Heptral 400 mg Tablet – Uses, Dosage, Side Effects, Composition

How to take Heptral in pills

Good day, dear readers!

The liver is the most important organ in the human body. If liver function is impaired, it can cause a serious deterioration in health. That is why it is so important to maintain normal liver function.

Liver treatment with Heptral is very widespread in USA. On the features of this drug, we will talk in the next article.

How does the drug Geptrale

Heptral normalizes the production and entry of bile acids from liver cells into the biliary tract. The drug Heptrale improves the motility of the gastrointestinal tract (prevents stagnation of bile in the liver cells).

The main effect of the drug Heptral is aimed at restoring the concentration of the biologically active substance ademetionin in liver cells, which increases the protective properties of liver cells to various damaging factors (alcohol, antibiotics, toxic substances).

pharmachologic effect

Heptral has choleretic (increases the amount of bile acids in the bile) cholekinetic (promotes the secretion of bile into the intestine), regenerating, detoxifying (removes toxins from the body), antifibrinolytic (reduces the ability of the blood to dissolve blood clots spontaneously), antioxidant, anti-depression and neuroprotective (eliminates disturbances in the blood cells) properties.

The active ingredient of Heptral is ademetionin, which is a substance that is needed by almost all tissues.

Ademetionin plays an important role in the metabolic processes of the body, participates in such important biochemical reactions as transmethylation, transsulfation, transamination, increases the protective functions of liver cells.

The use of Heptral helps to normalize the production of bile acids, their entry into the biliary tract, as well as improve the motility of the digestive tract by eliminating the stagnation of bile in liver cells.

Hepatoprotective (purification and restoration of the liver) and choleretic effects of Heptral are observed for 3 more months after completion of the drug. The level of ademetionine decreases with age, and the concentration of this substance is below normal in people with depressive syndrome.

The use of Heptral allows to increase the content of ademetionine in the body, in particular in the brain tissue, which helps stabilize the transmission of nerve impulses and prolong the functioning time of nerve cells. Clinical studies and reviews of Heptral confirm the antidepressant effect of the drug, which develops quickly enough, and reaches its maximum effectiveness on the 5-7 day of using the drug.

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Drug properties

Heptral is actively used to treat the liver after drinking. With its help, it is possible to improve the performance of this organ in the chronic form of hepatitis, alcohol damage, fatty hepatosis. Also, this medicine perfectly treats withdrawal syndrome.

The drug has the following characteristics: antidepressive – increases the viability of neurons, restores the transmission of nerve impulses; antioxidant – stimulates the synthesis of amino acids that are required for the recovery of liver cells; regenerating – increases the speed of hepatocyte division, which significantly speeds up the regenerative processes in the liver; cholekinetic – provides removal of bile from the gallbladder; neuroprotective – reduces the risk of liver encephalopathy.

The mechanism of action of Heptral

The mechanism of action of Heptral is associated with biochemical processes occurring in the liver cells – hepatocytes. It contributes to a better penetration through the membranes of hepatocytes, the substances necessary for them, participating in metabolic processes. In addition, it increases the synthesis and content of substances that protect cells from bile acids and free radicals.

Heptral, participating in biochemical reactions, increases the mobility of membranes and improves the functioning of the transport systems of bile acids associated with hepatocyte membranes.

Another type of biochemical reactions in which Heptral is directly involved is the formation of glutathione and taurine, substances with detoxifying properties. In chronic liver diseases, the amount of glutathione is reduced, with the result that hepatocytes become defenseless against any toxic substances. Taurine helps reduce the toxic effects of bile acids on liver cells.

In addition, heptral is involved in the biochemical reactions of the formation of putrescine – a substance that stimulates the regeneration of the liver and promotes reproduction (proliferation) of hepatocytes.

Heptral is prescribed for a long time, resulting in slowly but steadily improving liver function, regenerating its cells, improving the flow of bile, suppressing the development of cirrhosis of the liver – replacing hepatocytes with connective tissue cells with a decrease in the function of this organ.

When to use the drug Heptrall

The main indications for the use of the drug Heptral are the following:

  • Chronic hepatitis
  • Cirrhosis of the liver
  • Toxic liver damage (antiviral drugs, alcohol, contraceptives, antibiotics, anticancer drugs, anti-tuberculosis drugs)
  • Depression
  • Fatty degeneration of the liver
  • Chronic cholecystitis

What diseases are used for?

Heptral can be used for any diseases of the liver and biliary tract. The only exception is gallstone disease: an increase in the amount of bile can cause bouts of biliary colic due to blockage of the hepatic ducts with stones. Heptral is particularly effective in cirrhosis of the liver, developing on the background of various intoxications – alcohol, drugs, drugs, and others.

In this case, on the one hand, it protects liver cells from destruction by toxins, and on the other, it inhibits the growth of connective tissue. This leads to a halt in the progression of the pathological process and prolongs the life of the sick.

Heptral is also used to relieve the state of abstinence, which develops when the patient is separated from alcohol or drugs, who has developed physical dependence on these substances.

Heptral has a beneficial effect on the liver and viral hepatitis, including chronic hepatitis – in this case, the process of destruction of liver cells and a decrease in the function of this organ also slows down.

In depressions, Heptral actively acts on metabolic processes in brain cells (neurons), which helps to improve their function and eliminate the patient from a depressive state.

