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Heptral

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S-Adenosylmethionine · Abbott, Biologici Italia Laboratories

4 forms: coated tablet, powder. In force in Georgia: 4 of 4 (human register).

Forms and doses4 of 4 in force in Georgia

Form Dose Frequency Georgia
400 mg, Coated tablet No label dose in the reference yet - Georgia Yes, human
In force until 20 Aug 2031
Human (Ministry of Health, RAMA)
In the register: ჰეპტრალი 400 მგ, გასტრორეზისტენტული ტაბლეტი
№ რ-046175
Verified on: 22 Oct 2026
Details: pack, label wording, sources, registration

Heptral 400 mg, Coated tablet

gastro-resistant tablet, human medicine
vetman assessment
vetman’s 10-point assessment brings together a product’s regulatory credibility, clinical efficacy, safety and practicality. Cost-effectiveness is assessed only when reliable data are available. It is informational and does not replace a veterinarian’s clinical judgment for an individual patient.
Dog Adjunctive antioxidant and hepatoprotective support in a veterinarian-diagnosed hepatobiliary disorder; not diagnostic or disease-modifying monotherapy
4.7/10
Weak evidence support
vetman assessment

Heptral

400 mg, gastro-resistant tablet, human medicine
Assessed clinical scopeDog · Adjunctive antioxidant and hepatoprotective support in a veterinarian-diagnosed hepatobiliary disorder; not diagnostic or disease-modifying monotherapy · By mouth
Care settingVeterinarian-directed outpatient adjunct after the underlying disorder is defined, with an intact tablet on an empty stomach and disease-appropriate clinical and biochemical monitoring.
vetman score 4.7/10 Weak evidence support
Evidence confidence: Medium Georgia: Yes, human · № რ-046175 · Verified on 22 Oct 2026 Off-label use

A plausible but weakly outcome-supported adjunct. Use only after defining and treating the underlying hepatobiliary disorder; this exact human whole-tablet strength is practical only near its matching body weight.

Regulatory and scientific credibility4.0/10

Both exact strengths are verifiable, compositionally transparent human gastro-resistant medicines with current Georgian registrations and official Abbott or regulator information. Neither is authorised for dogs or cats, and exact-product veterinary bioavailability, efficacy and safety have not been demonstrated.

Clinical efficacy4.0/10

ACVIM recognises plausible glutathione and cytoprotective mechanisms but states that clinical benefit has not been rigorously investigated. A small controlled prednisolone model improved selected redox measures without preventing classic vacuolar-hepatopathy findings; a recent gallbladder-mucocele trial found little effect from SAMe plus silymarin without ursodeoxycholic acid. No exact-Heptral outcome trial was identified.

Safety and tolerability6.5/10

SAMe is generally regarded as well tolerated and the canine controlled study found biological exposure without a major treatment signal, but clinical safety datasets are small. Gastrointestinal effects are possible, and exact human-tablet excipients, long-term use, organ-disease subgroups and reproductive safety are incompletely characterised in dogs.

Clinical practicality4.0/10

At 18 mg/kg, one intact 400 mg tablet approximates a 22.2 kg dose. The gastro-resistant tablet must not be split or crushed and is given on an empty stomach, so many dogs need a different validated tablet strength; once-daily administration is otherwise manageable.

Full-course cost-effectiveness-

Current comparable full-course local prices were not verified.

Important safety and use flags

  • Adjunct only. Diagnose and treat the underlying hepatobiliary disorder; do not use SAMe as a substitute for nutrition, toxin-specific treatment, antimicrobial or immunosuppressive therapy, copper management, biliary intervention or other indicated care.
  • Clinical outcome evidence is limited. Mechanistic, redox or liver-enzyme changes do not prove improved histology, survival or durable disease control, and exact Heptral tablets have not been tested in veterinary clinical outcome trials.
  • Give the gastro-resistant tablet intact. Do not split, chew or crush it: damaging the coat can expose acid-labile SAMe in the stomach and creates an unvalidated dose unit.
  • Give on an empty stomach according to the established veterinary regimen. Food can reduce or delay absorption; select a tablet strength that can be given whole rather than estimating a fragment.
  • At 18 mg/kg, one intact 400 mg tablet corresponds to about 22.2 kg. This is not a minimum-weight label: use another validated strength whenever the calculated dose is materially different.
  • Monitor the disease, not merely the supplement: clinical status, appetite, weight and condition-specific liver biochemistry, imaging or histology remain necessary. Stop and reassess if disease progresses despite adjunctive use.
  • Monitor for vomiting, diarrhoea, abdominal discomfort, reduced appetite or another new adverse effect. Exact dog and cat adverse-event frequencies for these human tablets are unknown.
  • Review concomitant medicines and supplements. Human product information warns about serotonergic medicines and tryptophan; the clinical magnitude in dogs and cats is not established, so avoid unreviewed combinations.
  • Safety in pregnancy, lactation, breeding animals, neonates and severe renal disease is not established for these exact human presentations. Use only after an individual veterinary benefit-risk review.
Assessment sources
  1. Heptral market audit2026
  2. Abbott Heptral overview2026
  3. Heptral 500 mg CMI2022
  4. MSD Vet Manual 20242024
  5. ACVIM canine hepatitis consensus2019
  6. Canine prednisolone SAMe trial2005
  7. Feline acetaminophen SAMe study2003
  8. Healthy-cat SAMe study2005
  9. Canine GBM hepatoprotectant trial2025
Assessed: 22 Oct 2026The overall score uses 25/25/25/15/10 weights. An unassessed price is excluded and the remaining weights are proportionally renormalised.
Cat Adjunctive antioxidant and hepatoprotective support in a veterinarian-diagnosed hepatobiliary disorder; not diagnostic or disease-modifying monotherapy
3.8/10
Poor / unconvincing
vetman assessment

