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Hepa-mezh

Hepa-mezh

Ask a doctor about a prescription for Hepa-mezh

5.0(2)
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(102)
Doctor

Alina Tsurkan

Family medicine12 years of experience

Dr. Alina Tsurkan is a licensed family medicine physician based in Portugal, offering online consultations for adults and children. She provides professional primary care, with a focus on prevention, accurate diagnosis, and long-term management of acute and chronic conditions.

Dr. Tsurkan supports patients with a wide range of health issues, including:

  • Respiratory infections: cold, flu, bronchitis, pneumonia, and lingering coughs.
  • ENT conditions: sinusitis, tonsillitis, otitis (ear infections), sore throat, allergic rhinitis.
  • Eye conditions: allergic or infectious conjunctivitis, red eyes, irritation.
  • Digestive issues: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), constipation, bloating, nausea.
  • Urinary and reproductive health: urinary tract infections (UTIs), cystitis, prevention of recurrent infections.
  • Chronic diseases: hypertension, elevated cholesterol, weight management.
  • Neurological complaints: headaches, migraines, sleep disturbances, fatigue, general weakness.
  • Children’s health: fever, infections, digestive issues, follow-ups, vaccination guidance.

She also provides:

  • IMT medical certificates for driving licence exchange in Portugal.
  • Personalised preventive care and wellness consultations.
  • Interpretation of test results and medical reports.
  • Follow-up care and medication review.
  • Support in managing multiple coexisting conditions.
  • Remote prescription management and medical documentation.

Dr. Tsurkan’s approach is evidence-based and holistic. She works closely with each patient to develop an individualised care plan that addresses both symptoms and root causes. Her goal is to empower patients to take control of their health and maintain well-being through lifestyle adjustments, routine check-ups, and early intervention.

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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

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
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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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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

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
December 2209:00
December 2210:05
December 2211:10
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December 2213:20
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5.0(102)
Doctor

Alina Tsurkan

Family medicine12 years of experience

Dr. Alina Tsurkan is a licensed family medicine physician based in Portugal, offering online consultations for adults and children. She provides professional primary care, with a focus on prevention, accurate diagnosis, and long-term management of acute and chronic conditions.

Dr. Tsurkan supports patients with a wide range of health issues, including:

  • Respiratory infections: cold, flu, bronchitis, pneumonia, and lingering coughs.
  • ENT conditions: sinusitis, tonsillitis, otitis (ear infections), sore throat, allergic rhinitis.
  • Eye conditions: allergic or infectious conjunctivitis, red eyes, irritation.
  • Digestive issues: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), constipation, bloating, nausea.
  • Urinary and reproductive health: urinary tract infections (UTIs), cystitis, prevention of recurrent infections.
  • Chronic diseases: hypertension, elevated cholesterol, weight management.
  • Neurological complaints: headaches, migraines, sleep disturbances, fatigue, general weakness.
  • Children’s health: fever, infections, digestive issues, follow-ups, vaccination guidance.

She also provides:

  • IMT medical certificates for driving licence exchange in Portugal.
  • Personalised preventive care and wellness consultations.
  • Interpretation of test results and medical reports.
  • Follow-up care and medication review.
  • Support in managing multiple coexisting conditions.
  • Remote prescription management and medical documentation.

Dr. Tsurkan’s approach is evidence-based and holistic. She works closely with each patient to develop an individualised care plan that addresses both symptoms and root causes. Her goal is to empower patients to take control of their health and maintain well-being through lifestyle adjustments, routine check-ups, and early intervention.

CameraBook a video appointment
€55
December 2211:00
December 2514:00
December 2514:40
December 2515:20
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5.0(8)
Doctor

Mar Tabeshadze

Endocrinology10 years of experience

Dr. Mar Tabeshadze is a licensed endocrinologist and general practitioner in Spain. She provides online consultations for adults, offering medical support for a wide range of endocrine conditions and related health concerns.

  • Diagnostic consultations for suspected endocrine disorders
  • Management of thyroid conditions, including in pregnant women
  • Early detection and treatment of type 1 and type 2 diabetes, with personalised therapy plans
  • Obesity treatment: identifying underlying causes of weight gain, combining medication and non-pharmacological strategies, and long-term support
  • Diagnosis and treatment of endocrine-related skin, hair, and nail issues
  • Ongoing care for patients with osteoporosis, pituitary, and adrenal gland disorders
Dr. Tabeshadze takes a patient-centred approach based on evidence-based medicine. Her goal is to help patients achieve hormonal balance, manage chronic conditions effectively, and improve overall well-being through targeted, personalised care.
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0.0(0)
Doctor

Antonio Cayatte

General medicine43 years of experience

Dr Antonio Cayatte is a physician in General and Acute Medicine with over 30 years of experience across clinical care, medical research, and education. He offers online consultations for adults with a wide range of symptoms, both acute and chronic.

His clinical background includes:

  • assessment of sudden or unclear symptoms
  • ongoing care for chronic conditions
  • follow-up after hospital discharge
  • interpretation of test results
  • medical support while abroad
Dr Cayatte earned his degree from the University of Lisbon and taught internal medicine at Boston University School of Medicine. He holds active medical registrations in both Portugal and the UK and is a Fellow of the American Heart Association.

Consultations are available in English and Portuguese. Patients value his clarity, professionalism, and balanced approach to evidence-based care.

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5.0(2)
Doctor

Lina Travkina

Family medicine12 years of experience

Dr. Lina Travkina is a licensed family and preventive medicine doctor based in Italy. She provides online consultations for adults and children, supporting patients across all stages of care – from acute symptom management to long-term health monitoring and prevention.

Areas of medical care include:

  • Respiratory conditions: colds, flu, acute and chronic bronchitis, mild to moderate pneumonia, bronchial asthma.
  • ENT and eye conditions: sinusitis, tonsillitis, pharyngitis, otitis, infectious and allergic conjunctivitis.
  • Digestive issues: gastritis, acid reflux (GERD), IBS, dyspepsia, bloating, constipation, diarrhoea, functional bowel symptoms, intestinal infections.
  • Urological and infectious diseases: acute and recurrent cystitis, bladder and kidney infections, prevention of recurrent UTIs, asymptomatic bacteriuria.
  • Chronic conditions: hypertension, diabetes, hypercholesterolemia, metabolic syndrome, thyroid disorders, excess weight.
  • Neurological and general symptoms: headache, migraine, dizziness, fatigue, sleep disturbances, reduced concentration, anxiety, asthenia.
  • Chronic pain support: back, neck, joint, and muscle pain, tension syndromes, pain associated with osteochondrosis and chronic conditions.

Additional care areas:

  • Preventive consultations and check-up planning.
  • Medical advice and follow-up consultations.
  • Test interpretation and diagnostic guidance.
  • Structured support for undiagnosed complaints.
  • Second opinion on diagnoses and treatment plans.
  • Nutritional and lifestyle support for vitamin deficiencies, anaemia, metabolic issues.
  • Post-operative recovery support and pain management.
  • Preconception counselling and postpartum support.
  • Immunity support and strategies to reduce frequency of infections.

Dr. Travkina combines evidence-based medicine with an attentive, personalised approach. Her consultations focus not only on treatment, but also on prevention, recovery, and long-term wellbeing.

If during the consultation it becomes clear that your case requires in-person assessment or specialised care outside of her scope, the session will be terminated and the payment fully refunded.

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0.0(3)
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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€59
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