Heptral 400 mg №20

Description SAMe ® Tablets 400 mg:

Pharmacological Effects:
Hepatoprotective agent, has choleretic and holekineticheskoe, as well as some antidepressant effects. Replenish ademetionine deficit and stimulate its production in the body, primarily in the liver and brain. Involved in biological transmethylation reactions (donator of methyl groups), doniruet methyl group in reactions of methylation of phospholipids of cell membrane proteins, hormones, etc. neytromediatorov; transsulfatirovaniya - a precursor of cysteine, taurine, glutathione (provides a redox mechanism of cellular detoxification), the coenzyme of acetylation. Increases the content of glutamine in the liver, cysteine and taurine in the plasma reduces the content of methionine in blood serum, normalizing the metabolic reactions in the liver. After decarboxylation is involved in aminopropilirovaniya as a precursor of polyamines - putrescine (stimulator cell regeneration and proliferation of hepatocytes), spermidine and spermine, occurring in the structure of ribosomes. Exerts choleretic effect due to increased mobility and polarization of the membrane of hepatocytes by stimulating the synthesis of phosphatidylcholine in them. It improves the function associated with the membranes of hepatocyte bile acid transport systems and promotes passage of bile acids in biliary system. Effective with the intralobular cholestasis version (violation of the synthesis of bile and current). Promotes detoxification of bile acids, increases the content in hepatocytes of conjugated and sulfated bile acids. Conjugation with taurine increases the solubility of bile acids and removing them from the hepatocytes. The process of sulfation of bile acids contributes to the possibility of their elimination by the kidneys, facilitates passage through the membrane of hepatocytes and excretion in the bile. In addition, sulfated bile acids protect the membranes of liver cells from the toxic action nesulfatirovannyh bile acids (present in high concentrations in hepatocytes in intrahepatic cholestasis). Patients with diffuse liver diseases (cirrhosis, hepatitis) with intrahepatic cholestasis syndrome reduces the severity of pruritus and biochemical changes such as the level of direct bilirubin, alkaline phosphatase activity, liver transaminases and other choleretic and hepatoprotective effect lasts up to 3 months after cessation treatment. The efficiency with hepatopathy caused by hepatotoxic drugs. That patients with opioid addiction, accompanied by liver disease, leads to regression of clinical manifestations of withdrawal symptoms, improve functional status and liver microsomal oxidation processes. Antidepressant activity manifests itself gradually, starting from the end of 1 week of treatment, and stabilized within 2 weeks of treatment. Effective with the recurrence of endogenous and neurotic depression resistant to amitriptyline. Has the ability to interrupt the relapse of depression. Appointment Osteoarthritis reduces the severity of pain, increases the synthesis of proteoglycans and leads to partial regeneration of cartilage tissue.


Indications:
Chronic cholecystitis, cholangitis, intrahepatic cholestasis, toxic liver damage, including alcoholic, viral and drug origin (antibiotics, anticancer, anti, anti-viral drugs, tricyclic antidepressants, oral contraceptives), fatty liver, chronic hepatitis, cirrhosis, encephalopathy, including associated with hepatic insufficiency (alcoholic, etc.). Depression (including secondary), withdrawal syndrome.


Contraindications:
Hypersensitivity, pregnancy (I-II trimester), during laktatsii.C caution. Childhood.


Side effects:
Stomachodynia, indigestion, heartburn, allergic reactions.


Dosage and administration:
Inside, in / m / in. In intensive care - in the first 2-3 weeks of treatment prescribed 400-800 mg / day IV (very slow) or V / m) powder was dissolved only in a special enclosed solvent (a solution of L-lysine). For maintenance therapy - oral 800-1600 mg / day between meals, swallowed without chewing, preferably in the morning.


Special instructions:
Not recommended for acceptance at bedtime in the treatment of patients with liver cirrhosis against a background of giperazotemii need to control the level of azotemia. During long-term therapy is necessary to determine the content of urea and creatinine in serum. The solution was prepared immediately before use, if the color or lyophilisate tablet differs from a proper - white, you must refrain from using them.