Geptral

• Structure
• Release form
• Pharmacological action
• Pharmacodynamics and pharmacokinetics
• Indications to Geptral's use
• Contraindications
• Side effects
• Application instruction of Geptral
• Overdose
• Interaction
• Terms of sale
• Storage conditions
• Period of validity
• Special instructions
• Analogs
• For children
• With alcohol
• At pregnancy and a lactation
• Responses
• How many there are tablets and Geptral's ampoules?

Structure

Structure of tablets: 400 mg of an ademetionin (MNN), MKTs, silicon dioxide (in a colloid form), Na-karboksimetilkrakhmal (type A), Mg stearate.

Kishechnorastvorimy cover: ethyl acrylate and methacrylic acid copolymer (1:1), 30% emulsion of a simetikon, talc, macrogoal 6000, polysorbate 80, Na hydroxide, water.

Dosage of an ademetionin rolled into one lyophilisate — 400 mg. With solvent contain in an ampoule: A L-lysine, Na hydroxide, water for and.

Release form

• Tablets in to / r to a cover; packaging No. 10 and No. 20. Geptral's tablets of an oval form, biconvex, white color (the yellowish shade is possible).
• Lyophilisate for preparation of solution for in oil and in/in introductions; 400 mg fl. with solvent in ampoules of 5 ml, packaging No. 5. The lyophilized mass of white (yellow-white) color, foreign inclusions are absent. Both solvent, and the recovered solution have an appearance of transparent colourless (slightly yellowish) liquid.

Pharmacological action

Holeretichesky, detoksitsiruyushchy, gepato-and neuroprotective, holekinetichesky, antioxidant, antidepressive.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

Substance ademetionin possesses gepatoprotektorny and antidepressive activity, and also the regenerating, detoksikatsionny, neuroprotective, antifibroziruyushchy, antioxidant properties.

Strengthens biliary secretion and promotes its allocation in intestines.

Fills shortage of SAM and stimulates its education in a liver.

SAM (S - adenozil - L - methionine) contains in all environments of an organism (in the greatest concentration — in a brain and a liver) and plays an important role in reactions of a metabolism.

In reactions of transmethylation of SAM tints methyl group for synthesis of nucleic acids, neurotransmitters, phospholipids of cellular membranes, hormones, proteins, etc.

In reactions of a transulfatirovaniye, being a predecessor of glutathione, taurine, cysteine, provides okislitelno the recovery mechanism of clarification and a detoxication of an organism at the cellular level.

Being a predecessor of HSKoA (a coenzyme And), joins in reactions of a citrate cycle and promotes completion of an energy potential of a cell.

Increases plasma concentration of taurine and cysteine, and also the maintenance of a glutamine in a liver; normalizing exchange processes in a liver, reduces methionine level in serum.

After decarboxylation as the predecessor of polyamines — in particular, a stimulator of proliferation of hepatocytes and regeneration of cells of a putrestsin, and also entering into structure of ribosomes of spermine and spermidine — takes part in aminopro-milling reactions that allows to reduce risk of fibrosing.

Normalizes formation of endogenous phosphatidylsincaline in liver cells that increases polarization and flowability of membranes. Thanks to it function of the cells of a liver of transport systems of the bile acids (BA) associated with membranes improves and the bile passage in zhelchevyvodyashchy system is facilitated.

It is effective at a hepatocanalicular and pro-current cholestasia. Carrying out sulphation and konjyugirovany ZhK in a liver cell, reduces that their toxicity.

Conjugation with taurine promotes increase of solubility of ZhK and their removal from liver cells.

Sulphation of ZhK does possible their elimination by kidneys, and also facilitates passing through cellular membranes of hepatocytes and removal with bile.

At the same time the sulphated ZhK in addition protect membranes of hepatocytes from toxic action of not sulphated ZhK which at an intra hepatic cholestasia (VPH) are present at hepatocytes in high concentration).

At hepatitis, cirrhosis and other VPH which are followed by a syndrome diffusion diseases of a liver, SAM reduces expressiveness of changes of indicators of biochemical analysis of blood (activity of ShchF, ALT, nuclear heating plant, concentration of direct bilirubin and so forth) and a skin itch.

Gepatoprotektivny and holeretichesky effects after the termination of treatment by Geptral remain about three months.

Efficiency of an ademetionin at hepatopathies which reason use of hepatotoxic HP is is proved.

Geptral's appointment to patients with opium drug addiction which is followed by damage of a liver, improves function of a liver and processes of monooksigenazny oxidation, and also causes regression of clinical manifestations of narcotic abstinence.