Heptral

400 mg, gastro-resistant tablet, human medicine
Assessed clinical scopeCat · Adjunctive antioxidant and hepatoprotective support in a veterinarian-diagnosed hepatobiliary disorder; not diagnostic or disease-modifying monotherapy · By mouth
Care settingVeterinarian-directed outpatient adjunct after the underlying disorder is defined, with an intact tablet on an empty stomach and disease-appropriate clinical and biochemical monitoring.
vetman score 3.8/10 Poor / unconvincing
Evidence confidence: Low Georgia: Yes, human · № რ-046175 · Verified on 22 Oct 2026 Off-label use

A poorly matched feline presentation with indirect efficacy evidence. The whole gastro-resistant 400/500 mg unit cannot accurately deliver a typical cat dose and should not substitute for a validated cat-sized product.

Regulatory and scientific credibility4.0/10

Both exact strengths are verifiable, compositionally transparent human gastro-resistant medicines with current Georgian registrations and official Abbott or regulator information. Neither is authorised for dogs or cats, and exact-product veterinary bioavailability, efficacy and safety have not been demonstrated.

Clinical efficacy3.5/10

Feline evidence is experimental rather than clinical disease evidence. Small studies in healthy cats and an acetaminophen oxidative-injury model support exposure and selected antioxidant effects, but do not establish benefit for naturally occurring feline hepatobiliary disease or for these exact 400/500 mg tablets.

Safety and tolerability5.5/10

Healthy cats tolerated prolonged enteric-coated SAMe exposure in a small study, but the evidence base is limited and used a different veterinary product. The acetaminophen model was small and included deaths attributable to the toxin; it cannot define safety in ill cats. Exact-tablet tolerability, reproductive safety and clinically important interactions remain uncertain.

Clinical practicality1.0/10

A typical 4 kg cat requires about 72 mg, only 18% of this 400 mg tablet. Because the gastro-resistant unit cannot be split or crushed, accurate administration is generally impossible; a validated cat-sized veterinary presentation is required.

Full-course cost-effectiveness-

Current comparable full-course local prices were not verified.

Important safety and use flags

  • Adjunct only. Diagnose and treat the underlying hepatobiliary disorder; do not use SAMe as a substitute for nutrition, toxin-specific treatment, antimicrobial or immunosuppressive therapy, copper management, biliary intervention or other indicated care.
  • Clinical outcome evidence is limited. Mechanistic, redox or liver-enzyme changes do not prove improved histology, survival or durable disease control, and exact Heptral tablets have not been tested in veterinary clinical outcome trials.
  • Give the gastro-resistant tablet intact. Do not split, chew or crush it: damaging the coat can expose acid-labile SAMe in the stomach and creates an unvalidated dose unit.
  • Give on an empty stomach according to the established veterinary regimen. Food can reduce or delay absorption; select a tablet strength that can be given whole rather than estimating a fragment.
  • At 18 mg/kg, one intact 400 mg tablet corresponds to about 22.2 kg. This is not a minimum-weight label: use another validated strength whenever the calculated dose is materially different.
  • Monitor the disease, not merely the supplement: clinical status, appetite, weight and condition-specific liver biochemistry, imaging or histology remain necessary. Stop and reassess if disease progresses despite adjunctive use.
  • Monitor for vomiting, diarrhoea, abdominal discomfort, reduced appetite or another new adverse effect. Exact dog and cat adverse-event frequencies for these human tablets are unknown.
  • Review concomitant medicines and supplements. Human product information warns about serotonergic medicines and tryptophan; the clinical magnitude in dogs and cats is not established, so avoid unreviewed combinations.
  • Safety in pregnancy, lactation, breeding animals, neonates and severe renal disease is not established for these exact human presentations. Use only after an individual veterinary benefit-risk review.
Assessment sources
  1. Heptral market audit2026
  2. Abbott Heptral overview2026
  3. Heptral 500 mg CMI2022
  4. MSD Vet Manual 20242024
  5. ACVIM canine hepatitis consensus2019
  6. Canine prednisolone SAMe trial2005
  7. Feline acetaminophen SAMe study2003
  8. Healthy-cat SAMe study2005
  9. Canine GBM hepatoprotectant trial2025
Assessed: 22 Oct 2026The overall score uses 25/25/25/15/10 weights. An unassessed price is excluded and the remaining weights are proportionally renormalised.
Composition / strength
S-Adenosylmethionine400 mg
Formulation Type
Coated tablet
Administration route
By mouth
Manufacturer
Abbott · United States
Registration
Georgia Yes, human
In force until 20 Aug 2031
Human (Ministry of Health, RAMA)
In the register: ჰეპტრალი 400 მგ, გასტრორეზისტენტული ტაბლეტი
№ რ-046175
Verified on: 22 Oct 2026
 EU No
Verified on: 16 Oct 2026
 UK No
Verified on: 16 Oct 2026
 US No
Verified on: 16 Oct 2026
Controlled in Georgia
No
Checked against the narcotics law, Annex 1, lists I-IV, and Order No. 22/n.
Verified on: 16 Oct 2026
400 mg, Powder No label dose in the reference yet - Georgia Yes, human
In force until 29 Apr 2030
Human (Ministry of Health, RAMA)
№ რ-043196
Verified on: 22 Oct 2026
Details: pack, label wording, sources, registration

