Treatment of concomitant diseases and complications caused by impaired detoxification of the liver (for example, cirrhosis of the liver) with symptoms of latent or severe hepatic encephalopathy.
active substance: 1 ml of the drug contains L-ornithine-L-aspartate in terms of 100% of the substance 500 mg;
Excipient: water for injections.
Dosage form. Concentrate for solution for infusion.
Larnamin Pharmacotherapeutic group.
Drugs used in liver disease, lipotropic substances. Hepatotropic drugs. ATC code A05B A.
Treatment of concomitant diseases and complications caused by impaired liver detoxification function (eg, liver cirrhosis) with symptoms of latent or severe hepatic encephalopathy, especially disturbances of consciousness (precoma, coma).
Hypersensitivity to L-ornithine-L-aspartate.
Severe renal insufficiency (creatinine clearance above 3 mg / 100 ml is considered an indicative value).
Method of application and dosage.
Unless otherwise prescribed, you can use up to 4 ampoules (40 ml) per day.
In the case of precoma or coma, up to 8 ampoules (80 ml) are administered within 24 hours, depending on the severity of the condition.
Before administration, the contents of the ampoules are added to 500 ml of infusion solution, but do not dissolve more than 6 ampoules in 500 ml of infusion solution.
The maximum rate of administration of Larnamin is 5 g / h (corresponding to the content of 1 ampoule).
The course of treatment is regulated by the clinical condition of the patient.
Gastrointestinal disorders: nausea, vomiting.
These symptoms are usually short-lived and do not require discontinuation of the drug. They disappear with decreasing dose or rate of drug administration.
Allergic reactions are possible.
To date, no signs of intoxication due to overdose of L-ornithine-L-aspartate have been observed. In case of overdose, symptomatic treatment is recommended.
Use during pregnancy or breastfeeding.
There are no data on the use of L-ornithine L-aspartate during pregnancy, so its use should be avoided during this period.
However, if treatment with Larnamine is considered necessary for vital signs, the risk / benefit ratio should be carefully considered.
It is not known whether L-ornithine-L-aspartate is excreted in human milk. Therefore, the drug should be avoided during breastfeeding.
Experience in children is limited, so the drug is not used in pediatric practice.
Special security measures.
Larnamine, a concentrate for solution for infusion, should not be injected into an artery.
Features of application.
At administration of high doses of the drug Larnamin it is necessary to control the level of urea in blood plasma and urine.
In case of significant hepatic impairment, the infusion rate should be adjusted according to the individual patient’s condition to prevent nausea and vomiting.
Ability to influence the speed of reaction when driving a car or working with other mechanisms.
As a result of the disease, the ability to drive or use machines may be impaired during treatment with Larnamine, so this type of activity should be avoided during treatment.
Interaction with other drugs and other types of interactions.
No interaction studies have been performed. No data available.
Pharmacodynamics. In vivo action of L-ornithine-L-aspartate is due to the amino acids ornithine and aspartate by two key methods of ammonia detoxification: urea synthesis and glutamine synthesis.
Urea synthesis occurs in peri-portal hepatocytes, where ornithine acts as an activator of two enzymes: ornithine carbamoyltransferase and carbamoylphosphate synthetase, as well as a substrate for urea synthesis.
Glutamine synthesis occurs in peripheral hepatocytes. In particular, under pathological conditions, aspartate and dicarboxylate, including products of ornithine metabolism, are absorbed into cells and used there to bind ammonia in the form of glutamine.
Glutamate is an amino acid that binds ammonia under both physiological and pathological conditions. The resulting amino acid, glutamine, is not only a non-toxic form of ammonia excretion, but also activates an important urea cycle (intracellular glutamine metabolism).
Under physiological conditions, ornithine and aspartate do not limit the synthesis of urea.