L-Ornithine L-Aspartate (LOLA)
Also called LOLA, L-ornithine-L-aspartate, ornithine aspartate, L-ornithine L-aspartate.
Best grade C across 10 graded outcomes Amino acid Last checked
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The short answer
From 12 sourcesLOLA is studied almost entirely in people with liver cirrhosis, where it lowers blood ammonia. A Cochrane review of 36 trials found less hepatic encephalopathy overall, but no benefit in the few trials at low risk of bias. Oral LOLA improved mental test scores in some trials and not others, and there is almost no research in healthy people.
Quick pick
From a partner brand · paid link
Nutricology/Allergy Research Group L-Ornithine-L-Aspartate Liver Support Metabolite, 100 Grams
from HerbsPro
Label: 1 rounded teaspoon: 3 g L-ornithine-L-aspartate (oral trials used 15 to 18 g a day).
Best for trying one bottle: $74.30 one-time (checked Oct 15, 2026).
Every graded outcome on this page
10 rows · line = participants- CGrade CHepatic encephalopathy in cirrhosis (all trials)Hepatic encephalopathyn 1,375
- CGrade CHepatic encephalopathy, LOLA added to lactuloseHepatic encephalopathyn 858
- CGrade CProgression to overt hepatic encephalopathyHepatic encephalopathyn 384
- CGrade CMinimal hepatic encephalopathyHepatic encephalopathyn 292
- CGrade CAmmonia and mental function in chronic hepatic encephalopathyHepatic encephalopathyn 66
- CGrade CMinimal hepatic encephalopathy (oral, 60 days)Hepatic encephalopathyn 64
- DGrade DLiver fat and liver enzymes in NASH (two doses compared)Fatty livern 72
- DGrade DAmmonia in overt hepatic encephalopathy, IV vs oralHepatic encephalopathyn 40
- DGrade DAmmonia and mental status vs lactuloseHepatic encephalopathyn 20
- DGrade DReaction time and ammonia during exhaustive exercise (with BCAAs)Exercisen 11
Key facts
- What it is
- A combination of the amino acids L-ornithine and L-aspartate, given by mouth or into a vein82
- Cochrane review (2018)
- 36 trials: less hepatic encephalopathy across all trials (RR 0.70) but not in the one low-risk-of-bias trial; very low quality evidence2
- Oral vs IV
- Ammonia fell similarly with oral and intravenous LOLA over 5 days in 40 patients8
- Side effects
- Non-serious adverse events did not differ from placebo or no intervention across 14 trials (RR 1.15)2
- Fatty liver (2026 review)
- 9 clinical studies (about 1,671 participants; 3 RCTs) reported lower liver enzymes and liver fat, but no large trial has used current MASLD criteria11
What it is
L-ornithine L-aspartate (LOLA) combines two amino acids and is used to lower blood ammonia in people with cirrhosis.
How it works
ProposedLOLA is studied for its ammonia-lowering properties; ammonia is thought to play a key role in hepatic encephalopathy, though the exact cause of the condition is unknown.2
Forms
Form
| Form | Elemental % | Absorption (human data) | GI tolerance | Studied for |
|---|---|---|---|---|
| Oral powder or granules | Varies3Not applicable (an amino-acid combination) | Oral and intravenous LOLA lowered ammonia similarly over 5 days in one trial; in a 2024 meta-analysis oral LOLA reversed minimal encephalopathy (RR 2.648) while intravenous LOLA did not reach significance.86 | No adverse events at 18 g a day for 14 days; no serious adverse effects at 15 g a day for 60 days.34 | High ammonia and hepatic encephalopathy in cirrhosis |
What the human research says
Human trials only, one row per outcome. The form line shows what each trial actually tested. Grades follow our evidence-grading policy.
Trial map
10 graded outcomes, largest study first10 graded outcomes: 7 improved, 3 mixed. The largest, a 2018 meta-analysis of 1,375 people on hepatic encephalopathy in cirrhosis (all trials), found mixed results.
