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L-ornithine aspartate is a stable salt formed from the amino acids L-ornithine and L-aspartic acid. It is used primarily for the treatment and prevention of hepatic encephalopathy in patients with chronic liver disease, especially cirrhosis. The drug works by increasing levels of ornithine and aspartic acid in the body, which participate in ammonia detoxification through the urea cycle and glutamine synthesis pathways. This leads to a reduction in toxic blood ammonia levels—a key factor in hepatic encephalopathy pathogenesis[1][2][4]. L-ornithine serves as an intermediary in the urea cycle within periportal hepatocytes, while both amino acids also facilitate transamination to glutamate via glutamine synthetase[2]. Additional proposed benefits include hepatoprotective effects and support for skeletal muscle proteostasis[2][6]. The drug can be administered orally or intravenously; IV forms are typically reserved for hospital use[1][4].
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