Hepa-Merz 5g Sachet (L-Ornithine L-Aspartate)

Drug Class: Hepatoprotective & Ammonia-Detoxifying Agent | Form: Oral Granules Sachet | Prescription Status: Prescription Only (Rx) — DRAP Registered

What is Hepa-Merz 5g Sachet?

Hepa-Merz 5g Sachet contains L-Ornithine L-Aspartate (LOLA), a medicine used to treat liver disease (جگر کی بیماری) and reduce dangerously high levels of ammonia (امونیا) in the blood. Each sachet contains 5g of LOLA in granule form that is dissolved in water and drunk as a solution. The sachet form is convenient, easy to take at home, and delivers a precise measured dose every time. It is used for a wide range of liver conditions including cirrhosis, hepatitis, fatty liver, and hepatic encephalopathy — a serious brain complication caused by ammonia build-up. Hepa-Merz 5g Sachet is typically prescribed as a long-term or maintenance treatment, often after a patient has been stabilised on the IV infusion in hospital. It must only be taken as prescribed by your doctor.

What is Hepa-Merz 5g Sachet Used For?

Hepa-Merz 5g Sachet is prescribed for the treatment and management of the following conditions:

• Liver Cirrhosis with Hyperammonaemia — severe scarring of the liver with high ammonia levels in the blood (جگر کا سکڑنا اور خون میں امونیا کی زیادتی)
• Hepatic Encephalopathy — brain dysfunction caused by ammonia build-up from liver failure including confusion, drowsiness, and disorientation (جگر کی خرابی سے دماغ پر اثر)
• Acute and Chronic Hepatitis — sudden or long-term inflammation of the liver (جگر کی سوزش — ہیپاٹائٹس)
• Fatty Liver Disease (Hepatic Steatosis) — abnormal build-up of fat inside liver cells (جگر پر چربی چڑھنا)
• Maintenance After IV Hepa-Merz Treatment — continued ammonia control and liver support after hospital treatment with Hepa-Merz infusion
• Liver Damage from Medicines or Toxins — protecting and supporting the liver from damage caused by prolonged medicine use or harmful substances
• General Liver Function Support — improving liver cell health and function in patients with chronic liver disease

How Does Hepa-Merz 5g Sachet Work?

L-Ornithine L-Aspartate works through two important and closely connected mechanisms:

Ammonia Detoxification: The liver normally converts ammonia — a toxic waste product produced when the body breaks down protein from food — into a harmless substance called urea, which is safely removed from the body through urine. When the liver is diseased or damaged, this process slows down or stops altogether, causing ammonia to accumulate in the blood. High blood ammonia is dangerous — when it reaches the brain it disrupts normal brain function and causes hepatic encephalopathy. L-Ornithine and L-Aspartate are natural amino acids that directly activate and support the liver's urea cycle — the chemical pathway used to convert ammonia into urea. By supplying these amino acids, Hepa-Merz restores and accelerates this detoxification process, reducing ammonia levels in the blood and protecting the brain from ammonia-related damage.

Liver Cell Protection and Regeneration: L-Ornithine L-Aspartate also supports the repair and regeneration of liver cells damaged by disease, infection, alcohol, or toxins. It helps reduce inflammation inside the liver, supports the production of important liver proteins, and improves the overall health and function of liver cells — helping the liver gradually recover and work more efficiently over time.

Dosage and Administration

⚠️ Always take this medicine exactly as your doctor prescribed. Do not take more sachets than recommended. Always dissolve each sachet completely in water before drinking — do not swallow the granules dry.

• Dissolve the contents of each sachet in a full glass of water (200–250ml) — stir well until completely dissolved
• Can also be dissolved in juice or a soft drink if preferred — ask your pharmacist
• Always take after meals to reduce the chance of stomach upset
• Take at the same times every day for consistent effect
• Do not skip doses — regular use is important for controlling ammonia levels
• Your doctor will monitor your blood ammonia levels and liver function tests regularly
• Do not stop treatment without consulting your doctor even if you feel better

Active Ingredient

Who Should NOT Use Hepa-Merz 5g Sachet?

Do not take this medicine if you:

• Are allergic to L-Ornithine, L-Aspartate, or any other ingredient in the sachet
• Have severe kidney failure or end-stage kidney disease (گردے کی شدید ناکامی) — this medicine and its breakdown products are cleared by the kidneys and may accumulate dangerously in kidney failure
• Have significantly elevated serum creatinine levels — kidney function must be checked before starting treatment
• Have been told by your doctor to avoid this medicine for any reason

Tell your doctor before use if you have:

• Any degree of kidney impairment — even mild — as dose adjustment and monitoring may be needed
• Diabetes — the sachet may contain sugars and your doctor needs to know
• Any electrolyte imbalances — particularly low potassium or sodium levels
• If you are pregnant or planning to become pregnant — your doctor will assess safety before prescribing
• If you are breastfeeding — consult your doctor before taking this medicine
• If you are on a protein-restricted or low-ammonia diet — your doctor and dietitian must coordinate your treatment plan
• If you are taking any other medicines for liver or kidney disease

Side Effects

Like all medicines, Hepa-Merz 5g Sachet can cause side effects. Not everyone will experience them. Most side effects are mild and often improve when the sachet is taken after food or when the dose is adjusted.

