Hepasol-Neo
Hepasol-Neo: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. For violations of liver function
- 10. Drug interactions
- 11. Analogs
- 12. Terms and conditions of storage
- 13. Terms of dispensing from pharmacies
- 14. Reviews
- 15. Price in pharmacies
Latin name: Hepasol-Neo
ATX code: B05VA04
Active ingredient: aminoacids for parenteral nutrition
Manufacturer: Hemofarm (Serbia)
Description and photo updated: 12.12.2018
Hepasol-Neo is a preparation containing a solution of amino acids for parenteral nutrition, used in the treatment of liver failure.
Release form and composition
Hepasol-Neo is produced in the form of an 8% solution for infusion: transparent, from slightly yellow to colorless; with osmolarity - 770 mOsm / L, pH - 5.7-6.3 (500 ml in glass vials, 1 vial in a cardboard box or 10 vials in a cardboard box).
1 liter of solution contains active substances: glycine - 5.82 g; L-arginine - 10.72 g; L-histidine 2.8 g; L-serine 2.24 g; L-methionine - 1.1 g; L-proline 5.73 g; L-isoleucine - 10.4 g; L-leucine - 13.09 g; L-valine - 10.08 g; L-phenylalanine 0.88 g; L-lysine monoacetate - 9.71 g (L-lysine content - 6.88 g); L-threonine 4.4 g; L-alanine 4.64 g; L-tryptophan - 0.7 g; acetylcysteine - 0.7 g (L-cysteine content - 0.52 g).
Auxiliary components: glacial acetic acid - 4.42 g / l; water for injection - up to 1 liter.
The energy value of the solution is 320 kcal / l (1344 kJ / l).
Pharmacological properties
Pharmacodynamics
The preparation contains all 8 essential amino acids that the human body is unable to synthesize (L-tryptophan, L-valine, L-phenylalanine, L-leucine, L-isoleucine, L-threonine, L-methionine, L-lysine), 2 conditionally nonessential amino acids (L-histidine and L-arginine), which are produced in insufficient quantities in certain pathophysiological disorders, and 5 nonessential amino acids, which support an adequate metabolism in patients with liver diseases. In Hepasol-Neo, amino acids are in the L-form, which gives them the opportunity to directly participate in the biosynthesis of proteins (nitrogen concentration is 12.9 g / l).
L-Arginine is an essential element in the ornithine urea cycle. L-proline and L-alanine reduce the body's need for glycine (this amino acid is poorly absorbed in the body, its replacement makes it impossible to develop hyperammonemia).
L-valine, L-leucine and L-isoleucine, which are essential branched-chain amino acids, are directly absorbed by peripheral tissues, and their metabolism is not determined by the degree of liver damage, reduce the absorption and transport of aromatic amino acids in the central nervous system (central nervous system), reducing the severity of the symptoms of hepatic encephalopathy, and also normalize the nitrogen and energy balance in the body.
Hepasol-Neo is intended for the correction of amino acid disorders that often accompany liver failure. It also significantly improves protein tolerance in patients with hepatitis and liver cirrhosis. The preparation does not contain carbohydrates or electrolytes.
Pharmacokinetics
Hepasol-Neo includes a variety of amino acids that normally are normally absorbed into the body during meals.
Amino acids entered the body through infusion are metabolized in two possible ways: catabolic, which consists in the transamination of amino acids, and anabolic way, which consists in binding amino acids by peptide bonds with the subsequent formation of proteins from them. The equilibrium concentration of amino acids, which are administered in the framework of complete parenteral nutrition together with fats and dextrose (the ratio of fats and carbohydrates is 30:70) at an average rate of 10.5 mg nitrogen / kg / hour, in the blood is established 3 hours after administration.
With a rapid increase in the level of amino acids in the blood, the latter can be excreted unchanged. Their half-life (for healthy people) is 5-15 minutes. It is during this short period of time that amino acids enter into reactions that lead to protein synthesis. Remains of amino acids that were not used during the production of proteins are involved in deamination processes, the result of which is the formation of urea, which must be excreted from the body.
Arginine is almost 100% reabsorbed in the renal tubules.
The metabolism of amino acids is carried out in all tissues of the body, the degree of their destruction depends on the intensity of stress to which the patient is exposed. Stress intensifies the metabolism of amino acids and increases the severity of liver dysfunction, which slows down the metabolism of amino acids. Sepsis also speeds up their metabolism, while renal dysfunction, on the contrary, inhibits it.