Antidepressive action develops gradually, since the end of the first week of a course of use of drug. The effect is stabilized within 2 weeks of treatment.

Medicine is effective at recurrent depressions (neurotic or endogenous) which rezistentna to amitriptyline. One of SAM properties is ability to interrupt a recurrent depression.

Use at an osteoarthritis allows to reduce expressiveness of pain, promotes increase of synthesis of proteoglycans and partial recovery of cartilaginous tissue.

Pharmacokinetics

In Wikipedia it is specified that at oral administration bioavailability of SAM — 5%, when using an injection form of drug — almost absolute.

Cmax at a single dose of 1 tablet of Geptral — 700 mkg/l, TCmax — from 2 to 6 hours.

In the state connected with plasma proteins there is only an insignificant part of the accepted dose of an ademetionin.

Passes through GEB, in high concentration it is found in liquor.

The semi-elimination period — Biotransformirutsya 1,5 hours in a liver. It is removed by kidneys.

Tablets are covered to / r with a cover thanks to what active substance of drug begins to be released only in a duodenum.

Indications to Geptral's use

The indication to Geptral's use is VPH developing at pretsirrotichesky and cirrhotic states.

Drug is appointed for treatment of a fatty hepatosis of a liver, an angiocholitis, chronic hepatitis, cirrhosis, chronic not calculous cholecystitis, VPH at pregnant women; at intoxication of a liver of various form and etiology (including toxic defeats which reason are drug intake, an alcohol abuse, a viral infection), and also at encephalopathy including if the disease is associated with baked insufficiency, and depressions.

Contraindications

Use of an ademetionin is contraindicated at genetic disorders which:

• influence the cycle SAM;
• cause a gipergomotsisteinemiya
• cause a homocystinuria.

Other contraindications are the children's age (Geptral appoint only to persons 18 years of age or over) and intolerance of tablets/solution.

With care medicine has to be applied at patients with BAD (bipolar affective disorders), on early durations of gestation (the first 13 weeks) and in the period of a lactation.

Side effects

Most often against treatment diarrhea, an abdominal pain and nausea arose drug.

Sometimes Geptral's use (in/in, in oil or in tablets) can become the reason:

• reactions of hypersensitivity, throat hypostasis;
• skin displays of an allergy, itch, rash, perspiration, Quincke's edema;
• IUT (infections of urinary tract);
• concerns, sleeplessnesses, headache, confusion of consciousness, paresthesia, dizziness;
• disturbances of activity of blood vessels and heart, inflammation of walls of superficial veins, inflow;
• dryness in a mouth, abdominal distentions, an esophagitis, an abdominal pain, dyspepsia, diarrhea, a meteorism, vomiting, hepatic colic, nausea, bleeding from different departments of a gastrointestinal tract, functional disorders of a digestive tract, cirrhosis;
• muscular spasm, joint pain;
• indispositions, fevers, grippopodobny syndrome, fever, adynamy, peripheral hypostases.

Application instruction of Geptral

How to take a pill?

Following recommendations in application instructions, a pill Geptral it is necessary to take inside between meals in the first half of day, without chewing and without crushing. The tablet is taken out from packaging just before reception.

Daily dose — 2-4 tablets of 400 mg. Duration of treatment depends on indications.

Geptral's ampoules: application instruction

Geptral in ampoules enter intravenously or intramusculary. Intravenous injections carry out very slowly.

Solution is prepared how to give an injection, using the solvent which is specially attached to it for cultivation of the lyophilized weight.

After an injection the remained medicine has to be utilized.

The injection form of Geptral is incompatible with the drugs and alkaline solutions containing calcium ions.

Daily dose of drug at VPH — 1-2 ampoules (400-800 mg of an ademetionin a day). Treatment lasts for 2 weeks.

At a depression drug is used in a similar dosage. Injections should be given within 15-20 days.

In need of the supporting treatment of the patient transfer to the tableted form of an ademetioniin. A pill is taken on 2-4 pieces/days for 2-4 weeks.

Overdose

Overdose cases at administration of drug intravenously, in a muscle and at intake were not noted.

Interaction

The known medicinal interactions were not observed.

The patient accepting Klomipramin and Ademetionin has messages on serotoninovy intoxication.

As such interaction is found possible potentially, drugs of an ademetionin have to be appointed carefully with tricyclic antidepressants, SIOZS and herbs containing tryptophane.

Terms of sale

According to the recipe.

Storage conditions

Both lyophilisate, and tablets have to be stored at a temperature of 15-25 °C.

Period of validity

Three years.

