Heptor - instructions for use, analogs, reviews and release forms (400 mg tablets, injections in injections, N) for the treatment of cholecystitis, hepatitis, liver cirrhosis in adults, children and pregnancy. Composition of the hepatoprotector

In this article, you can read the instructions for using the drug Heptor. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Heptor in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of the heptor with available structural analogues. Use to treat cholecystitis, hepatitis, cholangitis and liver cirrhosis in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Heptor - hepatoprotector, has antidepressant activity. Has choleretic and cholekinetic effect. It has detoxification, regenerating, antioxidant, antifibrozing and neuroprotective properties.

Replenishes the deficit of ademetionine and stimulates its production in the body, primarily in the liver and brain. Participates in biological reactions of transmethylation (methyl group donor) - S-adenosyl-L-methionine molecule (ademethionine), is a methyl group donor in the reactions of methylation of phospholipids of cell membranes, proteins, hormones, neurotransmitters; participates in transulfation reactions as a precursor of cysteine, taurine, glutathione (provides redox mechanism of cellular detoxification), coenzyme acetylation. Increases the glutamine content in the liver, cysteine ​​and Taurine in plasma; reduces the content of methionine in the serum, normalizing metabolic reactions in the liver. In addition to decarboxylation, it participates in aminopropylation processes as a precursor of polyamines-putrescine (a stimulator of cell regeneration and proliferation of hepatocytes), spermidine and spermine, which are part of the ribosome structure.

Has a choleretic effect due to increased mobility and polarization of hepatocyte membranes, due to stimulation of the synthesis of phosphatidylcholine in them. This improves the function of hepatocyte-associated transport systems of bile acids and promotes the passage of bile acids into the biliary system. Effective with intraloble variant of cholestasis (a violation of synthesis and current of bile). It contributes to the detoxification of bile acids, increases the content of conjugated and sulfated bile acids in hepatocytes. Conjugation with taurine increases the solubility of bile acids and their removal from the hepatocyte. The process of sulphation of bile acids contributes to the possibility of their elimination by the kidneys, facilitates the passage through the membrane of the hepatocyte and excretion with bile. In addition, sulfated bile acids protect the liver cells from the toxic effect of non-sulphated bile acids (in high concentrations present in hepatocytes with intrahepatic cholestasis). In patients with diffuse liver disease (cirrhosis, hepatitis) with intrahepatic cholestasis syndrome reduces the severity of itching and changes in biochemical parameters,in t.ch. level of direct bilirubin, activity of alkaline phosphatase, aminotransferases.

Composition

Ademethionine (in the form of S-adenosylmethionine) + auxiliary substances (heptor).

Ademethionine 1,4-butanedisulfonate + auxiliary substances (Heptor H).

Pharmacokinetics

Bioavailability of the drug for oral administration is 5%, with intramuscular injection - 95%. Binding to serum proteins is negligible. Penetrates through the blood-brain barrier (BBB). Regardless of the route of administration, a significant increase in the concentration of ademetionine in the cerebrospinal fluid is noted. Metabolised in the liver. It is excreted with the kidneys.

Indications

• chronic non-calculous cholecystitis;
• cholangitis;
• intrahepatic cholestasis;
• Hepatitis of various genesis: viral, toxic, incl. alcoholic and medicinal origin (antibiotics, antitumor, antituberculosis and antiviral drugs, tricyclic antidepressants, oral contraceptives);
• fatty degeneration of the liver;
• cirrhosis of the liver;
• encephalopathy, incl. associated with hepatic insufficiency (alcoholic, etc.);
• depression (including secondary);
• abstinence syndrome (alcoholic, etc.).

Forms of release

Tablets coated with enteric-coated 400 mg (heptor and heptor H).

Lyophilizate for the preparation of solution for intravenous and intramuscular injection (injections in ampoules for injections).

Instructions for use and reception scheme

Pills

Inside, swallowing whole, without chewing. To improve the therapeutic effect, tablets are recommended between meals. In the period of maintenance therapy, the recommended daily dose is 800-1600 mg (2-4 tablets).

Duration of treatment is determined individually depending on the severity and course of the disease.

The duration of maintenance therapy is on average 2-4 weeks.

In elderly patients, treatment is recommended starting with the lowest recommended dose, taking into account the decrease in hepatic, renal or cardiac function, the presence of concomitant pathological conditions and the use of other drugs.

