Background pattern
Hepa-mezh

Hepa-mezh

Ask a doctor about a prescription for Hepa-mezh

This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use Hepa-mezh

Package Leaflet: Information for the Patient

Hepa-Merz, 5 g/10 ml, Concentrate for Solution for Infusion

Ornithine aspartate

Read the Package Leaflet Carefully Before Using the Medicinal Product, as it Contains Important Information for the Patient.

  • Keep this package leaflet, you may need to read it again.
  • If you have any further questions, ask your doctor or pharmacist.
  • This medicinal product has been prescribed for you. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
  • If you experience any side effects, including those not listed in this package leaflet, please inform your doctor or pharmacist. See section 4.

Table of Contents of the Package Leaflet

  • 1. What Hepa-Merz is and what it is used for
  • 2. Important information before using Hepa-Merz
  • 3. How to use Hepa-Merz
  • 4. Possible side effects
  • 5. How to store Hepa-Merz
  • 6. Contents of the pack and other information

1. What Hepa-Merz is and what it is used for

Hepa-Merz is a medicinal product that stimulates the removal of ammonia from the body by increasing the synthesis of urea in the liver. Hepa-Merz also supports the removal of ammonia from tissues other than the liver.
Hepa-Merz is used to treat hepatic encephalopathy in the course of acute and chronic liver diseases, such as fatty liver, cirrhosis, and hyperammonemia.

2. Important information before using Hepa-Merz

When not to use Hepa-Merz

Do not use Hepa-Merz in patients with the following disorders:

  • Hypersensitivity to L-ornithine L-aspartate;
  • Severe renal impairment (serum creatinine concentration above 3 mg/100 ml);
  • Disorders of amino acid metabolism involved in the urea cycle, e.g. due to enzymatic defects.

Warnings and precautions

Before starting the use of Hepa-Merz, discuss it with your doctor or pharmacist.
During the use of high doses of the medicinal product, monitor the urea concentration in serum and urine.
In the case of severe liver dysfunction, the infusion rate should be adjusted individually to avoid gastrointestinal disorders, such as nausea and vomiting.

Children

There are no data on the use of Hepa-Merz in children.

Hepa-Merz and other medicinal products

Tell your doctor about all the medicinal products you are taking or have recently taken, as well as any medicinal products you plan to take.
No interactions between Hepa-Merz and other medicinal products are known.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant or plan to have a child, consult your doctor before using this medicinal product.
Pregnancy:
There are insufficient data on the safety of using Hepa-Merz during pregnancy, therefore, the use of the medicinal product during pregnancy should be avoided. However, if the use of the medicinal product in a pregnant woman is necessary, the doctor should weigh the potential benefits against the risks before making a decision.
Breastfeeding:
It is not known whether L-ornithine L-aspartate (the active substance of Hepa-Merz) passes into breast milk. The use of the medicinal product during breastfeeding should be avoided. However, if the use of the medicinal product in a breastfeeding woman is necessary, the doctor should weigh the potential benefits against the risks before making a decision.

Driving and using machines

The ability to drive and use machines may be impaired due to the disease being treated with Hepa-Merz.

3. How to use Hepa-Merz

Dosage:

This medicinal product should always be used as directed by your doctor. If you are unsure, consult your doctor or pharmacist.
Usually, up to 20 g (4 ampoules) per day are administered.
In pre-comatose states and coma, up to 40 g (8 ampoules) per day, depending on the patient's condition.
If you feel that the effect of the medicinal product is too strong or too weak, contact your doctor or pharmacist.

Method of administration

Intravenous administration.
Before administration, dissolve the contents of the ampoule in the infusion fluid. Hepa-Merz can be administered in all commonly used infusion fluids. No incompatibilities related to dissolution have been observed so far.
It is recommended to prepare the infusion solution immediately before administration.
Due to the risk of vein damage, do not administer more than 6 ampoules in 500 ml of fluid.
Infusion rate: maximum 5 g (1 ampoule)/hour.
Do not administer intra-arterially.

