Heptral synonyms analogues. Heptral - cheap analogues (list), which substitute is better

Restoring the liver is not only difficult, but also very expensive. You can easily verify this if you find out the price of popular hepatoprotectors. It is the cost that forces patients to choose between the original drug and the generic. Let's try to make this task a little easier and figure out what, according to doctors, is better - heptor or heptral.

When and for what? About prescribing medications

The original drug Heptral (Italy) and its substitute - Heptor (Russia) belong to hepatoprotectors with antidepressant activity. These are medications that promote the regeneration of liver cells. They are prescribed when various diseases liver (cirrhosis, fatty degeneration, chronic hepatitis, toxic lesions, acalculous cholecystitis), including in order to stop their progression. They are also used in psychiatry to relieve symptoms of depression.

Read also:

"Phosphogliv" or "Essentiale" - which is better? How to choose an inexpensive alternative to Essentiale Forte?

Patients often have a question: Heptor or Heptral - which is better? The opinion of doctors is this: the Italian drug is more effective, but only if it is used not in tablets, but in the form of injections. If we talk about tablets, then there is not much difference between the original and the generic - except perhaps the cost.

Important! Heptral and Heptor are not used for prophylactic purposes. These are drugs with their own list of indications.

To pay or to overpay? Objectively about the drug Heptral


Let's start the analysis with a more expensive medicine that is produced abroad. This is Heptral. First, let's look at its instructions for use, and then pay attention to such aspects as price, reviews and analogues.


Here's what Heptral is:

Compound. Each tablet contains 400 mg of ademetionine (amino acid) and Excipients; recommendations for use. The medicine is prescribed orally in 2-4 tablets. per day for a period of 2 to 4 weeks. Ampoules with solution for intravenous or intramuscular injection Before use, dilute with the supplied special solvent. Daily dosage– 1-2 bottles. Course of therapy – 2 weeks; action. Restores liver cells, stimulates the utilization of fats in hepatocytes, but does not have a pronounced effect choleretic action, helps eliminate fatty degeneration, which leads to cirrhosis, relieves symptoms of depression; contraindications. This is pregnancy (1st and 2nd trimester), lactation, age under 18 years, hypersensitivity to components; side effects. Although in most cases the medicine does not provoke adverse reactions, at intravenous use Some people experience diarrhea, and taking the drug in tablets leads to colic in the liver and nausea. Undesirable effects indicated in the instructions include heartburn, allergies, gastralgia and dyspepsia; price. A package containing 20 tablets costs from 1,630 rubles.

Why do competent doctors prescribe Heptral in injections, and not in tablets, because the latter option is more convenient? The fact is that its bioavailability when taken orally is no more than 5%. That is, when taking a tablet, so little of the active substance is absorbed in the intestine that it therapeutic effect can be assessed as minimal. But with intravenous use, biavailability is almost 100%.

Savings in exchange for side benefits? How is Heptor different from the original?

The Russian prototype of Heptral is Heptor. Its manufacturer is the Veropharm company, located in Belgorod. However, its development was carried out not by domestic, but by German pharmacists, specialists from the Knoll company.

We will evaluate the drug Heptor according to the same criteria - instructions for use, price, reviews, and also find out whether it has analogues.

Here are the main characteristics of Heptor:

action. If we compare drugs in tablet form, they have the same therapeutic effect. It, like Heptral, prevents bile stagnation, produces choleretic, regenerating, antioxidant, neuroprotective, antifibrosing effects, relieves intoxication and relieves depression; compound. Although the main component of the medicine is the same - ademetionine (400 mg), according to experts, lyophilate is more popular among Italians High Quality. In addition, Heptor contains excipients such as copovidone (19 mg) and kraspovidone (9 mg). They are the main provocateurs of adverse reactions; application. Completely identical to Heptral: 2-4 tablets per day for 2-4 weeks. There are no differences in the dosage of the drug used in the injections; contraindications. Exactly the same as the original; side effects. It is precisely for this indicator (as stated by patients who have had experience taking both drugs) that Heptor is inferior to its foreign counterpart. The domestic hepatoprojector is less well tolerated. Its use is often accompanied unpleasant phenomena: headache, sleep disturbance, abdominal discomfort. Also, after taking it, a burning sensation and pain in the epigastric region may appear; price. In this, Heptor undoubtedly wins, since its cost is almost 2 times lower than the price of Heptral. For 20 tablets you will have to pay about 912 rubles.