Ampoules

Intramuscularly, intravenously. With intensive therapy - in the first 2-3 weeks of treatment, Heptor is prescribed at a dose of 400-800 mg per day intravenously drip (very slowly, in the form of a dropper) or in / m.

The lyophilizate is dissolved only in a special applied solvent (L-lysine solution).After the completion of intensive care, maintenance therapy is carried out using the medicinal form of the heptor for oral administration (400 mg tablets).

Side effect

• nausea, vomiting;
• stomach ache;
• diarrhea;
• dry mouth;
• esophagitis;
• dyspepsia;
• flatulence;
• gastrointestinal pain;
• gastrointestinal bleeding;
• hepatic colic;
• confusion of consciousness;
• insomnia;
• dizziness;
• headache;
• paresthesia;
• arthralgia;
• muscle cramps;
• urinary tract infections;
• hyperhidrosis;
• itching;
• skin rash;
• reactions at the site of administration;
• necrosis of the skin at the injection site;
• anaphylactic reactions;
• angioedema;
• laryngeal edema;
• tides;
• superficial phlebitis;
• asthenia;
• chills;
• influenza-like symptoms;
• weakness;
• peripheral edema;
• hyperthermia.

Contraindications

• 1 and 2 trimester of pregnancy;
• children and adolescents under 18;
• hypersensitivity to ademetionin.

Application in pregnancy and lactation

In the first and second trimesters of pregnancy, the heptor is used only in case of emergency, when the expected benefit for the mother exceeds the potential risk to the fetus.The use of ademetionine in high doses in the 3 trimester of pregnancy did not cause any undesirable effects.

The use of ademetionine in the period of breastfeeding is possible only if the expected benefit for the mother exceeds the potential risk for the child.

Use in children

Contraindicated in children and adolescents under the age of 18 years.

special instructions

Use with caution Heptor in patients with renal insufficiency.

Insufficiency of vitamin B12 and folic acid may lead to a decrease in ademetionin concentrations, therefore, their concomitant use in usual doses is recommended.

It is not recommended for use in patients with bipolar psychosis. There are reports of the transition of depression to hypomania or mania when treated with ademethionine.

Patients with depression need close monitoring and ongoing psychiatric care in the treatment with Hepter to monitor the effectiveness of treatment.

When used in patients with cirrhosis of the liver against a background of hyperaemia, systematic monitoring of the level of Nitrogen in the blood is necessary. During prolonged therapy, it is necessary to determine the content of urea and creatinine in the blood serum.

Impact on the ability to drive vehicles and manage mechanisms

When using ademetionine, dizziness is possible. Patients should not drive vehicles or work with other mechanisms until the symptoms disappear completely, which can affect the response rate for these activities.

Drug Interactions

There is a report on the development of serotonin syndrome in a patient who used heptor and clomipramine.

Ademetionine should be used with caution at the same time as selective serotonin reuptake inhibitors, tricyclic antidepressants, preparations and herbal products containing tryptophan.

Analogues of the drug Heptor

Structural analogs for the active substance:

• S-Adenosyl-L-methionine 1,4-butanedisulfonate;
• Ademethionine 1,4-butanedisulfonate;
• Heptor H;
• Heptral.

Analogues for the pharmacological group (hepatoprotectors):

• Alpha-lipoic acid;
• Antraliv;
• Berlition;
• HepaMerz;
• Gepabene;
• Hepatosan;
• Hepafor;
• Heptral;
• Glutargin;
• Covechol;
• Karsil;
• Karsil Forte;
• Legalon;
• Liv.52;
• Liventziale;
• Livedoksa;
• Livolife Forte;
• Lipoic acid;
• Maxar;
• Methionine;
• Moliksan;
• Octolipen;
• Progepar;
• Resalute Pro;
• Silegon;
• Silibinin;
• Sylimar;
• Silymarin;
• Thioctic acid;
• Tiotriazolin;
• Ursodez;
• Ursodeoxycholic acid;
• Ursodex;
• Ursuliv;
• Ursor;
• Ursosan;
• Ursofalk;
• Phosphogliv;
• Phosphontsiale;
• Hepabos;
• Holudexan;
• Erbisol;
• Eslidine;
• Essentiale N;
• Essentiale forte N;
• Essential phospholipids;
• Essley forte;
• The Essler.

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