KA/EN
Register
Medicines reference
Search
Search
Active substance

L-Ornithine-L-Aspartate

Favourites

Amino acid salt (ammonia detoxification). Registered in Georgia: 1 human medicine. Forms: solution, tablet.

Dose and use

Doses

Each dose comes with its source. Check the label of the product you use.

Active substance L-Ornithine-L-Aspartate
Dose calculatorCalculates the active-substance amount; it is not a prescription.
PatientSpecies and weight will be filled in automatically in other calculators.
Selected dose
Dose Species Indication Route Frequency Source
616 mg/kg
off-label
 Dog Hepatic Encephalopathy Intravenous daily for 1 day
Ahn et al. 2016
Scientific article
A study or review published in a scientific journal. Its findings apply to the animals and conditions it studied.
Hyperammonemic hepatic encephalopathy management through L-ornithin-L-aspartate administration in dogs
Journal of Veterinary Science, 2016
1232 mg/kg
off-label
 Dog Hepatic Encephalopathy
Emergency
 Intravenous per day
Ahn et al. 2016
Scientific article
A study or review published in a scientific journal. Its findings apply to the animals and conditions it studied.
Hyperammonemic hepatic encephalopathy management through L-ornithin-L-aspartate administration in dogs
Journal of Veterinary Science, 2016
Before use

Safety information

Known Contraindications

  • Critical
    if you suffer from severely impaired kidney function (renal insufficiency). A serum creatinine value over 3 mg/100 ml can be used as a guideline value.
    Sources: Product label
  • Critical
    Known hypersensitivity to L-ornithine L-aspartate is a contraindication.
    Sources: Product label
  • Warning (Cat)
    No dose has been established for cats. The only identified veterinary publication concerns dogs, and even that dose was extrapolated from human medicine. Use in cats therefore requires an individual veterinary decision.
  • Caution
    Do not administer ornithine aspartate infusion concentrate intra-arterially.
    Sources: Product label
Latin name
L-Ornithine-L-Aspartate
Georgian name
L-ორნითინ-L-ასპარტატი
Authorisation status
Human medicine, cascade use
No veterinary authorisation was found in any register checked. Veterinary use is off-label, under the prescribing cascade.
Registered in Georgia
1 of 2 forms
Products
Hepa-Merz, Hepatosil Advanced
Human medicines in Georgia
Hepa-Merz, Hepalornitin, Liversan
Human medicines with this substance in the Georgian register of medicines (Ministry of Health), checked on 18 Oct 2026. They are human medicines, not veterinary products; strengths and forms differ.
Controlled in Georgia
No
Checked against the narcotics law, Annex 1, lists I-IV, and Order No. 22/n.
Verified on: 16 Oct 2026
All forms and registration2

Registration in Georgia and abroad: the register, number, validity and source are behind (i).

Hepa-Merz, Solution

infusion concentrate 500 mg/ml (5 g/10 ml ampoule), 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 Intravenous LOLA as a hospital rescue adjunct for diagnosed hyperammonaemic hepatic encephalopathy refractory to conventional cause-directed and supportive treatment
4.5/10
Weak evidence support
vetman assessment

Hepa-Merz

infusion concentrate 500 mg/ml (5 g/10 ml ampoule), human medicine
Assessed clinical scopeDog · Intravenous LOLA as a hospital rescue adjunct for diagnosed hyperammonaemic hepatic encephalopathy refractory to conventional cause-directed and supportive treatment · Intravenous
Care settingSpecialist hospital use with pharmacy-reviewed dilution, infusion pump, dedicated line/compatibility review and serial neurologic, ammonia, renal, urea, fluid and electrolyte monitoring.
vetman score 4.5/10 Weak evidence support
Evidence confidence: Low Georgia: Yes, human · № რ-041313 · Verified on 15 Oct 2026 Off-label use

A biologically plausible salvage adjunct with one encouraging but methodologically weak canine series; exact dilution, renal screening and rate arithmetic are essential, and it is not a first-line replacement.

Regulatory and scientific credibility4.0/10

Exact human identity and current Georgian/Lithuanian authorisations are verifiable, but veterinary use has no authorisation and the sole old canine report used a differently described Hepa-Merz market product; the PLAYBOOK formulation/evidence gate caps this axis.

