Heptral lyophilized powder for the preparation of injection solution 500 mg (complete with 5 ml solvent) No. 5

Compound

Where to look for help

Remember that even though the disease may seem unserious, only a highly qualified psychiatrist with sufficient practical experience can cure it. If you find these symptoms in yourself or your loved ones, we recommend that you contact a specialist.

It is important to convince the patient that help will be effective if the specialist’s recommendations are fully followed. CELT employs doctors who will help you quickly cope with any manifestation of depression. Treatment will always give a positive result if you start working with the patient in a timely manner.

Depersonalization-derealization syndrome is a fairly serious mental disorder that can easily be corrected. If you find these symptoms in yourself or your loved ones, we recommend that you consult a specialist. To clarify the diagnosis and receive qualified medical care, you can contact CELT. This is one of those conditions in the treatment of which our psychoneurologists achieve good results.

Make an appointment through the application or by calling +7 +7 We work every day:

• Monday—Friday: 8.00—20.00
• Saturday: 8.00–18.00
• Sunday is a day off

The nearest metro and MCC stations to the clinic:

• Highway of Enthusiasts or Perovo
• Partisan
• Enthusiast Highway

Driving directions

Pharmacodynamics

Ademetionine belongs to the group of hepatoprotectors and also has antidepressant activity. It has choleretic and cholekinetic effects, has detoxification, regenerating, antioxidant, antifibrosing and neuroprotective properties. Replenishes the deficiency of S-adenosyl-L-methionine (ademetionine) and stimulates its production in the body; it is found in all environments of the body. The highest concentration of ademetionine was observed in the liver and brain.

Plays a key role in the metabolic processes of the body, takes part in important biochemical reactions: transmethylation, transsulfation, transamination.

In transmethylation reactions, ademetionine donates a methyl group for the synthesis of cell membrane phospholipids, neurotransmitters, nucleic acids, proteins, hormones, etc. In transsulfation reactions, ademetionine is a precursor of cysteine, taurine, glutathione (providing a redox mechanism for cellular detoxification), acetylation coenzyme (included in biochemical reactions of the tricarboxylic acid cycle and replenishes the energy potential of the cell).

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. After decarboxylation, it participates in aminopropylation reactions as a precursor of polyamines - putrescine (stimulator of cell regeneration and hepatocyte proliferation), spermidine and spermine, which are part of the ribosome structure, which reduces the risk of fibrosis. Has a choleretic effect.

Ademetionine normalizes the synthesis of endogenous phosphatidylcholine in hepatocytes, which increases membrane fluidity and polarization. This improves the function of bile acid transport systems associated with hepatocyte membranes and promotes the passage of bile acids into the biliary system. Effective for intrahepatic (intralobular and interlobular) variants of cholestasis (impaired synthesis and flow of bile). Ademetionine reduces the toxicity of bile acids in hepatocytes by conjugating and sulfating them. Conjugation with taurine increases the solubility of bile acids and their removal from the hepatocyte. The process of sulfation of bile acids facilitates their elimination by the kidneys, facilitates their passage through the hepatocyte membrane and excretion in the bile. In addition, sulfated bile acids themselves additionally protect liver cell membranes from the toxic effects of non-sulfated bile acids (present in high concentrations in hepatocytes during intrahepatic cholestasis).

In patients with diffuse liver diseases (cirrhosis, hepatitis) with intrahepatic cholestasis syndrome, ademetionine reduces the severity of skin itching and changes in biochemical parameters, incl. level of direct bilirubin, alkaline phosphatase activity, aminotransferases, etc. The choleretic and hepatoprotective effect lasts up to 3 months after cessation of treatment.

It has been shown to be effective against hepatopathies caused by various hepatotoxic drugs. Prescription to patients with opioid addiction accompanied by liver damage leads to regression of clinical manifestations of withdrawal, improvement of the functional state of the liver and microsomal oxidation processes.

Antidepressant activity appears gradually, starting from the end of the first week of treatment, and stabilizes within 2 weeks of treatment. Effective for recurrent endogenous and neurotic depressions resistant to amitriptyline. Has the ability to interrupt relapses of depression.

Prescription for osteoarthritis reduces the severity of pain, increases the synthesis of proteoglycans and leads to partial regeneration of cartilage tissue.

Popular questions about Heptral

How to take Heptral?

Treatment begins with injections, then the patient is transferred to oral administration. The tablets are swallowed whole. The daily dose is divided into 2-3 doses. The dosage is calculated based on the recommendations given in the instructions.

Heptral: how often can I take it?

Tablets are taken 2-3 times a day at equal intervals, distributed between meals. Injections can be given 2 times a day, morning and evening. The duration of treatment is determined by the doctor individually.

How to inject Heptral?

Heptral ampoules are administered intravenously or intramuscularly. The dosage is prescribed depending on the patient's weight. The solution is prepared immediately before injection. The average course duration is 2 weeks.

Where can I buy Heptral?

The medicine is sold by prescription. The drug can be purchased at any pharmacy or ordered delivery through specialized online services.

Pharmacokinetics

Bioavailability when taken orally - 5%. With a single oral dose of 400 mg, Cmax is 0.7 mg/l; Tmax - 2–6 hours.

Communication with plasma proteins is insignificant, penetrates the BBB. There is a significant increase in the concentration of the drug in the cerebrospinal fluid.

Metabolized in the liver. T1/2 - 1.5 hours. Excreted by the kidneys.

The tablets are coated with a special coating that dissolves only in the intestines, due to which ademetionine is released in the duodenum.