Heptral 400 mg, Powder

powder and solvent for solution for injection, human medicine
vetman assessment
vetman’s 10-point assessment brings together a product’s regulatory credibility, clinical efficacy, safety and practicality. Cost-effectiveness is assessed only when reliable data are available. It is informational and does not replace a veterinarian’s clinical judgment for an individual patient.
Dog Proposed adjunctive parenteral use in diagnosed hepatobiliary disease when oral treatment is not feasible
Not rateable
No numerical score assigned
vetman assessment

Heptral

400 mg, powder and solvent for solution for injection, human medicine
Assessed clinical scopeDog · Proposed adjunctive parenteral use in diagnosed hepatobiliary disease when oral treatment is not feasible · IV,IM
Care settingHospital consideration only; no veterinary parenteral regimen is established. Any use requires independent dose, preparation, compatibility and monitoring justification.
vetman score Not rateable No numerical score assigned
Evidence confidence: Low Georgia: Yes, human · № რ-043196 · Verified on 22 Oct 2026 Off-label use
Not rateable

No defensible canine IV or IM Heptral/ademetionine dose, pharmacokinetic bridge, target-animal safety margin or clinical-outcome evidence was located. Oral veterinary evidence and human injectable information cannot establish a responsible parenteral score.

Exact human presentations are traceable in Georgia, but veterinary parenteral dosing, exposure, safety and outcomes are not established. The product remains unscoreable for dog or cat IV/IM use; oral SAMe regimens and comparator human handling must not be transferred.

Important safety and use flags

  • This is a human medicine. All dog/cat IV or IM use is off-label, and no veterinary parenteral dose is established.
  • Never transfer the 18 mg/kg oral SAMe regimen to IV or IM use. It is tied to an intact enteric-coated tablet and oral absorption; parenteral exposure is fundamentally different.
  • Adjunct only. Diagnose and treat the underlying hepatobiliary disorder; do not substitute ademetionine for nutrition, toxin-specific care, antimicrobial or immunosuppressive treatment, copper management, biliary intervention or other indicated therapy.
  • Verify the exact local Heptral insert before preparation. The available package confirms supplied solvent but does not establish a veterinary post-reconstitution concentration, sterility period or partial-vial protocol.
  • A different human ademetionine product uses further 250 ml saline dilution for slow IV use. This is comparator information only and must never be transferred automatically to Heptral or a small animal.
  • A comparator human label warns against alkaline or calcium-containing solutions. Confirm exact-product compatibility for every fluid, Y-site and injectable medicine rather than assuming the comparator applies.
  • No validated dog/cat dose or final concentration exists for either strength. Do not estimate a dose volume or retain a partial vial without independently sourced dosing, concentration, stability and sterility evidence.
  • Monitor clinical status, fluid balance, injection/infusion reactions and disease-appropriate liver biochemistry; stop and reassess for deterioration, agitation, vomiting, diarrhoea, abdominal discomfort, hypersensitivity or a new neurologic sign.
  • Review concomitant medicines and supplements. Human information warns about serotonergic medicines and tryptophan; veterinary clinical magnitude is uncertain, so avoid unreviewed combinations.
  • Safety in pregnancy, lactation, breeding animals, neonates and severe renal or multisystem disease is not established. Use, if at all, only after explicit individual benefit-risk review.
Assessment sources
  1. Georgia Heptral injection register2026
  2. Abbott Heptral overview2026
  3. AIFA SPC 20232023
  4. Armenia Heptral injection register2026
  5. EMA ademetionine national list2026
  6. MSD Vet Manual 20242024
  7. ACVIM canine hepatitis consensus2019
  8. Canine prednisolone SAMe trial2005
  9. Feline acetaminophen SAMe study2003
  10. Healthy-cat SAMe study2005
  11. Human oral-IV SAMe PK2009
Assessed: 22 Oct 2026No axis or overall score is shown when the available evidence does not support a responsible numerical assessment.
Cat Proposed adjunctive parenteral use in diagnosed hepatobiliary disease when oral treatment is not feasible
Not rateable
No numerical score assigned
vetman assessment