Clinical efficacy4.0/10

Fifteen of 17 dogs improved with falling ammonia, but owner-selected treatment, a three-dog non-equivalent control, mixed diseases/severity, no blinding and a 24-hour before-after analysis cannot establish comparative efficacy or an optimal regimen.

Safety and tolerability5.5/10

No obvious adverse effects were reported in 17 dogs and the exact human label is transparent, but this was not a safety study; high exploratory doses, severe renal contraindication, rate-related nausea/vomiting and reproduction gaps remain important.

Clinical practicality4.5/10

A 24-hour two-rate infusion is feasible in intensive care but requires exact dilution, pump programming, continuous venous access and reconciliation of weight-based study rates with a 5 g/hour absolute label ceiling and patient fluid tolerance.

Full-course cost-effectiveness-

A current Georgian exact-pack price and patient-specific full hospital-course cost were not verified, so cost is excluded.

Important safety and use flags

  • Human infusion concentrate. Current Georgian and Lithuanian human authorisations do not establish veterinary approval; all assessed use is off-label, and no authorised veterinary LOLA infusion was identified.
  • CONCENTRATE: never infuse the 500 mg/ml ampoule neat. Add to a compatible infusion solution; the exact human label allows no more than six ampoules per 500 ml and a maximum absolute rate of 5 g/hour.
  • The severe-dog paper prints 154 mg/kg/hour for 4 hours then 30 mg/kg/hour for 20 hours: arithmetic gives 1,216 mg/kg/day, not its stated 1,232 mg/kg/day. Use the phase rates only under specialist review.
  • The canine study regimen was converted from humans, tested in only 17 non-randomly selected dogs and used a differently described Korean Hepa-Merz product. It is exploratory, not an established standard dose or comparative first-line therapy.
  • Severe renal impairment is an exact-label contraindication. The human creatinine >3 mg/dl guide is not a validated canine/feline threshold; review renal function, urine output, hydration, acid-base/electrolytes and serum/urine urea.
  • Never administer intra-arterially. Use a pump, verified venous access and line/solution compatibility; inspect the clear solution and prepare immediately before use according to local sterile-infusion policy.
  • Nausea and vomiting can be dose/rate related. Slow or stop the infusion and reassess if they occur; do not assume absent adverse events in 17 dogs establishes safety at the exact regimen.
  • Treat HE causes and precipitants and provide standard supportive management. MSD describes LOLA as salvage for chronic hyperammonaemic HE refractory to conventional interventions, not a replacement for definitive shunt/liver care or first-line enteric ammonia control.
  • The 154 mg/kg/hour canine initial rate reaches the exact human-label 5 g/hour ceiling at about 32.5 kg. No validated canine rule reconciles the weight-based study rate with that absolute product limit; obtain specialist/pharmacy review.
  • Pregnancy, lactation, breeding-animal and paediatric veterinary safety are not established; human information advises avoidance unless benefit clearly outweighs risk.
Assessment sources
  1. Hepa-Merz exact SPC2008
  2. GE Hepa-Merz audit2026
  3. LT Hepa-Merz register2026
  4. Canine IV LOLA report2016
  5. MSD small-animal HE2024
  6. Dog-cat HE review2016
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 Intravenous LOLA as a hospital rescue adjunct for diagnosed hyperammonaemic hepatic encephalopathy refractory to conventional cause-directed and supportive treatment
Not rateable
No numerical score assigned
vetman assessment

Hepa-Merz

infusion concentrate 500 mg/ml (5 g/10 ml ampoule), human medicine
Assessed clinical scopeCat · Intravenous LOLA as a hospital rescue adjunct for diagnosed hyperammonaemic hepatic encephalopathy refractory to conventional cause-directed and supportive treatment · Intravenous
Care settingSpecialist hospital use with pharmacy-reviewed dilution, infusion pump, dedicated line/compatibility review and serial neurologic, ammonia, renal, urea, fluid and electrolyte monitoring.
vetman score Not rateable No numerical score assigned
Evidence confidence: Low Georgia: Yes, human · № რ-041313 · Verified on 15 Oct 2026 Off-label use
Not rateable

No defensible feline IV dose, exact-product efficacy study or target-animal safety cohort was located. Canine exploratory rates and human fixed ampoule counts cannot be transferred responsibly to a cat.

Exact product identity is known, but feline dose, benefit and target-animal safety are not; a numerical score would imply evidence that does not exist.