1Hepatic encephalopathy in cirrhosis (all trials)
Mixed · Grade C · Meta-analysis, 1,375 people, 2018
People with cirrhosis and minimal or overt hepatic encephalopathy, or at risk of it (22 trials in this analysis)
Dose, result and source| Outcome | Found | People | Study | Who was studied |
|---|---|---|---|---|
| Hepatic encephalopathy in cirrhosis (all trials) | Mixed | 1,375 | Grade C · Meta-analysis, 2018 | People with cirrhosis and minimal or overt hepatic encephalopathy, or at risk of it (22 trials in this analysis) |
| Hepatic encephalopathy, LOLA added to lactulose | Improved | 858 | Grade C · Meta-analysis, 2025 | Patients with hepatic encephalopathy (12 RCTs; 433 on LOLA plus lactulose, 425 on lactulose alone) |
| Progression to overt hepatic encephalopathy | Improved | 384 | Grade C · Meta-analysis, 2020 | Patients with cirrhosis across 6 RCTs |
| Minimal hepatic encephalopathy | Improved | 292 | Grade C · Meta-analysis, 2024 | Adults with cirrhosis and minimal hepatic encephalopathy (6 RCTs) |
| Liver fat and liver enzymes in NASH (two doses compared) | Improved | 72 | Grade D · Open-label trial, 2013 | Adults with non-alcoholic steatohepatitis (38 on the higher dose, 34 on the lower) |
| Ammonia and mental function in chronic hepatic encephalopathy | Improved | 66 | Grade C · RCT, 1998 | Patients with cirrhosis, high ammonia and stable chronic hepatic encephalopathy (34 LOLA, 32 placebo) |
| Minimal hepatic encephalopathy (oral, 60 days) | Mixed | 64 | Grade C · RCT, 2014 | 64 outpatients with cirrhosis in Brazil, 63 with minimal encephalopathy |
| Ammonia in overt hepatic encephalopathy, IV vs oral | Improved | 40 | Grade D · RCT, 2024 | 40 Indian patients with chronic liver disease and overt encephalopathy |
| Ammonia and mental status vs lactulose | Improved | 20 | Grade D · RCT, 2006 | 20 Mexican patients with cirrhosis and high-ammonia encephalopathy (10 per group) |
| Reaction time and ammonia during exhaustive exercise (with BCAAs) | Mixed | 11 | Grade D · Crossover RCT, 2015 | 11 endurance-trained healthy men |
Every graded row
10 rowsShowing 10 of 10 outcomes. Human trials only.
CGrade CHepatic encephalopathy in cirrhosis (all trials)Hepatic encephalopathyBenefit only in weaker trialsMeta-analysis · 22 studies
n 1,375 · 2018
Mixed LOLA reduced hepatic encephalopathy across all trials (RR 0.70, 95% CI 0.59 to 0.83; 1375 participants) but not in the one trial at low risk of bias (RR 0.96; 63 participants). A mortality benefit (RR 0.42) was not seen in low-risk-of-bias trials (RR 0.47, 95% CI 0.06 to 3.58). Evidence was very low quality.
- Design
- Meta-analysis, 22 studies, n = 1,375, 2018
- Population
- People with cirrhosis and minimal or overt hepatic encephalopathy, or at risk of it (22 trials in this analysis)
- Form
- Oral or intravenous LOLA vs placebo or no intervention
- Dose
- Varied by trial
- Duration
- Varied by trial
- Source
- Reference 2 · PubMed 29762873 (opens PubMed)
CGrade CHepatic encephalopathy, LOLA added to lactuloseHepatic encephalopathyBetter response than lactulose aloneMeta-analysis · 12 studies
n 858 · 2025
Improved The combination had a higher 'total effective rate' than lactulose alone (RR 1.31, 95% CI 1.22 to 1.42), with larger falls in ALT, AST, bilirubin and ammonia (all P = 0.00001).
- Design
- Meta-analysis, 12 studies, n = 858, 2025
- Population
- Patients with hepatic encephalopathy (12 RCTs; 433 on LOLA plus lactulose, 425 on lactulose alone)
- Form
- LOLA plus lactulose vs lactulose alone (route not stated in the abstract)
- Dose
- Varied by trial
- Duration
- Varied by trial
- Source
- Reference 10 · PubMed 40370740 (opens PubMed)
CGrade CProgression to overt hepatic encephalopathyHepatic encephalopathyLess progressionMeta-analysis · 6 studies
n 384 · 2020
Improved LOLA reduced progression from minimal to overt encephalopathy (RR: 0.23, 95% CI: 0.07, 0.73; 3 studies) and recurrence (RR: 0.389), with lower blood ammonia.
