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Livact, consisting only of branched-chain amino acid alone and does not contain all amino acid required for protein synthesis. Therefore, the patient taking Livact must ingest the amount of protein (amino acids) and calories required (daily protein intake, ≥40 g; and daily calorie intake, ≥1000 kCal) in the diet according to the patient's condition. If the patient is on restricted protein intake, in particular, caution must be exercised in that the patient may not respond with Livact therapy and, moreover, long-term use of Livact may lead to aggravation of nutriture unless the minimum protein and calorie requirements are secured.
If abnormal BUN or blood ammonia is noted following administration of Livact, caution must be taken because it may be attributable to overdose. Caution should also be observed regarding long-term overdosage since it may give rise to aggravation of nutriture.
If no improvement in hypoalbuminemia is attained within ≥2 months with the use of Livact, appropriate measures should be taken eg, replacement with another therapy.
Use in pregnancy & lactation: The safety of Livact in pregnant women and nursing mothers has not been established. Therefore, Livact should not be used in pregnant women, and women suspected of being pregnant, and nursing mothers unless the expected benefits outweigh any potential risk.
Use in the elderly: Livact should be administered to elderly patients with caution since such patients often have decreased physiological functions, and metabolic disorders eg, blood ammonia elevation can be more sensitive to develop during Livact therapy.
Use in children: The safety of Livact in children has not been established. (No clinical experience).
