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 User

Warning! Keep the leaflet! Information on the immediate packaging in a foreign language.

Hepa-Merz

5 g/10 ml (0.5 g/ml), concentrate for solution for infusion

Ornithine aspartate

Read the leaflet carefully before using the medicine, as it contains important information for the patient.

  • Keep this leaflet, so you can read it again if you need to.
  • If you have any doubts, consult your doctor or pharmacist.
  • This medicine has been prescribed specifically for you. Do not pass it on to others. The medicine may harm another person, even if their symptoms are the same.
  • If the patient experiences any side effects, including any side effects not listed in this leaflet, they should tell their doctor or pharmacist. See section 4.

Table of Contents of the Leaflet:

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

Hepa-Merz is a medicine 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 insufficiency (serum creatinine above 3 mg/100 ml);
  • disorders of amino acid metabolism involved in the urea cycle, e.g., due to enzymatic defects.

Warnings and precautions

When using high doses of the medicine, monitor the urea concentration in serum and urine.
In cases 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 medicines

Tell your doctor about all medicines you are currently taking or have recently taken, as well as any medicines you plan to take.
No interactions between Hepa-Merz and other medicines 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 medicine.
Pregnancy
There are insufficient studies on the safety of using Hepa-Merz during pregnancy; therefore, avoid using the medicine during pregnancy. However, if the use of the medicine in a pregnant woman is necessary, the doctor should consider the potential benefits versus 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. Avoid using the medicine during breastfeeding. However, if the use of the medicine in a breastfeeding woman is necessary, the doctor should consider the potential benefits versus the risks before making a decision.

Driving and using machines

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

3. How to use Hepa-Merz

Dosage

Always use this medicine exactly as your doctor has told you. If you are not sure, consult your doctor or pharmacist.
Usually, up to 20 g (4 ampoules) per day is administered.
In pre-coma and coma states, up to 40 g (8 ampoules) per day, depending on the patient's condition.
If you feel that the effect of the medicine is too strong or too weak, consult your doctor or pharmacist.

Method of administration

Intravenous administration.
Before administration, dissolve the contents of the ampoule in an infusion solution. Hepa-Merz can be administered in all commonly used infusion solutions. 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 solution.
Infusion rate: maximum 5 g (1 ampoule)/hour.
Do not administer intra-arterially.

Using more than the recommended dose of Hepa-Merz

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

4. Possible side effects

Like all medicines, 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 medicine.
They subside after reducing the dose or infusion rate.

Reporting side effects

If you experience any side effects, including any side effects not listed in this leaflet, tell 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 181C, 02-222 Warsaw, tel.: +48 22 49 21 301, fax: +48 22 49 21 309, website: https://smz.ezdrowie.gov.pl.
Reporting side effects will help gather more information on the safety of the medicine.

5. How to store Hepa-Merz

Keep the medicine out of the sight and reach of children.
Do not use this medicine after the expiry date stated on the packaging.
The expiry date refers to the last day of the given month.
Store in the original packaging.
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 is L-ornithine L-aspartate.
1 ampoule (10 ml) of the concentrate for solution for infusion contains 5 g of L-ornithine L-aspartate.
The 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.
For more detailed information, consult the marketing authorization holder or the parallel importer.

Marketing authorization holder in Romania, the country of export:

Merz Pharmaceuticals GmbH
Eckenheimer Landstrasse 100
60318 Frankfurt am Main
Germany

Manufacturer:

MERZ PHARMA GmbH & Co. KGaA
Ludwigstraße 22
64354 Reinheim
Germany

Parallel importer:

InPharm Sp. z o.o.
ul. Strumykowa 28/11
03-138 Warsaw

Repackaged by:

InPharm Sp. z o.o. Services sp. k.
ul. Chełmżyńska 249
04-458 Warsaw
Marketing authorization number in Romania, the country of export:7377/2006/01

Parallel import authorization number: 416/22 Date of approval of the leaflet: 22.11.2022

[Information about the trademark]

  • Country of registration
  • Prescription required
    No
  • Marketing authorisation holder (MAH)
    Merz Pharmaceuticals GmbH
  • 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.

5.0(2)
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
€50
Today22:00
December 2111:00
December 2111:50
December 2112:40
December 2113:30
More times
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
December 2102:00
December 2102:15
December 2102:30
December 2102:45
December 2103:00
More times
5.0(4)
Doctor

Salome Akhvlediani

Pediatrics11 years of experience

Dr Salome Akhvlediani is a paediatrician providing online consultations for children of all ages. She supports families with preventive care, diagnosis, and long-term management of both acute and chronic conditions.

Her areas of focus include:

  • Fever, infections, cough, sore throat, and digestive issues.
  • Preventive care – vaccinations, regular check-ups, and health monitoring.
  • Allergies, asthma, and skin conditions.
  • Nutritional advice and healthy development support.
  • Sleep difficulties, fatigue, and behavioural concerns.
  • Ongoing care for chronic or complex health conditions.
  • Guidance for parents and follow-up after medical treatment.

