Heptor tablets: instructions for use, ademetionine tosylate disulfate 400 mg

Heptor tablets belong to the group of hepatoprotectors with antidepressant activity. They have choleretic and cholekinetic effects. They have detoxifying, regenerating, antioxidant, antifibrosing and neuroprotective effects.

Registration number: LS-001820 dated 08/22/2011

Trade name: Heptor

International nonproprietary name: ademetionine

Dosage form: enteric-coated tablets

Photo of Heptor tablets showing the composition

Heptor tablets composition

One tablet contains:

Active substance: ademetionine tosylate disulfate in terms of ademetionine ion - 400 mg.

Excipients to obtain a tablet weighing 0.95 g (without shell): polyplasdon X El-10 (crospovidone) - 19 mg, microcrystalline cellulose - 53 mg, mannitol (mannitol) - 53 mg, magnesium stearate - 15 mg.

There is a sufficient amount of excipients to obtain a coated tablet weighing 1.045 g: acrylic yellow - methacrylic acid and ethyl acrylate copolymer (1:1), talc, titanium dioxide, colloidal silicon dioxide, triethyl citrate, sodium bicarbonate, sodium lauryl sulfate, yellow iron oxide, quinoline yellow aluminum varnish, hydroxypropyl methylcellulose, plasdon ES-630 (copovidone), polyethylene glycol 6000.

Description

Enteric-coated tablets are yellow, oblong, biconvex.

Pharmacotherapeutic group: hepatoprotective agent

ATX code: A16AA02

pharmachologic effect

Pharmacodynamics

Heptor belongs to the group of hepatoprotectors with antidepressant activity. It has choleretic and cholekinetic effects. It has detoxifying, regenerating, antioxidant, antifibrosing and neuroprotective effects. Replenishes ademetionine deficiency and stimulates its production in the body, primarily in the liver and brain. Participates in biological transmethylation reactions (methyl group donor) - the E-adenosyl-methionine molecule (ademetionine) donates a methyl group in methylation reactions of phospholipids of cell membranes, proteins, hormones, neurotransmitters, etc.; transsulfation - a precursor of cysteine, taurine, glutathione (provides a redox mechanism of cellular detoxification), coenzyme A. Increases the content of glutamine in the liver, cysteine ​​and taurine in the plasma; reduces the content of methionine in the blood serum, normalizing metabolic reactions in the liver. After decarboxylation, it participates in the processes of aminopropylation as a precursor of polyamines - putrescine (stimulator of cell regeneration and proliferation of hepatocytes), spermidine and spermine, which are part of the ribosome structure. It has a choleretic effect due to increased mobility and polarization of hepatocyte membranes due to stimulation of the synthesis of phosphatidylcholine in them. 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 intralobular cholestasis (impaired synthesis and flow of bile). Promotes 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 hepatocytes. The process of sulfation of bile acids promotes their elimination by the kidneys, facilitates their passage through the hepatocyte membrane and excretion with bile. In addition, sulfated bile acids protect liver cell membranes from the toxic effects of non-sulfated bile acids, which are present in high concentrations in hepatocytes during intrahepatic cholestasis. In patients with diffuse liver diseases (cirrhosis, hepatitis) with intrahepatic cholestasis syndrome, it reduces the severity of skin itching and changes in biochemical parameters, incl. concentrations of direct and total bilirubin, activity of alkaline phosphatase, glutamyl transpeptidase, aminotransferases. The choleretic and hepatoprotective effect lasts up to 3 months after cessation of treatment. Shown to be effective in hepatopathy caused by hepatotoxic drugs. Prescribing ademetionine 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 1 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.

Pharmacokinetics

Bioavailability when taken orally - 5%. With a single oral dose of 400 mg, the maximum plasma concentration (Cmax) is 0.7 mg/l. Time to reach maximum concentration (TCmax) - 2-6 hours. Binding to plasma proteins is insignificant, penetrates the blood-brain barrier. When taken, there is a significant increase in the concentration of ademetionine in the cerebrospinal fluid. Metabolized in the liver. The half-life (Tie) is 1.5 hours. It is excreted by the kidneys.

