Used intravenously or intramuscularly, "Heptral" in the form of injections, as well as tablets produced under this name, is an effective means of cleansing the body. The drug belongs to the class of liver protectors and is used for cirrhosis, against the background of a depressive syndrome or alcohol poisoning. Indications include cholestasis inside the liver during childbearing, 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;
- cholangitis;
- chronic hepatitis;
- encephalopathy;
- toxic liver damage of various etiologies, including alcoholic, viral, drug;
- cirrhosis of the liver;
- chronic acalculous cholecystitis;
- symptoms of depression.
- intrahepatic cholestasis in pregnancy;
Contraindications:
- Geneticdisorders affecting the methionine cycle and/or causing homocystinuria and/or hyperhomocysteinemia.
- Sensitivity to any of the components of the medication;
- Under 18 years old.
Rules of application
Following the instructions for "Heptral", intravenous drip of the drug is prescribed only to persons of legal age. Usually, injections are given only in the first period of treatment, then the patient is transferred to the tablet version of the drug.
In case of liver diseases, the drug is prescribed for two weeks in the amount of 0.4-0.8 g per day. To maintain a stable condition, the patient is shown continued therapy with tablets: from two to four tablets per day.
If the appointment is associated with a 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 the tablet version of the drug. A dose of 2-3 tablets will be prescribed per day. 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.
Nuances of some cases
So far, no scientific studies have been conducted to determine how effective it is to prescribe to elderly patients, produced in Heptral ampoules. Intravenous drip may not always be prescribed for older people. There are no official voluminous clinical observations on such drug practice. If it is necessary to select a course for an elderly person,it is wise to start with the lowest possible dosage. It is important to take into account comorbidities, diseases of the liver, kidneys and heart. When formulating a course of drug therapy, you need to pay attention to other drugs used by the patient.
How to apply correctly?
Before administering Heptral diluted in saline by intravenous drip, you must read the instructions supplied by the manufacturer with the product. It is important to prepare the substance for administration. Dilute the powder contained in sterile ampoules immediately before use. All release options include not only powder, but also a special liquid in which it must be diluted. The prepared drug must be injected into the patient's vein in drops. The procedure is long, the speed is very slow.
According to the instructions for use accompanying the Heptral ampoule, only a freshly prepared product can be used intravenously. If some part of the solution remains unused, it is disposed of. Keeping the medication is strictly prohibited. Do not use the product if the color of the powder has changed during storage. It is not allowed to mix the medicinal substance and alkaline solutions, as well as liquids with calcium ions.
Keeping on course
According to reviews, "Heptral" is administered intravenously only for the first few days or weeks of treatment, after which the patient is transferred to a tablet form. Using the tablets is quite simple. The manufacturer warns that each pill must beswallow 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 shell dissolves as it passes through the intestinal tract, and it is here that the main compound is released, quickly breaking through the mucous membranes of the intestines.
In order for the 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 eating. If the shade of the drug has changed, the product is disposed of - you should not use it, it may be unsafe.
Negative consequences: what is possible
According to the instructions for use and reviews for Heptral, intravenous administration of the drug can cause an undesirable response of 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 disorders, pain in the abdomen were more common.
There is an assumption that "Heptral" may be the cause of some other undesirable responses of the body, but during the official study it was not possible to establish for certain the connection between the condition and the drug course. These responses include infection of the urinary system, sleep disturbance, confusion, headaches and dizziness, paresthesia. Presumably, the drug can cause hot flashes, phlebitis, flatulence, dryness in the cavitymouth, bleeding and disorders of the functioning of the gastrointestinal tract. In some cases, there were reasons to assume a connection between the drug and cirrhosis, rash, itching of the skin, muscle spasms. There is a risk of flu-like symptoms, swelling, fever, chills.
More often negative reactions are observed local, at the injection point. They are most pronounced if the medication is used carelessly, not following the rules for intravenous administration of Heptral.
Absolutely not allowed
The introduction of "Heptral" intravenously, intramuscularly, as well as the tablet form of the drug is strictly prohibited if the patient has hypersensitivity to any of the substances present in the composition of the drug. Do not use the composition if any of its components provokes an allergic response of the body.
The drug is prohibited if the patient's condition includes genetic defects that provoke hyperhomocysteinemia, homocystinuria - any of these syndromes or both at the same time.
"Interesting" position
Trials were conducted with the appointment of the drug in question to pregnant women. The use of the substance in the third part of the term, even at a high dosage, did not cause an undesirable response of the body. In the first two trimesters, the composition should be used only if there are vital indications.
During lactation, the use of Heptral intravenously, into muscle tissue or orally is allowed only if the obvious benefit of the drug course is higher than the potential dangers forbaby.