- Design
- Meta-analysis, 6 studies, n = 384, 2020
- Population
- Patients with cirrhosis across 6 RCTs
- Form
- Oral or intravenous LOLA vs placebo or no intervention
- Dose
- Varied by trial
- Duration
- Varied by trial
- Source
- Reference 7 · PubMed 31338724 (opens PubMed)
CGrade CMinimal hepatic encephalopathyHepatic encephalopathyMore reversal of minimal HEMeta-analysis · 6 studies
n 292 · 2024
Improved LOLA reversed minimal encephalopathy more often (RR = 2.264, 95 % CI = 1.528, 3.352) and cut progression to overt encephalopathy (RR = 0.220); no effect on mortality (RR = 0.422) or ammonia (SMD = 0.044). Oral LOLA alone: RR = 2.648.
- Design
- Meta-analysis, 6 studies, n = 292, 2024
- Population
- Adults with cirrhosis and minimal hepatic encephalopathy (6 RCTs)
- Form
- Oral or intravenous LOLA vs placebo or no intervention
- Dose
- Varied by trial
- Duration
- Varied by trial
- Source
- Reference 6 · PubMed 38403493 (opens PubMed)
CGrade CAmmonia and mental function in chronic hepatic encephalopathyHepatic encephalopathyLower ammonia, better test scoresRCT
n 66 · 1998
Improved Number Connection Test times (p<0.01) and fasting (p<0.01) and after-meal (p<0.05) ammonia improved vs placebo, as did mental state grade (p<0.05) and the Portosystemic Encephalopathy Index (p<0.01); no adverse events in either group.
- Design
- RCT, n = 66, 1998
- Population
- Patients with cirrhosis, high ammonia and stable chronic hepatic encephalopathy (34 LOLA, 32 placebo)
- Form
- Oral LOLA
- Dose
- 18 g a day in three doses
- Duration
- 14 days
- Source
- Reference 3 · PubMed 9625322 (opens PubMed)
CGrade CMinimal hepatic encephalopathy (oral, 60 days)Hepatic encephalopathyPrimary tests null; fewer later episodesRCT
n 64 · 2014
Mixed Not better than placebo on psychometric tests, flicker frequency, quality of life or anxiety-depression scores; fewer overt encephalopathy episodes at 6 months (5% vs 37.9%, P = 0.016).
- Design
- RCT, n = 64, 2014
- Population
- 64 outpatients with cirrhosis in Brazil, 63 with minimal encephalopathy
- Form
- Oral LOLA
- Dose
- 5 g three times a day
- Duration
- 60 days, then 6 months of follow-up
- Source
- Reference 4 · PubMed 24033861 (opens PubMed)
DGrade DLiver fat and liver enzymes in NASH (two doses compared)Fatty liverBetter liver tests from baselineOpen-label trial
n 72 · 2013
Improved Liver-to-spleen CT ratio, ALT, AST, GGT and triglycerides improved from baseline in both groups; CT ratio and ALT improved more on 12 g/day (overall ALT improvement 79.0% vs 53.0%). Adverse reactions occurred in 4.8% and 4.4%, all gastrointestinal.
- Design
- Open-label trial, n = 72, 2013
- Population
- Adults with non-alcoholic steatohepatitis (38 on the higher dose, 34 on the lower)
- Form
- Oral LOLA granules
- Dose
- 3 g or 6 g twice a day (6 or 12 g/day)
- Duration
- 12 weeks
- Source
- Reference 12 · PubMed 24074713 (opens PubMed)
DGrade DAmmonia in overt hepatic encephalopathy, IV vs oralHepatic encephalopathyOral matched IVRCT
n 40 · 2024
Improved Ammonia fell by 60.75 µmol/L with oral and 55.4 µmol/L with IV LOLA from day 1 to day 5 (p = 0.511); both fell significantly within groups (p < 0.001).
- Design
- RCT, n = 40, 2024
- Population
- 40 Indian patients with chronic liver disease and overt encephalopathy
- Form
- Oral vs intravenous LOLA
- Dose
- Dose not stated in the abstract
- Duration
- 5 days
- Source
- Reference 8 · PubMed 38789596 (opens PubMed)
DGrade DAmmonia and mental status vs lactuloseHepatic encephalopathyAmmonia fell like lactuloseRCT
n 20 · 2006
Improved Ammonia fell in both groups (lactulose 120.4 to 91.4; LOLA 141.6 to 96.9; p < 0.05); only LOLA improved mental status, Number Connection Test, asterixis and EEG; lactulose caused more bowel movements, abdominal pain or flatulence.
