Hepatosol Hepatosol
Product
Product Hepatosol
Product

Hepatosol is a specialized nutrition formulated to meet the requirement for conditions such as chronic liver disease. 

Hepatosol contains :

  1. High energy and protein amount
  2. MCT (Medium Chain Triglycerides)
  3. BCAA (Isoleucine, Leucine, and Valine)
  4. Completed with vitamins and minerals premix

Brands Info

Feature Benefit

 

FEATURES BENEFITS
High Energy

(380 kcal/serv)

To restore/maintain nutritional status and enhance liver regeneration
High Protein

(12 g/serv)

For regeneration of liver cells and to maintain the nitrogen balance but low enough to prevent hepatic coma
MCT  

14 g/serv

To protect the liver from steatosis and reverse alcoholic liver injury
BCAA 

2.66 g/serv

To improve liver function and a lower hospital mortality rate.
Vitamins

(A,B,C,D, E) 

To replenish liver stores and repair tissue damage especially if the patient has anorexia
Minerals 

(Ca, Fe, Zn)

Zn : antioxidant (increase GSH)

Fe : prevent anemia

Ca : prevent bone loss

Low Osmolality

415 mOsmol/kg

to reduce the risk of gastrointestinal disturbance and can be given by tube feeding
Density 

1.05 kCal/mL

Can be given through NGT/Sonde/tube feeding.

 

 

References :

1.Fukui A, Kawabe N, Hashimoto S, Murao M, Nakano T, Shimazaki H, et al. Additional BCAA-enriched nutrient mixture improves the nutritional condition in cirrhotic patients with hypoalbuminemia despite treatment with regular BCAA granules: A pilot study. Turk J Gastroenterol 2015; 26: 328-35

2.Maki H, Yamanaka-Okumura H, Katayama T, Ozawa Y, Hosoda A, Kurata N, et al. Late evening snacks with branched-chain amino acids improve the Fischer ratio with patients liver cirrhosis at fasting in the next morning. [Internet]. [cited 2020 May 5th ]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30904214

3.HEPATOSOL[Product Information] Jakarta. Indonesia. PT Kalbe Farma Tbk; 2020

4.Park JG, Tak WY, Park SY, Kweon YO, Jang SY, Lee YR, et al. Effects of branched-chain amino acids (BCAAs) on the progression of advanced liver disease. Medicine 2017:96-24.

5.Plauth M, Bernal W, Dasarathy S, Merli M, Plank LD, Schutz T, et al., ESPEN guideline on clinical nutrition in liver disease. [Internet]. [cited 2020 May 5th]. Available from:  https://www.espen.org/files/ESPEN-Guidelines/ESPEN-guideline-liver-disease-2019.pdf

6.Sanchez AJ, Aranda-Michel J. Nutrition for the liver transplant patient. Liver Transpl. 2006 Sep;12(9):1310-6

Preparation

Hepatosol can be taken orally or administered via a nasogastric tube.

  • Oral feeding: To prepare a 363 ml of solution, add 1 sachet of Hepatosol (+ 80 gram) into a 300 ml warm water and mix until dissolve. It’s not advisable to cook or boil in high temperature (above 600 Celsius) as it may denature protein content of Hepatosol
  • Tube feeding: Follow physician’s instructor.
  • Not intended to be used for parenteral administration

Nutrition Fact

1.05 kcal/mL nutritionally complete nutritional drink, with high protein, MCT, BCAA, 12 vitamins, and 7 minerals

NUTRITION UNIT PER SERVING % DV
Calories kcal 380
          Calories from fat kcal 140
Total Fat g 15 23%
          Monounsaturated Fatty Acid g 0
          Polyunsaturated Fatty Acid g 0
          Trans Fatty Acid g 0
          Cholesterol mg 2 1%
          Saturated Fatty Acid g 15 76%
              Medium Chain Triglycerides (MCT) mg 14
Protein g 12 19%
Total Carbohydrates g 49 15%
          Dietary Fiber g 2 7%
Total Sugar g 23 15%
          Lactose g 0
          Sucrose g 17
Vitamins 
Vitamin A mcg 93 15%
Vitamin B1 / Thiamine mg 0.18 15%
Vitamin B2 / Riboflavin mg 0.2 15%
Vitamin B3 / Niacin mg 1.8 10%
Vitamin B5 / Pantothenic Acid mg 0.77 15%
Vitamin B6 / Pyridoxine mg 0.14 10%
Folic Acid mcg 58 15%
Vitamin B12 / Cobalamin mcg 0.32 15%
Vitamin C mg 11 10%
Vitamin D3 mcg 2.3 15%
Vitamin E mg 2.2 15%
Biotin mcg 3.7 10%
Minerals
Sodium mg 170 11%
Potassium mg 60 1%
Calcium mg 150 15%
Phosphorus mg 82 10%
Iron mg 3.4 15%
Iodine mcg 18 10%
Zinc mg 1.3 10%
Branched-Chain Amino Acids (BCAA)
          Leucine g 1.22
          Isoleucine g 0.80
          Valine g 0.64

Ingredients

Maltodextrin, Medium Chain Triglycerides Powder, Sucrose, Whey Protein Isolate, Whey Protein Concentrate, Inulin, Premix amino acid BCAA (L-Leucine, L-Isoleucine, L-Valine), Calcium Carbonate, Sodium Chloride, Sodium Monophosphate, Artificial Vanilla Flavor, Vegetable Oil Powder (Mixed Sunflower and Rapeseed Oil), Nature Identical Milk Cream Flavor, Vitamin and Mineral Premix (Sodium Ascorbate, Ferric Pyrophosphate, Vitamin E, Zinc Oxide, Nicotinamide, Vitamin A Palmitate, Vitamin D3, Calcium Pantothenate, Cyanocobalamine, Riboflavin, Thiamine Hydrochloride, Pyridoxine Hydrochloride, Folic Acid, Potassium Iodide, Biotin)

Storage

Opened package should be stored tightly in a cool, dry, and clean place. Consume within 1 month of opening.