Common Side Effects (relatively frequent):

• Nausea (متلی) — most common, especially at higher doses or if taken on an empty stomach
• Vomiting (قے) — usually mild and temporary
• Stomach discomfort, bloating, or cramping (پیٹ میں بے آرامی یا درد)
• Loose stools or mild diarrhoea (دست)
• Loss of appetite — usually temporary

Serious Side Effects (less common — seek medical help immediately):

• Severe allergic reaction — sudden rash, swelling of the face, lips, or throat, difficulty breathing
• Worsening confusion, extreme drowsiness, or loss of orientation (یہ امونیا کی بڑھتی ہوئی سطح یا جگر کی خراب ہوتی حالت کی علامت ہو سکتی ہے)
• Significant worsening of nausea or vomiting that does not settle
• Increasing yellowing of skin or eyes (یرقان) — sign of worsening liver function
• Reduced urination or signs of kidney stress — stop and consult your doctor immediately

If you notice any serious side effects, stop taking the medicine and go to the nearest hospital or emergency immediately.

Drug and Food Interactions

Tell your doctor about ALL medicines you are currently taking. Hepa-Merz 5g Sachet may interact with:

Always inform your doctor about all medicines, vitamins, herbal products, or dietary supplements you are taking.

Storage Instructions

• Store below 25°C in a cool, dry place
• Keep away from direct sunlight and moisture
• Keep sachets in their original packaging until ready to use
• Keep out of reach of children (بچوں کی پہنچ سے دور رکھیں)
• Do not use after the expiry date printed on the sachet or outer carton
• Once dissolved in water, drink immediately — do not prepare in advance and store
• Do not use a sachet if the packaging is damaged, torn, or already open

Frequently Asked Questions

What is Hepa-Merz 5g Sachet used for?

Hepa-Merz 5g Sachet is used to treat liver diseases associated with high blood ammonia levels — including liver cirrhosis, hepatitis, fatty liver disease, and hepatic encephalopathy. It works by helping the liver remove toxic ammonia from the blood and by supporting the repair and recovery of damaged liver cells.

How do I prepare and take Hepa-Merz Sachet correctly?

Tear open one sachet and pour the granules into a full glass of water — approximately 200 to 250ml. Stir well until the granules are completely dissolved and no lumps remain. Drink the entire glass immediately after meals. Do not swallow the dry granules directly without dissolving them first. If your doctor has prescribed more than one sachet per dose, dissolve all the sachets in a larger amount of water and drink the full amount.

What is the difference between Hepa-Merz Sachet and Hepa-Merz Syrup?

Both the sachet and syrup contain the same active medicine — L-Ornithine L-Aspartate — and work in exactly the same way. The sachet contains 5g of LOLA per sachet in granule form that you dissolve in water. The syrup contains a pre-prepared liquid solution. Some patients prefer the sachet because it is easier to carry, has a longer shelf life before opening, and delivers a precise dose. Your doctor or pharmacist will advise which form is most suitable for you.

Can I take Hepa-Merz Sachet if I have kidney disease?

Hepa-Merz Sachet should be used with great caution in patients with kidney disease and is completely contraindicated in severe kidney failure. The kidneys play an important role in clearing ammonia and the breakdown products of this medicine. If you have any kidney problems, always tell your doctor before starting treatment so they can check your kidney function and decide if it is safe for you.

How long will I need to take Hepa-Merz Sachet?

The duration of treatment depends on your liver condition and how well your ammonia levels are controlled. Some patients with acute hepatitis take it for a few weeks. Patients with cirrhosis or chronic liver disease may need long-term or even indefinite treatment to keep ammonia levels under control and prevent brain complications. Your doctor will review your liver function tests and ammonia levels regularly to decide how long you need to continue.

Can I eat normally while taking Hepa-Merz Sachet?

Good nutrition is very important for liver patients. In most cases, your doctor will not recommend severe protein restriction — instead they may advise eating smaller, more frequent meals and choosing plant-based proteins where possible, as these produce less ammonia. Do not restrict your diet without medical guidance. Always follow the nutritional advice given by your doctor or dietitian alongside your Hepa-Merz treatment for the best possible results.

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⚕️ Medical Disclaimer: This product description is for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified doctor or pharmacist before starting, stopping, or changing any medication. This product is a prescription medicine — it must only be used under the supervision of a licensed healthcare professional.

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DRAP Registered | Prescription Required (Rx) | For use under medical supervision only