- Design
- RCT, n = 20, 2006
- Population
- 20 Mexican patients with cirrhosis and high-ammonia encephalopathy (10 per group)
- Form
- Oral LOLA vs lactulose
- Dose
- Dose not stated in the abstract
- Duration
- 2 weeks
- Source
- Reference 5 · PubMed 17151582 (opens PubMed)
DGrade DReaction time and ammonia during exhaustive exercise (with BCAAs)ExerciseFaster reactions, more ammoniaCrossover RCT
n 11 · 2015
Mixed Reaction time at the end of graded exercise was shorter than placebo (p < 0.05), but plasma ammonia was higher at the end of prolonged exercise (p < 0.05).
- Design
- Crossover RCT, n = 11, 2015
- Population
- 11 endurance-trained healthy men
- Form
- BCAAs plus L-ornithine L-aspartate vs flavoured water
- Dose
- 16 g BCAA plus 12 g ornithine aspartate in total
- Duration
- Two single sessions a week apart
- Source
- Reference 9 · PubMed 26785372 (opens PubMed)
What the numbers add up to
Each point is worked out from the data and the sources numbered on this page, with the arithmetic shown under it. It adds no new data and is not medical advice.
The benefit shrinks in the best trials
Across 22 trials LOLA cut hepatic encephalopathy by about 30%, but in the single trial at low risk of bias the effect was close to none (RR 0.96).2
Tested in liver patients, not healthy people
Studied doses
Doses used in research, shown against the official limits. They describe the studies, not a recommendation for you.
Studied doses in research, not advice. These are amounts used in research, not personal advice. Your clinician or pharmacist can say what fits you.
Doses studied in human trials
When trials measured an effect
3 outcomes| Outcome | Measured at | Basis |
|---|---|---|
| Blood ammonia in overt hepatic encephalopathy | Day 5 | Oral and intravenous LOLA both lowered ammonia significantly from day 1 to day 5 in 40 patients8 |
| Ammonia and mental test scores in chronic hepatic encephalopathy | Day 14 (end of trial) | Oral 18 g/day vs placebo in 66 patients3 |
| Liver enzymes in NASH | Week 6, larger by week 12 | ALT fell from baseline at 6 and 12 weeks on 6 or 12 g/day (no placebo group)12 |
Interactions and safety
Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.
What L-Ornithine L-Aspartate meets
0 cited rows 1 tested togetherMedicines 0
No medicine rows in our sources.
Supplements and foods 1
- Tested together in a graded trial
Choose a medicine or supplement above to read its cited rows here.
Also cited: 1 tested together
BCAAsBCAAs page
Tested together
Reaction time and ammonia during exhaustive exercise (with BCAAs). Graded on the L-Ornithine L-Aspartate page; tested together is not a claim that they work better together.
Interactions
0 agentsNone found in our sources.
Check with what you take
Kept on this device onlyAdd what you take. We list every interaction our evidence profiles cite between L-Ornithine L-Aspartate and your picks, and between your picks.
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Add a supplement or medicine you take to check it against L-Ornithine L-Aspartate.
Starting from one medicine? The interaction checker rates how serious each pair is, on a curated list of 19 entries for 11 medicines. This cabinet has no severity rating: it lists every interaction row our supplement pages cite.
Who should be careful
2 groups- Pregnancy, breastfeeding and children
- NCCIH notes that many dietary supplements have not been tested in pregnant women, nursing mothers or children.1
- Medicines and surgery
- NCCIH advises that supplements may interact with medications or pose risks before surgery, and to tell your health care providers about everything you use.1
How to read the label
What to check on the Supplement Facts panel.
How to read the label
1 checksWhere to buy L-Ornithine L-Aspartate (LOLA)
Products from brands we partner with that contain L-Ornithine L-Aspartate (LOLA). Check the amount per serving against the doses studied above, and the label for other ingredients.
L-Ornithine L-Aspartate (LOLA) products from partner brands
1 product Paid links · we earn a commission- Quick pickHerbsProNutricology/Allergy Research Group L-Ornithine-L-Aspartate Liver Support Metabolite, 100 Grams
1 rounded teaspoon: 3 g L-ornithine-L-aspartate (oral trials used 15 to 18 g a day)
$74.30one-timeChecked Oct 15, 2026
Frequently asked questions
Short answers to common questions; the numbers link to the sources below.
Common questions
7 answersDoes LOLA help hepatic encephalopathy?
A Cochrane review found less hepatic encephalopathy across 22 trials (RR 0.70) but not in the one trial at low risk of bias, and rated the evidence very low quality.2
Does oral LOLA work as well as IV?
