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Heme arginate is an intravenous, arginine-stabilized heme product used to treat acute attacks of acute hepatic porphyrias, including acute intermittent porphyria, variegate porphyria, and hereditary coproporphyria. It restores hepatic heme availability and suppresses hepatic 5-aminolevulinate synthase 1 through feedback inhibition, reducing production of the neurotoxic heme precursors delta-aminolevulinic acid and porphobilinogen. It is marketed by Recordati as **Normosang**, a 25 mg/mL concentrate for infusion. Heme arginate has also been clinically investigated as an inducer of heme oxygenase 1 for protection against ischemia-reperfusion injury, acute kidney injury, cardiac injury, and post-ERCP pancreatitis. ([rxreasoner.com](https://www.rxreasoner.com/monographs/normosang/pharmacology))
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