Important! Both drugs are not recommended to be taken at night, as they have a tonic effect and can cause insomnia. Another important note: these medications may cause dizziness, so do not drive or engage in activities that require maximum concentration while taking them.

Search for analogues: negative result

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

Let's listen to the experts

So which drug to choose - Heptor or Heptral? If we summarize the doctors’ reviews, we get the following result: both drugs are almost identical in composition. The frequency of side effects, as practice shows, is also approximately the same (in this matter, everything depends, rather, on individual characteristics organism). No one has conducted a comparative analysis of effectiveness, that is, there is no scientifically proven data on this matter. But subjectively (according to the patients’ feelings) and in the opinion of specialists, the Italian remedy is more effective, especially in injections.

Important! Doctors warn that you should not inject these drugs at home, as they require proper dilution and must be administered very slowly. This should be done by specialists in a hospital setting.

Read also:

Heptral or Essentiale, which is better? Carsil or Essentiale Forte - which is better? New generation hepatoprotectors: list

Conclusion: if you have indications for prescribing a hepatoprotector and have financial and other opportunities to instill Heptral, then this will be the most the best option. If you cannot afford such expenses, then purchase Heptor - this will reduce your treatment costs, and the result (if no adverse reactions occur) will be almost the same as when using an imported analogue.

It is very important to keep your health strong in order to be able to adapt to the rhythm of life modern world. Without health internal organs a person will not feel full of strength and enjoying life, so it is very important to maintain the good condition of such an organ gastrointestinal tract, like the liver.

Liver

The liver is an exocrine gland that acts as a filter, purifying human blood from harmful substances, excess hormones, vitamins, passing it through its cells - hepatocytes.

The liver produces bile, which is involved in digestive process, the liver also serves as a blood depot, replenishing its supply during blood loss. Without the normal functioning of this organ, the quality of life will noticeably decrease or, in the worst case, the person will be doomed. Fortunately, the liver is capable of regeneration, i.e. its cells can renew themselves, promoting the appearance of new, healthy tissue. This can be actively helped by drugs - hepatoprotectors, such as Heptral - an imported drug and a product of the domestic concern "Veropharm" - Heptor.

Heptral and Heptor

Both of these drugs are produced on the basis of Ademethionine, which, in the normal functional state of the liver, produced by the body, participates in metabolic processes, promotes the synthesis of liver cell membranes, promotes the production of important biological compounds. In addition, hepatoprotectors promote normal bile outflow, reduce the degree of liver damage during chronic diseases, prevent the degeneration of liver tissue into connective tissue. For cholecystitis, cholestasis, fatty degeneration, chemical, alcohol poisoning, at oncological processes and others pathological conditions liver production of Ademethionine is disrupted.

By using Heptral or Heptor, you can compensate for the deficiency of Ademethionine by improving the functioning of hepatocytes. As a result, the liver’s resistance to harmful factors increases, cells are renewed, new ones appear, and the outflow of bile improves. Heptor or heptral, which is better, doctors' opinions can be found online. Both drugs have a similar mechanism of action, range of indications and contraindications. Contraindications include:

hypersensitivity to the components of the drug; childhood up to 18 years old; pregnancy and lactation.

Possible side effects:

nausea; heartburn; stomach ache; allergic reactions; rash, itching; dizziness, headache; arthralgia.

Which is better: Heptral or Heptor? Doctors' opinion

Conducting comparative analysis both drugs, you can be sure that having the same chemical composition, they differ in impact. According to reviews, both have a positive effect on liver diseases, but the domestic drug Heptor can give more intense side effects. This may be due to the fact that pharmacological production in Belgorod uses slightly different excipients for the production of Heptor.

Reviews from people who took Heptral are overwhelmingly positive. The only downside is the high price compared to other hepatoprotectors. Doctors and their patients note high efficiency Heptral in the treatment of liver diseases and almost complete absence side effects.

conclusions

Heptral or Heptor - which is better? The opinion of doctors is as follows: when choosing the optimal one for yourself from two drugs, you need to focus on own feelings and the state of your body in this moment. Even for the same person, in different periods life, the same drug can have different action. Many people who took both Heptral and Heptor did not notice significant difference between them. In this case, if Heptor is well tolerated, then you can opt for it, because its clinical and pharmacological effect is the same as that of the more expensive one original analogue, but Heptor will save money by carrying out a course of treatment. If there are side effects or are difficult to tolerate, then Heptral should be the drug of choice, as a better hepatoprotector. Some proponents of careful use of Heptral recommend its use for pronounced violation liver functions.