Heptral

400 mg, powder and solvent for solution for injection, human medicine
Assessed clinical scopeCat · Proposed adjunctive parenteral use in diagnosed hepatobiliary disease when oral treatment is not feasible · IV,IM
Care settingHospital consideration only; no veterinary parenteral regimen is established. Any use requires independent dose, preparation, compatibility and monitoring justification.
vetman score Not rateable No numerical score assigned
Evidence confidence: Low Georgia: Yes, human · № რ-043196 · Verified on 22 Oct 2026 Off-label use
Not rateable

No defensible feline IV or IM Heptral/ademetionine dose, pharmacokinetic bridge, target-animal safety margin or clinical-outcome evidence was located. Oral feline studies and human injectable information cannot establish a responsible parenteral score.

Exact human presentations are traceable in Georgia, but veterinary parenteral dosing, exposure, safety and outcomes are not established. The product remains unscoreable for dog or cat IV/IM use; oral SAMe regimens and comparator human handling must not be transferred.

Important safety and use flags

  • This is a human medicine. All dog/cat IV or IM use is off-label, and no veterinary parenteral dose is established.
  • Never transfer the 18 mg/kg oral SAMe regimen to IV or IM use. It is tied to an intact enteric-coated tablet and oral absorption; parenteral exposure is fundamentally different.
  • Adjunct only. Diagnose and treat the underlying hepatobiliary disorder; do not substitute ademetionine for nutrition, toxin-specific care, antimicrobial or immunosuppressive treatment, copper management, biliary intervention or other indicated therapy.
  • Verify the exact local Heptral insert before preparation. The available package confirms supplied solvent but does not establish a veterinary post-reconstitution concentration, sterility period or partial-vial protocol.
  • A different human ademetionine product uses further 250 ml saline dilution for slow IV use. This is comparator information only and must never be transferred automatically to Heptral or a small animal.
  • A comparator human label warns against alkaline or calcium-containing solutions. Confirm exact-product compatibility for every fluid, Y-site and injectable medicine rather than assuming the comparator applies.
  • No validated dog/cat dose or final concentration exists for either strength. Do not estimate a dose volume or retain a partial vial without independently sourced dosing, concentration, stability and sterility evidence.
  • Monitor clinical status, fluid balance, injection/infusion reactions and disease-appropriate liver biochemistry; stop and reassess for deterioration, agitation, vomiting, diarrhoea, abdominal discomfort, hypersensitivity or a new neurologic sign.
  • Review concomitant medicines and supplements. Human information warns about serotonergic medicines and tryptophan; veterinary clinical magnitude is uncertain, so avoid unreviewed combinations.
  • Safety in pregnancy, lactation, breeding animals, neonates and severe renal or multisystem disease is not established. Use, if at all, only after explicit individual benefit-risk review.
Assessment sources
  1. Georgia Heptral injection register2026
  2. Abbott Heptral overview2026
  3. AIFA SPC 20232023
  4. Armenia Heptral injection register2026
  5. EMA ademetionine national list2026
  6. MSD Vet Manual 20242024
  7. ACVIM canine hepatitis consensus2019
  8. Canine prednisolone SAMe trial2005
  9. Feline acetaminophen SAMe study2003
  10. Healthy-cat SAMe study2005
  11. Human oral-IV SAMe PK2009
Assessed: 22 Oct 2026No axis or overall score is shown when the available evidence does not support a responsible numerical assessment.
Composition / strength
S-Adenosylmethionine400 mg
Formulation Type
Powder
Administration route
Intravenous, Intramuscular
Manufacturer
Biologici Italia Laboratories · Italy
Registration
Georgia Yes, human
In force until 29 Apr 2030
Human (Ministry of Health, RAMA)
№ რ-043196
Verified on: 22 Oct 2026
 EU Not confirmed
Verified on: 22 Oct 2026
 UK Not confirmed
Verified on: 22 Oct 2026
 US Not confirmed
Verified on: 22 Oct 2026
Controlled in Georgia
No
Checked against the narcotics law, Annex 1, lists I-IV, and Order No. 22/n.
Verified on: 16 Oct 2026
Information not fully verified No dog or cat parenteral dose is established. Do not transfer the 18 mg/kg oral enteric-coated-tablet regimen to IV or IM use: intravenous exposure bypasses the absorption limitation that shaped the oral dose. Use only in a hospital under a veterinarian-defined, source-justified plan; no calculator dose is supplied.
500 mg, Coated tablet No label dose in the reference yet - Georgia Yes, human
In force until 29 Nov 2027
Human (Ministry of Health, RAMA)
In the register: ჰეპტრალი 500 მგ, გასტრორეზისტენტული აბი
№ რ-036929
Verified on: 16 Oct 2026
Details: pack, label wording, sources, registration