Special occasions
Experiments were conducted with the participation of volunteers, as well as persons suffering from chronic liver pathologies. Studies of the results showed that the pharmacological kinetics of the drug does not differ in patients and he althy subjects. If hyperammonemia is established at the stage preceding cirrhosis, as well as at the cirrhotic stage, it is indicated to regularly check the content of ammonia in the body. This is especially important when taking a tablet form, but accuracy does not hurt when administered injectively.
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 in this category. Presumably, the drug is quite safe, so kidney failure is not an absolute contraindication, but requires monitoring of the patient's condition.
No official statistics have yet been collected on the use of medicines by the elderly, but the medicine is strictly contraindicated for children.
Nuances of the state of the body
For greater effect, it is better to inject "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 can cause a decrease in the content of ademetionine, on which Heptral is based, which will make the usemedication less effective.
Against the background of bipolar psychosis, the drug in question is not recommended. There are isolated cases of the transformation of a depressive syndrome into hypomania, mania against the background of the use of the drug.
Effectiveness in depressive syndrome has been proven in a number of short-term official studies. The programs lasted from three to six weeks, with the drug administered intravenously. In the instructions for "Heptral" you can not find 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 manifestations of depression do not get better or the condition worsens, the treating doctor should 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 danger of a suicidal attempt is higher, which means that it is necessary to constantly monitor a person’s condition and provide him with qualified assistance as needed. This approach helps to track the effectiveness of the therapeutic course.
Security issues
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 safety, it is reasonable to refuse to drive vehicles, 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 increase speedreactions.
Too much
In the instructions for the use of "Heptral" intravenously drip (as well as injections into the muscle or orally), there is practically no information about a possible overdose. Although such cases have occurred in clinical practice, they were rare. The manufacturer recommends that when an overdose is detected, carefully monitor the patient's he alth and practice supportive therapy, focusing on the specifics of he alth.
Safety: especially amid depression
The combination of ademetionine and clomipramine can provoke serotonin syndrome. So far, it has not been possible to identify exactly how great the role of ademetionine is in this. Currently, it is recommended to use this remedy 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 drugs that contain tryptophan.
Dynamics
About how and why a liver protector based on ademetionine works, the manufacturer explains in detail in the accompanying instructions for use of Heptral. Intravenously, into muscle tissue, orally used composition has pronounced effects: choleretic, cholekinetic. The drug has the qualities of an antioxidant, a neuroprotector. The tool belongs to the group of antifibrosing, detoxifying, activates regenerative processes and makes up for the lack of ademetionine in the body, at the same time activating the generation of this substance. Top performanceconcentrations are observed in the brain, 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, transsulfation, transmethylation.
Biology and chemistry: the subtleties of the process
If you enter "Heptral" intravenously, the agent activates the processes of transmethylation, acting as a donor of the methyl group for the production of membrane phospholipids in cells. The elements supplied with the drug to the body are also participants in the reaction of generating proteins, hormonal and nucleic compounds, neurotransmitters.
Transsulfation due to the drug introduced into the body proceeds more correctly, since ademetionine is the basis for the manufacture of cysteine, glutathione, taurine.
If you enter "Heptral" intravenously drip, the active ingredient increases the concentration of taurine, cysteine, glutamine in the blood serum. The plasma concentration of methionine decreases, metabolic processes in the liver cells stabilize. Having passed the decarboxylation stage, the substance becomes an important element of aminopropylation, preceding polyamines. This applies to compounds included in the ribosomal structure. In total, this effect reduces the risk of fibrosis. Also, the drug shows a pronounced choleretic effect.
Reactions and their meaning
Intravenous Heptralhelps 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 in cholestasis inside the liver - in the lobules and between them. The toxic effect of bile acids decreases, the reactions of sulfation and conjugation 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 excretion of compounds through the kidneys. Sulfated acids are an element of the protective cellular system. They reduce the harmful effects of non-sulphated substances found in the liver in high levels in cholestasis.
Against the background of diffuse hepatic diseases with cholestasis inside the liver, intravenously administered Heptral helps to lower the concentration of direct bilirubin, relieves itching, normalizes the activity of aminotransferases. The effectiveness of the remedy is observed within three months after the completion of the main therapeutic course.
Nuances of the effect
Intravenously administered "Heptral" is recommended for hepatopathy associated with drugs toxic to the liver. Against the background of opioid addiction and hepatic disorders, the use of the composition makes it possible to achieve relief from the withdrawal syndrome. The liver begins to function better, microsomal oxidative reactions stabilize.
Efficiency in depressive syndrome increases gradually. The first result can be seen already in the firstweek of treatment, but stability can only be achieved by the end of the second. The most pronounced result of the therapeutic course is in the neurotic form of the disorder, recurrent endogenous. The drug is prescribed if the patient's body shows resistance to amitriptyline. Effectiveness has been proven in depressive relapse - "Heptral" can quickly interrupt it.
Introduced intravenously "Heptral" and osteoarthritis. Such a course allows to reduce pain manifestations and activate the generation of proteoglycans. Such changes stimulate regenerative processes, cartilage tissues are partially restored.