Heptral (pln in Latin "Heptral") is a medicine that is used as a hepatoprotector for the liver and is an antidepressant. Combines regenerating, antioxidant and detoxifying properties. The drug has a way to cleanse the liver well. (Information provided by Wikipedia and the Vidal reference book)

What it helps with, indications for use

The drug is prescribed when it is necessary to treat the liver, gallbladder, ducts. Can be recommended and used as a prophylactic drug.

As a rule, they are prescribed for hepatitis, psoriasis, depression, fatty hepatosis, with cirrhosis, with pancreatitis. It can also be used after chemotherapy.

Ingredients, how much does it cost?

Release form: injection ampoules, tablets.

Compound: active ingredient ademitionine 400 mg. As auxiliaries: colloidal silicon dioxide, MCC, magnesium stearate, sodium carboxymethyl starch.

Pills covered white shell.

Manufacturer: country Italy.

average cost in Moscow, in St. Petersburg 1500 rubles for 20 tablets.

Analogs

There are many analogues that are much cheaper. But the difference between them is significant. There are quite a lot of generic drugs. These are progepar, karsil, heptor, essentiale forte, ursosan, phosphogliv, essliver, hepa-merz, ademetionine, remaxol.

Doctors have different opinions about which one is better. But, before changing the drug, consult your doctor, who will write a prescription and prescribe the dosage of the drug.

What is better Essentiale forte or Heptral?

These drugs should only be prescribed by a doctor to the patient, as they have therapeutic effect. Essentiale contains more vitamin complex and it can be taken for a long time, about 2 months, while heptral is a stable active substance. Doctors often prescribe Heptral for treatment, but as an IV. So its effect is enhanced.

Heptor or Heptral, which is better?

Heptor is a Russian substitute for heptral, a generic. The product is produced by Belgorod. Their differences are significant. Heptral is quite expensive, but has less side effects than heptor. The reason is the additional substances.

Heptral instructions for use

The medicine should be taken orally in the 1st half of the day, between meals. Why is the appointment in the 1st half of the day? Because it can cause the body to become overactive, nervous excitement, which is absolutely not necessary before bed. How many days of treatment will be prescribed exclusively by the doctor.

Daily dose dry preparation 400-800 mg. For liver treatment - 2 weeks, for depression - 3 weeks. Preparation of the solution is possible only before the injection.

Intravenous ampoules, drip injections

If you need to put a dropper in, then it is additionally diluted in saline and slowly, gradually injected into a vein.

But you can also not dilute it and inject it in a stream into a vein. Your doctor will tell you in more detail how to properly drip the medicine.

The tablet is taken in the morning. Can be done before meals (lunch), do not chew and wash down big amount water.

Is it possible during pregnancy?

You can take the drug during pregnancy, without harm to the baby, from the third trimester. The rest of the time, as well as during breastfeeding (lactation), only if the benefit to the mother outweighs the risk to the child.

IN modern conditions very often, to restore the condition of a patient’s liver, it is necessary to prescribe an effective and affordable hepatoprotector - a substance that promotes the regeneration of hepatocytes (liver parenchyma cells). Despite the fact that some experts believe that the ideal hepatoprotector is as unattainable an ideal as the philosopher's stone, real progress in scientific developments there is, and currently Heptral is indeed the most popular drug of this kind. But when prescribing this drug, most patients have a question: is it possible to find an analogue of heptral on the pharmaceutical market that is comparable to it in its mechanism of action and clinical effects and is more affordable.

Heptral - clinical effects and comparison with other hepatoprotectors

The active ingredient of heptral is ademetionine - an amino acid human body, which has a direct effect on metabolic processes in the cells of the liver and brain, and the introduction of this drug not only introduces an additional amount of amino acid into the body, but also stimulates its production by liver cells, due to which it has a detoxifying, regenerating, antioxidant, neuroprotective and antifibrinating effect. In the pharmacy chain the drug is available in two dosage forms- heptral injections for intramuscular or intravenous administration and heptral tablets for oral administration.