Heptral 500 mg, Coated tablet

gastro-resistant tablet, human medicine
vetman assessment
vetman’s 10-point assessment brings together a product’s regulatory credibility, clinical efficacy, safety and practicality. Cost-effectiveness is assessed only when reliable data are available. It is informational and does not replace a veterinarian’s clinical judgment for an individual patient.
Dog Adjunctive antioxidant and hepatoprotective support in a veterinarian-diagnosed hepatobiliary disorder; not diagnostic or disease-modifying monotherapy
4.6/10
Weak evidence support
vetman assessment

Heptral

500 mg, gastro-resistant tablet, human medicine
Assessed clinical scopeDog · Adjunctive antioxidant and hepatoprotective support in a veterinarian-diagnosed hepatobiliary disorder; not diagnostic or disease-modifying monotherapy · By mouth
Care settingVeterinarian-directed outpatient adjunct after the underlying disorder is defined, with an intact tablet on an empty stomach and disease-appropriate clinical and biochemical monitoring.
vetman score 4.6/10 Weak evidence support
Evidence confidence: Medium Georgia: Yes, human · № რ-036929 · Verified on 16 Oct 2026 Off-label use

A plausible but weakly outcome-supported adjunct. Use only after defining and treating the underlying hepatobiliary disorder; this exact human whole-tablet strength is practical only near its matching body weight.

Regulatory and scientific credibility4.0/10

Both exact strengths are verifiable, compositionally transparent human gastro-resistant medicines with current Georgian registrations and official Abbott or regulator information. Neither is authorised for dogs or cats, and exact-product veterinary bioavailability, efficacy and safety have not been demonstrated.

Clinical efficacy4.0/10

ACVIM recognises plausible glutathione and cytoprotective mechanisms but states that clinical benefit has not been rigorously investigated. A small controlled prednisolone model improved selected redox measures without preventing classic vacuolar-hepatopathy findings; a recent gallbladder-mucocele trial found little effect from SAMe plus silymarin without ursodeoxycholic acid. No exact-Heptral outcome trial was identified.

Safety and tolerability6.5/10

SAMe is generally regarded as well tolerated and the canine controlled study found biological exposure without a major treatment signal, but clinical safety datasets are small. Gastrointestinal effects are possible, and exact human-tablet excipients, long-term use, organ-disease subgroups and reproductive safety are incompletely characterised in dogs.

Clinical practicality3.5/10

At 18 mg/kg, one intact 500 mg tablet approximates a 27.8 kg dose. Its gastro-resistant whole-only unit fits fewer dogs than 400 mg, and empty-stomach administration adds adherence burden; use a validated smaller veterinary presentation rather than dividing this tablet.

Full-course cost-effectiveness-

Current comparable full-course local prices were not verified.

Important safety and use flags

  • Adjunct only. Diagnose and treat the underlying hepatobiliary disorder; do not use SAMe as a substitute for nutrition, toxin-specific treatment, antimicrobial or immunosuppressive therapy, copper management, biliary intervention or other indicated care.
  • Clinical outcome evidence is limited. Mechanistic, redox or liver-enzyme changes do not prove improved histology, survival or durable disease control, and exact Heptral tablets have not been tested in veterinary clinical outcome trials.
  • Give the gastro-resistant tablet intact. Do not split, chew or crush it: damaging the coat can expose acid-labile SAMe in the stomach and creates an unvalidated dose unit.
  • Give on an empty stomach according to the established veterinary regimen. Food can reduce or delay absorption; select a tablet strength that can be given whole rather than estimating a fragment.
  • At 18 mg/kg, one intact 500 mg tablet corresponds to about 27.8 kg. This is not a minimum-weight label: use another validated strength whenever the calculated dose is materially different.
  • Monitor the disease, not merely the supplement: clinical status, appetite, weight and condition-specific liver biochemistry, imaging or histology remain necessary. Stop and reassess if disease progresses despite adjunctive use.
  • Monitor for vomiting, diarrhoea, abdominal discomfort, reduced appetite or another new adverse effect. Exact dog and cat adverse-event frequencies for these human tablets are unknown.
  • Review concomitant medicines and supplements. Human product information warns about serotonergic medicines and tryptophan; the clinical magnitude in dogs and cats is not established, so avoid unreviewed combinations.
  • Safety in pregnancy, lactation, breeding animals, neonates and severe renal disease is not established for these exact human presentations. Use only after an individual veterinary benefit-risk review.
Assessment sources
  1. Heptral market audit2026
  2. Abbott Heptral overview2026
  3. Heptral 500 mg CMI2022
  4. MSD Vet Manual 20242024
  5. ACVIM canine hepatitis consensus2019
  6. Canine prednisolone SAMe trial2005
  7. Feline acetaminophen SAMe study2003
  8. Healthy-cat SAMe study2005
  9. Canine GBM hepatoprotectant trial2025
Assessed: 22 Oct 2026The overall score uses 25/25/25/15/10 weights. An unassessed price is excluded and the remaining weights are proportionally renormalised.
Cat Adjunctive antioxidant and hepatoprotective support in a veterinarian-diagnosed hepatobiliary disorder; not diagnostic or disease-modifying monotherapy
3.7/10
Poor / unconvincing
vetman assessment