Special instructions

Ademetionin has tonic effect because of what drug is not recommended to be accepted in the second half of day and especially before going to bed.

If medicine is applied at patients with cirrhosis against the increased content in blood of derivatives of nitrogen, it is necessary to control the level of residual nitrogen systematically.

During prolonged treatment control of serumal concentration of creatinine and urea is necessary.

Ademetionin should not be applied to treatment of patients from BARS that is caused by a possibility of transition of a depression to a hypomania or mania.

It is known of cases of sudden emergence or increase of concern against therapy ademetioniny. As a rule, for normalization of a condition of the patient was to lower a drug dose enough.

Level of an ademetionin can decrease at a vitamin deficiency of B9 and B12 therefore during treatment it is necessary to keep under control the level of vitamins, in particular at vegetarians, patients forced to adhere to a certain diet, and pregnant women, and also at pathologies of a liver, anemia and some other states at which the risk of development of a vitamin deficiency increases.

At the confirmed vitamin deficiency it is recommended to add treatment with purpose of folic acid and B12 vitamin.

Ademetionin changes results of immunoassay of a gomotsistein in blood because of what indicators of plasma concentration of a gomotsistein can be false raised.

In this regard for the patients accepting ademetionin it is necessary to use not immunological methods of research for determination of concentration of a gomotsistein.

The drivers and persons working with mechanisms should remember that during treatment Geptral dizzinesses can arise drug. It is necessary to be engaged in activity which requires the speed of reactions and attention only after the patient is firmly convinced that treatment does not disturb it.

Use in veterinary science

In veterinary science the injection form of drug is, as a rule, applied to treatment of pretsirrotichesky states and cirrhosis.

For cats the dose depending on indications varies from 0,7 to 2,5 ml of the recovered solution. The dose for dogs is selected depending on animal weight, at the same time exceeding of a dose does not pose threat.

Geptral's analogs

Structural analog: Geptor.

Drugs with the close mechanism of action: Glyutaminovy acid, Histidine, Karniten, Carnitine, Elkar, Epilapton.

The price of analogs in tablets — from 645 rub.

What it is better — Geptral or Geptor?

As well as Geptral, Geptor treats group of the drugs which are increasing stability and stirring up activity of cells of a liver.

Medicine is issued in the form of tablets and lyophilisate for preparation of injection solution which part as actively operating substance is ademetionin. And both in tablets, and in solution substance contains in the same concentration, as in Geptrale.

Thus, drugs are interchangeable. If at the choice of medicine the price plays a crucial role, essential advantage of Geptor is the cost, much lower in comparison with analog.

Geptral or Essentiale — what is better?

Essentiale is a gepatoprotektor which basis are phospholipids of soybeans. Drug promotes recovery of hepatocytes and normalization of health due to elimination of such symptoms as loss of appetite, fatigue, weight in right hypochondrium.

Essentiale appoint at cirrhosis, hepatitis, a steatogepatoza, psoriasis, toxicosis of pregnant women, a necrosis of hepatocytes, hepatic prekome / to a coma, before and after surgical interventions in the field of a gepatobiliarny zone, liver intoxication, a radiation syndrome.

Geptral's difference is that this drug can be used not only as a gepatoprotektor, but also for treatment of encephalopathies and depressions.

It is unambiguous to tell that it is better — Geptral or Essentiale Fort/Essentiale of N — for the specific patient, only the doctor who knows features of a course of a disease can.

Phosphogliv or Geptral — what is better?

Phosphogliv is a gepatoprotektor with antiviral activity. Active components of drug are the glycyrrhizic acid (GA) and phospholipids.

The phosphatidylsincaline which is contained in it is a component of a phospholipidic layer of biological membranes, its action is directed to recovery of structure and function of the damaged membranes of cells of a liver, and also disintoxication function of a liver, the prevention of loss by cells of active agents (enzymes, etc.), normalization of fatty, lipidic and proteinaceous exchanges, suppression of growth of connecting fabric in a liver, the prevention of fibrosis and cirrhosis.

Under the influence of group of companies implementation of active particles of viruses in hepatocytes is blocked, and also ability of viruses to formation of new structural components is broken.

Suppression of a reproduction of viruses is carried out at the expense of a promoting effect of group of companies on products of IFN, strengthening of phagocytosis, increase in activity of a Tax Code cells, etc. Due to detergentny action of group of companies promotes emulsification of phosphatidylsincaline in intestines.

Phosphogliv is applied to treatment of hepatoses, hepatitises, intoxication of a liver, cirrhosis, after a cholecystectomia, and also in complex therapy of diseases of skin (eczema, neurodermatitis, psoriasis).