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Use of the drug in withdrawal syndrome

This condition is characteristic of people who suffer from chronic alcoholism. The withdrawal syndrome develops after the cessation of the use of alcohol. At the same time in the human body there is a violation of metabolic processes and there are many toxic products. At the same time, the liver is significantly impaired – it is this organ that is responsible for the neutralization of these substances, and therefore suffers first of all. In addition, there is a strong intoxication of the body.

Heptral helps to protect cells and neutralize toxic substances that subsequently leave the body through the kidneys. Injections or oral administration of the drug are part of the combined treatment of withdrawal symptoms. Due to this, it is possible to improve the condition of a person significantly. If the withdrawal syndrome is pronounced, it is better to administer the drug intravenously.

Sometimes perform intramuscular injections. Subsequently, the person switches to tablet form. In the mild and medium form of the disease, you can immediately take the drug inside – injections in this situation are not needed.

Instructions for use and dose

Heptral, the use of which is possible only on prescription, is available in the form of tablets and solution for injection. Heptral tablets are covered with an enteric coating and are intended for oral administration; they should be swallowed whole, without chewing, drinking water (in small quantities). The recommended single dose corresponding to 1 tablet of Gepral, should be taken 3-4 times a day.

To the lyophilisate Heptral in the ampoules is applied the solvent L-lysine. Intravenous drip or intramuscularly, the drug is administered in a daily dose of 400-800 mg. Intensive therapy with Heptral in ampoules is carried out in the first 2-3 weeks of treatment, supporting – the next 2-4 weeks (800-1600 mg/day).

Dosage and method of use of the drug Heptral

Heptral is available in the form of tablets (enteric-coated) for oral administration and solution for injection. The drug Heptrall is dispensed from pharmacies solely on prescription.

Heptral in pills:

Assign 1 tablet 3-4 times a day. The duration of treatment with the drug tablets Heptral is 3-4 weeks.   Recommendations for the use of the drug Heptral in pills: tablets of the drug Heptral should be taken in the first half of the day between meals (it is not recommended to use Heptral in bedtime). Tablets drug Geptrala should be swallowed whole, washed down with a small amount of water.

Heptral in powder form for injection:

Assign 1-2 vials (400-800mg) per day. The duration of treatment with Heptral in the form of powder for injection is 2-3 weeks.

Recommendations for the use of the drug Heptral in powder form for injection: Before using the drug Heptral it is necessary to make sure that the powder in the vial is white (if the powder is yellow, then use the drug is strictly contraindicated). Before use, the powder of the drug Heptral should be mixed with a solvent (use only the solvent supplied with the preparation – L-lysine solution). Heptrale is administered intramuscularly or intravenously (slowly).

Side effects when using the drug Heptral

The most common side effects when using drug Heptrale include nausea, vomiting, abdominal pain, heartburn, bloating. As a rule, in the presence of the aforementioned side effects, the patient may continue to take the drug Heptral. In most cases, side effects with the use of the drug Heptrall disappear independently. Rarely: urticaria, pruritus, angioedema, dermatitis.

Use of the drug Heptral in pregnancy and breastfeeding

The drug Heptrale is not recommended to use during pregnancy and breastfeeding. The use of the drug Heptrale is strictly contraindicated in the 1st and 2nd trimester of pregnancy (taking the drug Heptral in the 1st and 2nd trimester of pregnancy adversely affects the development of the child). If necessary, the use of the drug Heptral, breastfeeding should be stopped at the time of treatment.

In what cases can not use the drug Heptral;

The drug Heptrale is not recommended when the patient has hypersensitivity to the drug or its components. The drug Heptrale is categorically contraindicated in children under 18 years of age.

The overdose of the drug Heptral

So far, no cases of overdose of the drug Heptral have been identified.

Special instructions on the use of the drug Heptral

Heptral should not be used at bedtime because of the pronounced tonic effect. When using the drug Heptral, it is necessary to control the level of nitrogen in the patient’s blood (especially if the patient suffers from cirrhosis of the liver).

The drug Heptral does not affect the ability to drive motor vehicles and control complex mechanisms. In most cases, the use of the drug Heptrale is contraindicated in children under 18 years of age (children under the age of 18 are prescribed the drug Heptral in strictly according to strict indications).

Heptral in treating depression

Depression can occur with many mental illnesses and borderline conditions (conditions between normal and pathological). Sometimes the patient’s condition can be so painful that he tries to commit suicide – this is one of the biggest dangers in depression.
I am treating depression with antidepressant drugs.

But lately, patients with resistance (lack of sensitivity) to antidepressants have become increasingly common. In such cases, psychiatrists prescribe Heptral, which improves metabolism in brain cells and slightly activates the central nervous system. All this contributes to the removal of depression.

Features Heptral for injection

When the state of hepatocytes and their membranes is disturbed under the action of toxins of different origin, the work of the transport systems is also disturbed. This leads to the accumulation of bile acids inside hepatocytes, which destroy them, and then connective tissue grows in place of hepatocytes. Heptral suspends this process, restores the normal state of cell membranes, transport of bile acids through i

Similarly, Heptral protects the liver cells from the action of any toxins, both those formed inside the body (for example, free radicals) and those from outside (alcohol, drugs, hepatotoxic drugs).

It was also established that the active ingredient. Heptral ademethionine can penetrate the blood-brain barrier, that is, from the blood into the brain tissue. Here he actively intervenes in biochemical processes and restores the normal state of neurons. As a result, the conductivity of nerve impulses is improved, the activity of the entire central nervous system is activated, and the patient leaves the depressive state.

Can I drink for the prevention

Profile physicians do not prescribe “Heptral” as a prophylactic agent for the prevention of liver pathologies.

