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Hepa-mezh

Hepa-mezh

Ask a doctor about a prescription for Hepa-mezh

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Doctor

Svetlana Kolomeeva

Cardiology17 years of experience

Dr. Svetlana Kolomeeva is a general practitioner and internal medicine doctor providing online consultations for adults. She helps patients manage acute symptoms, chronic conditions, and preventive care. Her clinical focus includes cardiovascular health, hypertension control, and managing symptoms like fatigue, weakness, sleep issues, and overall low energy.

Patients commonly seek her help for:

  • High blood pressure, headaches, dizziness, swelling, palpitations.
  • Diagnosis and management of hypertension, arrhythmias, and tachycardia.
  • Metabolic syndrome, excess weight, high cholesterol.
  • Chronic fatigue, insomnia, poor concentration, anxiety.
  • Respiratory symptoms: colds, flu, sore throat, cough, fever.
  • Digestive issues: heartburn, bloating, constipation, IBS symptoms.
  • Chronic conditions: diabetes, thyroid disorders.
  • Interpretation of lab tests and medical reports, therapy adjustment.
  • Second opinion and decision-making support.
  • Cardiovascular disease prevention and metabolic risk reduction.
  • Long-term follow-up and dynamic health monitoring.

Dr Kolomeeva combines clinical expertise with personalised care. She clearly explains diagnoses, guides patients through symptoms and treatment options, and provides actionable plans. Her consultations are designed not only to address current complaints but also to stabilise chronic conditions and prevent future complications. She supports patients through every stage of care – from first symptoms to ongoing health management.

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5.0(38)
Doctor

Yevgen Yakovenko

General surgery11 years of experience

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
  • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
  • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
  • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
  • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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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

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 not listed in this leaflet, they should inform their doctor, pharmacist, or nurse. 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 liver 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 kidney failure (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

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. There are no known interactions between Hepa-Merz and other medicines.

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. PregnancyThere 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 benefit versus the risk before making a decision. BreastfeedingIt 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 benefit versus the risk 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 unsure, 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, contact your doctor or pharmacist.

Method of administration

Intravenous administration. Before administration, dissolve the contents of the ampoule in an infusion fluid. Hepa-Merz can be administered in all commonly used infusion fluids. No incompatibilities related to dissolution have been observed to date. 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.

Using more than the recommended dose of Hepa-Merz

No symptoms of overdose have been observed with Hepa-Merz to date. 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 not listed in this leaflet, inform your doctor, pharmacist, or nurse. Side effects can be reported directly to the Department of Monitoring of Adverse Reactions to Medicinal Products of the Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products: Al. Jerozolimskie 181C, 02-222 Warsaw, tel.: 22 49-21-301, fax: 22 49-21-309, website: https://smz.ezdrowie.gov.pl. By reporting side effects, you can help provide more information on the safety of this 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 month stated. 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 is L-ornithine L-aspartate. One 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, contact the marketing authorization holder or the parallel importer.

Marketing authorization holder in Romania, the country of export:

Merz Pharmaceuticals GmbH, Eckenheimer Landstr. 100, 60318 Frankfurt am Main, Germany

Manufacturer:

Merz Pharma GmbH & Co. KGaA, Ludwigstraße 22, 64354 Reinheim, Germany

Parallel importer:

Delfarma Sp. z o.o., ul. Św. Teresy od Dzieciątka Jezus 111, 91-222 Łódź

Repackaged by:

Delfarma Sp. z o.o., ul. Św. Teresy od Dzieciątka Jezus 111, 91-222 Łódź, Romania export authorization number: 7377/2006/01

Parallel import authorization number: 151/22 Date of approval of the leaflet: 05.04.2022

[Information about the trademark]

  • Country of registration
  • Prescription required
    No
  • Marketing authorisation holder (MAH)
    Merz Pharmaceuticals GmbH
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Alternative to Hepa-mezh in Spain

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Alternative to Hepa-mezh in Ukraine

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Prescription not required
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Manufacturer: AT "Farmak
Prescription required
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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(1)
Doctor

Svetlana Kolomeeva

Cardiology17 years of experience

Dr. Svetlana Kolomeeva is a general practitioner and internal medicine doctor providing online consultations for adults. She helps patients manage acute symptoms, chronic conditions, and preventive care. Her clinical focus includes cardiovascular health, hypertension control, and managing symptoms like fatigue, weakness, sleep issues, and overall low energy.

Patients commonly seek her help for:

  • High blood pressure, headaches, dizziness, swelling, palpitations.
  • Diagnosis and management of hypertension, arrhythmias, and tachycardia.
  • Metabolic syndrome, excess weight, high cholesterol.
  • Chronic fatigue, insomnia, poor concentration, anxiety.
  • Respiratory symptoms: colds, flu, sore throat, cough, fever.
  • Digestive issues: heartburn, bloating, constipation, IBS symptoms.
  • Chronic conditions: diabetes, thyroid disorders.
  • Interpretation of lab tests and medical reports, therapy adjustment.
  • Second opinion and decision-making support.
  • Cardiovascular disease prevention and metabolic risk reduction.
  • Long-term follow-up and dynamic health monitoring.

