Fresenius Kabi Fresubin HEPA Cappuccino – Liver Support Medical Nutrition Drink, 200 ml (Pack of 4)

Product Overview

Fresubin HEPA Cappuccino is a disease-specific oral nutritional supplement developed by Fresenius Kabi for patients with liver disease who are at risk of or experiencing disease-related malnutrition. Hepatic patients frequently develop protein-energy malnutrition due to impaired nutrient metabolism, reduced oral intake and altered amino acid profiles characterised by low branched-chain amino acid levels and elevated aromatic amino acid concentrations. Fresubin HEPA addresses this imbalance with a BCAA-enriched protein source that supports nitrogen balance while minimising the risk of hepatic encephalopathy.

The formulation incorporates 36% medium-chain triglycerides in its fat component, reflecting the impaired long-chain fatty acid absorption common in cholestatic and cirrhotic liver disease. The low sodium content supports fluid management in patients prone to ascites and peripheral oedema. Fresubin HEPA is lactose-free, gluten-free and available in a palatable cappuccino flavour to encourage compliance in patients with altered taste perception, a frequent complication of chronic liver disease.

Specifications

Clinical Indications

• Acute hepatic failure requiring BCAA-enriched enteral nutrition to reduce risk of hepatic encephalopathy
• Chronic liver cirrhosis (Child-Pugh B/C) with protein-energy malnutrition per ESPEN 2019 liver disease guidelines
• Pre-transplant nutritional optimisation in patients awaiting liver transplantation
• Alcoholic hepatitis with associated malnutrition and impaired oral intake
• Cholestatic liver disease where long-chain fatty acid malabsorption necessitates MCT-enriched formulations

Frequently Asked Questions

Why is Fresubin HEPA enriched with branched-chain amino acids?

Patients with liver failure exhibit reduced plasma BCAA relative to aromatic amino acids. This altered Fischer ratio contributes to hepatic encephalopathy. ESPEN guidelines recommend BCAA-enriched oral supplements to improve nitrogen balance and reduce encephalopathy episodes in advanced cirrhosis.

Why does Fresubin HEPA contain medium-chain triglycerides?

MCTs are absorbed directly into the portal circulation without requiring bile salt emulsification. This is clinically important in liver disease where bile production is impaired. The 36% MCT content ensures adequate fat absorption even in patients with significant cholestasis.

Can Fresubin HEPA be used as a sole source of nutrition?

Yes. At 7-8 bottles per day, Fresubin HEPA provides complete nutrition. Most clinical protocols use it as a supplementary feed (1-3 bottles per day) alongside modified oral diet, titrated by a clinical dietitian.

Is Fresubin HEPA suitable for hepatic encephalopathy patients?

Yes. The elevated BCAA-to-aromatic amino acid ratio addresses the altered amino acid metabolism contributing to encephalopathy. Clinical use should be supervised by a hepatologist or gastroenterologist.

How can I order for my Singapore healthcare facility?

Fresubin HEPA is available through EMIS (Essential Medical International Supplies Pte Ltd) for Singapore healthcare facilities. FSMP classification means it should be used under medical supervision. Institutional and bulk pricing available.