Dr Akhvlediani combines professional care with a warm, attentive approach – helping children stay healthy and supporting parents at every stage of their child’s growth.

CameraBook a video appointment
€45
December 2106:00
December 2106:40
December 2107:20
December 2108:00
December 2108:40
More times
0.0(1)
Doctor

Khrystyna Habrykevych

Gastroenterology6 years of experience

Dr Khrystyna Habrykevych is a gastroenterologist providing online consultations for adults with digestive and abdominal health concerns. She helps patients understand the causes of their symptoms, interpret test results, and choose appropriate next steps – whether it’s further investigation, treatment, or lifestyle adjustments.

Common reasons for consultation include:

  • abdominal pain, cramps, discomfort, painful bowel movements
  • heartburn, acid reflux, burping, bitter taste in the mouth
  • bloating, excessive gas, nausea or vomiting
  • diarrhoea, constipation, difficulty passing stool
  • unexplained changes in weight or appetite
  • concern about gut health or long-term digestive issues
  • changes in lab results, questions about test interpretation
  • digestive system cancer screening and prevention
  • general digestive check-ups and health assessments
Dr Habrykevych follows evidence-based medical standards and adapts each consultation to the patient’s individual situation. The online format allows for timely medical support without the need for an in-person visit.
CameraBook a video appointment
€60
December 2106:00
December 2806:00
January 406:00
January 1106:00
January 1806:00
More times
0.0(4)
Doctor

Karina Travkina

Otolaryngology (ENT)16 years of experience

Dr Karina Travkina is an ENT specialist providing online consultations for adults with acute and chronic conditions affecting the ears, nose and throat. She takes a structured and personalised approach to each consultation, beginning with a thorough review of symptoms and medical history, followed by diagnostic interpretation and a tailored treatment plan.

Common reasons for consultation include:

  • chronic pharyngitis and recurrent tonsillitis
  • allergic, vasomotor and medication-induced rhinitis
  • sinusitis, nasal obstruction, and postnasal drip
  • nosebleeds, earwax build-up, or foreign bodies in the ear, nose, or throat
  • Eustachian tube dysfunction and related complaints
Dr Travkina follows evidence-based guidelines and ensures patients receive clear explanations and follow-up recommendations. Whether you need help with ENT symptoms, clarification of test results, or guidance on next steps – she offers expert medical advice in a convenient online format.
CameraBook a video appointment
€64
December 2107:00
December 2107:30
December 2108:00
December 2108:30
December 2109:00
More times
5.0(7)
Doctor

Tarek Agami

General medicine10 years of experience

Dr. Tarek Agami is a general practitioner registered in both Portugal and Israel, with broad experience in family and preventive medicine. He offers online consultations for adults and children, providing personalised support for primary care needs, chronic disease management, and everyday health concerns.

Dr. Agami received clinical training and worked in leading medical institutions in Israel (Kaplan Medical Center, Barzilai Medical Center, Wolfson Medical Center) and Portugal (European Healthcare City, Viscura Internacional, Hospital Dr. José Maria Grande, Hospital Vila Franca de Xira). His approach combines international medical standards with individualised attention to each patient.

Main areas of consultation:

  • Diagnosis and treatment of acute and chronic conditions (high blood pressure, diabetes, respiratory infections, cardiovascular symptoms)
  • Evaluation of symptoms and guidance on further diagnostic testing
  • Preventive check-ups and regular health monitoring
  • Medical support during travel or after relocation
  • Treatment adjustments and lifestyle recommendations based on your personal history
Dr. Agami provides medical support for patients using GLP-1 medications (such as Ozempic or Mounjaro) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Portugal and Israel.

Dr. Agami is committed to evidence-based, patient-centred care, ensuring that each person receives trusted medical support tailored to their health goals.

CameraBook a video appointment
€69
December 2107:00
December 2107:25
December 2107:50
December 2108:15
December 2108:40
More times
5.0(8)
Doctor

Iryna Reznychenko

Gynecology25 years of experience

Dr Iryna Reznychenko is an obstetrician-gynaecologist, paediatric gynaecologist, and certified lactation consultant. She provides online consultations for women at all stages of life – from adolescence to menopause. Her work combines medical care for gynaecological conditions with dedicated support for breastfeeding challenges, both physical and emotional.

Areas of expertise:

  • interpretation of test results and personalised treatment planning
  • menstrual irregularities, PCOS, endometriosis
  • abnormal uterine bleeding, endometrial hyperplasia, cervical dysplasia
  • care during perimenopause and menopause, hormonal balance, cancer prevention
  • breastfeeding issues: nipple pain, cracked skin, blocked ducts, low milk supply
  • support during the postpartum and lactation period
Dr Reznychenko offers a clear, attentive and professional approach. Her consultations help prevent minor discomforts from developing into more serious concerns – all in a convenient online format.
CameraBook a video appointment
€50
December 2107:00
December 2107:50
December 2108:40
December 2109:30
December 2110:20
More times
0.0(0)
Doctor

Andreea Mateescu

Pediatrics7 years of experience

Dr Andreea Mateescu is a board-certified paediatrician with 7 years of clinical experience. She graduated from Carol Davila University of Medicine and Pharmacy in Bucharest, Romania, and completed her paediatric residency at INSMC Alessandrescu-Rusescu. She also holds additional training in general ultrasound diagnostics.