Use of a higher than recommended dose of Hepa-Merz

No symptoms of overdose have been observed with Hepa-Merz so far.
In the event of an overdose, symptomatic treatment is used.

4. Possible side effects

Like all medicinal products, Hepa-Merz can cause side effects, although not everybody gets them.

Uncommon side effects (less than 1 in 100 people):

Nausea

Rare side effects (less than 1 in 1,000 people):

Vomiting

Frequency not known (cannot be estimated from the available data):

Hypersensitivity, allergic reactions (anaphylactic)
Nausea and vomiting are usually transient and do not require discontinuation of the medicinal product.
They subside after reducing the dose or infusion rate.

Reporting side effects

If you experience any side effects, including those not listed in this package leaflet, please inform your doctor or pharmacist.
Side effects can be reported directly to the Department of Monitoring of Adverse Reactions to Medicinal Products, Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products
Al. Jerozolimskie 181 C, 02-222 Warsaw
Phone: +48 22 49 21 301, Fax: +48 22 49 21 309
Website: https://smz.ezdrowie.gov.pl
Side effects can also be reported to the marketing authorization holder.
By reporting side effects, you can help provide more information on the safety of the medicinal product.

5. How to store Hepa-Merz

Store the medicinal product out of sight and reach of children.
Do not use this medicinal product after the expiry date stated on the carton.
The expiry date refers to the last day of the month.
Do not store above 30°C.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines no longer required. This will help protect the environment.

6. Contents of the pack and other information

What Hepa-Merz contains

The active substance of the medicinal product is L-ornithine L-aspartate.
1 ampoule (10 ml) of concentrate for solution for infusion contains 5 g of L-ornithine L-aspartate.
The other ingredient (excipient) is water for injections.

What Hepa-Merz looks like and contents of the pack

Hepa-Merz, concentrate for solution for infusion, is a clear solution.
The pack contains 10 ampoules of 10 ml each.

Marketing authorization holder and manufacturer

Marketing authorization holder:

Merz Pharmaceuticals GmbH
Eckenheimer Landstrasse 100
60318 Frankfurt/Main
Germany
Phone: +49 69 1503 0
e-mail: [email protected]

Manufacturer:

Merz Pharma GmbH & Co.KGaA
Eckenheimer Landstrasse 100
60318 Frankfurt/Main
Germany

Date of last revision of the package leaflet:

  • Country of registration
  • Active substance
  • Prescription required
    No
  • Importer
    Merz Pharma GmbH & Co. KGaA
  • Alternatives to Hepa-mezh
    Dosage form: Granulate, 3 g/5 g
    Active substance: ornithine oxoglurate
    Prescription required
    Dosage form: Granulate, 3 g/5 g
    Active substance: ornithine oxoglurate
    Prescription required
    Dosage form: Granulate, 3 g/5 g
    Active substance: ornithine oxoglurate
    Prescription required

Alternatives to Hepa-mezh in other countries

The best alternatives with the same active ingredient and therapeutic effect.

Alternative to Hepa-mezh in Spain

Dosage form: CAPSULE, 300 mg
Prescription not required
Dosage form: CAPSULE, 100 mg Dry extract of milk thistle (equivalent to 80 mg of silymarin)
Active substance: silymarin
Prescription required
Dosage form: INJECTABLE PERFUSION, 350 mg sodium silibinate
Prescription required
Dosage form: CAPSULE, 150 mg silymarin
Active substance: silymarin
Prescription required
Dosage form: TABLET, 4.6 mg dry extract Cynara scolimus (1:30-31); 1.2 mg dry extract Taraxacum officinalis (1:17-18); 0.7 mg dry extract Peumus boldus (1:10-11); 3.2 mg dry extract Silibum marianum (1:2-2.1)
Prescription not required
Dosage form: CAPSULE, 390 mg
Prescription not required