Heptral

500 mg, gastro-resistant tablet, human medicine
Assessed clinical scopeCat · Adjunctive antioxidant and hepatoprotective support in a veterinarian-diagnosed hepatobiliary disorder; not diagnostic or disease-modifying monotherapy · By mouth
Care settingVeterinarian-directed outpatient adjunct after the underlying disorder is defined, with an intact tablet on an empty stomach and disease-appropriate clinical and biochemical monitoring.
vetman score 3.7/10 Poor / unconvincing
Evidence confidence: Low Georgia: Yes, human · № რ-036929 · Verified on 16 Oct 2026 Off-label use

A poorly matched feline presentation with indirect efficacy evidence. The whole gastro-resistant 400/500 mg unit cannot accurately deliver a typical cat dose and should not substitute for a validated cat-sized product.

Regulatory and scientific credibility4.0/10

Both exact strengths are verifiable, compositionally transparent human gastro-resistant medicines with current Georgian registrations and official Abbott or regulator information. Neither is authorised for dogs or cats, and exact-product veterinary bioavailability, efficacy and safety have not been demonstrated.

Clinical efficacy3.5/10

Feline evidence is experimental rather than clinical disease evidence. Small studies in healthy cats and an acetaminophen oxidative-injury model support exposure and selected antioxidant effects, but do not establish benefit for naturally occurring feline hepatobiliary disease or for these exact 400/500 mg tablets.

Safety and tolerability5.5/10

Healthy cats tolerated prolonged enteric-coated SAMe exposure in a small study, but the evidence base is limited and used a different veterinary product. The acetaminophen model was small and included deaths attributable to the toxin; it cannot define safety in ill cats. Exact-tablet tolerability, reproductive safety and clinically important interactions remain uncertain.

Clinical practicality0.5/10

A typical 4 kg cat requires about 72 mg, only 14% of this 500 mg tablet. The gastro-resistant unit cannot be split or crushed, making this exact presentation an exceptionally poor feline dose unit; use a validated cat-sized veterinary presentation.

Full-course cost-effectiveness-

Current comparable full-course local prices were not verified.

Important safety and use flags

  • Adjunct only. Diagnose and treat the underlying hepatobiliary disorder; do not use SAMe as a substitute for nutrition, toxin-specific treatment, antimicrobial or immunosuppressive therapy, copper management, biliary intervention or other indicated care.
  • Clinical outcome evidence is limited. Mechanistic, redox or liver-enzyme changes do not prove improved histology, survival or durable disease control, and exact Heptral tablets have not been tested in veterinary clinical outcome trials.
  • Give the gastro-resistant tablet intact. Do not split, chew or crush it: damaging the coat can expose acid-labile SAMe in the stomach and creates an unvalidated dose unit.
  • Give on an empty stomach according to the established veterinary regimen. Food can reduce or delay absorption; select a tablet strength that can be given whole rather than estimating a fragment.
  • At 18 mg/kg, one intact 500 mg tablet corresponds to about 27.8 kg. This is not a minimum-weight label: use another validated strength whenever the calculated dose is materially different.
  • Monitor the disease, not merely the supplement: clinical status, appetite, weight and condition-specific liver biochemistry, imaging or histology remain necessary. Stop and reassess if disease progresses despite adjunctive use.
  • Monitor for vomiting, diarrhoea, abdominal discomfort, reduced appetite or another new adverse effect. Exact dog and cat adverse-event frequencies for these human tablets are unknown.
  • Review concomitant medicines and supplements. Human product information warns about serotonergic medicines and tryptophan; the clinical magnitude in dogs and cats is not established, so avoid unreviewed combinations.
  • Safety in pregnancy, lactation, breeding animals, neonates and severe renal disease is not established for these exact human presentations. Use only after an individual veterinary benefit-risk review.
Assessment sources
  1. Heptral market audit2026
  2. Abbott Heptral overview2026
  3. Heptral 500 mg CMI2022
  4. MSD Vet Manual 20242024
  5. ACVIM canine hepatitis consensus2019
  6. Canine prednisolone SAMe trial2005
  7. Feline acetaminophen SAMe study2003
  8. Healthy-cat SAMe study2005
  9. Canine GBM hepatoprotectant trial2025
Assessed: 22 Oct 2026The overall score uses 25/25/25/15/10 weights. An unassessed price is excluded and the remaining weights are proportionally renormalised.
Composition / strength
S-Adenosylmethionine500 mg
Formulation Type
Coated tablet
Administration route
By mouth
Manufacturer
Abbott · United States
Registration
Georgia Yes, human
In force until 29 Nov 2027
Human (Ministry of Health, RAMA)
In the register: ჰეპტრალი 500 მგ, გასტრორეზისტენტული აბი
№ რ-036929
Verified on: 16 Oct 2026
 EU No
Verified on: 16 Oct 2026
 UK No
Verified on: 16 Oct 2026
 US No
Verified on: 16 Oct 2026
Controlled in Georgia
No
Checked against the narcotics law, Annex 1, lists I-IV, and Order No. 22/n.
Verified on: 16 Oct 2026
500 mg, Powder No label dose in the reference yet - Georgia Yes, human
In force until 23 May 2030
Human (Ministry of Health, RAMA)
In the register: ჰეპტრალი 500 მგ, ფხვნილი და გამხსნელი საინექციო ხსნარისთვის
№ რ-043294, რ-038849
Verified on: 22 Oct 2026
Details: pack, label wording, sources, registration