However, in some cases, it can be used by patients who are shown prolonged use of “heavy” pharmacological agents. For example, it is recommended to use “Heptral” to patients on chemotherapy, when long-term treatment with antibiotics, hormonal and immunosuppressive drugs is required.

Compatibility of the drug and alcoholic beverages

The use of this drug should be the basis for a complete rejection of alcohol. First of all, to eliminate the underlying disease is very important to follow a special diet.

It strictly prohibits the use of any alcoholic beverages. If you violate this rule, there is a risk of serious health consequences. The interaction of alcoholic beverages and the drug leads to a significant reduction 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 should stop drinking alcohol. This is especially true for those cases where the disease is a consequence of complex forms of alcoholism. Often, the combination of medication with alcoholic beverages provokes an increase in heartbeat, which leads to the development of hypertension.

This creates a vicious circle. This disease should be treated with antidepressants, but today they are far from all. In such situations, Heptral is actively used. With it, you can restore metabolic processes in the brain and make the nervous system more active.

Taking the drug helps to eliminate melancholy and return the person to a full life. The duration of such therapy should be about 2 months. At the same time, it is important to take into account that the medicine cannot be used in manic-depressive syndrome.

Under the influence of the active components of this drug, depression can transform into a manic state. It is important to bear in mind that the combination of a drug with alcohol can negatively affect the work of the nervous and circulatory systems. Often, the functioning of the heart and pancreas suffers. People’s consciousness is disturbed, insomnia appears.

Treatment with Heptrale: indications and limitations

Active ingredient – ademetionin (concentration in tablets and powder for injection 400 or 500 mg). Additional components in each of the pharmacological forms of minor significance.

Recommended in the framework of complex therapy for such diseases and conditions:
1) intrahepatic cholestasis that occurs in the background:

  • hepatitis of various etiologies;
  • cirrhosis;
  • toxic lesions;
  • fatty degeneration;
  • hepatic encephalopathy;

2) osteoarthritis;
3) depressive syndrome.

Heptral is characterized by the following types of positive effects: anti-fibrosing, antioxidant, detoxifying, neuroprotective, regenerating, choleretic and cholekinetic.

Direct contraindications:

  • allergic reaction to ademetionine, intolerance to macrogol, simethicone, L-lysine, other components;
  • age up to 18 years;
  • the first two trimesters of pregnancy.

Relative limitations:

  • following a vegetarian diet;
  • Lactation. Nursing mothers prescribed in cases where the benefits of treatment outweigh the risk to the child.

Elderly patients and people with renal insufficiency are recommended to take minimal doses, constant supervision by a specialist is necessary.

If we talk about the interaction with other drugs, the drug is poorly combined with clomipramine, tryptophan.

Do patients ask if Heptral and alcohol are compatible? Can you afford to skip a glass during therapy? The answer is: the probability of an allergic reaction is negligible, but alcohol is contraindicated. 

Even minimal doses in this situation negate all the efforts of doctors. Besides, alcohol in patients with liver damage, as well as mental disorders, is unacceptable.

The drug tones, so taking overnight is undesirable. In some situations, it is combined with mild sedatives. Manufacturers warn of the possibility of other side effects, such as skin reactions, abdominal pain, nausea, heartburn. The practice of using proves the low probability of their occurrence.

How to take Heptrale 400 mg (tablets and injections)

The course of treatment, as a rule, begins with intravenous/intramuscular administration with the subsequent transition to oral administration. Less often – immediately with pills.

The advantage of injections – the rate of absorption of the drug. Nuances depend on “technical” factors. If the patient is in the hospital, Geptral’s injections are given intravenously or intramuscularly. In other conditions, preferred tablet form.

Restrictions on dosages at the beginning of treatment with Heptral (duration from 2 weeks to 20 days):

  • parenteral – from 0.005 to 0.012 g / kg of weight;
  • inwards – standard – 0.8 g / day, maximum – 1.6 g.

In the process of maintenance treatment is recommended to drink 2-4 tablets daily. The course duration is adjusted individually, taking into account the severity and features of the course of the disease.

Important: the injection solution is prepared immediately before the injection. Enter very slowly, drip. Heptral tablets should be taken immediately, taking out of the blister. Swallow whole. Drink between meals. During treatment, dizziness, decreased concentration. Patients better to refrain from driving and working with mechanisms.

It is useful to read: Rules for taking medication.

The drug Heptrale: reviews of doctors

We present the results of an anonymous survey of gastroenterologists and psychiatrists (10 people).

Doctors call these main advantages of the drug: a complex effect, high efficacy in the treatment of alcoholic liver disease.

In depressions, ademetionine may cause suicidal tendencies and other undesirable conditions, so patients need constant monitoring (preferably in the hospital setting). The drug has a tonic effect, so the reception must be adjusted to reflect this particular.

The main disadvantage is the high price of Heptral.

Now let’s count a little. The course of treatment for cirrhosis of the liver with the use of the medicinal product is 4 weeks. The recommended dosage form is tablets; the daily dosage is 800 mg. Total patients buy 3 (2.8) packs. Total costs – $ 150. But other medications are required.

At the request of the Ukrainian Association of Gastroenterologists, the manufacturer, Abbot, held events concerning the expansion of General accessibility. Since 2015, only the first package (400 mg tablets) is sold to the holders of branded cards at full price; a 30% discount applies to the second and subsequent (ninth).
Drugs analogs of Heptral (cheaper): Admetin ($ 25-30), Heptor (≈ $ 40/20 table.).
Novelty – lyophilisate + solvent Hepametion (generic ademetionine, 18-20 $ / 5 ampoules).