Packaging & Flavor

1 box contain 240 gram nutrition powder with Vanilla flavor.

1 box available for 3 servings (3 sachets @ 80 g).

FAQ

What is the content of HEPATOSOL?
HEPATOSOL is an enteral nutrition specifically for liver function disorders, has a composition of 62% carbohydrate, 13% protein and 35% fat and is equipped with specific nutrients such as BCAA to increase the Fischer ratio and the process of restoring muscle protein, and MCT which is a type of fat that is easier to digest and metabolized and easy to use as an alternative energy source.
How many calories/serving of HEPATOSOL ?

HEPATOSOL contains 380 kcal/serving

What is the calorie density of HEPATOSOL?

The calorie density of HEPATOSOL is 1.04 so it can be given by orally or stube feeding.

What is the osmolality of HEPATOSOL?
The osmolality of HEPATOSOL is 415 mOsm/kg
Can HEPATOSOL be concentrated / diluted?
HEPATOSOL can be concentrated / diluted according to the patient's condition and tolerance. In concentrated HEPATOSOL, please pay attention to it’s density, especially when given through a feeding tube, so that HEPATOSOL can enter the feeding tube smoothly.
In what clinical condition can HEPATOSOL be used?
HEPATOSOL can be given to patients with chronic liver disease who suffer from malnutrition / anorexia so that are not able to maintain adequate oral intake from daily meal
How do we prepare HEPATOSOL?
Mix 1 sachet (80 g) of HEPATOSOL into a 300 mL of warm boiled water at a temperature of <70 degrees Celsius, stir and mix until dissolve. It’s not advisable to cook / boil in high temperature, above 700C, as it may denature protein content of HEPATOSOL
How many servings of HEPATOSOL can be consumed per day ?
If as a substitute food, HEPATOSOL can be given up to 6 times / day or adjusted to the needs and patient’s conditions. If as a complementary food can be given 1-3 times / day.
Can HEPATOSOL be combined with other enteral nutrients?
HEPATOSOL can be combined with other enteral nutrients if needed, but the dissolution process should be separately.
Can HEPATOSOL be given to diabetes mellitus (DM) patients?
There is no study of HEPATOSOL in diabetic patients, but considering there are carbohydrates derived from maltodextrin so that it can still affect the blood glucose levels of diabetic patients. DM patients who are given HEPATOSOL have to monitor their blood sugar levels in order to stay controlled. Sometimes, it requires to adjust the dose or the type of diabetes medication so that the fulfillment of nutrition in DM patients is fulfilled.
How is the stability / storage method of HEPATOSOL before it is dissolved?
The stability for HEPATOSOL that has been opened is about 1 month as long as it stays in the aluminum foil bag. Storage condition: in a dry place with a temperature < 25 degrees Celsius. It is not recommended to move HEPATOSOL into another container because it can interfere with its stability. If it is to be stored in a jar it should be together with the aluminum bag.
What is the stability / storage method of HEPATOSOL after it is dissolved?
HEPATOSOL which has dissolved within 5 hours must be consumed. If you have not taken it, HEPATOSOL can be stored in the refrigerator, only after that it is not recommended to be heated (Microwave).
What is the packaging form of HEPATOSOL?
Packaging form of HEPATOSOL is a single sachet (80 g / sachet) which is there are 3 sachets in a box.
The recommended dosage of HEPATOSOL is 3 servings/day, how to use HEPATOSOL as late evening snack ?
Hepatosol should be given 3 times a day, where out of 3 times, once at night, because from clinical studies it was found that late evening snacks with BCAA can improve the balance of albumin and nitrogen in patients. This happens because a patient with fasting cirrhosis for 1 day is the same as a normal fasting person for 3 days. When cirrhosis patients sleep at night for 8 hours is same with fast 24 hours in normal people, so it is advisable to be given a night snack to provide a reserve of nutrition during the night's rest.
Is there a risk of diarrhoea?
One of the risks of enteral nutrition is gastrointestinal disorders including nausea, vomiting and diarrhea. However, these side effects are very rare. Gastrointestinal side effects are generally found due to large doses.
Can HEPATOSOL be combined with parenteral nutrition?
Yes it can, Hepatosol can be consumed as complementary food, replacement food aor as a combination with parenteral nutrition.
Why is it recommended to give 3 times a day(morning, evening and 1 time at night)?
We recommend from 3 times the administration, there is 1 time giving hepatosol at night late evening snack) because there are studies showed that giving a high BCAA as late evening snack can provide better albumin levels, more positive nitrogen balance, and a better fischer ratio.
Can HEPATOSOL be given to children?
There is no study of HEPATOSOL in children. However, remembering is an amino acid (protein) so that it is not harmful, it only needs to adjust the dose and pay attention to the calorie needs of children.
Can HEPATOSOL be given to pregnant women?
There is no study of HEPATOSOL in pregnant women but Because of HEPATOSOL contains nutrients that are normally obtained every-day and are not contraindicated for pregnant women, HEPATOSOL can be given; if, needed.
Can hepatosol be given to patients with cholestasis because it contains MCT?
Hepatosol can be given to all liver function disorders including cholestasis because the fat comes from MCT so that it does not make the liver work harder. However, close monitoring of liver function and markers of cholestasis must be carried out.
Why is the fat content in Hepatosol high?
High fat in Hepatosol aims to increase calorie content. Types of fat used in HEPATOSOL is MCT (Medium Chain Triglycerides), which is the type of fat recommended for liver patients.
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Kalbe International