Heptral 500 mg, Powder

powder and solvent for solution for injection, human medicine
vetman assessment
vetman’s 10-point assessment brings together a product’s regulatory credibility, clinical efficacy, safety and practicality. Cost-effectiveness is assessed only when reliable data are available. It is informational and does not replace a veterinarian’s clinical judgment for an individual patient.
Dog Proposed adjunctive parenteral use in diagnosed hepatobiliary disease when oral treatment is not feasible
Not rateable
No numerical score assigned
vetman assessment

Heptral

500 mg, powder and solvent for solution for injection, human medicine
Assessed clinical scopeDog · Proposed adjunctive parenteral use in diagnosed hepatobiliary disease when oral treatment is not feasible · IV,IM
Care settingHospital consideration only; no veterinary parenteral regimen is established. Any use requires independent dose, preparation, compatibility and monitoring justification.
vetman score Not rateable No numerical score assigned
Evidence confidence: Low Georgia: Yes, human · № რ-043294, რ-038849 · Verified on 22 Oct 2026 Off-label use
Not rateable

No defensible canine IV or IM Heptral/ademetionine dose, pharmacokinetic bridge, target-animal safety margin or clinical-outcome evidence was located. Oral veterinary evidence and human injectable information cannot establish a responsible parenteral score.

Exact human presentations are traceable in Georgia, but veterinary parenteral dosing, exposure, safety and outcomes are not established. The product remains unscoreable for dog or cat IV/IM use; oral SAMe regimens and comparator human handling must not be transferred.

Important safety and use flags

  • This is a human medicine. All dog/cat IV or IM use is off-label, and no veterinary parenteral dose is established.
  • Never transfer the 18 mg/kg oral SAMe regimen to IV or IM use. It is tied to an intact enteric-coated tablet and oral absorption; parenteral exposure is fundamentally different.
  • Adjunct only. Diagnose and treat the underlying hepatobiliary disorder; do not substitute ademetionine for nutrition, toxin-specific care, antimicrobial or immunosuppressive treatment, copper management, biliary intervention or other indicated therapy.
  • Verify the exact local Heptral insert before preparation. The available package confirms supplied solvent but does not establish a veterinary post-reconstitution concentration, sterility period or partial-vial protocol.
  • A different human ademetionine product uses further 250 ml saline dilution for slow IV use. This is comparator information only and must never be transferred automatically to Heptral or a small animal.
  • A comparator human label warns against alkaline or calcium-containing solutions. Confirm exact-product compatibility for every fluid, Y-site and injectable medicine rather than assuming the comparator applies.
  • No validated dog/cat dose or final concentration exists for either strength. Do not estimate a dose volume or retain a partial vial without independently sourced dosing, concentration, stability and sterility evidence.
  • Monitor clinical status, fluid balance, injection/infusion reactions and disease-appropriate liver biochemistry; stop and reassess for deterioration, agitation, vomiting, diarrhoea, abdominal discomfort, hypersensitivity or a new neurologic sign.
  • Review concomitant medicines and supplements. Human information warns about serotonergic medicines and tryptophan; veterinary clinical magnitude is uncertain, so avoid unreviewed combinations.
  • Safety in pregnancy, lactation, breeding animals, neonates and severe renal or multisystem disease is not established. Use, if at all, only after explicit individual benefit-risk review.
Assessment sources
  1. Georgia Heptral injection register2026
  2. Abbott Heptral overview2026
  3. AIFA SPC 20232023
  4. Armenia Heptral injection register2026
  5. EMA ademetionine national list2026
  6. MSD Vet Manual 20242024
  7. ACVIM canine hepatitis consensus2019
  8. Canine prednisolone SAMe trial2005
  9. Feline acetaminophen SAMe study2003
  10. Healthy-cat SAMe study2005
  11. Human oral-IV SAMe PK2009
Assessed: 22 Oct 2026No axis or overall score is shown when the available evidence does not support a responsible numerical assessment.
Cat Proposed adjunctive parenteral use in diagnosed hepatobiliary disease when oral treatment is not feasible
Not rateable
No numerical score assigned
vetman assessment