See also:
Hepatoprotectors: list, characteristics.
Unavailable Heptrale? Analogs are cheaper: list, prices.

Hepatoprotector has antidepressant activity. It has choleretic and cholekinetic effects. It has detoxification, regenerating, antioxidant, antifibrosis and neuroprotective properties.

It compensates for the deficiency of ademetionine and stimulates its production in the body, primarily in the liver and brain. Participates in biological reactions of transmethylation (a donor of the methyl group) – S-adenosyl-L-methionine molecule (ademetionine), is a donor of the methyl group in the methylation reactions of phospholipids of cell membranes, proteins, hormones, neurotransmitters; participates in transsulfatization reactions as a precursor of cysteine, taurine, glutathione (provides the redox mechanism of cell detoxification), acetylation coenzyme.

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.

It has a choleretic effect due to increased mobility and polarization of hepatocyte membranes, due to the stimulation of the synthesis of phosphatidylcholine in them. This improves the function of transport systems of bile acids associated with membranes of hepatocytes and contributes to the passage of bile acids into the biliary system.

Effective with intralobular cholestasis (violation of the synthesis and flow 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 sulfation of bile acids contributes to the possibility of their elimination by the kidneys, facilitates the passage of hepatocyte through the membrane and excretion of bile. Besides, Sulfated bile acids protect the membranes of liver cells from the toxic effects of non-sulfated bile acids (in high concentrations present in hepatocytes with intrahepatic cholestasis).

In patients with diffuse liver diseases (cirrhosis, hepatitis) with intrahepatic cholestasis syndrome reduces the severity of pruritus and changes in biochemical parameters, including direct bilirubin level, an activity of alkaline phosphatase, aminotransferase.

Forms of release, types, and composition of Geptral

Currently, there is only one type of drug on the pharmaceutical market – Heptral, which, in turn, is available in two dosage forms – oral tablets and a lyophilisate for preparing a solution for intravenous or intramuscular administration. However, there is also a dietary supplement with a similar name – HeptraLight, which is available only in tablets for oral administration. This dietary supplement should not be confused with the drug, despite the very similar names.

In everyday speech, almost no one calls the drug dosage forms completely, preferring to use certain terms and phrases to designate each option, making it easy to recognize one or another form and kind of medicine. Thus, the Heptrale tablets are designated by adding to the word “Heptral” numbers that reflect the dosage of the active substance, for example, “Heptral 400” or “Heptral 400 mg.”

The following terms are used to designate a lyophilisate for preparing a solution for intramuscular and intravenous administration – “Heptral Ampoule,” “Heptral Injection” and “Heptral Injections.” Such capacious terms allow you to quickly understand what you mean, to all participants in the conversation – both to pharmacists and doctors and patients.

The composition of all varieties and dosage forms of Heptral as the active substance is ademetionine in different dosages. Thus, Heptral tablets contain 400 mg of ademetionine. Lyophilisate contains 400 mg of active substance per bottle. 
Heptral tablets contain the following excipients:

  • Colloidal silicon dioxide;
  • Microcrystalline cellulose;
  • Sodium carboxymethyl starch;
  • Magnesium stearate;
  • A copolymer of methacrylic acid and ethyl acrylate;
  • Macrogol 6000;
  • Polysorbate;
  • Simethicone;
  • Sodium hydroxide;
  • Talc;
  • Water.

Lyophilisate powder does not contain any auxiliary components. However, the solvent for the lyophilisate, in addition to deionized water, contains lysine and sodium hydroxide, which are necessary for stabilizing the finished solution.

Heptrale tablets have an oval, biconvex shape, covered with an enteric coating of pure white or white-yellowish color and are available in packs of 20 pieces.

Lyphilisate Heptral is a white or white-yellowish powder without any impurities, poured into glass vials. Soldered ampoules with a solvent, which is a clear, colorless or pale yellow liquid, are attached to lyophilized vials.

The ready-to-use solution obtained by mixing the lyophilisate with a solvent is clear, colored in color or light yellow, with no visible sediment or suspended particles. Heptral for injections is available in packs of 5 bottles with lyophilisate, to which is attached 5 ampoules with a solvent.

Therapeutic Effects of Heptral

The therapeutic effects of Heptral are as follows:

  • Detoxifying effect;
  • Cholekinetic effect;
  • Choleretic action;
  • Neuroprotective action;
  • Hepatoprotective action;
  • Antidepressant effect;
  • Antioxidant action.

All of these therapeutic effects are provided by the properties of the active ingredient Heptral – ademetionine. This substance is normally produced and contained in all cells of the human body, but the greatest amounts of it are found in the brain and liver. That is why Heptral has the most pronounced therapeutic effects on the liver and brain.

Hepatoprotective action is to increase the resistance of liver cells to various negative factors. Under the influence of Heptral, the liver cells become more durable and resistant to any damage, as a result of which the functional activity and the structure of the organ improve.

Also, the water influence of the drug improves the process of growth and reproduction of liver cells, which replace dead cell elements.

The process of replacing dead cells with new, functionally active prophylaxis of the development of cirrhosis and liver fibrosis in chronic diseases (cholangitis, hepatitis, etc.).