Important safety and use flags

  • Human infusion concentrate. Current Georgian and Lithuanian human authorisations do not establish veterinary approval; all assessed use is off-label, and no authorised veterinary LOLA infusion was identified.
  • CONCENTRATE: never infuse the 500 mg/ml ampoule neat. Add to a compatible infusion solution; the exact human label allows no more than six ampoules per 500 ml and a maximum absolute rate of 5 g/hour.
  • No feline dose is established. Do not copy the 17-dog exploratory protocol, convert a human ampoule count by body weight or use the historical 2 ml patient-chart exposure as a dose rule.
  • The canine study regimen was converted from humans, tested in only 17 non-randomly selected dogs and used a differently described Korean Hepa-Merz product. It is exploratory, not an established standard dose or comparative first-line therapy.
  • Severe renal impairment is an exact-label contraindication. The human creatinine >3 mg/dl guide is not a validated canine/feline threshold; review renal function, urine output, hydration, acid-base/electrolytes and serum/urine urea.
  • Never administer intra-arterially. Use a pump, verified venous access and line/solution compatibility; inspect the clear solution and prepare immediately before use according to local sterile-infusion policy.
  • Nausea and vomiting can be dose/rate related. Slow or stop the infusion and reassess if they occur; do not assume absent adverse events in 17 dogs establishes safety at the exact regimen.
  • Treat HE causes and precipitants and provide standard supportive management. MSD describes LOLA as salvage for chronic hyperammonaemic HE refractory to conventional interventions, not a replacement for definitive shunt/liver care or first-line enteric ammonia control.
  • The 154 mg/kg/hour canine initial rate reaches the exact human-label 5 g/hour ceiling at about 32.5 kg. No validated canine rule reconciles the weight-based study rate with that absolute product limit; obtain specialist/pharmacy review.
  • Pregnancy, lactation, breeding-animal and paediatric veterinary safety are not established; human information advises avoidance unless benefit clearly outweighs risk.
Assessment sources
  1. Hepa-Merz exact SPC2008
  2. GE Hepa-Merz audit2026
  3. LT Hepa-Merz register2026
  4. Canine IV LOLA report2016
  5. MSD small-animal HE2024
  6. Dog-cat HE review2016
Assessed: 22 Oct 2026No axis or overall score is shown when the available evidence does not support a responsible numerical assessment.
Composition / strength
L-Ornithine-L-Aspartate500 mg/ml
Formulation Type
Solution
Administration route
Intravenous
Manufacturer
Merz Pharmaceuticals GmbH · Germany
Registration
Georgia Yes, human
In force until 17 Jun 2029
Human (Ministry of Health, RAMA)
№ რ-041313
Verified on: 15 Oct 2026
 EU Yes, human
№ LT/1/94/0572/001
Verified on: 22 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
Information not fully verified Human IV concentrate; all veterinary use is off-label. Do not administer neat: add to a compatible infusion solution. Exact human label: no more than six ampoules per 500 ml and maximum 5 g/hour. One weak canine study used 616 mg/kg/day IV for mild HE; for severe HE it printed 154 mg/kg/hour for 4 hours then 30 mg/kg/hour for 20 hours. Those phases total 1,216 mg/kg/day, not the paper-stated 1,232 mg/kg/day. No defensible feline dose is established.

Hepatosil Advanced 30 tablets, Tablet

complementary feed for dogs and cats
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 nutritional and hepatoprotective support after diagnosis of a hepatobiliary disorder
4.6/10
Weak evidence support
vetman assessment

Hepatosil Advanced

30 tablets, complementary feed for dogs and cats
Assessed clinical scopeDog · Adjunctive nutritional and hepatoprotective support after diagnosis of a hepatobiliary disorder · By mouth
Care settingVeterinarian-directed home adjunct with disease-specific treatment and objective clinical/biochemical monitoring
vetman score 4.6/10 Weak evidence support
Evidence confidence: Low Georgia: Not a medicine · Verified on 22 Oct 2026

A transparent-category but weakly outcome-supported complementary feed. It may be used as a monitored adjunct, but exact-product evidence, quantitative label transparency and dose/formulation certainty do not support stronger claims.

Regulatory and scientific credibility4.5/10

Exact current identity and complementary-feed category are clear, but the manufacturer omits ingredient quantities and detailed cat instructions; those rely on a retailer reproduction, quality standardisation is incomplete and no exact-product trial exists.

