L-Ornithine-L-aspartate (LOLA) is used to support the hepatic system, particularly in the management of hepatic encephalopathy (HE), a neuropsychiatric complication of liver dysfunction. The primary mechanism is the enhancement of ammonia detoxification. LOLA provides substrates for the urea cycle (ornithine) and for glutamine synthesis (aspartate), both of which help convert toxic ammonia to urea and glutamine, reducing blood ammonia levels—a key goal in liver disease management.

Multiple randomized controlled trials and systematic reviews have evaluated LOLA’s efficacy. Evidence shows that oral or intravenous LOLA can significantly lower ammonia levels and improve mental status in patients with mild to moderate hepatic encephalopathy. A 2013 Cochrane review and subsequent meta-analyses support its use as an effective and safe therapy, with outcomes comparable to or better than other ammonia-lowering agents such as lactulose. Clinical guidelines for hepatic encephalopathy management (e.g., EASL, AASLD) include LOLA as a therapeutic option.

While most evidence relates to hepatic encephalopathy, some studies suggest potential benefits in general liver function or in preventing progression of liver disease, but data in these areas are less robust. Overall, the primary justification for LOLA’s use in hepatic system support is strong scientific validation, specifically for conditions involving hyperammonemia.