Choleretic and cholekinetic action is to increase the production of bile with a simultaneous intensification of its outflow from the gallbladder into the duodenum. Due to the choleretic effect, bile does not stagnate in the liver and does not expand its ducts, which contributes to a better functioning of the organ and the prevention of chronic inflammatory process.

Also, the cholekinetic effect normalizes the flow of bile from the gallbladder, which prevents and eliminates cholestasis, and also prolongs the duration of the remission period for cholecystitis. Choleretic and cholekinetic effects persist for at least three months after discontinuation of the course of therapy.

The detoxifying effect is to reduce the production and neutralization of various toxic substances entering the body from the outside or synthesized by various organs and tissues. Heptral improves the functioning of the liver, which removes toxic substances much faster and more intensively, which is what the detoxification effect is achieved.

The neuroprotective effect of Heptral is to increase resistance to negative factors of brain cells and nerve fibers. Due to this effect, even in severe poisoning and intoxication, the development of encephalopathy is prevented. In addition, Heptrale stimulates the growth and reproduction of nerve cells, thereby replacing dead cell elements and preventing fibrosis and hardening.

The antioxidant effect is to increase the resistance of all human cells to the damaging effects of free radicals.

The antidepressant effect develops from 6 to 7 days of treatment and reaches its maximum severity by the end of the second week of taking the drug. Heptral effectively suppresses depression that is not amenable to treatment with amitriptyline and interrupts the relapse of this disorder.

In osteoarthritis, the drug reduces the intensity of pain and improves the recovery of cartilage tissue. In case of cirrhosis and hepatitis, Heptral reduces the intensity and intensity of pruritus, and also maintains the level of bilirubin, the activity of alkaline phosphatase, AcAT, AlAT, etc., within the normal range. In case of toxic liver damage (poisoning with poisons, drugs, drug taking, etc.), Geptral reduces abstinence phenomena (“breaking”) and improves the functioning of the organ.

Heptral – indications for use

Heptral is indicated for use in diseases that cause bile stasis in the liver, such as:

  • Fatty degeneration of the liver;
  • Chronic hepatitis;
  • Toxic liver damage by various factors, such as alcohol, viruses, drugs (antibiotics, anticancer drugs, antiviral and antituberculosis drugs, tricyclic antidepressants, oral contraceptives);
  • Chronic cholecystitis without stone formation;
  • Cholangitis;
  • Cirrhosis of the liver;
  • Intrahepatic cholestasis (stagnation of bile in the hepatic ducts) in pregnant women;
  • Encephalopathy associated with liver failure;
  • Withdrawal syndrome (alcoholic, narcotic);
  • Depression.

Instructions for use

Consider the rules of application, dosage and treatment regimen with tablets and Heptral solution.

Heptrale tablets – instructions for use

Tablets should be taken orally, swallowing whole, not chewed, not cracking or grinding in other ways, but with a small amount of water. The drug must be taken in between meals, preferably in the morning, because Heptral has a tonic effect.

Do not pull the pills out of the blister in advance and place them in a box or jar, as this may adversely affect the properties of the drug. Remove the pills from the blister should be immediately before taking.

After the required number of tablets is removed from the blister, you should carefully look at them and evaluate the color. If the tablets are not white or white-yellowish but are painted in any other colors and shades, then they cannot be taken.

In various diseases, Heptral should be taken in a daily dosage of 800 – 1600 mg (2 – 4 tablets). Typically, the daily dosage is divided into 2 – 3 doses per day, the last of which is carried out up to a maximum of 18-00 hours. It is best to take Heptrale twice a day – in the morning after waking up, and between lunch and dinner.

The duration of the course of therapy with Heptral is individual and is determined by the doctor based on the rate of normalization of the condition. On average, the course of therapy lasts from 2 to 4 weeks. Repeated treatment with Heptral can be made after an interval of 1 – 2 months after the end of the previous course of therapy.

Instructions for the use of Heptral injection (in ampoules)

Packaging for injection contains vials of lyophilized Heptral and ampoules with a solvent. It is this enclosed solvent that should be used to dilute the lyophilisate and get ready for intramuscular or intravenous administration of the solution.

In various diseases and pathologies of the liver, Heptral is injected intramuscularly or intravenously at 400-800 mg per day (1-2 flasks of lyophilisate) daily for two weeks. Then, if necessary, you can continue therapy by going to receive Heptral in the form of tablets of 800 – 1600 mg (2 – 4 tablets) per day. The duration of the pills after injection of Heptral should not exceed 4 weeks.

In case of depression, Heptral is also administered intravenously or intramuscularly at 400–800 mg (1–2 bottles) daily, for 15–20 days. After completing the course, you can continue taking Heptral in the form of tablets of 800 – 1600 mg (2 to 4 tablets) per day for another 2 to 4 weeks.

For administration of the solution, intravenous injection is preferable to intramuscular injection, since the risk of developing complications is much lower.

The lyophilisate is always diluted with a solvent immediately before administration, and not beforehand. The finished solution should be used immediately and not stored for several hours. If after the injection, any part of the drug remains, then it should be thrown away and not left until the next time.

Heptral should not be mixed in one syringe or vial with solutions containing calcium ions. With other solutions for infusions (e.g., glucose, saline, etc.) the drug is compatible.

So, immediately before the injection, the lyophilisate should be diluted with a solvent from the ampoule. To do this, the end of the ampoule is filmed and carefully broken off, after which a solvent is collected with a sterile syringe. From the vial with lyophilisate remove the aluminum cover of the soft cover.