Depressive episode and its dangers

In this state, a number of patients have an irresistible desire to commit suicide. Severe depression can lead to suicide. An inexplicable feeling of anxiety or melancholy pushes people between the ages of fifteen and twenty-five to take rash, spontaneous actions. This is the most dangerous period of life, when a lack of worldly wisdom can push you to a terrible point. Every day, about fifteen people die attempting suicide. Experts say that depression most often leads people to suicide. If you are plagued by feelings of anxiety, joylessness, or depression of an inexplicable nature, do not delay visiting a specialist.

Indications

intrahepatic cholestasis in pre-cirrhotic and cirrhotic conditions, which can be observed in the following diseases:

- fatty liver;

- chronic hepatitis;

- toxic liver damage of various etiologies, including alcohol, viral, drugs (antibiotics, antitumor, anti-tuberculosis and antiviral drugs, tricyclic antidepressants, oral contraceptives);

— chronic acalculous cholecystitis;

- cholangitis;

- cirrhosis of the liver;

— encephalopathy, incl. associated with liver failure (alcohol, etc.);

intrahepatic cholestasis in pregnant women;

symptoms of depression.

Symptoms

The first thing that catches your eye when talking with a person who is depressed is joylessness and pronounced depression. Melancholy and anxiety can be read on the patient’s face. In this state, people feel abandoned and forgotten, it seems to them that friends and relatives have turned their backs, and the world around them wants to get rid of their presence as quickly as possible. When talking with such patients, you can find that they most often complain about:

• A sharply decreased appetite or a complete loss of interest in food (although with the so-called “atypical depression”, on the contrary, the appetite increases and there is a craving for sweet, starchy, and sometimes fatty foods - the person “eats” depression and can gain several kilograms in a relatively short period of time) .
• Having problems sleeping. Constantly haunted by nightmares, night's sleep becomes superficial and light, not bringing a sense of rest. In order to fall asleep, you need to take strong medications. After waking up, such people do not feel relief; fatigue does not leave them.
• The feeling of joy goes away. Even ordinary physiological pleasures become inaccessible.
• Interest in the events happening around is lost, even if they directly concern the person.
• Loss of strength is expressed in the reluctance to do the usual work. A little tension causes an attack of mortal fatigue.
• It is difficult to concentrate on simple life situations.
• Symptoms are often expressed in absolute helplessness and a feeling of uselessness to loved ones.
• A painful feeling of guilt that arises for any reason (or “the beginning of a feeling of guilt” - the feeling “I’m disturbing everyone,” “it would be better without me”) is a very dangerous symptom from the point of view of the risk of a suicide attempt.

Side effects

The most common adverse reactions include nausea, abdominal pain and diarrhea. Below are summarized data on adverse reactions that were observed during the use of ademetionine both in tablets and in injection dosage form.

From the immune system: laryngeal edema, allergic reactions.

Skin: sweating, itching, rash, Quincke's edema, skin reactions.

Infections and infestations: urinary tract infections.

From the nervous system: dizziness, headache, paresthesia, anxiety, confusion, insomnia.

From the CCC side: hot flashes, phlebitis of superficial veins, cardiovascular disorders.

From the digestive system: bloating, abdominal pain, diarrhea, dry mouth, dyspepsia, esophagitis, flatulence, gastrointestinal disorders, gastrointestinal bleeding, nausea, vomiting, hepatic colic, cirrhosis.

From the musculoskeletal system: arthralgia, muscle spasms.

Others: asthenia, chills, flu-like syndrome, malaise, peripheral edema, fever.

How to identify depression

If a person close to you is constantly gloomy and sheds tears for any reason or without it, he is overcome by thoughts about the imminent end of his life, he constantly looks at everyone as enemies, take him to the doctor or invite a specialist to your home. Treatment will be more effective if you start fighting the disease in a timely manner. This is the case when it is impossible to play it safe. It is easier to fight the disease if a person is aware of the danger and is ready to listen to the doctor’s recommendations. A severe form of the disease requires hospital treatment. If you notice frequent mood swings, lethargy, lack of appetite, or the appearance of unexplained pain in different parts of the body, do not delay, visit a doctor as soon as possible.

special instructions

Given the tonic effect of the drug, it is not recommended to take it before bed. When prescribing Heptral® to patients with liver cirrhosis due to hyperazotemia, systematic monitoring of residual nitrogen is necessary. During long-term therapy, it is necessary to determine the content of urea and creatinine in the blood serum.

It is not recommended to prescribe ademetionine to patients with bipolar disorders. There are reports of the transition of depression to hypomania or mania in patients taking ademetionine.

There are also reports of sudden onset or worsening anxiety in patients taking ademetionine. In most cases, discontinuation of therapy is not required; in a few cases, anxiety resolved after dose reduction or drug discontinuation.

Since vitamin B12 and folic acid deficiency may reduce ademetionine levels in patients at risk (with anemia, liver disease, pregnancy or the possibility of vitamin deficiency due to other diseases or diet, such as vegetarians), vitamin levels should be monitored. If deficiency is detected, simultaneous administration of ademetionine with vitamin B12 and folic acid is recommended. Ademetionine interferes with homocysteine ​​immunoassay results, which may cause falsely high plasma homocysteine ​​levels. For patients taking ademetionine, it is recommended to use non-immunological methods of analysis to determine homocysteine ​​levels.

Impact on the ability to drive a car and operate machinery. Some patients may experience dizziness while taking Heptral®. It is not recommended to drive a car or operate machinery while taking the drug until patients are sure that the therapy does not affect the ability to engage in this type of activity.

Note!

The description of the drug Heptral on this page is a simplified author’s version of the apteka911 website, created on the basis of the instructions for use.
Before purchasing or using the drug, you should consult your doctor and read the manufacturer's original instructions (attached to each package of the drug). Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide to prescribe the drug, as well as determine the dose and methods of its use.