Alternative to Hepa-mezh in Ukraine

Dosage form: fruits, 50 g, or 100 g, or 200 g
Manufacturer: PRAT "FITOFARM
Prescription not required
Dosage form: fruits, 50 g, 100 g or 200 g
Prescription not required
Dosage form: lyophilizate, 1 vial (bottle) contains lecithin standard - 320 mg; anthral - 4.2 mg
Manufacturer: TOV "BIOLIK FARMA
Prescription required
Dosage form: capsules, 10 capsules in a blister
Prescription not required
Dosage form: solution, 50mg/ml in 5ml ampoule
Manufacturer: AT "Farmak
Prescription required
Dosage form: capsules, 10 capsules in a blister
Manufacturer: Nabros Farma Pvt. Ltd.
Prescription not required

Online doctors for Hepa-mezh

Discuss dosage, side effects, interactions, contraindications, and prescription renewal for Hepa-mezh – subject to medical assessment and local rules.

0.0(0)
Doctor

Abdullah Alhasan

General medicine10 years of experience

Dr. Abdullah Alhasan is a physician specialising in cardiology and general medicine, with international clinical experience and a commitment to evidence-based care. He offers online consultations for adults, focusing on both acute symptoms and long-term health management.

Main areas of consultation:

  • Chest pain, shortness of breath, heart palpitations, high blood pressure
  • Hypertension control and cardiovascular disease prevention
  • Interpretation of ECG, blood tests, and Holter monitor results
  • Management of heart failure and coronary artery disease
  • General medical issues: infections, fever, fatigue, gastrointestinal symptoms
  • Guidance on diagnostics, treatment plans, and medication adjustments
Dr. Alhasan’s approach is based on thorough assessment, clear communication, and personalised care – helping patients understand their health and make informed decisions about their treatment.
CameraBook a video appointment
€69
Today06:20
Today06:35
Today06:50
Today07:05
Today07:20
More times
5.0(1)
Doctor

Ngozi Precious Okwuosa

General medicine5 years of experience

Dr. Ngozi Precious Okwuosa is a Primary Care Physician with over 5 years of clinical experience in Hungary, Sweden, and Nigeria. A graduate of the University of Szeged (cum laude), she offers online consultations for adults in the areas of internal medicine, women’s health, and postoperative care.

Key areas of consultation:

  • Preventive and family medicine
  • Women’s health, including gynaecology and obstetrics
  • Chronic disease management: hypertension, diabetes, and more
  • Mental health support, anxiety, and counselling
  • Postoperative care and lab test interpretation
She has conducted research on the genetic background of stroke and is skilled in communicating with patients from diverse cultural backgrounds. Her approach combines clinical expertise with empathy and clear communication.
CameraBook a video appointment
€60
Today06:20
Today07:10
Today08:00
Today08:50
Today09:40
More times
5.0(15)
Doctor

Taisiya Minorskaya

Family medicine12 years of experience

Dr Taisiya Minorskaya is a family medicine doctor with an official licence to practise in Spain and over 12 years of clinical experience. She provides online consultations for adults and children, combining evidence-based medicine with a personalised, modern European approach.

She helps with:

  • Viral infections and cold symptoms (flu, sore throat, cough, runny nose)
  • Review and adjustment of antibiotics
  • Skin rashes and allergic reactions
  • Chronic condition flare-ups, high blood pressure, headaches, fatigue
  • Lab and test interpretation
  • Medication review and adaptation to European standards
  • Patient navigation: what tests are needed, which specialists to see, when an in-person visit is required
Dr Minorskaya also specialises in the diagnosis and management of gastrointestinal conditions, including bloating, abdominal pain, chronic nausea, IBS, and SIBO. She supports patients with unexplained physical symptoms that may be linked to somatisation or stress, helping them find relief and improve quality of life.

She offers care for people undergoing GLP-1 therapy (Ozempic, Mounjaro, and others) for weight management. Her support follows Spanish clinical guidelines, from treatment planning and side effect counselling to regular follow-ups and coordination with private or public healthcare providers.

CameraBook a video appointment
€65
Today08:05
Today09:35
Today10:05
Today10:35
Today11:05
More times
5.0(11)
Doctor

Dmytro Horobets

Family medicine6 years of experience

Dr. Dmytro Horobets is a licensed family medicine physician in Poland, specialising in endocrinology, diabetology, obesity management, gastroenterology, pediatrics, general surgery, and pain medicine. He offers online consultations for adults and children, providing personalised medical support for a wide range of acute and chronic health concerns.