Pharmacodynamics

Heptor belongs to the group of hepatoprotectors, has antidepressant activity, detoxifying, regenerating, antioxidant, antifibrosing and neuroprotective effects.

Ademetionine is included in the biochemical processes of the body, simultaneously stimulating the production of endogenous ademetionine. Ademetionine (S-adenosyl-L-methionine) is a biological substance found in all tissues and fluids of the body. Its molecule is included in most biological reactions both as a methyl group donor - methylation of phospholipids in the lipid layer of the cell membrane (transmethylation), and as a precursor of physiological thiol compounds - cysteine, taurine, glutathione, one of the most important intracellular antitoxic agents, CoA, etc. (transsulfation), and as a precursor of polyamines - putrescine, which stimulates cell regeneration and proliferation of hepatocytes, spermidine, spermine, included in the structure of ribosomes (aminopropylation).

Geptor indications for use

• chronic non-capculous cholecystitis;
• cholangitis;
• intrahepatic cholestasis;
• hepatitis of various origins: viral, toxic, incl. alcohol and drugs
• origin (antibiotics, antitumor, antituberculosis and antiviral drugs, tricyclic antidepressants, oral contraceptives);
• fatty liver;
• cirrhosis of the liver;
• encephalopathy, incl. associated with liver failure (alcohol, etc.);
• depression (including secondary);
• withdrawal syndrome (alcohol, etc.).

Nosological classification (ICD-10)

• B19 Viral hepatitis, unspecified
• F10.2 Alcohol dependence syndrome
• F10.3 Withdrawal state
• F32 Depressive episode
• G93.4 Encephalopathy, unspecified
• K70 Alcoholic liver disease
• K71 Liver toxicity
• K71.0 Toxic liver damage with cholestasis
• K72.9 Liver failure, unspecified
• K73.9 Chronic hepatitis, unspecified
• K74 Fibrosis and cirrhosis of the liver
• K76.9 Liver disease, unspecified
• T36 Systemic antibiotic poisoning
• T37.1 Poisoning with antimycobacterial drugs
• T37.5 Antiviral drug poisoning
• T38.4 Poisoning by oral contraceptives
• T43.0 Poisoning with tricyclic and tetracyclic antidepressants
• T45.1 Poisoning by antineoplastic and immunosuppressive drugs

Heptor tablets: dosage and method of use

During the period of maintenance therapy, a daily dose of 800-1600 mg (2-4 tablets) is recommended. The duration of maintenance therapy is on average 2-4 weeks. The tablets should be swallowed whole without chewing. To improve the therapeutic effect, it is recommended to take the tablets in the first half of the day between meals.

Precautions for use

Given the tonic effect of the drug, it is not recommended to take it before bedtime. Oral use of the drug in patients with liver cirrhosis associated with hyperazotemia should be carried out under medical supervision with monitoring of nitrogen levels. The tablets of the drug are coated with a special coating that dissolves only in the intestines, due to which ademetionine is released in the duodenum. In patients with bipolar affective disorder, taking ademetionine can induce an inversion of affect (the development of hypomania or mania).

Overdose

There were no clinical cases of overdose.

Search for analogues: negative result

The medication is available by prescription and is used exclusively for the treatment of liver diseases. Analogs can be used for prophylactic purposes. For example, with long-term use of antiviral drugs, antibiotics, and hormonal agents, organ function is inhibited. To protect the liver, restore, and reduce the manifestations of intoxication, you can choose freely available, over-the-counter substitutes at the pharmacy.

Analogues of Heptor and prices for reference (region - Moscow)

Karsil

An over-the-counter therapeutic and prophylactic agent for liver diseases is Karsil (35 mg) and the enhanced form of Karsil forte (145 mg). They contain milk thistle extract, which has hepatoprotective, antioxidant, regenerative and detoxifying effects. The analogue inhibits and prevents the penetration of toxic substances into the liver and cell destruction.