A domestically produced analogue of heptral is heptor, but this drug is presented on the pharmaceutical market only in the form of tablets for oral administration. Its cost is much lower than the cost of the original drug, but this drug cannot even be classified as generic heptral - it contains chemical formula the original substance has not been fully reproduced. Heptral contains a more active levorotatory isomer of ademetionine, while heptor contains a levorotatory isomer, the activity of which is slightly less. In a sense, methionine itself can be considered as an analogue of heptral, but taking this medicinal substance for patients with impaired liver function, it is generally practically useless - effective metabolism of methionine in liver failure is impossible, and this drug is often used only by beginning bodybuilders. In the treatment of patients with liver cell damage of any origin, if possible, it is necessary to use not a heptral analogue, but original drug.

In any case, especially when in serious condition The patient's treatment with this drug should begin with intramuscular or intravenous administration - the drug solution decomposes very quickly in the light, which is why it is prepared by mixing two components (dry powder and a special solvent) immediately before use. Simultaneously with the parenteral administration of this drug, it is necessary to begin taking adenomethionine orally - if possible, use the original drug or an analogue of Heptral, for which there is no injection form. The patient himself can choose which drug he will use for treatment, but it is the duty of the doctor and pharmacist to explain that the difference is clinical effects heptral and heptor are noticeable, especially in the treatment of severe liver damage.

The duration of treatment with the drug largely depends on the stage of the disease at which treatment was started - you must always remember that this is a drug maximum effect renders with early start treatment. In this case, complete restoration of liver function is possible, but to maintain the achieved result, treatment must be repeated. During treatment severe forms liver failure to expect full recovery liver functions are not necessary, but general state the patient improves significantly.

In this article you can find instructions for use medicinal product Heptral. Feedback from site visitors - consumers - is presented of this medicine, as well as the opinions of specialist doctors on the use of Heptral in their practice. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Heptral in the presence of existing structural analogues. Use for the treatment of liver diseases in adults, children, as well as during pregnancy and lactation.

Heptral- hepatoprotector, has antidepressant activity. It has choleretic and cholekinetic effects. It has detoxifying, regenerating, antioxidant, antifibrosing and neuroprotective properties.

Replenishes the deficiency of ademetionine (the active ingredient of the drug Heptral) and stimulates its production in the body, primarily in the liver and brain. Participates in biological transmethylation reactions (methyl group donor) - the S-adenosyl-L-methionine molecule (ademetionine) donates a methyl group in phospholipid methylation reactions cell membranes, proteins, hormones, neurotransmitters; transsulfation - a precursor of cysteine, taurine, glutathione (provides a redox mechanism for cellular detoxification), acetylation coenzyme. 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 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. It improves the function of membrane-associated hepatocytes transport systems bile acids 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 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 protect liver cell membranes from toxic effect non-sulfated bile acids (present in high concentrations in hepatocytes during intrahepatic cholestasis). In patients with diffuse diseases liver (cirrhosis, hepatitis) with intrahepatic cholestasis syndrome reduces the severity skin itching and changes biochemical parameters, incl. level of direct bilirubin, alkaline phosphatase activity, aminotransferases.

The choleretic and hepatoprotective effect lasts up to 3 months after cessation of treatment.

Shown to be effective in hepatopathies caused by hepatotoxic drugs.

Prescribing the drug to patients with opioid addiction accompanied by liver damage leads to regression clinical manifestations abstinence, improvement functional state 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. The drug is effective for recurrent endogenous and neurotic depression resistant to amitriptyline. Has the ability to interrupt relapses of depression.

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

Pharmacokinetics

The tablets are coated with a special coating that dissolves only in the intestines, thanks to which ademetionine is released into the intestines. duodenum. Binding to serum proteins is negligible. Penetrates the blood-brain barrier. Regardless of the route of administration, there is a significant increase in the concentration of ademetionine in the cerebrospinal fluid. Biotransformed in the liver. Excreted by the kidneys.

Indications

  • chronic acalculous cholecystitis;
  • cholangitis;
  • intrahepatic cholestasis;
  • toxic lesions liver of various etiologies(including alcoholic, viral, medicinal/antibiotics, antitumor agents, anti-tuberculosis and antiviral drugs, tricyclic antidepressants, oral contraceptives/);
  • fatty degeneration liver;
  • chronic hepatitis;
  • cirrhosis of the liver;
  • encephalopathy, incl. associated with liver failure(including alcohol);
  • depression (including secondary);
  • withdrawal syndrome (including alcohol).