Clinical efficacy3.0/10

Ingredient mechanisms and limited dog studies are plausible, but consensus and reviews find weak clinical-outcome evidence; no Hepatosil trial exists, and recent SAMe+silymarin data showed minimal effect without disease-specific therapy.

Safety and tolerability5.5/10

The ingredients are commonly used adjuncts and serious toxicity is not prominent in indirect sources, but exact-product adverse-event rates, long-term diseased-dog safety, interaction testing and reproductive data are absent.

Clinical practicality6.0/10

Once-daily oral use is manageable, but fasting/food separation, double-coat versus crushing uncertainty, ambiguous dosing above 10 kg and undefined duration add meaningful burden.

Full-course cost-effectiveness-

Current exact Georgian course price and an evidence-based duration were not verified; cost is excluded.

Important safety and use flags

  • This is a complementary feed, not a medicine. Medicine-authorisation status is not applicable; that category does not prove clinical efficacy, pharmaceutical equivalence or regulator-reviewed safety.
  • Adjunct only: diagnose and treat the hepatobiliary disorder. Do not substitute this product for nutrition, toxin-specific care, copper management, antimicrobial/immunosuppressive therapy or biliary intervention.
  • No exact-product clinical-outcome, pharmacokinetic/bioavailability or target-animal safety study was located. Ingredient mechanisms and different formulations cannot be added together as product proof.
  • The manufacturer lists ingredients but not per-tablet quantities or a cat-specific dose. Current quantities and feline instructions come from a retailer reproduction of pack information.
  • At the printed schedule, declared SAMe exposure is about 4.5 mg/kg, materially below commonly referenced stable-salt adjunctive dosing. Do not claim equivalence or increase the blend dose by transferring a single-ingredient regimen.
  • The product is described as double-coated, while the reproduced instructions allow crushing into food. SAMe bioavailability after coat disruption is not established; use one deliberate administration method and monitor response.
  • The feline half-tablet instruction is not supported by a verified score line or equal-dose subdivision. Use a validated small-animal presentation when dose accuracy matters.
  • Review polypharmacy: silymarin may inhibit CYP450 enzymes and P-glycoprotein, but exact-product interaction magnitude is unknown. Avoid assuming that “supplement” means interaction-free.
  • Monitor appetite, GI signs, weight, clinical status and disease-appropriate liver biochemistry/imaging. Stop and reassess if objective benefit is absent or the underlying disease progresses.
  • Safety in pregnancy, lactation, neonates and long-term severe organ disease is not established. Use only after an individual benefit-risk review.
Assessment sources
  1. Hepatosil VetaPro page2026
  2. Hepatosil leaflet copy2026
  3. Hepatosil category audit2026
  4. ACVIM canine hepatitis consensus2019
  5. Canine liver nutraceutical review2013
  6. Canine prednisolone SAMe trial2005
  7. Canine GBM hepatoprotectant trial2025
  8. Canine IV LOLA report2016
  9. Healthy-cat SAMe study2005
  10. Feline acetaminophen SAMe study2003
  11. Veterinary cytoprotectant review2009
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 nutritional and hepatoprotective support after diagnosis of a hepatobiliary disorder
4.1/10
Weak evidence support
vetman assessment

Hepatosil Advanced

30 tablets, complementary feed for dogs and cats
Assessed clinical scopeCat · Adjunctive nutritional and hepatoprotective support after diagnosis of a hepatobiliary disorder · By mouth
Care settingVeterinarian-directed home adjunct with disease-specific treatment and objective clinical/biochemical monitoring
vetman score 4.1/10 Weak evidence support
Evidence confidence: Low Georgia: Not a medicine · Verified on 22 Oct 2026

A weakly supported complementary feed with especially indirect feline evidence and an unvalidated half-tablet dose unit. It should not replace diagnosis, disease-specific treatment or a validated cat-sized product.

Regulatory and scientific credibility4.5/10

Exact current identity and complementary-feed category are clear, but the manufacturer omits ingredient quantities and detailed cat instructions; those rely on a retailer reproduction, quality standardisation is incomplete and no exact-product trial exists.

Clinical efficacy2.5/10

Feline evidence consists mainly of small experimental SAMe studies using different enteric-coated products; it does not establish benefit for spontaneous feline liver disease or this five-ingredient tablet.

Safety and tolerability5.0/10

A small healthy-cat study supports tolerability of a different SAMe product, but exact-formulation safety in ill cats, interactions, long-term use and reproductive groups are unestablished.