An analogue of Karsil in composition is Silimar, containing 100 mg of milk thistle extract.

When choosing between Karsil or Heptor, which is better depends on the indications. The first herbal remedy is often used for prophylactic purposes. The second medication is available in injections for quick and effective action, and tablets for continuing the course. This scheme is effective for severe liver damage.

Legalon

An analogue of Karsil forte and Karsil in composition (milk thistle extract), it contains different doses of the active substance - 70 and 140 mg. Manufactured by a German pharmaceutical company. Prescribed for the treatment and prevention of toxic liver damage - alcoholism, exposure to heavy metals, hydrogen halogen compounds, and certain medications. Available freely, without a prescription.

Samelix

A cheaper analogue is Samelix, produced by the Russian company Canonpharma in the form of tablets and bottles with lyophilisate and solvent for injection. It contains the same substance as Heptor and Heptral - ademetionine. Possible differences are the manufacturer of the raw materials used, the degree of purification and technology. The medication is available by prescription.

Other substitutes for Heptor (Heptral) with the same composition:

• Heptrazan (Russia);
• Ademetionine (China);
• Heparetta (RF).

Liv 52

An analogue of Heptor tablets - Liv 52, a drug with a unique composition. Contains herbal extracts - yarrow, capers, chicory, cassia, nightshade and others. Thanks to the incoming elements, it has the following actions:

• prevents the destruction of liver cells by toxins;
• relieves inflammation;
• improves digestion and absorption of food;
• has antianorexic and choleretic properties;
• improves the indicators of elements in the blood;
• prevents the formation of stones and sand in the gallbladder;
• reduces the risk of “hangover” syndrome;
• in case of alcoholism, it improves the removal of acetaldehyde from the body and reduces the risk of liver damage.

Liv 52 is available freely.

Hepatrin

The Evalar company produces Hepatrin dietary supplement to support the liver and protect the organ from the effects of toxins. The analogue contains artichoke and milk thistle extract, lecithin, B vitamins. It is not prescribed by doctors; it is more often used by patients for prevention.

Ovesol

Another analogue related to dietary supplements used to prevent liver damage is Ovesol. Available in the form of tablets, a strengthened form of Ovesol forte, an oral solution and tea. Contains plant components - extracts of oats, mint, immortelle and turmeric.

In the pharmacy assortment you will not find drugs that are complete analogues of these hepatoprotectors in composition. Other drugs that are also intended to restore liver function include Carnitene, Gepadif, Ademethionine, but they cannot boast of antidepressant properties.

In pharmacies you can also find other products based on ademetionine: the pharmaceutical drug “Heptor” and a variety of biologically active additives (BAS). All of them are available in tablets. The analogue drug "Geptor" is also available in powder in bottles and with a solvent in ampoules.

Heptor side effects

For this dosage form:

From the nervous system: headache, insomnia. From the digestive system: abdominal pain, diarrhea, dry mouth, dyspepsia, flatulence, nausea.

Interaction with other drugs

No interactions with other drugs were observed.

Use during pregnancy and lactation

Taking the drug is contraindicated in the I-II trimester of pregnancy and during lactation.

Impact on the ability to drive a car and operate machinery

When used in this dosage form, the drug does not affect the ability to drive a car or operate machinery.

Release form

Enteric-coated tablets, 400 mg. 10 tablets per blister pack. 20, 40 or 50 tablets per polymer jar. Each jar contains either 1 or 2 blister packs along with instructions for use in a pack.

Photo of a blister of Heptor tablets 10 pieces

Storage conditions

In a dry place, protected from light, at a temperature not exceeding 25 C. Keep out of the reach of children.

Best before date

2 years. Do not use after the expiration date.

Photo of Heptor tablets showing the series and the shelf life of these tablets

Conditions for dispensing from pharmacies

On prescription.

Manufacturer: OJSC “VEROPHARM” Legal address: 107023, Moscow, Barabanny lane, D-3

The address for production and acceptance of claims is 308013, Belgorod, st. Rabochaya, tel., fax

Composition and release form

in a blister pack or a blister-free pack 10 pcs.; in a cardboard pack of 1 or 2 packages or in dark glass or polymer jars of 20, 40 or 50 pcs.; in a cardboard pack 1 jar.