Release forms

Tablets, coated, soluble in the intestine 400 mg.

Lyophilisate for the preparation of a solution for intravenous and intramuscular administration (injections in injection ampoules).

Instructions for use and dosage

Pills

The drug is prescribed orally in a daily dose of 800-1600 mg. The duration of maintenance therapy can average 2-4 weeks.

The tablets should be swallowed whole, without chewing, it is advisable to take them in the first half of the day, between meals.

Ampoules

Use intravenously or intramuscularly.

The lyophilisate must be dissolved in a specially supplied solvent immediately before administration. The remainder of the drug must be disposed of.

The drug must not be mixed with alkaline solutions and solutions containing calcium ions.

If the lyophilisate has a color other than almost white to white with a yellowish tint (due to a crack in the bottle or exposure to heat), the use of Heptral is not recommended.

The drug Heptral for intravenous use injected very slowly.

Intrahepatic cholestasis

The drug is administered in a dose of 400 mg per day to 800 mg per day (1-2 bottles per day) for 2 weeks.

Depression

The drug is administered in a dose of 400 mg per day to 800 mg per day (1-2 bottles per day) for 15-20 days.

If maintenance therapy is necessary, it is recommended to continue taking Heptral in tablet form at a dose of 800-1600 mg per day for 2-4 weeks.

Side effect

  • gastralgia;
  • dyspepsia;
  • heartburn;
  • allergic reactions.

Contraindications

  • 1st and 2nd trimester of pregnancy;
  • lactation period ( breastfeeding);
  • age under 18 years;
  • hypersensitivity to the components of the drug.

Use during pregnancy and breastfeeding

Use in children

Contraindicated in children and adolescents under 18 years of age.

special instructions

Considering the tonic effect of Heptral, it is not recommended to use it before bedtime.

When prescribing Heptral to patients with liver cirrhosis due to hyperazotemia, systematic monitoring of the level of nitrogen in the blood is necessary. During long-term therapy, it is necessary to determine the content of urea and creatinine in the blood serum.

The solution is prepared immediately before use; If the color of the lyophilized powder differs from the intended white color, you should refrain from using it.

Drug interactions

Famous drug interactions the drug Heptral with others medicines was not observed.

Analogues of the drug Heptral

Structural analogues of the active substance:

  • S-adenosyl-L-methionine disulfate p-toluenesulfonate;
  • S-Adenosylmethionine;
  • Ademethionine 1,4-butane disulfonate;
  • Heptor;
  • Heptor N.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Heptral (Italy) is an effective hepatoprotector - antidepressant. There are very few structural cheap analogues of heptral, but they still exist. The medication is intended for the treatment of liver diseases: chronic hepatitis, liver cirrhosis, cholestasis, opium addiction, toxic damage to the organ caused by drug therapy, alcohol intoxication and others.

Restores and cleanses the organ of bile acids, has antioxidant properties and anti-depressant activity. A decrease in depression is noticeable already by the end of the first week of therapy. After a course of treatment, the choleretic and hepatoprotective effect lasts up to three months.

The main component of the drug is ademetionine, with long-term use of which, liver function indicators improve.

The medicine has a high cost. Price per pack of 400 mg tablets 20 pcs. is 1615 rubles, in ampoules 5 pcs. 400 mg - 1900 rub.

List of cheap heptral analogues

1. Heptor (Veropharm, Russia). According to the active substance, the medicine is an exact structural analogue of heptral. Used to treat liver diseases: cirrhosis, hepatitis of various origins, alcohol withdrawal syndrome, secondary encephalopathy, intrahepatic cholestasis. Makes it easier depressive states, contributes to the gradual restoration of normal psycho-emotional background in the patient.

Has a tonic effect on the body. To avoid insomnia, it is recommended to take it in the first half of the day. The daily dose ranges from 800 to 1600 mg and is determined by the doctor. It has a small list of contraindications: individual intolerance to the components of the drug, pregnancy I - II trimester, possible allergies, contraindicated for children.

  • Cost of packing 400 mg tablets 20 pcs. - 850 rub.

With this single drug, the list of exact analogues is limited. At the time of writing, no other similar medicines were found below the cost of the original (nationwide).

Analogous by pharmacological group

Almost all drugs belonging to the group of hepatoprotectors used to treat the liver have a high cost, so they can only be called cheap analogues of heptral only conditionally, given the cost of the original.

