L-ORNITHINE-L-ASPARTATE

OTHER NAME(S):

2,5-Diaminopentanoic Acid 2-Aminobutanedioic Acid, L-Ornithin-L-Aspartat, L-Ornithine-L-Aspartate Salt, LOLA, Ornithine Aspartate, Ornithylaspartate.

Overview

Overview Information

L-ornithine-L-aspartate is a chemical made up of the two amino acids ornithine and aspartic acid. Most amino acids are used as building blocks to make protein. But L-ornithine-L-aspartate is not used to make protein. Instead it is broken down in the body to provide ornithine and aspartic acid.

L-ornithine-L-aspartate is most commonly used for reduced brain function in people with advanced liver disease (hepatic encephalopathy). It is also used for athletic performance, cirrhosis, and other conditions, but there is no good scientific evidence to support these uses.

How does it work?

L-ornithine-L-aspartate increases the levels of ornithine and aspartic acid in the body. These amino acids help to reduce levels of a toxic chemical called ammonia in the blood.

Uses

Uses & Effectiveness?

Possibly Effective for

  • Reduced brain function in people with advanced liver disease (hepatic encephalopathy). Most research shows that L-ornithine-L-aspartate may reduce symptoms of hepatic encephalopathy in people with a liver disease called cirrhosis. But most of this research is low-quality. And not all people who get hepatic encephalopathy have cirrhosis. L-ornithine-L-aspartate might not help reduce symptoms in people with other causes of hepatic encephalopathy.

Insufficient Evidence for

  • Liver scarring (cirrhosis). Research shows that giving L-ornithine-L-aspartate by mouth or with a needle might reduce the risk of death in people with cirrhosis. But not all research agrees. More research is needed to understand if L-ornithine-L-aspartate can help people with cirrhosis.
  • To improve mental performance during exercise.
  • Involuntary weight loss in people who are very ill (cachexia or wasting syndrome).
  • Wound healing.
  • Burns.
  • Other conditions.
More evidence is needed to rate L-ornithine-L-aspartate for these uses.

Side Effects

Side Effects & Safety

When taken by mouth: L-ornithine-L-aspartate is POSSIBLY SAFE when taken by mouth. No side effects have been reported.

When given by IV: L-ornithine-L-aspartate is POSSIBLY SAFE when given by IV. Nausea, vomiting, cough, muscle cramping, and diarrhea have happened in some people getting injections of L-ornithine-L-aspartate. But these side effects are rare.

Special Precautions & Warnings:

Pregnancy and breast-feeding: Not enough is known about the use of L-ornithine-L-aspartate during pregnancy and breast-feeding. Stay on the safe side and avoid use.

Interactions

Interactions?

We currently have no information for L-ORNITHINE-L-ASPARTATE Interactions.

Dosing

Dosing

The following doses have been studied in scientific research:

ADULTS
BY MOUTH:

  • For reduced brain function in people with advanced liver disease (hepatic encephalopathy): 9-18 grams daily for up to 3 months has been used.
WITH A NEEDLE:
  • For reduced brain function in people with advanced liver disease (hepatic encephalopathy): 5-40 grams daily for up to 7 days has been used.

View References

REFERENCES:

  • Acharya, S. K., Bhatia, V., Sreenivas, V., Khanal, S., and Panda, S. K. Efficacy of L-ornithine L-aspartate in acute liver failure: a double-blind, randomized, placebo-controlled study. Gastroenterology 2009;136(7):2159-2168. View abstract.
  • Ahmad, I., Khan, A. A., Alam, A., Dilshad, A., Butt, A. K., Shafqat, F., Malik, K., and Sarwar, S. L-ornithine-L-aspartate infusion efficacy in hepatic encephalopathy. J.Coll.Physicians Surg.Pak. 2008;18(11):684-687. View abstract.
  • Feher J, Lang I Gogl A Varga L Varga L Tompos G Pronai L. Effect of ornithine-aspartate infusion on elevated serum ammonia concentration in cirrhotic patients - Results of a randomized, placebo-controlled double-blind multicentre trial. Medical Science Monitor. 1997;3(5):669-673.
  • Kircheis, G., Nilius, R., Held, C., Berndt, H., Buchner, M., Gortelmeyer, R., Hendricks, R., Kruger, B., Kuklinski, B., Meister, H., Otto, H. J., Rink, C., Rosch, W., and Stauch, S. Therapeutic efficacy of L-ornithine-L-aspartate infusions in patients with cirrhosis and hepatic encephalopathy: results of a placebo-controlled, double-blind study. Hepatology 1997;25(6):1351-1360. View abstract.
  • Kowalski, P. and Bieniecki, M. Pharmacokinetics and bioavailability study of L-ornithine-L-aspartate in healthy volunteers--a comparative study of two oral formulations. J.Pharm.Biomed.Anal. 6-7-2006;41(3):1061-1064. View abstract.
  • Mittal, V. V., Sharma, B. C., Sharma, P., and Sarin, S. K. A randomized controlled trial comparing lactulose, probiotics, and L-ornithine L-aspartate in treatment of minimal hepatic encephalopathy. Eur.J.Gastroenterol.Hepatol. 2011;23(8):725-732. View abstract.
  • Ndraha, S., Hasan, I., and Simadibrata, M. The effect of L-ornithine L-aspartate and branch chain amino acids on encephalopathy and nutritional status in liver cirrhosis with malnutrition. Acta Med.Indones. 2011;43(1):18-22. View abstract.
  • Ong, J. P., Oehler, G., Kruger-Jansen, C., Lambert-Baumann, J., and Younossi, Z. M. Oral L-ornithine-L-aspartate improves health-related quality of life in cirrhotic patients with hepatic encephalopathy: an open-label, prospective, multicentre observational study. Clin.Drug Investig. 2011;31(4):213-220. View abstract.
  • Poo, J. L., Gongora, J., Sanchez-Avila, F., Aguilar-Castillo, S., Garcia-Ramos, G., Fernandez-Zertuche, M., Rodriguez-Fragoso, L., and Uribe, M. Efficacy of oral L-ornithine-L-aspartate in cirrhotic patients with hyperammonemic hepatic encephalopathy. Results of a randomized, lactulose-controlled study. Ann.Hepatol. 2006;5(4):281-288. View abstract.
  • Stauch, S., Kircheis, G., Adler, G., Beckh, K., Ditschuneit, H., Gortelmeyer, R., Hendricks, R., Heuser, A., Karoff, C., Malfertheiner, P., Mayer, D., Rosch, W., and Steffens, J. Oral L-ornithine-L-aspartate therapy of chronic hepatic encephalopathy: results of a placebo-controlled double-blind study. J.Hepatol. 1998;28(5):856-864. View abstract.
  • Abid S, Jafri W, Mumtaz K, et al. Efficacy of L-ornithine-L-aspartate as an adjuvant therapy in cirrhotic patients with hepatic encephalopathy. J Coll Physicians Surg Pak 2011;21:666-71. View abstract.
  • Alehagen U, Alexander J, Aaseth J. Supplementation with selenium and coenzyme Q10 reduces cardiovascular mortality in elderly with low selenium status. A secondary analysis of a randomized clinical trial. PLoS One. 2016 Jul 1;11(7):e0157541. View abstract.
  • Alvares-da-Silva MR, de Araujo A, Vicenzi JR, et al. Oral L-ornithine-L-aspartate in minimal hepatic encephalopathy: a randomized, double-blind, placebo-controlled trial. Hepatol Res 2014;44:956-63. View abstract.
  • Bai M, He C, Yin Z, et al. Randomised clinical trial: L-ornithine-L-aspartate reduces significantly the increase of venous ammonia concentration after TIPSS. Aliment Pharmacol Ther 2014;40:63-71. View abstract.
  • Bai M, Yang Z, Qi X, et al. L-ornithine-L-aspartate for hepatic encephalopathy in patients with cirrhosis: a meta-analysis of randomized controlled trials. J Gastroenterol Hepatol 2013;28:783-92. View abstract.
  • Goh ET, Stokes CS, Sidhu SS, Vilstrup H, Gluud LL, Morgan MY. L-onrhithine L-aspartate for prevention and treatment of hepatic encephalopathy in people with cirrhosis. Cochrane Database Syst Rev. 2018 May 15;5:CD012410. View abstract.
  • Mikulski T, Dabrowski J, Hilgier W, et al. Effects of supplementation with branched chain amino acids and ornithine aspartate on plasma ammonia and central fatigue during exercise in healthy men. Folia Neuropathol 2015;53:377-86. View abstract.
  • Pérez Hernández JL, Higuera de la Tijera F, Serralde-Zúñiga AE, Abdo Francis JM. Critical analysis of studies evaluating the efficacy of infusion of L-ornithine L-aspartate in clinical hepatic encephalopathy in patients with liver failure. Ann Hepatol 2011;10 Suppl 2:S66-9. View abstract.
  • Rees C, Oppong K, Mardini H, et al. Effect of L-Ornithine-L-Aspartate on patients with and without TIPS undergoing glutamine challenge: a double blind, placebo controlled trial. Gut 2000;47:571-4.. View abstract.
  • Schmid M, Peck-Radosavljevic M König F Mittermaier C Gangl A Ferenci P. A double-blind, randomized, placebo-controlled trial of intravenous L-ornithine-L-aspartate on postural control in patients with cirrhosis. Liver Int. 2010;30(4):574-582. View abstract.
  • Shalimar, Acharya SK. Management in acute liver failure. J Clin Exp Hepatol 2015;5:S104-15. View abstract.
  • Sharma K, Pant S, Misra S, et al. Effect of rifaximin, probiotics, and l-ornithine l-aspartate on minimal hepatic encephalopathy: a randomized controlled trial. Saudi J Gastroenterol 2014;20:225-32. View abstract.
  • Varakanahalli S, Sharma BC, Srivastava S, Sachdeva S, Dahale AS. Secondary prophylaxis of hepatic encephalopathy in cirrhosis of liver: a double-blind randomized controlled trial of L-ornithine L-aspartate versus placebo. Eur J Gastroenterol Hepatol. 2018 Apr 30. View abstract.
  • Waghray A, Waghray N, Mullen K. Management of covert hepatic encephalopathy. J Clin Exp Hepatol 2015;5:S75-81. View abstract.
  • Zhu GQ, Shi KQ, Huang S, et al. Systematic review with network meta-analysis: the comparative effectiveness and safety of interventions in patients with overt hepatic encephalopathy. Aliment Pharmacol Ther 2015;41:624-35. View abstract.

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