Then the needle of the syringe with the solvent collected in it is introduced into the vial of lyophilisate, piercing the soft lid through. The solvent is carefully released into the vial, avoiding a sharp pressing of the piston so that the particles of the lyophilisate do not scatter along the walls. Then, to completely dissolve the lyophilisate, without removing the needle, gently chatter the vial from side to side, without turning it upside down.

When all lyophilisate is dissolved, the ready solution should be free of impurities and suspended particles and painted white or white-yellowish. If there are particles in the solution or its color is different from white-yellowish, then the drug cannot be used, it should be discarded.

The finished solution, subject to its normal appearance, is drawn into a syringe, which is removed from the tube. Then the solution is injected with the same syringe intravenously or intramuscularly. You can add a solution from the syringe to the dropper and inject the drug as an intravenous infusion.

How to administer Heptral in intravenous (dropper)

An intravenous, ready-made solution of Heptral, obtained after diluting the lyophilisate with a solvent, can be administered in two ways — jet or infusion. The solution is injected in an unchanged form by simply injecting it into a vein (as with an intramuscular injection). Infusion Heptral is introduced slowly, drop by drop, and it is pre-added to 250 – 500 ml of saline. Heptral’s infusion is usually referred to as a “dropper” because the drug drops into the vein.

For the jet injection of Heptral, lyophilisate is diluted immediately before the injection and collected in a syringe. Then a thin needle is put on the syringe for intravenous injection. The syringe is held in a vertical position with the needle upward and tapping with the finger along the wall in the direction of the needle holder so that all air bubbles accumulate in one place. Then press on the plunger of the syringe and release a small amount of the solution, which allows you to remove air outside.

Next, the skin in the injection area is wiped with a swab moistened with an antiseptic, and the needle is gently inserted into the vein. Then slowly inject the solution from the syringe (the ampoule is injected for at least 2 to 3 minutes). After that, the needle is removed from the vein and again wipe the puncture site with a swab moistened with an antiseptic.

For infusion, first, the lyophilisate in the bottle is diluted with a solvent from the ampoule. The ready solution of Heptral is poured into the infusion solution. At the same time keep the ratio – one bottle of lyophilisate per 250 ml of infusion solution. As an infusion solution usually take a physiological solution or 5% glucose. The prepared infusion solution is installed into the system, and they start to inject 15-25 drops per minute.

How to administer Heptrale intramuscularly

For the intramuscular administration of Heptral, immediately before performing the manipulation, the lyophilisate should be diluted with a solvent. The finished solution is drawn into a syringe; a relatively long and thick needle is attached to it, designed specifically for intramuscular injection. Care should be taken to ensure that there is no thin needle on the syringe for intravenous or subcutaneous administration of solutions since they can slide off the holder and go deep into the soft tissues. Such needles that have fallen into the muscles can remain in them for years, occasionally causing pain to occur in a person.

After dialing the solution into the syringe, it is held vertically, with the needle up, and lightly tapping the finger in the direction from the piston to the needle along the wall so that air bubbles gather in one place. Then they press on the piston, releasing a little solution into the air, which allows removing all the gas bubbles of the syringe.

The syringe prepared for the production of injection is postponed on a sterile napkin or bandage. Then the injection site is wiped with a swab moistened with an antiseptic. It is optimal to inject into the lateral upper third of the thigh or upper third of the shoulder because in these areas the muscles are close to the skin. Do not inject the solution into the buttock, since the muscles lie deep and there is a high risk of subcutaneous injection.

Having prepared the injection site, again take a syringe and insert the needle deeply into the tissue vertically to the skin surface. Then slowly press down on the piston, releasing the entire solution into the tissue. After the introduction of the solution, the syringe is removed, and the injection site is again wiped with a swab moistened with an antiseptic.

For the injection should be at least 1 cm from the previous one to minimize the risk of bruising and abscess.

special instructions

Elderly people (over 65 years old) tolerate Heptral so well that they do not need to reduce the dosage. However, older people are advised to start taking Heptral with minimal dosages, gradually increasing them if necessary.

Against the background of treatment, a person may experience anxiety, which usually disappears after the dosage reduction of the drug. Such anxiety is not an indication for discontinuation of Heptral.

Since Heptral has a tonic effect, you should not enter or take the drug in the evening, just before going to bed.

When using Heptral in case of liver cirrhosis, the concentration of residual nitrogen, urea, and creatinine in the blood should be periodically determined. Also on the background of drug therapy, it is recommended to take B vitamins, especially B 12 and folic acid, since Heptral is poorly absorbed with a lack of these vitamins.

Do not use the drug to relieve depression in people suffering from mania.

Influence on an ability to operate mechanisms

Heptral may provoke dizziness, so during therapy, with the drug, it is recommended to abandon any activity related to the need for a high reaction rate and concentration.


Cases of overdose with Heptral have not been recorded during the entire observation period for the clinical use of the drug.

Interaction with other drugs

Confirmed and reliably established interaction of Heptral with other medicinal preparations was not detected. However, there are data of individual observations about the appearance of an excess of serotonin in patients receiving Heptral. Therefore, it is recommended to use with caution Heptral with tricyclic antidepressants, selective serotonin reuptake inhibitors and drugs containing tryptophan.

Side Effects of Heptral

Heptral tablets and injections can cause the same adverse reactions, among which nausea, abdominal pain, and diarrhea are most common. In addition to them, Heptral in any medicinal form can provoke the following side effects from various organs and systems:
1. Immune system:

  • Laryngeal edema;
  • Allergic reactions (angioedema, skin reactions, shortness of breath, bronchospasm, back pain, tachycardia, bradycardia, etc.).

