This drug product consists of 3 BCAAs.

The following results were observed in association with improvement of hypoalbuminemia in patients with decompensated cirrhosis.

1. It increased the blood Fischer ratio.
2. It alleviated general malaise and fatigability.

This product is provided in a sachet containing approximately 16 kca (LIVACT^® Granules), and it is taken together with normal food or liver disease food.

Characteristics of LIVACT^® Granules
It is a compact drug product with a weight of 4.15 g, containing 4 g of active ingredient per sachet. It has excellent portability.

Adverse reaction
Among the 420 patients examined before approval, 40 adverse reactions were observed in 27 patients (6.4%). The major adverse reactions included (sensation of) abdominal distension (9 events, 2.1%), diarrhoea (5 events, 1.2%), and constipation (4 events, 1.0%). (At the time of approval of LIVACT^® Granules) Among the 2,877 patients in the drug use investigation, 267 adverse reactions were observed in 178 patients (6.2%). The major adverse reactions included hyperammonaemia (23 events, 0.8%), queasy (15 events, 0.5%), diarrhoea and BUN increased (14 events each, 0.5%), and abdominal pain (12 events, 0.4%). (At the end of re-examination of LIVACT^® Granules)
Among the 334 patients in the post-marketing clinical studies (including long-term studies), 63 adverse reactions were observed in 41 patients (12.3%). The major adverse reactions included (sensation of) abdominal distension (13 events, 3.9%), constipation (9 events, 2.7%), diarrhoea (5 events, 1.5%), pruritus (4 events, 1.2%), and queasy and vomiting (3 events each, 0.9%). (At the end of re-examination of LIVACT^® Granules)

Decreased BCAAs in patients with cirrhosis

In the patients with cirrhosis, BCAAs are decreased while aromatic amino acids (AAAs) are increased. This means that the Fischer ratio (BCAAs/AAAs) is decreased.

Serum albumin and Fischer ratio

Serum albumin levels in patients with hepatic disease are known to be correlated with the plasma Fischer ratio.