Dr Mateescu focuses on providing high-quality, evidence-based medical care for children, with a strong emphasis on prevention, healthy development, and long-term wellbeing. She believes that clear, empathetic communication with both children and parents is essential for building trust and ensuring effective care.

Online consultations with Dr Mateescu are suitable for:

  • preventive check-ups and monitoring of growth and development;
  • vaccination planning, including personalised and catch-up schedules;
  • assessment of psychomotor, emotional, and physical development;
  • diagnosis and management of acute and chronic paediatric conditions;
  • nutritional guidance for infants and children, including formula selection when medically indicated;
  • care for children with complex or rare conditions;
  • practical guidance and ongoing support for parents.
Dr Mateescu works with patience, empathy, and professionalism, ensuring that each child receives attentive, individualised care. Her goal is to support healthy, balanced development while helping parents feel confident and well-informed at every stage of their child’s care.
CameraBook a video appointment
€60
December 2107:30
December 2107:55
December 2108:20
December 2108:45
December 2109:10
More times
5.0(21)
Doctor

Farouk Laafif

Psychiatry3 years of experience

Dr. Farouk Laafif is a psychiatrist providing online consultations for adults and adolescents facing emotional or mental health challenges. His clinical approach integrates psychopharmacology with psychotherapy, with a strong focus on the connection between mental and physical well-being.

He offers compassionate, evidence-based support for individuals dealing with:

  • depression and anxiety disorders
  • bipolar affective disorder
  • schizophrenia and other psychotic conditions
  • psychosomatic symptoms and chronic stress
  • treatment planning and medication adjustment
Dr. Laafif combines scientific expertise with human empathy, helping patients restore emotional balance, improve daily functioning, and regain confidence in their recovery journey.
CameraBook a video appointment
€110
December 2108:00
December 2108:45
December 2109:30
December 2110:15
December 2111:00
More times
0.0(0)
Doctor

Hocine Lokchiri

General medicine20 years of experience

Dr. Hocine Lokchiri is a French consultant with over 20 years of experience in General and Emergency Medicine. He works with adults and children, helping patients with urgent symptoms, infections, sudden health changes and everyday medical concerns that require timely evaluation. His background includes clinical practice in France, Switzerland and the United Arab Emirates, which allows him to navigate different healthcare systems and manage a wide range of conditions with confidence. Patients value his calm, structured approach, clear explanations and evidence-based decision-making.

Online consultations with Dr. Lokchiri are suitable for many situations when someone needs quick medical guidance, reassurance or a clear next step. Common reasons for booking include:

  • fever, chills, fatigue and viral symptoms
  • cough, sore throat, nasal congestion, breathing discomfort
  • bronchitis and mild asthma flare-ups
  • nausea, diarrhoea, abdominal pain, digestive infections
  • rashes, allergic reactions, redness, insect bites
  • muscle or joint pain, mild injuries, sprains
  • headache, dizziness, migraine symptoms
  • stress-related symptoms, sleep disturbances
  • questions about test results and treatment plans
  • management of chronic conditions in stable phases
Many patients reach out when symptoms appear suddenly and cause concern, when a child becomes unwell unexpectedly, when a rash changes or spreads, or when it’s unclear whether an in-person examination is necessary. His emergency medicine background is particularly valuable online, helping patients understand risk levels, identify warning signs and choose safe next steps.

Some situations are not suitable for online care. If a patient has loss of consciousness, severe chest pain, uncontrolled bleeding, seizures, major trauma or symptoms suggesting a stroke or heart attack, he will advise seeking immediate local emergency services. This improves safety and ensures patients receive the right level of care.

Dr. Lokchiri’s professional training includes:

  • Advanced Trauma Life Support (ATLS)
  • Basic and Advanced Cardiac Life Support (BLS/ACLS)
  • Pediatric Advanced Life Support (PALS)
  • Prehospital Trauma Life Support (PHTLS)
  • eFAST and critical care transthoracic echocardiography
  • aviation medicine
He is an active member of several professional organisations, including the French Society of Emergency Medicine (SFMU), the French Association for Emergency Physicians (AMUF) and the Swiss Society of Emergency and Rescue Medicine (SGNOR). In consultations, he works with clarity and precision, helping patients understand their symptoms, possible risks and the safest treatment options.
CameraBook a video appointment
€58
December 2108:00
December 2109:00
December 2110:15
December 2112:30
December 2113:15
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