Heptor tablets summary (instructions for use) in photographs

Photo of instructions for use of heptor tablets, part 1

Photo of instructions for use of heptor tablets, part 2

Similar drugs:

• Carsil Dragee
• Ukrliv Oral tablets
• Choludexan Capsule
• Cholosas Syrup
• Heptral Lyophilisate for the preparation of a solution for intramuscular, subconjunctival administration and for instillation into the eye
• Galstena Oral drops
• Ursosan Capsule
• Heptor (Heptor) Lyophilisate for the preparation of solution for injection
• Liv.52 (Liv.52) Oral tablets
• Ursodez Capsule

** The Drug Directory is intended for informational purposes only. For more complete information, please refer to the manufacturer's instructions. Do not self-medicate; Before starting to use the drug Heptor, you should consult a doctor. EUROLAB is not responsible for the consequences caused by the use of information posted on the portal. Any information on the site does not replace medical advice and cannot serve as a guarantee of the positive effect of the drug.

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** Attention! The information presented in this medication guide is intended for medical professionals and should not be used as a basis for self-medication. The description of the drug Heptor is provided for informational purposes and is not intended for prescribing treatment without the participation of a doctor. Patients need to consult a specialist!

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Heptor tablets: reviews of the drug

Sergey Belozerov, Rybinsk A couple of years ago I became seriously ill and started having liver problems. The doctor prescribed Heptor tablets and said that they not only treat the liver, but also the nerves. At that moment I did not understand that I was depressed. But now, after a while, I say thank you to the doctor. I believe that thanks to the correctly prescribed treatment, I did not commit suicide. Not only have my liver parameters improved, but my nerves have also healed. The depression passed, the desire to live, communicate with people and solve my problems appeared. Andrey Karasev, Perm As soon as I became seriously ill and took a lot of medications, my liver immediately suffered. It’s not for nothing that they say: we treat one thing, we cripple another. Then I had to restore the liver cells. The doctor prescribed Heptor tablets. He said that it differs from others in that it has a beneficial effect on the brain and calms the nerves. Apparently, at that moment I needed it. After the course of treatment, the liver recovered, the test results pleased not only me, but also the doctor. My general condition has become much better. The pain on the right side has gone away, the heartburn that has bothered me for many years has also gone away, I didn’t even pay attention to it before. Victoria Ushakova, Barnaul The drug was prescribed for the treatment of the liver. From the very beginning of taking it, my head and stomach began to hurt. I have never had any side effects from any medication before. I didn’t even immediately realize that it was because of the pills. Only when I canceled it, everything went away immediately. I threw my money away, they are not cheap. Vyacheslav Petrov, Krasnodar After a long treatment, he took tests and it turned out that something was wrong in the liver. This is understandable, the drugs I took were strong antibiotics. Not only did insomnia appear during the treatment, but after the course the results changed, but not much. This turned out to be such an ineffective drug. And it is very expensive. Nikolay Ivanov, Moscow I have a weakness for alcohol, once I start, I can’t stop. Binges are long, after which the whole body suffers, but the liver suffers the most. The doctor prescribed Heptor tablets and said they have a great effect on the brain. At that moment I really had problems, I had no desire to live, I didn’t want to see anyone. After the course, the liver recovered, decreased in size and stopped hurting. I also looked at life with new eyes. Yes, the price is high, but nothing is a pity for your health. Tatyana Sidorova, Belogorsk Improvements appear within a week after taking it. When I found out that I had hepatitis, my thoughts were different, I fell into depression. These pills help a person calm down. After the course of treatment, having undergone tests, I noticed positive dynamics, and my general psychological state improved. Apart from the high price, I don’t see any downsides. She tolerated the drug perfectly, without allergic reactions or side effects. Irina Volkova, Krasnoyarsk After a divorce from my husband, problems with alcohol appeared. A friend pulled them out of this situation. She is a doctor herself and prescribed me Heptor. First there were injections, then pills. Helped me cope with depression. Of course, one cannot say that I came to my senses only thanks to this drug. I need to say thank you to friends and family. But it was Heptor who restored the liver, but again, diet is required. Apart from the high price, there are no complaints. She tolerated it well, there were no side effects.

