness of depression, if it is prescribed for a course exceeding six weeks, there is simply no such information officially.
The patient should know: if the manifestations of depression do not become easier or the condition worsens, it is necessary to immediately warn the attending doctor about this. Depressive syndrome is a reason for referring the patient to patients whose condition is associated with a particular risk. It is believed that for such persons the risk of suicidal attempts is higher, which means that it is necessary to constantly monitor the condition of a person and provide him with qualified assistance as necessary. This approach helps to track the effectiveness of the therapeutic course.
Safety nuances
As follows from the reviews of the intravenous use of Heptral, occasionally patients experienced dizziness. Although such a reaction is quite rare, in order to ensure the maximum level of security it is reasonable to refuse to drive vehicles and high-precision machines, while the risk of undesirable manifestations remains. You should refrain from dangerous activities and all forms of activity that require a person to have an increased reaction rate.
Too much!
In the instructions for use of "Heptral" intravenously (as well as injections into the muscle or orally) practically do not find information about a possible overdose. Although such cases have occurred in clinical practice, they have been isolated. The manufacturer recommends that, when an overdose is detected, the patient's health status should be closely monitored and supportive therapy practiced, focusing on the specifics of health.
Safety: especially with depression!
The combination of ademetionin and clomipramine can provoke serotonin syndrome. So far, it has not been possible to determine exactly how great the role of ademetionine is in this. Currently, it is recommended to use this agent with caution against the background of the need to take medications from the SSRI class, as well as tricyclic antidepressants. It is believed that serotonin syndrome can provoke a combination of ademetionine and medications that contain tryptophan.
Dynamics
About how and why the liver protector based on ademetionine works, the manufacturer is explained in detail in the accompanying instructions for the use of Heptral. Intravenously, in muscle tissue, an orally ingested composition has pronounced effects: choleretic, cholekinetic. The drug has inherent qualities of an antioxidant, a neuroprotective agent. The tool belongs to the group of antifibrosing, detoxifying, activates regenerative processes and compensates for the lack of ademethionine in the body, while also activating the generation of this substance. The highest concentration indicators are observed in the brain and liver.
Introduced in accordance with the instructions for use intravenously, "Heptral" helps to stabilize metabolic reactions. The active component of the drug is involved in many biochemical processes, including transamination, trans sulfation, transmethylation.
Biology and chemistry: the subtleties of the process
If Heptral is administered intravenously, the agent activates transmethylation processes, acting as a methyl group donor for the production of membrane phospholipids in cells. The elements supplied with the medication to the body are also participants in the reaction of generating proteins, hormonal and nucleic compounds, and neurotransmitters.
Trans-sulfation due to the medication introduced into the body proceeds more correctly, since ademetionin is the basis for the manufacture of cysteine, glutathione, taurine.
If Heptral is administered intravenously, the active component increases the concentration of taurine, cysteine, glutamine in the blood serum. The plasma concentration of methionine is reduced, metabolic processes in the liver cells are stabilized. Having passed the stage of decarboxylation, the substance becomes an important element of aminopropylation, preceding polyamines. This applies to compounds included in the ribosome structure. In total, this effect reduces the risk of fibrosis. Also, the drug shows a pronounced choleretic effect.
Reactions and their meaning
Heptral administered intravenously helps to stabilize the production of phosphatidylcholine (the reaction is localized in hepatocytes), due to which membrane fluidity and polarization increase. The functionality of transports associated with hepatocyte membranes increases. The drug shows a good effect with cholestasis inside the liver - in the lobules and between them. The toxic effect of bile acids is reduced, sulfation and conjugation reactions are activated. With the participation of taurine, the ability of the medium to dissolve bile acids and remove them from the cells increases.
Sulfation of acids simplifies and speeds up the elimination of compounds through the kidneys. Sulfated acids are an element of the protective cellular system. They reduce the harmful effects of non-sulfated substances detected in the liver in high levels with cholestasis.
Against the background of diffuse hepatic diseases with cholestasis inside the liver, heptral administered intravenously helps to reduce the concentration of direct bilirubin, reduces itching, and normalizes the activity of aminotransferases. The effectiveness of the drug is observed within three months after the completion of the main therapeutic course.
The nuances of the effect
Heptral administered intravenously is recommended for hepatopathies associated with liver toxic drugs. Against the background of opioid addiction and hepatic impairment, the use of the composition makes it possible to alleviate withdrawal symptoms. The liver begins to function better, microsomal oxidative reactions stabilize.
Effectiveness in depressive syndrome is increasing gradually. The first result can be seen already in the first week of treatment, but stability can only be achieved by the end of the second. The most pronounced result of the therapeutic course in the neurotic form of the disorder, recurrent endogenous. The drug is prescribed if the patient's body is resistant to amitriptyline. Proven effectiveness in depressive relapse - Heptral can quickly interrupt it.
Heptral is also administered intravenously for osteoarthritis. Such a course allows to reduce pain manifestations and to activate the generation of proteoglycans. Such changes stimulate regenerative processes, cartilage tissue is partially restored.
Issue Composition
The powder intended for administration to the patient’s body must be mixed with a special solution in an ampoule before use. Instructions for use "Heptral" intravenously contains a complete list of compounds included in the medication. The main one is ademethionine in the form of butanedisulfonate. Additionally, the manufacturer used lysines, sodium hydroxide. One package contains five ampoules with Heptral for intravenous use and instructions. We will review reviews about the drug below.
Safety comes first
In the instructions for use, the manufacturer draws attention to the tonic effect of the drug. Its use should be avoided shortly before bedtime. Cases of increased excitability of patients against the background of a therapeutic program are known. This condition may progress. As a rule, this does not force to cancel the course, but in some situations the syndrome disappeared with a decrease in dose or a complete abandonment of the drug.
