Hepamerz Dosing Clarification
Hepamerz is L-ornithine L-aspartate (LOLA), not penicillamine—these are completely different medications used for different conditions. Hepamerz is used for hepatic encephalopathy, while penicillamine is a copper chelator for Wilson's disease.
Hepamerz (L-ornithine L-aspartate) Dosing for Hepatic Encephalopathy
For hepatic encephalopathy, Hepamerz should be administered as 7 intravenous drip infusions followed by oral administration for 14 days. 1
Intravenous Administration
- Initial phase: 7 intravenous drip infusions 1
- This approach demonstrated effectiveness in reducing blood ammonia levels in 67% of fasting patients and 82% of post-meal measurements 1
Oral Maintenance
- Following IV therapy: Continue oral administration for 14 days 1
- This regimen improved psychomotor parameters in 68% of cirrhotic patients with hepatic encephalopathy 1
Adverse Effects
- Transient nausea may occur in approximately 21% of patients (3 out of 14 in the study) 1
- This side effect is generally mild and self-limiting 1
Renal Function Considerations
There is no specific evidence provided regarding dose adjustments for renal impairment with Hepamerz. The available literature does not address dosing modifications in patients with compromised kidney function. Clinical judgment and close monitoring would be necessary in this population, though specific guidance is lacking in the current evidence base.
Important Distinction
If you were asking about penicillamine for Wilson's disease (not Hepamerz), the dosing would be entirely different: 250-500 mg/day initially, titrated to 1000-1500 mg/day in divided doses 2, 3. However, this is a different medication for a different indication.