Cost and analogues

One package of 20 Heptor tablets costs from 984 to 1011 rubles. A package of five ampoules costs from 1318 to 1449 rubles. Analogs of the drug are Ademethionine, Heptral.

Before choosing an analogue, a mandatory consultation with your doctor is required, who will select the most effective and safe form of the drug!

Heptral

When choosing which is better between Heptral and Heptor, you should not rely only on the cost of the drugs. In composition they are absolute analogues, but have some differences.

Heptral, like Heptor, is more often prescribed in injections than in tablets due to its higher bioavailability, and therefore greater effectiveness. Heptral is produced by an Italian pharmaceutical company and costs about 1911-1985 rubles per pack of five bottles of lyophilisate, which is more expensive than Heptor.

Heptral differs in that it has fewer contraindications and adverse reactions. Among the latter, the manufacturer identifies only heartburn, allergic reactions due to intolerance and gastralgia. The Russian analogue is Heptor, produced by the Belgorod pharmaceutical company, but pharmacologists were involved in the development of the analogue.

No special studies have been conducted to compare these two analogues, but based on reviews from patients and doctors, it can be concluded that Heptor is slightly less tolerated than its foreign analogue. Among the adverse reactions, Heptor also has significantly more conditions than Heptral.

The choice between Heptor and Heptral should be made by the attending physician based on the patient’s individual characteristics.

"Heptral" or "Heptor": which is better?

"Heptral" restores the liver after alcohol abuse. It is often included in complex treatment of alcohol dependence and withdrawal symptoms. The choice of the form of release of the medicine depends on what condition of the patient (acute or chronic) they plan to treat with Heptral. Thus, when treating chronic alcoholism, it is better to take tablets, and when relieving withdrawal symptoms, it is better to use a solution for parenteral administration.

https://www.youtube.com/watch?v=OgrLRGetXTw

The course of treatment with Heptral can last more than one month, so patients often ask their doctor whether they can drink alcohol during treatment. Speaking about the compatibility of Heptral and alcohol, it is necessary to draw the attention of patients to the fact that the medication is intended to restore the liver, and alcohol and its breakdown products in the human body are very toxic to the liver. Does it make sense to treat and destroy the liver at the same time?

1. The difference between an oligophrenic and an imbecile

What do doctors think?

Comparing the results after treatment with generic and Heptral, doctors did not notice a difference. Both products have a similar composition, but differ in auxiliary components.

Heptor tablets and injections quickly eliminate:

• heaviness in the right hypochondrium;
• liver colic.

After use, liver parameters and the general picture on ultrasound are normalized.

The medication has proven itself in the treatment of patients with a tendency to develop cirrhosis of the liver. Thanks to several courses of therapy and lifestyle adjustments, good results were achieved. The organ damage stopped and the patients felt better.

Compared to Essentiale and similar agents, the hepatoprotector based on ademetionine produces a faster effect, but is slightly inferior to Heptral.

Considering that the use of both ademetionine-based products gives good results, we can conclude that it makes sense to overpay in cases where the issue is urgent and there is no time to wait.

In Russia, Heptral and Heptor are predominantly prescribed, and analogues based on ademetionine are rarely used, so it is difficult to say how effective they are.

To achieve maximum effect, the treatment regimen is selected for each patient individually and depends on many factors.

A sick person must follow all doctor's recommendations:

• follow a diet;
• to refuse from bad habits;
• take all medications on time;
• lead a healthy lifestyle.

The early stages of liver disease caused by alcohol intake can be completely eliminated with the help of an effective hepatoprotector, but this is subject to giving up the addiction. Combining Heptor and alcohol is pointless.