Table 2. Overview of the discussed (potential) treatment options for HE in CLD and their recommended or studied doses.
| Treatment | Drug | Recommended/studied dose |
|---|---|---|
| Non-absorbable disaccharides | Lactulose | Initial dose 25 mL. Dose titration
to maintain 2–3 loose bowel movements/day. |
| Antibiotics | Rifaximin | 550 mg BD orally |
| Ammonia/nitrogen scavengers | LOLA | 25–40 g/day (i.v.) |
| OP | Up to 20 g/day (i.v.) | |
| Sodium benzoate | 10 g/day (oral) | |
| Sodium phenylbutyrate | 200 mg/kg/day (oral or via
nasogastric tube) |
|
| Glycerol phenylbutyrate | 6 mL twice daily for 16 weeks (oral) | |
| Albumin dialysis | MARS | various |
| Probiotics | various | various |
| FMT | n.a. | various |
| BCAAs | n.a. | various (13.2–60 g/day) |
| Zinc | n.a. | various (50–600 g/day) |
| Selection of experimental
therapies targeting neuroinflammation |
Indomethacin | 0.5 mg/kg i.v. |
| Sildenafil | unknown | |
| SB239063
(MAP-kinase-p38 inhibitor) |
unknown |
BCAA, branched-chain amino acid; BD, twice daily; FMT, fecal microbiota transplantation; HE, hepatic encephalopathy; i.v., intravenously; LOLA, L-ornithine L-aspartate; OP, ornithine phenylacetate.