Areas of expertise:

  • Endocrinology: diabetes type 1 and type 2, prediabetes, thyroid disorders, metabolic syndrome, hormonal imbalance.
  • Obesity medicine: structured weight management plans, nutritional counselling, obesity-related health risks.
  • Gastroenterology: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), liver and biliary conditions.
  • Pediatric care: infections, respiratory symptoms, digestive issues, growth and development monitoring.
  • General surgery support: pre- and post-surgical consultations, wound care, rehabilitation.
  • Pain management: chronic and acute pain, back pain, joint pain, post-traumatic pain syndromes.
  • Cardiovascular health: hypertension, cholesterol control, risk assessment for heart disease.
  • Preventive medicine: regular check-ups, health screenings, long-term management of chronic conditions.

Dr. Horobets combines evidence-based medicine with a patient-centred approach. He carefully evaluates each patient’s medical history and symptoms, offering clear explanations and structured treatment plans adapted to individual needs.

Whether you need help managing diabetes, tackling weight-related health issues, interpreting lab results, or receiving general family medicine support, Dr. Horobets provides professional online care tailored to your specific health goals.

CameraBook a video appointment
€60
Today09:00
Today09:30
November 809:00
November 809:30
November 1509:00
More times
5.0(30)
Doctor

Nuno Tavares Lopes

Family medicine17 years of experience

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC. He offers online consultations in Portuguese, English, and Spanish — combining global expertise with a patient-centred, evidence-based approach.

  • Emergency care: infections, fever, chest/abdominal pain, minor injuries, paediatric emergencies
  • Family medicine: hypertension, diabetes, cholesterol, chronic disease management
  • Travel medicine: pre-travel advice, vaccinations, fit-to-fly certificates, travel-related illnesses
  • Sexual and reproductive health: PrEP, STD prevention, counselling, treatment
  • Weight management and wellness: personalised weight loss programmes, lifestyle guidance
  • Skin and ENT issues: acne, eczema, allergies, rashes, sore throat, sinusitis
  • Pain management: acute and chronic pain, post-surgical care
  • Public health: prevention, health screenings, long-term monitoring
  • Sick leave (Baixa médica) connected to Segurança Social in Portugal
  • IMT medical certificates for driving licence exchange
Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.
CameraBook a video appointment
€59
Today09:00
Today09:20
Today09:40
Today10:00
Today10:20
More times
5.0(10)
Doctor

Duarte Meneses

Family medicine4 years of experience

Dr. Duarte Meneses is a licensed family medicine and general practice doctor based in Portugal, with additional expertise in occupational health. He provides online consultations for adults, offering medical support for both acute symptoms and chronic health conditions.

  • Common symptoms such as fever, sore throat, cough, fatigue, or digestive issues
  • Chronic conditions including hypertension, diabetes, high cholesterol, and thyroid problems
  • Mental health concerns such as stress, sleep issues, anxiety, and burnout
  • Preventive care: health check-ups, lifestyle advice, and follow-up for existing conditions
  • Work-related health questions, sick leave documentation, and medical guidance for returning to work
Dr. Meneses graduated from the University of Beira Interior and has years of experience working with diverse patient populations. He is fluent in Portuguese, English, Spanish, and French.

His approach is friendly, clear, and focused on delivering practical medical advice tailored to each patient’s needs.

CameraBook a video appointment
€65
Today09:00
Today09:25
Today09:50
Today10:15
Today10:40
More times
0.0(3)
Doctor

Svetlana Kovalenko

Family medicine14 years of experience

Dr Svetlana Kovalenko is a family medicine doctor with over 14 years of experience and a medical degree from Kharkiv National Medical University. She offers online consultations for adults, supporting patients with both acute and chronic conditions, preventive care, and personalised medical advice.

