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The action of Heptral is due to the peculiarities of its molecule structure. The three active centres of the substance provide the main reactions for regeneration of liver cells and restoration of liver functions:
1ST ACTIVE CENTRE
The first centre restores the structure of liver cells, taking part in the production of special substances from acids and alcohols - phospholipids. They are essential for cellular renewal, enhancing their protective functions and normalising the function of the channels through which bile is excreted.
2ND ACTIVE CENTRE
The second centre is responsible for the process of division of healthy liver cells. Stimulation of their reproduction stops the development of pathological process and accelerates regeneration.
3RD ACTIVE CENTRE
The third centre is involved in the production of molecules crucial to the body: glutathione - the basis of the liver's purification process and protection against free radicals - and ATP - the source of cellular energy.
Intrahepatic cholestasis in precirrhotic and cirrhotic conditions, which may be seen in the following diseases:
Intrahepatic cholestasis in pregnant women.
Symptoms of depression.
How to take, course of treatment and dosage:
Intravenously and intramuscularly.
Lyophilisate for intramuscular and intravenous administration should be dissolved using the enclosed solvent before administration. The residue must be disposed of. The appropriate dose of the drug for intravenous administration should be further dissolved in 250 ml of physiological solution or 5% glucose solution and administered slowly over 1-2 hours.
The drug should not be mixed with alkaline solutions and solutions containing calcium ions.
In case the lyophilisate has a colour other than almost white to white with yellowish tint (due to a crack in the vial or heat exposure), HeptralŪ is not recommended.
Initial therapy: Recommended dose is 5-12 mg/kg/day intravenously or intramuscularly.
Depression: From 400 mg/day to 800 mg/day (1-2 vials/day) for 15-20 days.
Intrahepatic cholestasis: From 400 mg/day to 800 mg/day (1-2 vials/day) for 2 weeks.
In case of necessity of maintenance therapy it is recommended to continue treatment with HeptralŪ in tablet form in dose 800-1600 mg/day during 2-4 weeks.
Therapy with Heptral may be started from intravenous or intramuscular injection followed by administration of HeptralŪ tablets or directly from taking HeptralŪ tablets.
Clinical experience with Heptral showed no differences in efficacy between elderly patients and younger patients. However, taking into account high probability of hepatic, renal or cardiac impairment, other concomitant diseases or concomitant therapy with other drugs, the dose of HeptralŪ should be adjusted to elderly patients with caution, starting from the lowest dose range.
There are limited clinical data on the use of HeptralŪ in patients with renal impairment, therefore, caution is recommended when using HeptralŪ in such patients.
Parameters of ademetionine pharmacokinetics are similar in healthy volunteers and in patients with chronic liver disease.
Use of Heptral in children is contraindicated (efficacy and safety not established).
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