6g Bonded LOLA per serving

Available OTC for Inpatient & Outpatient use

GI friendly

Less than 1 calorie per scoop

Clinically studied*

Made in the USA in an FDA inspected facility

Clinical Video Presentations

Below are links to two video presentations.

These videos summarize the clinical data and the meta-analysis of the clinical data for the use of LOLA in HE.

HepLOLA Ammonia lowering Mechanism of Action - HE

L-Ornithine-L-Aspartate lowers plasma ammonia concentrations by enhancing the metabolism of ammonia to urea and glutamine in the liver.

Ornithine serves both as an activator of carbamyl phosphate synthetase and ornithine-carbamyl transferase in the urea cycle in the periportal hepatocytes and as a substrate for ureagenesis.

Ornithine increases ammonia removal in the perivenous hepatocytes by increasing the level of glutamate and stimulating glutamine synthesis.

Aspartate plays a major role in the urea cycle as it provides the second nitrogen needed to produce urea along with the first nitrogen derived from ammonia.

Efficacy of Oral LOLA in HE and MHE

In 3 separate clinical trials, oral LOLA has been shown to offer equal or superior efficacy to lactulose in regard to controlling or reducing ammonia levels as well as Health Related Quality of Life scores. The efficacy of LOLA is also paralleled by an improved GI side effect profile versus lactulose.

  • Efficacy of Oral L-Ornithine L-Aspartate in cirrhotic patients with hyperammonemic hepatic encephaplopathy. Result of a randomized lactulose controlled trial. Annals of Hepatology, Oct 2006, Poo JL et al.

    Find a link to the trial in the clinical references section found by scrolling down.

  • Scroll down to clinical references section to find a link to the clnical trial.

  • Scroll down to the clinical references section to link to abstract.

Scroll down to find further publications on the use of LOLA to manage HE.

HepLOLA dosing

For the management of Hepatic Encephalopathy, HepLOLA is typically dosed at 6g TID. A canister of HepLOLA contains 90 6g doses, a one month supply.

Some trials have utilized 3g TID, but the efficacy seen was typically inferior to 6g TID dosing.

Outpatient Access

HepLOLA is available to purchase on this website with quantity discounts and free shipping options.

HepLOLA is also available on Amazon.com at a higher price.

Inpatient Access

If you would like to utlize HepLOLA in the inpatient setting, please ask inpatient pharmacy to review HepLOLA for formulary inclusion.

Patients Not Appropriate for HepLOLA

Consistent with its mechanism of action, LOLA leads to the increased production of urea.

Urea is eliminated by the kidneys and therefore LOLA should not be used in patients with severely impaired renal function.

As a general rule, a patient's serum creatine should not be greater than 3mg/dl when initiating LOLA therapy.

Contact a clinical sales specialist

You can contact a Clinical Sales Specialist by calling 1-844-980-9955, or at sales@penguinmed.com

Side effects seen with LOLA

The clinical trials on the use of LOLA for Hepatic encephalopathy indicate that LOLA is very well tolerated. One trial showed that in a small percentage of patients (<2%), dyspepsia occurred for patients taking LOLA. No other safety issues have been reported on the use of oral LOLA in the management of Hepatic Encephalopathy.

Publications on the use of LOLA in Hepatic Encephalopathy with links.

Oral L-Ornithine-L-Aspartate therapy of chronic hepatic encephalopathy: results of a placebo-controlled double blind study.

Stauch S, Kircheis G, Alder G et al; J of Hepatology 1998, 28 856-864

Efficacy of Oral L-Ornithine-L-Aspartate in cirrhotic patients with hyperammonemic hepatic encephalopathy: results from a randomized lactulose-controlled study.

Poo L, et al; Annals of Hepatology 2006, 5(4) Oc-Dec 281-288

Secondary prophylaxis of hepatic encephalopathy in cirrhosis of liver: a double blind randomized controlled trial of L-Ornithine-L-Aspartate versus placebo.

Varakanahalli, S et al; Gastroenterology and Hepatology, Aug 2018 Vol 30, No 8

Effects of Rifaximin, Probiotics and LOLA on Minimal Hepatic Encephalopathy: a randomized controlled trial.

Sharma et al; Saudi J of Gastroenterology, 2014, Jul-Aug (4) 225-232

Reduction in hospital stay with the use of L-Ornithine L-Aspartate in patients with 
hepatic encephalopathy.

Abdo-Francis JM, Perez-Hernandez JL et al; Review of Gastro of Mexico 2010: 2(75):135-141

Oral L-Ornithine-L-Aspartate Improves Health-Related Quality of Life in Cirrhotic Patients with Hepatic Encephalopathy.

Ong, J et al: Clin Drug Investigation 2011: 31 (4)

A randomized controlled trial comparing lactulose, probiotics, and L-ornithine L-aspartate in treatment of minimal hepatic encephalopathy.

Mittal, V et al: European J of Gastroenterology and Hepatology, 2011, Vol 23 No 8

Efficacy of L-Ornithine L-Aspartate granules in chronic liver disease

Grungreif K, Lambert-Baumann J, Med Welt 2001, 219

About Medical Foods

Unlike supplements a medical food, as defined in section 5(b)(3) of the Orphan Drug Act (21 U.S.C. 360ee(b)(3)), is “a food which is formulated to be consumed or administered enterally under the supervision of a physician and which is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements, based on recognized scientific principles, are established by medical evaluation.” Medical Foods, including HepatoLOLA can be purchased without a prescription. HepatoLOLA is made in the USA in an FDA inspected facility under cGMP guidelines.