2. Skin:

  • Rash;
  • Itching;
  • Sweating;
  • Erythema;
  • Irritation at the injection site.

3. Nervous system:

  • Dizziness;
  • A headache;
  • Paresthesia (feeling of running ants, etc.);
  • Feeling of anxiety and anxiety;
  • Confusion;
  • Insomnia.

4. Cardiovascular system:

  • Tides;
  • Phlebitis of superficial veins.

5. The digestive tract:

  • Abdominal distention;
  • Abdominal pain;
  • Diarrhea;
  • Dry mouth;
  • Esophagitis;
  • Flatulence;
  • Bleeding from the digestive tract;
  • Nausea;
  • Vomiting;
  • Hepatic colic;
  • Cirrhosis of the liver.

6. Musculoskeletal system:

  • Arthralgia (joint pain);
  • Muscle cramps.

7. Others:

  • Asthenia;
  • Chills;
  • Flu-like syndrome;
  • Malaise;
  • Edema;
  • Fever.

8. Urinary tract infections.


Lyophilisate and Heptral tablets are contraindicated for use if a person has the following diseases or conditions:

  • Genetic disorders that cause a violation of the methionine cycle, homocysteinuria or hyperhomocysteinemia;
  • Violation of the metabolism of vitamin b 12 ;
  • Increased individual sensitivity to the components of the drug;
  • Age under 18;
  • I and II trimesters of pregnancy (up to the 27th week of gestation, inclusive);
  • Breastfeeding period.

Heptral – analogues

There are synonyms and analogues of Heptral on the pharmaceutical market. Synonyms are medicines that contain the same active substance as Heptral. Analogues are considered other drugs from the group of hepatoprotectors containing other active substances, but with the most similar spectrum of therapeutic effects.

The following drugs are synonymous with Heptral ;

  • Heptor tablets and lyophilisate;
  • Heptor H tablets.

Analogs of Heptral are the following drugs:

  • Brenziale forte capsules;
  • VG-5 tablets;
  • Hepa-Mertz granules and concentrate for solution for injection;
  • Hepatosan capsules;
  • Hepaphor capsules;
  • Heptrong Injection;
  • Histidine injection;
  • Glutargin concentrate and injection;
  • Glutamic acid tablets and granules for preparing a solution for oral administration;
  • Dipana pills;
  • Potassium orotat tablets and granules for preparing syrup;
  • Carniten solution and tablets;
  • Carnitine capsules, solution and concentrate;
  • Karsil dragee;
  • Karsil forte capsules;
  • Cryomelt MN solution for subcutaneous administration;
  • Laennec injection;
  • Legalon 140 and Legolon 70 capsules;
  • Liv 52 tablets and drops;
  • Livolin Forte capsules;
  • Lipostabil capsules and solution;
  • Maxar pills;
  • Methionine tablets;
  • Metrop GP injection;
  • Peponen capsules;
  • Procapar capsules;
  • Rezalyut Pro capsules;
  • Remaxol injection;
  • Ropren drops;
  • Rosilimarin tablets;
  • Silymarin sedico granules for suspension;
  • Thiotriazolin tablets and injection;
  • Tykveol capsules, rectal suppositories, and oil;
  • Phosphatidylcholine capsules;
  • Phosphogliv capsules;
  • Phosphonocyale capsules;
  • Holenol capsules;
  • Elkar solution and tablets;
  • Essel forte capsules;
  • Essentiale, Essentiale N, Essentiale Forte, Essentiale Forte N capsules and solution for injection;
  • Essliver forte capsules.

What is better than Heptral?

In medical practice, there is no concept of “best” about various drugs. Practitioners prefer to use the term “optimal,” which is understood as a drug that suits a particular person in the current situation in the best possible way.

That is, for different people, depending on the individual characteristics with the same pathology, different drugs will be optimal.

Moreover, for the same person suffering from a chronic disease, different drugs may be optimal at different stages of life. It is a drug that is best suited to a particular person in this situation, will be for him the best.

Thus, it is impossible to isolate any best medicine that would be consistently and equally effective in various diseases in different people. And in each situation, this or that drug may be the best. Therefore, it is not possible to isolate some drugs that would be “better” than Geptral.

Choosing between Heptral and other hepatoprotectors, you should focus only on your feelings. If someone subjectively better suited and transferred Heptral, then it should be considered the “best” drug. If this same person at another point in time is more suitable, for example, Essentiale, then this particular drug will be the “best,” etc.

If we compare Heptral with synonyms that also contain ademetionine as an active substance, then at the pharmaceutical market of the CIS countries, all drugs presented are worse than Heptral because they cause side effects and are more difficult to tolerate. From this position, there is nothing better than Heptral.


Most reviews of Heptral (from 80 to 90%) are positive, to some extent even enthusiastic, due to the apparent clinical effects of the drug. People note that the course of Heptral therapy significantly improved overall health, led to normal blood biochemistry (AsAT, AlAT, alkaline phosphatase, etc.), and also cured some liver problems, such as acne and acne, tongue plaque and dyspeptic symptoms (belching, heartburn, bloating, flatulence, etc.).

The disadvantages of the drug are its high cost, which, however, according to people, is justified, since Geptral effectively restores the normal functioning of the liver. Many people who have tried various hepatoprotectors consider Heptral to be one of the best medicines.

There are few negative reviews about Heptral, and they are caused by the development of any side effects that were hard tolerated by people and required the drug to be discontinued. In the reviews, people indicated that they developed edema, confusion, flu-like symptoms, and a severe headache.