Heptral

500 mg, powder and solvent for solution for injection, human medicine
Assessed clinical scopeCat · Proposed adjunctive parenteral use in diagnosed hepatobiliary disease when oral treatment is not feasible · IV,IM
Care settingHospital consideration only; no veterinary parenteral regimen is established. Any use requires independent dose, preparation, compatibility and monitoring justification.
vetman score Not rateable No numerical score assigned
Evidence confidence: Low Georgia: Yes, human · № რ-043294, რ-038849 · Verified on 22 Oct 2026 Off-label use
Not rateable

No defensible feline IV or IM Heptral/ademetionine dose, pharmacokinetic bridge, target-animal safety margin or clinical-outcome evidence was located. Oral feline studies and human injectable information cannot establish a responsible parenteral score.

Exact human presentations are traceable in Georgia, but veterinary parenteral dosing, exposure, safety and outcomes are not established. The product remains unscoreable for dog or cat IV/IM use; oral SAMe regimens and comparator human handling must not be transferred.

Important safety and use flags

  • This is a human medicine. All dog/cat IV or IM use is off-label, and no veterinary parenteral dose is established.
  • Never transfer the 18 mg/kg oral SAMe regimen to IV or IM use. It is tied to an intact enteric-coated tablet and oral absorption; parenteral exposure is fundamentally different.
  • Adjunct only. Diagnose and treat the underlying hepatobiliary disorder; do not substitute ademetionine for nutrition, toxin-specific care, antimicrobial or immunosuppressive treatment, copper management, biliary intervention or other indicated therapy.
  • Verify the exact local Heptral insert before preparation. The available package confirms supplied solvent but does not establish a veterinary post-reconstitution concentration, sterility period or partial-vial protocol.
  • A different human ademetionine product uses further 250 ml saline dilution for slow IV use. This is comparator information only and must never be transferred automatically to Heptral or a small animal.
  • A comparator human label warns against alkaline or calcium-containing solutions. Confirm exact-product compatibility for every fluid, Y-site and injectable medicine rather than assuming the comparator applies.
  • No validated dog/cat dose or final concentration exists for either strength. Do not estimate a dose volume or retain a partial vial without independently sourced dosing, concentration, stability and sterility evidence.
  • Monitor clinical status, fluid balance, injection/infusion reactions and disease-appropriate liver biochemistry; stop and reassess for deterioration, agitation, vomiting, diarrhoea, abdominal discomfort, hypersensitivity or a new neurologic sign.
  • Review concomitant medicines and supplements. Human information warns about serotonergic medicines and tryptophan; veterinary clinical magnitude is uncertain, so avoid unreviewed combinations.
  • Safety in pregnancy, lactation, breeding animals, neonates and severe renal or multisystem disease is not established. Use, if at all, only after explicit individual benefit-risk review.
Assessment sources
  1. Georgia Heptral injection register2026
  2. Abbott Heptral overview2026
  3. AIFA SPC 20232023
  4. Armenia Heptral injection register2026
  5. EMA ademetionine national list2026
  6. MSD Vet Manual 20242024
  7. ACVIM canine hepatitis consensus2019
  8. Canine prednisolone SAMe trial2005
  9. Feline acetaminophen SAMe study2003
  10. Healthy-cat SAMe study2005
  11. Human oral-IV SAMe PK2009
Assessed: 22 Oct 2026No axis or overall score is shown when the available evidence does not support a responsible numerical assessment.
Composition / strength
S-Adenosylmethionine500 mg
Formulation Type
Powder
Administration route
Intravenous, Intramuscular
Manufacturer
-
Registration
Georgia Yes, human
In force until 23 May 2030
Human (Ministry of Health, RAMA)
In the register: ჰეპტრალი 500 მგ, ფხვნილი და გამხსნელი საინექციო ხსნარისთვის
№ რ-043294, რ-038849
Verified on: 22 Oct 2026
 EU Not confirmed
Verified on: 22 Oct 2026
 UK Not confirmed
Verified on: 22 Oct 2026
 US Not confirmed
Verified on: 22 Oct 2026
Controlled in Georgia
No
Checked against the narcotics law, Annex 1, lists I-IV, and Order No. 22/n.
Verified on: 16 Oct 2026
Information not fully verified No dog or cat parenteral dose is established. Do not transfer the 18 mg/kg oral enteric-coated-tablet regimen to IV or IM use: intravenous exposure bypasses the absorption limitation that shaped the oral dose. Use only in a hospital under a veterinarian-defined, source-justified plan; no calculator dose is supplied.

S-Adenosylmethionine: No dose supported by a publicly verifiable source yet

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