FREQUENTLY ASKED QUESTIONS
Is it allowed to take Tivortin in case of high blood pressure?
The higher the pressure, the greater is stress experienced by vascular walls, consequently, when you take Tivortin® аspartate you protect your vascular walls from the damage by high pressure.
Important! Please consult your doctor if you have high blood pressure.
Is it possible to ingest Tivortin® manufactured for intravenous administration?
Unfortunately, the solution for intravenous administration is distasteful; moreover, the effect of intravenous solution on the gastrointestinal tract has not been studied.
Try to exchange Tivortin® infusion solution for Tivortin® аspartate oral solution in the pharmacy.
What is this medicine (active ingredient)?
This medicinal product contains a natural component L-arginine, which is also present in human tissues, so the product is not a foreign substance for human body and has a favorable tolerability.
Is it possible to take Tivortin® аspartate in case of liver diseases (is it harmful to the liver)?
Tivortin® аspartate exhibits an additional property – it removes toxic ammonia from the body accumulated in the blood in liver diseases. Consequently, hepatitis and liver cirrhosis are not contraindications, but indications for the use of this medicinal product (see Prescribing Information).
How many vials of Tivortin® аspartate are needed for a course of treatment?
The average course of treatment consists of three vials of 100 mL Tivortin® аspartate. The daily intake with this course is 20 mL (4 measuring spoons) of the solution.
How to measure the dose?
Each package includes measuring spoon. One measuring spoon – 5 mL of the solution equivalent to 1 g of the medicine.
When to take this medicinal product – before or after meals?
This medicinal product has a sweetish taste. It is better to take it immediately after meals not to spoil the appetite.
Why this medicinal product is supplied in brown vials?
Tivortin® аspartate should be stored protected from light and kept away from direct sunlight.
Role of tivortin in the plegic mixture. Regimen
In the majority of studies, 7.5 L-arginine has been used as the component of 500 mL cardioplegic solution, which is equivalent to 2 vials of 100 mL Tivortin® solution.
Has Tivortin® аspartate any effect on the spermatogenesis?
Konstantin Anatolievich Vladychenko, urologist, PhD in Medical Sciences,
‘Your question is really quite interesting, topical and highly debated. It is only relatively recently (the 1990s) that scientists have started to study the effect of nitric oxide on the human body. Available literature data reveal a great number of scientific works related to the effect of L-arginine on the erectile component of copulatory interval, maintenance of pregnancy in FGR, fetoplacental insufficiency and other somatic pathologies associated with the vascular system of the body. Publications in the field of reproductive medicine consider L-arginine as a medicinal product, which increases the efficacy of extracorporeal fertilization techniques (in terms of its effect on oocytes). The effect of L-arginine on spermatogenesis has not been adequately addressed in the literature. It has been established that a substantial part of prostatic secretions (according to amino acid content) is formed by L-arginine (in some animals – up to 90%).
Several clinical studies on the effect of L-arginine on spermatogenesis are currently being performed at the Bukovinsky Center for Reproductive Medicine, Chernovtsy city. According to the preliminary results of the ongoing study, oral administration of L-arginine (Tivortin® Aspartate solution) increases the number of active and motile spermatozoids by 25-30% (significant).
A positive clinical effect has been seen in asthenozoospermia. In some cases, increase in the total number of spermatozoids has been observed (however, these data require statistical processing to determine the correlation with the type of disorder in spermatogenesis). The effect of L-arginine on the patients’ hormone profiles has not been statistically analyzed yet.’
Can diabetic patients take Tivortin® (type 2 diabetes)?
The levels of insulin in the body are known to be sufficient or excessive in type 2 diabetes mellitus along with decreased sensitivity of the tissues to insulin. It is also known that diabetes ‘destroys’ vessels and causes such complications as nephropathy (damage to vessels in the kidneys), retinopathy (damage to vessels in the eyes), disorders of coronary vessels, cerebral vessels and vessels of the lower extremities.
This medicinal product is indicated in type 2 diabetes since it raises the sensitivity of tissues to insulin, prevents and/or ensures the delay in the development of vascular pathologies.
The recommended dosage schedule:
10 mL of Tivortin® Aspartate is administered 3 times a day for 14 days. Please consult your treating physician before starting therapy with Tivortin® Aspartate.
In case of significant complications of diabetes mellitus, in hospitalized patients, this medicinal product is administered by intravenous infusions.
Can Tivortin® be used for the treatment of circulatory disorders of optic disc in ischemic maculopathy?
Oksana Vasilyevna Petrenko, PhD in Medical Sciences, research assistant at the Department of Ophthalmology, eye surgeon of superior expert category, ‘In view of the vascular nature of disease, the product may and should be used in this pathology.’
Currently, the Department of Ophthalmology of the Bohomolets National Medical University plans to carry out several studies, and you will be the first to know their results in the news block of the web site.
The opportunities and experience of the use in obstetrics and gynecology
Professor V.I. Medved, Head of the Pathologic pregnancy department, Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine,
‘As for the use in gynecology, I don’t have now and will not have in the future a personal experience since my professional contacts are limited to pregnant women. I have a very successful practice of tivortin use in pregnant women with diabetes mellitus, particularly in the cases of intrauterine growth retardation and/or chronic foetal distress.
Tivortin® has been administered by intravenous infusions, 1 vial (4.2 g L-arginine) per course of 15 days minimum. Tivortin has also been used by our clinic in women with preeclampsia secondary to hypertension, diabetes mellitus, chronic renal diseases, other extragenital diseases.
Separate indication for the use of this medicinal product, which is specified in the patient information leaflet too, is the intrauterine growth restriction syndrome, irrespective of its origin.
Thank you for your interest.
Sincerely yours, V.I. Medved.’
What are the Tivortin® treatment regimens (duration of infusion therapy or oral administration) in patients with chronic CAD, stable and unstable angina?
V.A. Slobodskoy, ‘As previously reported, we have experience of the use of tivorin in patients with stable exertional angina, classes II-III. Regimen:
1st stage – 7-10 days intravenous infusions of Tivortin® with concomitant administration of 10-15 mL Tivortin® aspartate per os two times a day.
2nd stage – 15 mL per os Tivortin® aspartate BID for one month.
Following completion of the treatment course, the antianginal effect maintains for another 1-1.5 months.
What recommendations can you offer as to the dosage and course of treatment with Tivortin® in cardiology? Who of cardiologists deal with this issue?
This question was answered by V.A. Slobodskoy (PhD in Medical Sciences, Department of chronic CAD and atherosclerosis at M.D. Strazhesko Institute of Cardiology),
‘The patients are given 1 vial of solution by infusion daily for 7-10 days (during their stay in our hospital). They concurrently take 6 g Tivortin® aspartate (three measuring spoons BID). The patients receive oral solution (Tivortin® aspartate) during their stay in hospital and for one month following their discharge.’
Can Tivortin® be prescribed to a patient on potassium-sparing diuretics?
Tivortin® can be combined with potassium-sparing diuretics. However, it should be remembered that concomitant administration results in delayed elimination of potassium from the body. Thus, such patients should not additionally receive medicinal products containing potassium.