Anlovex

Yellow colored, caplet-shaped, biconvex, film-coated tablet, with breakline on one side and plain on other side.
Each film-coated tablet contains: Calcium-4-methyl-2-oxo-valerate (α-ketoanalogue to leucine, calcium salt) 101 mg, Calcium-3-methyl-2-oxo-butyrate (α-ketoanalogue to valine, calcium salt) 86 mg, Calcium-2-oxo-3-phenylpropionate (α-ketoanalogue to phenylalanine, calcium salt) 68 mg, Calcium-3-methyl-2-oxo-valerate (α-ketoanalogue to isoleucine, calcium salt) 67 mg, Calcium-DL-2-hydroxy-4-(methylthio) butyrate (α-hydroxyanalogue to methionine, calcium salt) 59 mg, L-Lysine acetate 105 mg, L-Threonine 53 mg, L-Histidine 38 mg, L-Tyrosine 30 mg, L-Tryptophan 23 mg.

Pharmacology: Pharmacodynamics: Ketoanalogues + Essential Amino Acids Tablet allows the intake of essential amino acids while minimizing the amino nitrogen intake.
Following ingestion the ketoanalogues are transaminated by taking nitrogen from non-essential amino acids, thereby decreasing the formation of urea by reusing the amino group. The levels accumulating uremic toxins are decreased. Keto- and/or hydroxy-acids do not elicit hyperfiltration of residual nephrons. Keto acid containing supplements have a positive influence on the renal hyperphosphatemia and secondary hyperparathyroidism can improve renal osteodystrophy. The use of Ketoanalogues + Essential Amino Acids Tablet in association with a very low protein diet allows a reduced intake of nitrogen while avoiding the deleterious consequences of inadequate dietary intake and malnourishment.
Pharmacokinetics: The plasma kinetics of amino acids and their integration in metabolic pathways are well established. It should nevertheless be noted that, in uremic patients, the plasma disturbances do not seem to depend on digested amino acid intake, and that the post-absorptive kinetics seems to be disturbed very early in the development of the disease in normal individuals, there is an increase in the plasma level of ketoanalogues, 10 minutes after oral ingestion. These levels reach values that are approximately 5 times higher than the initial level. Peak levels are reached within 20-60 minutes, and normal levels are reached again after 90 minutes. Gastrointestinal absorption is thus very rapid. In the plasma a simultaneous increase in levels of ketoanalogue and the corresponding amino acid show that transamination of the ketoanalogues is very rapid. Due to the natural pathways of disposal of ketonic acids in the organism, it is probable that exogenous intakes are very rapidly integrated into metabolic cycles. Ketoacids follow the same catabolic pathways as the classical amino acids. No specific study on ketoacid excretion has been performed to date.

Prevention and therapy of damages due to faulty or deficient protein metabolism in chronic renal insufficiency in connection with limited protein in food of 40 g per day (for adults), i.e., generally in patients with a glomerular filtration rate (GFR) below 25 mL/min.

Ketoanalogues + Essential Amino Acids Tablet is administered orally. Swallow whole. If not otherwise prescribed, take 4-8 tablets 3 times a day during meals. This dosage applies to adults (70 kg body weight). Ketoanalogues + Essential Amino Acids tablets are given as long as the glomerular filtration rate (GFR) is <25 mL/min and a diet with an intake of maximum 40 g protein/day for adults is allowed.

No symptoms have been observed to date.

Hypercalcaemia, disturbed amino acid metabolism. In case of hereditary phenylketonuria it has to be taken into account that Ketoanalogues + Essential Amino Acids contains phenylalanine. No experience has been made so far with the application in pregnancy and pediatrics.

Ketoanalogues + Essential Amino Acids should be taken during meals to allow proper absorption and metabolism into the corresponding amino acids. The serum calcium level should be monitored regularly. Ensure the sufficient supply of calories.

No experience has been made so far with the administration in pregnancy and lactation.

Hypercalcaemia may develop. In this case, it is recommended to decrease vitamin D intake. If the hypercalcaemia persists, reduce the dosage of Ketoanalogues + Essential Amino Acids as well as any source of calcium.

The simultaneous administration of medicaments containing calcium (e.g., acetolyte) may lead to pathological increases of the serum calcium level or intensification.
As the uraemic symptoms improve under Ketoanalogues + Essential Amino Acids, a possible administration of aluminum hydroxide should be reduced. Pay attention to a reduction of serum phosphate in order not to interfere with the absorption. Do not take Ketoanalogues + Essential Amino Acids together with drugs that form sparingly soluble compounds with calcium (e.g., tetracyclines, ciprofloxacin and norfloxacin, iron-fluoride and estramustine-containing drugs). Between the intake of Ketoanalogues + Essential Amino Acids tablets and drugs from the mentioned categories, a period of at least 2 hours should pass. The susceptibility towards heart/cardiac-active glycosides and hence also the risk of arrhythmia increases with the rise of the blood calcium concentration.

Stored at temperatures not exceeding 30°C.

Other Drugs Acting on the Genito-Urinary System

A16AA - Amino acids and derivatives ; Used in treatment of alimentary tract and metabolism problems.

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