The use of the drug can correct the results of homocysteine analyzes - a false determination of the high level of this substance in the blood serum is possible. If the patient is forced to use Heptral, when conducting appropriate tests, non-immunological methods should be resorted to - they will give a more accurate result.
Is it worth using? Reviews about the drug
There are many responses about the remedy - among other preparations for protecting the liver, it is Heptral that is especially popular. Persons who use the drug, note its effectiveness. An extremely small percentage of patients experienced adverse reactions. At the same time, you can find a lot of useful information about different applications, in particular, regarding the administration of the drug - which is better: intravenously or intramuscularly. "Heptral", as can be seen from the instructions, can be injected both this way and that way, and the doctor in each case selects the best option. From the reviews it is clear: most are advised to inject into a vein, since this way the drug shows a more pronounced and strong effect.
Patients who undergo such treatment recognize the effectiveness of the drug when used correctly. True, you need to use the drug under the supervision of a doctor, otherwise the risk of undesirable consequences is high, you may encounter a intolerance situation. Heptral is quite expensive, from one and a half thousand for one package with five ampoules, but those who took it claim that the medicine fully justifies its price.
Possible alternatives: what can be replaced?
The analogues of Heptral include the following:
- Ademethionine-Vial.
- Heparetta.
- Heptor.
- Heptrazan.
Alternative formats are available both in tablet form and in powder form for reconstitution and subsequent administration by injection.
Best analogues: Ademethionine-Vial
The drug belongs to the category of liver protectors, has a pronounced antidepressant effect. The use of a tablet form allows you to cleanse the body of toxic compounds, stimulate tissue regeneration, protect the cells of the nervous system, and enrich tissues with antioxidants. The drug has inherent effects: antifibrosing, choleretic, cholekinetic.
Ademethionine-Vial is recommended for cirrhosis and its preceding conditions, as well as for pathologies accompanied by similar problems in the functioning of the liver. You can use pills to relieve depression and liver disease caused by alcoholism. The hepatoprotector is based on the compound that gave it the name: ademetionine. The product is available in the form of tablets, top coated with a special film, soluble only in the intestinal tract. This allows you to protect the active compound from the aggressive effects of the gastric environment. It is forbidden to take the composition if hypersensitivity is detected, an allergic reaction to any substance present in the pharmaceutical product. You can not use "Ademethionine-Vial" in a minor age and with some genetic problems, due to which the methionine cycle is lost. The drug is contraindicated in case of a shortage of cystation beta-synthase in the body, in violation of metabolic reactions involving cyanocobalamin.
Avoid the use of the drug in old age, against the background of bipolar disorders, with insufficient kidney function.
Terms of use
Ademethionine-Vial should be used orally, swallowing the drug whole. You can not chew it, violate the integrity of the shell in any other way. Pills should be taken between meals in the morning, as they have a pronounced activating effect. The optimal dose is calculated by the doctor. The manufacturer recommends focusing on the patient's weight. "Ademethionine-Vial" is prescribed in an amount of 10-25 mg per kilogram of weight. With cholestasis inside the liver and depression, the daily dosage varies between 0.8-1.6 g. The duration of the program is chosen by the doctor, focusing on the patient's condition and the response of the body to treatment.
Ademethionine-Vial protects the liver and has an antidepressant effect, allows you to make up for the lack of ademethionine, and also activates the production of this substance in human tissues. The drug initiates and stabilizes transmethylation. Under its influence, the concentration of glutamine in the liver cells increases. Blood serum contains more taurine, cysteine, methionine content is reduced. The metabolism at the cellular level in the liver is returning to normal.
Application features
As tests have shown, Ademethionine-Vial can cause stool disorders and nausea. Some patients had a headache while taking the pills. There is a risk of an allergic response, infection of the urinary system, as well as local reactions. Skin areas may itch, possibly lowering blood pressure, phlebitis and hot flashes, general anxiety, anxiety, tenderness of the abdomen. Occasionally, dyspepsia, excessive intestinal gas production, and muscle spasms worried patients taking pills.
Due to its tonic effect, it is recommended to avoid the use of Ademethionine-Vial tablets shortly before bedtime. If you need prolonged use of the composition, it is reasonable to regularly take blood samples to determine the creatinine level and urea concentration. With bipolar disorder, it is worth abandoning drugs on ademetionine. The use of the composition is associated with a risk of dizziness, therefore, during treatment, you should refuse to control transport and interact with devices that require a high reaction rate and precise movements.
The best analogues: "Heptor"
The tool is indicated for use in cholestasis, depressive syndrome. With cholestasis inside the liver, the drug will help during the period of bearing the child, with hepatic pathologies and other conditions associated with impaired organ functionality. In chronic hepatic pathologies, there is a failure of clearance, the generation of bile acids. The use of “Heptor” against the background of such indications was carefully studied with the participation of people suffering from a variety of chronic diseases. The drug was prescribed for biliary cirrhosis, liver damage due to drug effects, sclerosing cholangitis, cholestasis due to intravenous administration of nutrients. Heptor was used against a background of liver disorders due to alcohol consumption and for other reasons.
During pregnancy, against the background of cholestasis, intravenous, intramuscular, oral use of the drug allows you to relieve itching of the skin, stabilize biochemical reactions in the body. In case of depressive syndrome "Heptor" it is recommended to use in an amount of 0.2-1.6 g per day. The drug is indicated for various forms and types of depression, including bipolar, unipolar. The effectiveness of the drug is close to the result of the use of tricyclic antidepressants.