Composition of the issue
The powder intended for introduction into the patient's body must be mixed with a special solution in an ampoule before use. Instructions for the use of "Heptral" intravenously contains a complete list of compounds included in the drug. The main one is ademetionine in the form of butane disulfonate. Additionally, the manufacturer used lysines, sodium hydroxide. One package contains five ampoules with Heptral for intravenous use and instructions. We will consider reviews about the drug below.
Safety First
In the instructions for use, the manufacturer draws attention to the tonic effect of the drug. It should be avoided shortly before bedtime. There are cases of increased excitability of patients against the background of a therapeutic program. This condition may progress. As a rule, this does not force the course to be canceled, but in some situations the syndrome disappeared when the dose was reduced or the drug was completely abandoned.funds.
The use of the drug may correct the results of homocysteine tests - it is possible to falsely determine the high level of this substance in the blood serum. If the patient is forced to use Heptral, when conducting appropriate tests, one should resort to non-immunological methods - they will give a more accurate result.
Should I use it? Medication reviews
You can find a lot of feedback about the remedy - among other drugs for protecting the liver, it is Heptral that is especially popular. The persons who used the remedy note its effectiveness. A very small percentage of patients experienced adverse reactions. At the same time, you can find a lot of useful information about different options for use, in particular, regarding the introduction of the drug - which is better: intravenously or intramuscularly. "Heptral", as can be seen from the instructions, can be administered injectively and so and so, and the doctor in each case selects the best option. It can be seen from the reviews: most people are advised to take injections into a vein, since this way the remedy shows a more pronounced and stronger effect.
Patients who have undergone such treatment recognize the effectiveness of the drug when used correctly. True, you need to use the remedy under the supervision of a doctor, otherwise the risk of undesirable consequences is high, you may encounter a situation of intolerance. "Heptral" is quite expensive, from one and a half thousand for one package with five ampoules, but the people who took it claim that the medication fully justifies itsprice.
Possible alternatives: what can be substituted?
The following means belong to the analogues of "Heptral":
- Ademetionin-Vial.
- Geparetta.
- Heptor.
- "Heptrazan".
Alternative formats are available in both tablet and powder form for reconstitution and subsequent injection.
The best analogues: "Ademetionin-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 cells of the nervous system, and enrich tissues with antioxidants. The drug has effects: antifibrosing, choleretic, cholekinetic.
"Ademetionin-Vial" is recommended for cirrhosis and its pre-existing conditions, as well as for pathologies accompanied by similar problems in the functioning of the liver. Tablets can be used to relieve depression and liver disease caused by alcoholism. The hepatoprotector is based on the compound that gave it its 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 influence of the gastric environment. It is forbidden to take the composition if hypersensitivity, an allergic reaction to any substance present in the pharmaceutical product is detected. You can not use "Ademetionin-Vial" at a minor age and with some geneticproblems that disrupt the methionine cycle. The drug is contraindicated in case of a lack of cystathion beta synthase in the body, a violation of metabolic reactions involving cyanocobalamin.
The use of the drug in old age, against the background of bipolar disorders, with insufficient kidney function should be avoided.
Usage rules
"Ademetionin-Vial" should be used orally, swallowing the drug whole. You can not chew it, violate the integrity of the shell in any other way. Tablets 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 weight of the patient. "Ademetionin-Vial" is prescribed in the 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 body's response to treatment.
"Ademetionine-Vial" protects the liver and has an antidepressant effect, allows you to compensate for the lack of ademetionine, 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. The blood serum contains more taurine, cysteine, the content of methionine decreases. Metabolism returns to normal at the cellular level in the liver.
Application Features
As tests have shown, "Ademetionine-Vial" can cause stool disorders, 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 pressure, phlebitis and hot flashes, general anxiety, anxiety, abdominal pain. Occasionally, while taking pills, patients were worried about dyspepsia, excessive production of intestinal gases and muscle spasms.
Due to the tonic effect, it is recommended to avoid the use of Ademetionin-Vial tablets shortly before bedtime. If it is necessary to use the composition for a long time, it is reasonable to regularly take blood samples to determine the creatinine level, 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 the period of treatment, one should refuse to drive vehicles and interact with devices that require a high reaction rate and precise movements.
The best analogues: "Heptor"
The remedy is indicated for use in cholestasis, depressive syndrome. With cholestasis inside the liver, the drug will help during the period of bearing a child, with hepatic pathologies and other conditions associated with a violation of the functionality of the organ. 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 has been carefully studied with the participation of persons suffering from a variety of chronic diseases. The drug was prescribed for biliary cirrhosis, hepaticlesions on the background of drug effects, sclerosing cholangitis, cholestasis due to intravenous administration of nutrients. Used "Heptor" against the 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 skin itching, stabilize biochemical reactions in the body. With depressive syndrome "Heptor" is recommended to use in the 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.