When the drug is infused, essential amino acids are absorbed by 99%, and non-essential amino acids by 97%. The total and renal clearance of essential amino acids is 0.5 L / min and 1.5 ml / min. For most nonessential amino acids, these figures are 0.6 l / min and 3 ml / min, respectively.
Indications for use
- Treatment and parenteral nutrition (full or partial - with the addition of solutions of fat emulsions and carbohydrates) for functional disorders of the liver (liver failure), accompanied by impaired brain function (hepatic encephalopathy) and without it;
- Treatment of precoma and hepatic coma.
Contraindications
- Hyperhydration;
- Amino acid metabolism disorders;
- Hypokalemia;
- Hyponatremia;
- Heart failure (in the stage of decompensation);
- Renal failure (in patients with renal failure with hepatic coma, it is necessary to consider which of these conditions is more dangerous);
- Pregnancy and lactation;
- Age up to 18 years (safety and efficacy for this age group of patients have not been established);
- Hypersensitivity to drug components.
Instructions for use of Hepasol-Neo: method and dosage
The dosage regimen of Hepasol-Neo is set individually. When prescribing the drug, the concentration of ammonia in the blood and the severity of the course of the disease are taken into account.
Hepasol-Neo is administered intravenously. The rate is 1.0-1.25 ml / kg of body weight per hour (30-35 drops per minute), which corresponds to 0.08-0.1 g of amino acids / kg per hour. The drug can be administered at a maximum rate of 1.25 ml / kg per hour.
The maximum dose of Hepasol-Neo is 18.75 ml / kg per day.
As a rule, the drug is used until the neurological symptoms disappear completely.
Side effects
When using Hepasol-Neo in recommended doses, according to indications, no side effects were identified.
Overdose
The main signs of an overdose of Hepasol-Neo include increased activity of liver enzymes, nausea, vomiting, tachycardia, sweating, fever and an increase in the concentration of residual nitrogen.
The high rate of administration of the drug can provoke overhydration, the occurrence of peripheral edema and the development of pulmonary edema.
In this case, it is recommended to immediately stop the Hepasol-Neo infusion and prescribe symptomatic therapy. The specific antidote is unknown.
special instructions
It is advisable to use Hepasol-Neo only for the indicated indications, exclusively in medical hospitals.
During therapy, it is periodically necessary to monitor the electrolyte and acid-base state, the degree of hydration of the body, and the state of renal function.
Only a clear solution can be used. Before use, you need to make sure that the bottle with the drug is not damaged.
Influence on the ability to drive vehicles and complex mechanisms
There are no data confirming the ability of the drug to affect the ability to drive any vehicles or perform work that requires increased concentration and immediate psychomotor reactions.
For violations of liver function
In patients with liver dysfunctions, the use of Hepasol-Neo is allowed if indicated.
Drug interactions
There is information about the interaction of individual components of Hepasol-Neo with theophylline, which can lead to an increase in clearance.
Due to the numerous data on in vitro interaction, it is not recommended to add other drugs to the Hepasol-Neo solution.
According to the instructions, Hepasol-Neo is compatible with antibiotics such as: piperacillin, erythromycin, ceftriaxone, amikacin, ampicillin, cefotaxime, doxycycline, gentamicin, chloramphenicol, clindamycin, penicillin, netilmicin, tetracycline, tobramycin and vancomycin.
Also, the drug can be used concurrently with the following drugs: chlorpromazine, cyclophosphamide, aminophylline, cimetidine, digoxin, cytarabine, dopamine, famotidine, fluorouracil, phytomenadione, folic acid, heparin, methylprednisolone, methotrexate, furosemidine, methylprednisolone, calcium metoclopramide, propranolol, morphine, norepinephrine, nizatidine, riboflavin, and ranitidine.
Analogs
There is no information on analogues of Hepasol-Neo.
Terms and conditions of storage
Store at 15-25 ° C, protected from light, out of reach of children.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Hepasol-Neo
On the Internet, reviews about Hepasol-Neo are almost completely absent. There are references to the fact that the drug is well compatible with antibiotics and can be used in combination therapy.
Price for Hepasol-Neo in pharmacies
On average, the price of Hepasol-Neo is 250‒352 rubles (for a 500 ml bottle).
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
