Usage
This combination medication is primarily prescribed for supporting liver health and function. It’s used to treat conditions like:
- Alcoholic liver disease
- Non-alcoholic fatty liver disease (NAFLD)
- Liver inflammation
- Chronic viral hepatitis B and C
- Cirrhosis
- Liver fibrosis
- General liver dysfunction
Pharmacological Classification:
This combination falls under several classifications:
- Hepatoprotective
- Antioxidant
- Vitamin Supplement
Mechanism of Action:
This combination works through the synergistic action of its components:
- Metadoxine: Accelerates alcohol breakdown, reduces liver fat accumulation, and protects against alcohol-induced damage.
- Silymarin: Acts as an antioxidant, scavenging free radicals, promoting liver cell regeneration, and stabilizing liver cell membranes.
- L-Ornithine L-Aspartate: (often included, although not mentioned in title) Reduces ammonia levels in the blood, thereby decreasing hepatic encephalopathy risk.
- Vitamin B6 (Pyridoxine): Supports enzyme activity crucial for protein metabolism in the liver and prevents vitamin B6 deficiency often associated with liver disease.
- Folic Acid: Supports cell growth and repair essential for overall liver function and prevents folic acid deficiency which can be worsened by liver conditions.
Alternate Names
There is no single official alternate name for this specific combination. The components are often seen listed in differing order. It’s sometimes referred to generally as a “liver support formula” or “hepatoprotective combination.” Some sources list Taurine as a potential component. Some brand names this combination may be sold under include:
- Livorus
- Reheptin
- Liviz
- Hepagold
How It Works
Pharmacodynamics:
The combined effect of the ingredients results in improved liver function, reduced oxidative stress, and decreased ammonia levels.
- Metadoxine: Increases the activity of alcohol dehydrogenase and aldehyde dehydrogenase, speeding up alcohol metabolism.
- Silymarin: Prevents lipid peroxidation, stabilizes liver cell membranes, and promotes protein synthesis, facilitating liver regeneration.
- L-Ornithine L-Aspartate: Participates in the urea cycle, converting ammonia to urea, thus lowering ammonia levels.
- Vitamin B6: Acts as a cofactor for various enzymes involved in liver metabolism.
- Folic Acid: Essential for DNA synthesis and cell division, contributing to liver regeneration and repair.
Pharmacokinetics:
- Absorption: Orally administered components are absorbed through the digestive system.
- Metabolism: Primarily metabolized in the liver.
- Elimination: Excreted through urine and bile.
Dosage
Standard Dosage
Adults:
The typical dosage is one tablet once or twice daily, usually taken after meals to enhance absorption. The exact dosage and frequency may vary depending on the specific product formulation and the patient’s condition. A common dosage is one tablet twice daily, commonly containing: Metadoxine 500mg, Silymarin 140mg, L-Ornithine L-Aspartate 150mg, Vitamin B6 3mg, and Folic Acid 1.5mg.
Children:
The safety and efficacy in children haven’t been fully established. Dosage should be determined by a doctor on a case-by-case basis.
Special Cases:
- Elderly Patients: Dosage adjustments may be required based on kidney and liver function.
- Patients with Renal Impairment: Caution is advised, and dose adjustments based on creatinine clearance may be necessary.
- Patients with Hepatic Dysfunction: Careful monitoring of liver function is recommended. Dosage may need adjustment.
- Patients with Comorbid Conditions: Evaluate potential drug interactions with pre-existing conditions like diabetes or cardiovascular disease.
Clinical Use Cases
The provided sources do not offer specific dosage recommendations for clinical scenarios like intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations. Dosing in these situations should be determined by a medical professional.
Side Effects
Common Side Effects:
- Nausea
- Mild stomach discomfort
- Diarrhea
- Headache
- Fatigue
- Abdominal pain
Rare but Serious Side Effects:
- Allergic reactions (rash, itching, swelling)
- Severe fatigue or dizziness
- Jaundice, Liver damage
Long-Term Effects:
Long-term effects haven’t been extensively studied. Regular monitoring of liver and kidney function is recommended during prolonged use.
Contraindications
- Hypersensitivity to any component
- Severe liver failure
- Severe renal impairment
Drug Interactions
- Alcohol (reduces medication effectiveness and may worsen liver damage)
- Anticoagulants (e.g., warfarin)
- Antidiabetic medications (e.g., metformin, glibenclamide)
- Antifungal medications (e.g., ketoconazole)
- Anti-seizure medications (e.g., phenytoin, carbamazepine)
- Levodopa
Pregnancy and Breastfeeding
Consult a doctor before using during pregnancy or breastfeeding. Safety hasn’t been fully established, and benefits must outweigh potential risks. Folic acid is generally recommended during pregnancy, but the combination should be evaluated by a physician.
Drug Profile Summary
- Mechanism of Action: See “How It Works” section.
- Side Effects: Nausea, stomach discomfort, diarrhea, headache, fatigue, allergic reactions, liver damage.
- Contraindications: Hypersensitivity, severe liver/renal failure.
- Drug Interactions: Alcohol, anticoagulants, antidiabetics, antifungals.
- Pregnancy & Breastfeeding: Consult a doctor before use.
- Dosage: Typically one tablet once or twice daily, adjusted as needed.
- Monitoring Parameters: Liver function tests (LFTs), kidney function tests.
Popular Combinations
This specific combination itself is commonly used for liver support.
Precautions
- Pre-existing medical conditions should be evaluated.
- Pregnant/breastfeeding women should consult their doctor.
- Dosage adjustments might be needed for children and the elderly.
- Alcohol should be avoided.
FAQs
A: The usual adult dose is one tablet once or twice daily, but it depends on the specific product formulation and the patient’s condition. Consult a physician for individualized dosing.
Q2: Is this combination safe during pregnancy?
A: Consult a doctor before use during pregnancy. Safety hasn’t been fully established.
Q3: What are the common side effects?
A: Common side effects include nausea, stomach discomfort, diarrhea, headache, and fatigue.
Q4: Does this combination interact with alcohol?
A: Yes, alcohol should be avoided as it can reduce the medication’s effectiveness and exacerbate liver damage.
Q5: Can this be used in children?
A: The safety and efficacy haven’t been established in children. Consult a doctor before use.
Q6: Are there any contraindications?
A: Contraindications include hypersensitivity to any of the components, severe liver failure, and severe renal impairment.
Q7: What should be monitored while taking this medication?
A: Liver function tests (LFTs) and kidney function tests should be monitored regularly.
Q8: What are the brand names under which this medicine is sold?
A: Some brand names include Livorus, Reheptin, Liviz, and Hepagold, though formulations may vary.
Q9: Should the dosage be adjusted for elderly patients?
A: Yes, dosage adjustments may be necessary based on kidney and liver function in the elderly.
Q10: What is the role of each ingredient in this combination?
A: Metadoxine aids alcohol detoxification, Silymarin acts as an antioxidant and protects liver cells, L-Ornithine L-Aspartate lowers ammonia, Vitamin B6 supports enzyme activity, and Folic Acid supports cell growth.