What patients commonly consult her for:

  • High blood pressure, type 2 diabetes, cholesterol management
  • Cold and flu symptoms: fever, cough, sore throat
  • Fatigue, sleep problems, headaches, general discomfort
  • Ongoing care for chronic conditions and medication review
  • Help interpreting test results and lab reports
  • Preventive check-ups and advice on healthy lifestyle habits

Dr Kovalenko combines evidence-based practice with a respectful, patient-centred approach. She takes time to explain, listens attentively, and helps each person make confident, informed decisions about their health.

CameraBook a video appointment
€55
Today09:00
Today09:25
Today09:50
Today10:15
Today10:40
More times
5.0(17)
Doctor

Sergio Correa

General medicine7 years of experience

Dr. Sergio Correa is a licensed general practitioner, aesthetic medicine specialist, and trichologist with experience in emergency care and preventive health. He offers online consultations in English and Spanish, supporting adult patients with a wide range of medical concerns – from acute symptoms to chronic condition management.

His areas of focus include:

  • General and urgent care: fever, fatigue, infections, digestive issues, respiratory symptoms, and other common concerns
  • Chronic condition support: hypertension, high cholesterol, diabetes, thyroid issues
  • Aesthetic medicine and dermatology: acne, skin ageing, hyperpigmentation, personalised skincare guidance
  • Trichology: hair loss, scalp conditions, treatment strategies for men and women
  • Preventive care: health check-ups, lifestyle advice, second opinions

Dr. Correa combines medical knowledge with an aesthetic and holistic approach to help patients improve both health and quality of life.

CameraBook a video appointment
€40
Today13:00
Today14:00
Today15:00
Today16:00
November 213:00
More times
5.0(14)
Doctor

Jonathan Marshall Ben Ami

Family medicine8 years of experience

Dr. Jonathan Marshall Ben Ami is a licensed family medicine doctor in Spain. He provides comprehensive care for adults and children, combining general medicine with emergency care expertise to address both acute and chronic health concerns.

Dr. Ben Ami offers expert diagnosis, treatment, and follow-up for:

  • Respiratory infections (cold, flu, bronchitis, pneumonia).
  • ENT conditions such as sinusitis, ear infections, and tonsillitis.
  • Digestive issues including gastritis, acid reflux, and irritable bowel syndrome (IBS).
  • Urinary tract infections and other common infections.
  • Management of chronic diseases: high blood pressure, diabetes, thyroid disorders.
  • Acute conditions requiring urgent medical attention.
  • Headaches, migraines, and minor injuries.
  • Wound care, health check-ups, and ongoing prescriptions.

With a patient-focused and evidence-based approach, Dr. Ben Ami supports individuals at all stages of life — offering clear medical guidance, timely interventions, and continuity of care.

CameraBook a video appointment
€55
Today13:30
Today14:15
Today15:00
November 813:30
November 814:15
More times
0.0(1)
Doctor

Maryna Kuznetsova

Cardiology16 years of experience

Dr Marina Kuznetsova is an internal medicine doctor and cardiologist with a PhD in medicine. She provides online consultations for adults with chronic and acute conditions, with a strong focus on cardiovascular health. Her approach is based on current clinical guidelines and evidence-based treatment strategies.

Areas of expertise:

  • dyslipidaemia and lipid metabolism disorders
  • prevention and management of atherosclerosis
  • blood pressure monitoring and antihypertensive therapy
  • arrhythmias: diagnosis, follow-up, and treatment adjustment
  • cardiovascular care and recovery support after Covid-19
Dr Kuznetsova helps patients manage cardiovascular risk factors, optimise long-term treatment, and gain clarity in complex health situations – all through accessible and structured online care.
CameraBook a video appointment
€50
November 207:00
November 207:50
November 208:40
November 209:30
November 210:20
More times

Get updates and exclusive offers

Be the first to know about new services, marketplace updates, and subscriber-only promos.

Follow us on social media
FacebookInstagram
Logo
Oladoctor
Find a doctor
Doctors by specialty
Services
Choose language
© 2025 Oladoctor. All rights reserved.
VisaMastercardStripe