1. Phosphogliv Forte (Pharmstandard, Russia). Combined remedy, main components - glycyrrhizic acid And phospholipids. Restores the cleansing function of the organ, as well as damaged liver cells and intracellular membranes, promotes the formation connective tissue. Has antiviral and antioxidant effects. Contains glycyrrhizic acid, which has antiviral activity.

In cases of skin damage, it stops the spread of the harmful process. Prescribed for hepatosis and liver damage due to toxic, drug or alcohol damage. Used in the treatment of cirrhosis, intoxication, hepatitis B acute form, including chronic.

It has a small list of contraindications. Allowed for children over 12 years of age. Adults take 1-2 capsules orally during meals three times a day.

  • Packaging price drops. 50 pcs. - 880 rubles.

2. Essentiale forte N (France). Hepatoprotective agent whose active substances are phospholipids obtained from soybeans. Used for functional impairment liver function, cirrhosis, fatty atrophy of the organ of various etiologies, with alcoholic and chronic hepatitis.

The drug is well tolerated. There are practically no contraindications except for children under twelve years of age and individual sensitivity. Adults are prescribed two capsules three times a day with meals.

  • Cost of a pack of drops. 300 mg 30 pcs. - 620 RUR, packing 90 pcs. - 950 rub.

Analog for liver treatment (antioxidant)

1. Berlition-600 (Germany). The product is an endogenous antioxidant. Active substance drug thioctic acid ota (600 units in 1 ampoule) is similar in biochemical properties to vitamins Group B. Has a pronounced antioxidant effect. Normalizes liver function, strengthens protective properties organ cells.

Thioctic acid neutralizes bad influence toxins on cells, which significantly improves liver function. The medicine is prescribed for alcoholic and diabetic polyneuropathy, severe liver diseases.

There is a small list of contraindications: pregnancy, lactation, individual sensitivity to the components of the product, childhood. The solution is administered intravenously at 12-24 ml per day.

  • Price ampoules 24 ml, 5 pcs. 850 rub.

P.S. The information is provided for reference, replacement of medications with inexpensive analogues heptral is determined by the doctor. Be reasonable.


Analogues of the drug Heptral are presented, in accordance with medical terminology, called “synonyms” - drugs that are interchangeable in their effects on the body, containing one or more identical active ingredients. When selecting synonyms, consider not only their cost, but also the country of production and the reputation of the manufacturer.

Description of the drug

Heptral- Hepatoprotector, has antidepressant activity. It has choleretic and cholekinetic effects. It has detoxifying, regenerating, antioxidant, antifibrosing and neuroprotective properties.
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 S-adenosyl-L-methionine molecule (ademetionine) donates a methyl group in methylation reactions of phospholipids of cell membranes, proteins, hormones, neurotransmitters; transsulfation - a precursor of cysteine, taurine, glutathione (provides a redox mechanism for cellular detoxification), acetylation coenzyme. 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 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 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 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, it reduces the severity of skin itching and changes in biochemical parameters, incl. level of direct bilirubin, alkaline phosphatase activity, aminotransferases.
The choleretic and hepatoprotective effect lasts up to 3 months after cessation of treatment.
Shown to be effective in hepatopathies caused by hepatotoxic drugs.
Prescribing the drug 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. The drug is effective for recurrent endogenous and neurotic depression resistant to amitriptyline. Has the ability to interrupt relapses of depression.
Prescribing the drug for osteoarthritis reduces the severity of pain, increases the synthesis of proteoglycans and leads to partial regeneration of cartilage tissue.

List of analogues

Note! The list contains synonyms for Heptral, which have a similar composition, so you can choose a replacement yourself, taking into account the form and dose of the medicine prescribed by your doctor. Give preference to manufacturers from the USA, Japan, Western Europe, as well as well-known companies from of Eastern Europe: KRKA, Gedeon Richter, Actavis, Aegis, Lek, Hexal, Teva, Zentiva.


