Hepamerz injection uses
Reading File
Finding Sources
Searching the Web
Hepamerz injection L-ornithine L-aspartate uses indications dosage
Hepamerz (L-Ornithine L-Aspartate / LOLA) Injection - Uses
Hepamerz is a brand of L-Ornithine L-Aspartate (LOLA) in injectable/infusion form. Each ampoule (10 ml) contains 5 g of L-ornithine L-aspartate.
Primary Therapeutic Indications
1. Hepatic Encephalopathy (HE) - Main Use
- Latent (minimal/covert) HE - subclinical cognitive impairment in liver disease
- Manifest (overt) HE - confusion, altered consciousness
- Pre-coma and coma - the IV infusion form is specifically indicated for these severe stages
- Reduces elevated blood ammonia levels that drive encephalopathy
2. Chronic Liver Disease with Impaired Detoxification
- Liver cirrhosis with hyperammonemia
- Sequelae of impaired hepatic detoxification function
3. Acute and Chronic Hepatic Diseases (supportive)
- Hepatitis (acute/chronic)
- Fatty liver disease
- Cirrhosis (supportive metabolic therapy)
Mechanism of Action
LOLA lowers ammonia by two pathways:
- Ornithine stimulates the urea cycle in periportal hepatocytes - promoting ammonia conversion to urea
- Aspartate stimulates glutamine synthesis in perivenous hepatocytes and muscle - incorporating ammonia into glutamine
- Net result: significant reduction in blood ammonia levels
Dosage (Injection/Infusion)
| Indication | Dose |
|---|---|
| Mild-moderate HE | 20 g/day IV infusion (4 ampoules in 500 ml saline) |
| Severe HE / Pre-coma / Coma | Up to 40 g/day IV infusion |
| Max infusion rate | 5 g/hour (to avoid nausea/vomiting) |
Contraindications
- Severe renal impairment (serum creatinine > 3 mg/100 ml) - absolute contraindication
- Hypersensitivity to L-ornithine L-aspartate
- Pregnancy and lactation - insufficient safety data; avoid
Side Effects
- Nausea and vomiting (most common, especially if infused too rapidly)
- Generally well tolerated at recommended infusion rates
Key Evidence
Per Rosen's Emergency Medicine, LOLA has demonstrated benefit in lowering postprandial serum ammonia levels and is used following TIPS procedures, which are known to increase or worsen hepatic encephalopathy. It is used alongside lactulose and rifaximin in the broader management of HE.
Bottom line: Hepamerz injection is primarily a liver support drug for ammonia detoxification, most commonly used in hepatic encephalopathy (all grades), especially the pre-coma/coma stages where IV administration is preferred over oral granules.
This is a shared conversation. Sign in to Orris to start your own chat.