Clinical practicality4.5/10

Once-daily use is simple, but the unscored half-tablet dose is not accuracy-validated, fasting and coating/crushing uncertainty remain, and a separate MINI presentation is better matched to small animals.

Full-course cost-effectiveness-

Current exact Georgian course price and an evidence-based duration were not verified; cost is excluded.

Important safety and use flags

  • This is a complementary feed, not a medicine. Medicine-authorisation status is not applicable; that category does not prove clinical efficacy, pharmaceutical equivalence or regulator-reviewed safety.
  • Adjunct only: diagnose and treat the hepatobiliary disorder. Do not substitute this product for nutrition, toxin-specific care, copper management, antimicrobial/immunosuppressive therapy or biliary intervention.
  • No exact-product clinical-outcome, pharmacokinetic/bioavailability or target-animal safety study was located. Ingredient mechanisms and different formulations cannot be added together as product proof.
  • The manufacturer lists ingredients but not per-tablet quantities or a cat-specific dose. Current quantities and feline instructions come from a retailer reproduction of pack information.
  • At the printed schedule, declared SAMe exposure is about 4.5 mg/kg, materially below commonly referenced stable-salt adjunctive dosing. Do not claim equivalence or increase the blend dose by transferring a single-ingredient regimen.
  • The product is described as double-coated, while the reproduced instructions allow crushing into food. SAMe bioavailability after coat disruption is not established; use one deliberate administration method and monitor response.
  • The feline half-tablet instruction is not supported by a verified score line or equal-dose subdivision. Use a validated small-animal presentation when dose accuracy matters.
  • Review polypharmacy: silymarin may inhibit CYP450 enzymes and P-glycoprotein, but exact-product interaction magnitude is unknown. Avoid assuming that “supplement” means interaction-free.
  • Monitor appetite, GI signs, weight, clinical status and disease-appropriate liver biochemistry/imaging. Stop and reassess if objective benefit is absent or the underlying disease progresses.
  • Safety in pregnancy, lactation, neonates and long-term severe organ disease is not established. Use only after an individual benefit-risk review.
Assessment sources
  1. Hepatosil VetaPro page2026
  2. Hepatosil leaflet copy2026
  3. Hepatosil category audit2026
  4. ACVIM canine hepatitis consensus2019
  5. Canine liver nutraceutical review2013
  6. Canine prednisolone SAMe trial2005
  7. Canine GBM hepatoprotectant trial2025
  8. Canine IV LOLA report2016
  9. Healthy-cat SAMe study2005
  10. Feline acetaminophen SAMe study2003
  11. Veterinary cytoprotectant review2009
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
Silymarin250 mg L-Ornithine-L-Aspartate50 mg S-Adenosylmethionine45 mg Artichoke Dry Extract40 mg Vitamin E20 mg
Formulation Type
Tablet
Administration route
By mouth
Manufacturer
VetaPro / Veterinarstvo · Serbia
Registration
Georgia Not a medicine
Not applicable (not a medicine)
Verified on: 22 Oct 2026
 EU Not a medicine
Not applicable (not a medicine)
Verified on: 22 Oct 2026
 UK Not a medicine
Not applicable (not a medicine)
Verified on: 22 Oct 2026
 US Not a medicine
Not applicable (not a medicine)
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 Adjunctive nutritional/hepatoprotective support only after diagnosis and disease-specific management. The manufacturer states one tablet up to 10 kg daily; a retailer-reproduced leaflet states dog one tablet/10 kg and cat half tablet/5 kg daily on an empty stomach. Do not extend the ambiguous schedule above 10 kg or assume an unscored half is equal-dose. A separate MINI presentation exists for small animals.

Professional reference for veterinary professionals. Not advertising and not a substitute for the product label/SPC.

For veterinary professionals only. It does not replace clinical judgement or the product label; check the dose in the official label (SPC). vetman is not liable for harm caused by using this information.

Trademarks belong to their owners; vetman is not affiliated with the manufacturers and receives no payment from them.

The database is protected under Chapter VII of the Law of Georgia on Copyright and Related Rights; automated or bulk copying is prohibited.

This reference is still growing. Missing a product? Let us know. · Report an error or request an addition · Updated: 23 Oct 2026

All of this shows in vetman as you prescribe

The dose for the patient's weight, registration in Georgia and controlled status, right on the prescription.

Register Demo ↗