Dr Kolomeeva combines clinical expertise with personalised care. She clearly explains diagnoses, guides patients through symptoms and treatment options, and provides actionable plans. Her consultations are designed not only to address current complaints but also to stabilise chronic conditions and prevent future complications. She supports patients through every stage of care – from first symptoms to ongoing health management.

CameraBook a video appointment
€50
November 1009:00
November 1010:05
November 1011:10
November 1012:15
November 1013:20
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5.0(38)
Doctor

Yevgen Yakovenko

General surgery11 years of experience

Dr. Yevgen Yakovenko is a licensed surgeon and general practitioner in Spain and Germany. He specialises in general, paediatric, and oncological surgery, internal medicine, and pain management. He offers online consultations for adults and children, combining surgical precision with therapeutic support. Dr Yakovenko works with patients across different countries and provides care in Ukrainian, Russian, English, and Spanish.

Areas of medical expertise:

  • Acute and chronic pain: headaches, muscle and joint pain, back pain, abdominal pain, postoperative pain. Identifying the cause, selecting treatment, and creating a care plan.
  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
  • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
  • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
  • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
  • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

CameraBook a video appointment
€54
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Doctor

Marianna Neshta

Endocrinology24 years of experience

Marianna Neshta is a medical doctor specialising in endocrinology and ultrasound diagnostics. She provides online consultations for adults, focusing on the diagnosis, treatment, and long-term management of endocrine disorders. Her approach includes personalised care plans, analysis of lab results and ultrasound scans, and evidence-based treatment.

Key areas of expertise:

  • Type 1 and Type 2 diabetes – diagnosis, therapy adjustment, CGM interpretation, and prevention of chronic complications
  • Obesity – treatment using both medication and lifestyle strategies, including modern GLP-1 medications and tailored follow-up plans
  • Thyroid disorders – ultrasound assessment, treatment planning, and management during pregnancy
  • Male hypogonadism – age-related or hormonal, including diagnostics and therapy
  • Metabolic syndrome, prediabetes, lipid disorders – risk assessment, lifestyle recommendations, and medical treatment
  • Calcium metabolism disorders – diagnosis and management of osteoporosis, hyperparathyroidism, and hypoparathyroidism
Dr Neshta applies current clinical guidelines and diagnostic tools, offering medical support adapted to each patient’s individual needs — all in an accessible online format.
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Doctor

Taisiia Proida

Psychiatry6 years of experience

Dr. Taisiia Proida is a psychiatrist and cognitive behavioural therapist (CBT), and a member of the European Psychiatric Association. She offers online consultations for adults aged 18 and over, combining evidence-based medicine with an individualised approach to mental health care.

She specialises in consultations and ongoing support for a wide range of mental health concerns, including:

  • Mood disorders: depression, bipolar disorder, postpartum depression.
  • Anxiety disorders: generalised anxiety, OCD, panic attacks, phobias.
  • Post-traumatic stress disorder (PTSD) and complex PTSD.
  • Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).
  • Personality disorders and emotional instability.
  • Cyclothymia and mood fluctuations.
  • Schizophrenia spectrum and related conditions.

Dr. Proida combines clinical expertise with an empathetic approach, offering structured support based on evidence-based practices. Her work integrates CBT techniques with medical management, with a focus on anxiety and depressive disorders.

She works with clients from different countries and cultural backgrounds, adapting her communication style and recommendations to individual needs. With experience in international clinical trials (Pfizer, Merck), she values clarity, trust, and collaborative partnership in patient care.

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Doctor

Alexandra Alexandrova

General medicine8 years of experience

Dr Alexandra Alexandrova is a licensed general medicine doctor in Spain, specialising in trichology, nutrition, and aesthetic medicine. She offers online consultations for adults, combining a therapeutic approach with personalised care for hair, scalp, and overall health.

Areas of expertise:

  • Hair loss in women and men, postpartum hair loss, androgenetic and telogen effluvium.
  • Scalp conditions: seborrheic dermatitis, psoriasis, scalp irritation, dandruff.
  • Chronic conditions: hypertension, diabetes, metabolic disorders.
  • Online trichology consultation: customised treatment plans, nutritional support, hair growth stimulation.
  • Hair loss prevention: hormonal imbalance, stress factors, haircare strategies.
  • Routine health check-ups, prevention of cardiovascular and metabolic diseases.
  • Personalised nutritional advice to improve hair strength, skin health, and hormonal balance.
  • Aesthetic medicine: non-invasive strategies to enhance skin quality, tone, and metabolic wellness.

Dr Alexandrova follows an evidence-based and holistic approach: online consultations with a therapist and trichologist on Oladoctor provide professional support for hair, scalp, and overall health — all from the comfort of your home.

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