Release form(by popularity)price, rub.
Tab 400 mg N20 (Hospira S.p.a. (Italy)1936.40
Fl 400mg N5 (Abbott S.p.A. (Italy)1951.90
Tab 0.4 N20 (Veropharm OJSC (Russia)1148.30
400 mg No. 1 lyof. for use in / in / m solution + solvent (Lance - Pharm LLC (Russia)1497.60
400 mg No. 1 lyophilized powder for the preparation of i/v i/m r - ra + solvent (Lance - Pharm LLC (Russia)1503.50
400 mg No. 5 lyophilized powder for the preparation of i/v i/m r - ra + solvent (Lance - Pharm LLC (Russia)1561.10

Reviews

Below are the results of surveys of site visitors about the medicine Heptral. They reflect the personal feelings of the respondents and cannot be used as an official recommendation for treatment with this drug. We strongly recommend that you contact a qualified medical specialist to select a personal course of treatment.

Visitor survey results

Twelve visitors reported effectiveness


Your answer about side effects »

37 visitors reported cost estimates

Participants%
Dear35 94.6%
Not expensive2 5.4%

Your answer about the cost estimate »

66 visitors reported frequency of intake per day

How often should I take Heptral?
Most respondents most often take this drug 2 times a day. The report shows how often other survey participants take this drug.
Participants%
2 times a day45 68.2%
3 times a day10 15.2%
1 per day10 15.2%
4 times a day1 1.5%

Your answer about the frequency of intake per day »

50 visitors reported dosage

Participants%
201-500mg33 66.0%
1-5mg5 10.0%
501mg-1g4 8.0%
101-200mg3 6.0%
11-50mg3 6.0%
51-100mg2 4.0%

Your answer about dosage »

Nine visitors reported a start date

How long does it take to take Heptral to feel an improvement in the patient’s condition?
Survey participants in most cases felt an improvement in their condition after 5 days. But this may not correspond to the period after which you will begin to improve. Check with your doctor for how long you need to take this medicine. The table below shows the results of the survey on the initiation of effective action.
Your answer about the start date »

Sixteen visitors reported appointment times

When is the best time to take Heptral: on an empty stomach, before, after or during meals?
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Official instructions for use

There are contraindications! Read the instructions before use

Heptral ®

Registration number ПN011968/02
Tradename Heptral ®
International nonproprietary name Heptral
Chemical name
S-Adenosyl-L-methionine 1,4-butane disulfonate.
Dosage form
Lyophilisate for preparing a solution for intravenous and intramuscular administration.
Compound
The bottle with lyophilisate contains:
Active substance: ademetionine 1,4-butane disulfonate 760 mg (corresponds to 400 mg ademetionine ion).
The solvent ampoule contains:
Excipients: L-lysine 342.4 mg; sodium hydroxide 11.5 mg; water for injections up to 5 ml.
Description
Lyophilisate
From almost white to white with a yellowish tint, lyophilisate without foreign inclusions.
Solvent
Transparent liquid from colorless to light yellowish color without foreign inclusions.
Reconstituted solution
Transparent solution from colorless to yellow color no visible sediment.
Pharmacotherapeutic group
Hepatoprotective agent.
ATX code
A16AA02

Pharmacological properties

Pharmacodynamics
Heptral 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, transsulfurization, transamination. In transmethylation reactions, Heptral 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 of cellular detoxification), acetylation coenzyme (included in the 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. Heptral 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). Heptral reduces the toxicity of bile acids in the hepatocyte, carrying out their conjugation and sulfation. 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, Heptral reduces the severity of skin itching and changes in biochemical parameters, incl. direct bilirubin level, activity alkaline phosphatase, 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.
Pharmacokinetics
Bioavailability after parenteral administration is 96%, plasma concentration reaches maximum values ​​after 45 minutes. Metabolized in the liver. Communication with blood plasma proteins is insignificant. Penetrates the blood-brain barrier. There is a significant increase in the concentration of ademetionine in the cerebrospinal fluid.
Half-life (T 1/2) - 1.5 hours. Excreted by the kidneys.

Indications for use

  • Intrahepatic cholestasis in precirrhotic and cirrhotic conditions, which can be observed with the following diseases:
  • fatty liver;
  • chronic hepatitis;
  • toxic liver damage of various etiologies, including alcohol, viral, drugs (antibiotics; antitumor, antituberculosis 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.
  • Contraindications

    Hypersensitivity to any of the components of the drug.
    Age up to 18 years.
    Carefully
    Bipolar disorders (see section "Special instructions").
    Pregnancy (1st trimester).
    Breastfeeding period.