These side effects were so severe and difficult to tolerate that people had to stop taking Heptral. This situation quite naturally caused people to be disappointed and annoyed, which became the emotional basis for writing a negative review.

However, when deciding whether to start Heptral therapy, it should be borne in mind that such an organism’s response is quite possible, and during its development, it is not necessary to perceive this fact emotionally so as not to intensify the already quite strong tension.

Heptral – doctors reviews

Reviews of doctors about Heptral in most cases are positive since this drug is one of the most effective and effective hepatoprotectors on the pharmaceutical market. Heptral has an excellent and pronounced effect on the liver, relatively quickly normalizing its functioning and eliminating the phenomena that cause fibrosis and cirrhosis in the long term.

That is, according to practicing hepatologists and gastroenterologists, Heptral is an effective drug for maintaining the functions of the liver and preventing cirrhosis for many years (sometimes several dozens).

However, among doctors, there are supporters of Heptral and supporters of its careful use, who believe that the drug has a very powerful effect that is not always necessary for a person with liver diseases. Adherents of Heptrala believe that the drug can be used for any liver damage since the clinical effect occurs in almost 100% of cases.

And supporters of the careful use of Heptral consider that the drug should be used only with pronounced abnormal liver function and under the constant control of blood tests (AST, AlAT, urea, and creatinine).

If a person has relatively mild damage to the liver, then you should not use a very powerful Heptral, it is better to replace it with another hepatoprotector with a milder effect, for example, Essentiale, Phosphogliv, Ursosan, etc.

Heptor or Heptrale?

Heptor and Heptral are synonymous since they contain the same active substance. However, Heptral is an original product of Italian production, and Heptor is its Russian generic. Unfortunately, regarding effectiveness, the severity of the therapeutic effect, the rate of normalization, and the frequency of side effects, Geptral is far superior to the Russian Heptor. This means that Heptral is more effective than Heptor and less likely to cause side effects.

Therefore, choosing between Heptral and Heptor, it is recommended to prefer the first drug. However, Heptral is much more expensive than Heptor. Therefore, it can be taken, especially with long courses, only if there is an adequate reserve of funds. If Heptral is financially unavailable, then it is quite possible to replace it with a Heptor.

Many people who have experience using both drugs claim that they did not feel any difference between the effectiveness and severity of the side effects of Heptral and Heptor. Therefore, you can try to take both drugs, and if the difference is not felt, then stop the final choice on Heptor, which is much cheaper than Heptral.

Essentiale or Heptrale?

Essentiale and Heptral are hepatoprotectors, but contain different active substances. Both drugs protect the liver from the negative effects of various factors, as well as help maintain its normal functioning in chronic diseases. But Essentiale has only hepatoprotective action, and Heptral also choleretic and anti-depressive. Therefore, in the presence of stagnation of bile or gallbladder diseases, it is recommended to choose Heptral.

For hepatitis C, it is recommended to take Heptral, rather than Essentiale, to maintain normal liver function and prevent cirrhosis before antiviral therapy begins. This is due to the fact that Heptral in this clinical situation is more effective, since it normalizes liver function and the activity of AST and ALT more quickly and more powerfully.

In other cases, Heptral and Essentiale have approximately the same therapeutic effects, so you can choose and use any drug that is more like it for any subjective reasons. However, it should always be remembered that each person is individual, and therefore Geptral, which is perfect for someone, and Essentiale for another.
Read more about the drug Essentiale

Heptral (tablets and ampoules) – price

Heptral is produced in Europe or the USA and is imported to the countries of the former USSR. Therefore differences in its cost are not caused by reasons reflecting the quality of the drug. This means that there is no difference in the quality of drugs sold at a higher or lower cost. Therefore, you can purchase the drug for the lowest price offered.

Currently, the cost of tablets and ampoules of Heptral in the domestic pharmaceutical market varies within the following limits:

  • Heptral pills 400 mg, 20 pieces –1618–1786 rubles;
  • Heptral lyophilisate 400 mg per vial, the pack of 5 vials and 5 ampoules with a solvent – 1572 – 1808 rubles.

How to take Heptral before meals or after?

  • Heptral contains the active ingredient ademetionin and is available in two forms – powder for solution for injection and tablets, coated. It is the shell that protects the active substance from the aggressive environment of the stomach and allows tablets to reach the intestine in an unchanged state. For this reason, tablets can not be chewed. It is advisable to take Heprtal in between meals so that ademetionine can be rapidly absorbed in the duodenum, and the presence of food in the gastrointestinal tract can slow down the adsorption and lead to a decrease in the therapeutic efficacy of Heptral.
  • In this case, in the instructions that the manufacturer of this agent presents to us, it is directly stated that the most productive technique will occur if this medicine is taken between meals. Which means nothing more than taking this medicine about an hour after a meal, because if you take it for example before a meal, it isn’t impossible to call it, so you took the drug between meals, since this is Essentially, after the first and before the second dose.
  • The drug Heptral is intended for the treatment of liver problems. Consider in detail at what time to take Heptral. For maximum effectiveness of the drug, Heptral should be taken until twelve o’clock in the afternoon.And it should be drunk either an hour and a half before meals , or one and a half hours after a meal.The attending physician usually prescribes Heptral. Heptral can be found in tablets and ampoules (administered intravenously). If we talk about pills, the course of treatment can be up to three months, and usually, take at one time from two to four tablets.