    Pregnancy and lactation

    The use of high doses of ademetionine in III trimester did not cause any pregnancy unwanted effects. The use of Heptral ® in pregnant women in the first trimester and during breastfeeding is possible only if the potential benefit to the mother exceeds possible risk for the fetus or child.

    Directions for use and doses

    Intravenously and intramuscularly.
    The lyophilisate must be dissolved in a specially supplied solvent immediately before administration. The remainder of the drug must be disposed of.
    The drug must not be mixed with alkaline solutions and solutions containing calcium ions.
    When administered intravenously, Heptral ® is administered very slowly.
    Intrahepatic cholestasis
    From 400 mg/day to 800 mg/day (1-2 bottles per day) for 2 weeks.
    Depression
    400 mg/day (1 bottle per day) for 15-20 days.
    If maintenance therapy is necessary, it is recommended to continue taking Heptral ® in tablet form at a dose of 800-1600 mg/day for 2-4 weeks.

    Side effects

    The most common adverse reactions include nausea, abdominal pain and diarrhea. Below is a summary of information about adverse reactions, which were noted during the use of ademetionine both in tablets and in injection dosage form.
    From the outside immune system : swelling of the larynx, allergic reactions.
    From the skin: reactions at the injection site (very rarely with skin necrosis), sweating, itching, rash, Quincke's edema, skin reactions.
    Infections and infestations: urinary tract infections.
    From the outside nervous system : dizziness, headache, paresthesia, confusion, insomnia.
    From the outside of cardio-vascular system: 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, liver cirrhosis.
    From the musculoskeletal system : arthralgia, muscle spasms .
    Other : asthenia, chills, reactions at the injection site, flu-like syndrome, malaise, peripheral edema, fever.

    Overdose

    There were no clinical cases of overdose.

    Interaction with other drugs

    No known interactions with other drugs were observed.
    There is a report of serotonin excess syndrome in a patient taking Heptral and clomipramine. It is believed that such an interaction is possible and Heptral should be used with caution when using selective serotonin reuptake inhibitors, tricyclic antidepressants (such as clomipramine), and herbs and drugs containing tryptophan.

    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 the level of nitrogen in the blood 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 Heptral to patients with bipolar disorders. There are reports of the transition of depression to hypomania or mania in patients taking Heptral.
    Patients taking Heptral ® are recommended to be prescribed B12 and folic acid since deficiency of cyanocobalamine (vitamin B12) and folic acid can reduce the concentration of ademetionine.
    Children
    The safety of using the drug Heptral ® in children has not been sufficiently studied.
    Impact on the ability to drive a car and operate machinery
    Some patients may experience dizziness when 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.

    Release form

    760 mg of lyophilisate in a type I flint glass vial, sealed with a chlorobutyl stopper with an aluminum cap with a plastic lid.
    Solvent 5 ml in glass ampoules type I with a break point.
    5 bottles and 5 ampoules per cardboard box along with instructions for medical use.
    5 bottles and 5 ampoules each in a plastic blister pack, covered aluminum foil. 1 blister pack in a cardboard box along with instructions for medical use.

    Storage conditions

    In a place protected from light at a temperature of 15 ° C to 25 ° C. Keep out of the reach of children.

    Best before date

    3 years. Do not use the drug after the expiration date.

    Vacation conditions

    Dispensed by prescription.
    Registration Certificate Holder
    Abbott S.r.L., Via Pontina Km.52, Campoverde di Aprilia Latina, 04010, Italy.
    Abbott SrL, Via Pontina Km.52, Campoverde di Aprilia Latina, 04010, Italy.

    Manufacturer

    1. Hospira S.p.A., Via Fosse Ardeatine, 2-20060 Liscate (MI), Italy.
    Hospira S.p.A., Via Fosse Ardeatine, 2-20060 Liscate (MI), Italy.
    2. Biologici Italia Laboratories S.R.L., Via Filippo Serpero 2 - 20060 Masate, Italy.
    Biologici Italia Laboratories S.R.L., Via Filippo Serpero 2 - 20060 Masate, Italy.
    3. Famar L'Eil, 28280 Saint-Rémy-sur-Avre, France.
    Famar L'Aigle, 28280 St Remy-sur-Avre, France.
    Representative office in Russia:
    Abbott Laboratories LLC
    141400 Moscow region, Khimki, st. Leningradskaya, possession 39, building 5, Khimki Business Park.

    The information on the page was verified by physician-therapist E.I. Vasilyeva.