Does LOLA help athletes or healthy people?
There is almost no evidence. One crossover in 11 trained men gave LOLA with BCAAs: reaction time improved, but blood ammonia ended higher.9
Does LOLA work better with lactulose?
A 2025 pooled analysis of 12 trials (858 patients) found a higher response rate with LOLA plus lactulose than with lactulose alone (RR 1.31), with larger falls in ammonia and liver enzymes. The trials used a loose 'total effective rate' measure, so the size of the benefit is uncertain.10
Is LOLA safe?
Does LOLA interact with medicines?
No drug interactions are documented in the sources checked: LiverTox, LactMed and NCCIH have no LOLA entry, and the trial abstracts cited here report none. NCCIH advises telling your health care providers about every supplement you use, especially alongside prescription medicines.1
Sources
12 sources: trial abstracts, NIH fact sheets and reference databases. Numbers in the text link here.
Sources cited on this page
12 sources- 1Using Dietary Supplements WiselyFact sheet National Center for Complementary and Integrative Health (NCCIH), 2019 · nccih.nih.gov
- 2L-ornithine L-aspartate for prevention and treatment of hepatic encephalopathy in people with cirrhosis.Meta-analysis Cochrane Database Syst Rev, 2018 · PMID 29762873
- 3Oral L-ornithine-L-aspartate therapy of chronic hepatic encephalopathy: results of a placebo-controlled double-blind study.RCT J Hepatol, 1998 · PMID 9625322
- 4Oral l-ornithine-l-aspartate in minimal hepatic encephalopathy: A randomized, double-blind, placebo-controlled trial.RCT Hepatol Res, 2014 · PMID 24033861
- 5Efficacy of oral L-ornithine-L-aspartate in cirrhotic patients with hyperammonemic hepatic encephalopathy. Results of a randomized, lactulose-controlled study.RCT Ann Hepatol, 2006 · PMID 17151582
- 6Efficacy of L-ornithine L-aspartate for minimal hepatic encephalopathy in patients with cirrhosis: A meta-analysis of randomized controlled trials.Meta-analysis Arab J Gastroenterol, 2024 · PMID 38403493
- 7Beneficial effects of L-ornithine L-aspartate for prevention of overt hepatic encephalopathy in patients with cirrhosis: a systematic review with meta-analysis.Meta-analysis Metab Brain Dis, 2020 · PMID 31338724
- 8Intravenous versus oral 'L-ornithine-L-aspartate' in overt hepatic encephalopathy: a randomized comparative study.RCT Sci Rep, 2024 · PMID 38789596
- 9Effects of supplementation with branched chain amino acids and ornithine aspartate on plasma ammonia and central fatigue during exercise in healthy men.Crossover RCT Folia Neuropathol, 2015 · PMID 26785372
- 10Efficacy and safety of L-ornithine L-aspartate combined with lactulose in treatment of hepatic encephalopathy: a systematic review and meta-analysis of randomized controlled trial.Meta-analysis Front Med (Lausanne), 2025 · PMID 40370740
- 11Can ammonia scavenging treat MASLD? Evaluating the evidence for L-ornithine L-aspartate-A systematic review.Systematic review Eur J Clin Invest, 2026 · PMID 41653037
- 12[Aspartate-ornithine granules in the treatment of nonalcoholic steatohepatitis: a multiple-dose parallel controlled clinical trial].Open-label trial Zhonghua Gan Zang Bing Za Zhi, 2013 · PMID 24074713
What changed
Every dated change to this page: what changed, who made it and why.
Change log
2 entries| Date | Change | Who and why |
|---|---|---|
| evidence, key facts, studied doses, time to effect, FAQ, questions, related | Added a 2025 meta-analysis of LOLA added to lactulose (12 trials, 858 patients, grade C, marked as clinical use), a 12-week dose-comparison trial in NASH without placebo (72 adults, grade D) and a 2026 systematic review of LOLA in fatty liver as a key fact (its participant total spans mixed designs, so it is not a graded row). Studied doses now start at 6 g a day; added time-to-effect rows (ammonia by day 5, test scores by day 14, liver enzymes by week 6), FAQ items on combining with lactulose and on interactions, page questions and a goal-hub link. Interactions re-checked: LiverTox, LactMed and NCCIH have no LOLA entry and the cited abstracts report none, so the list stays empty. The NASH trial's article is in Chinese; its row uses the English abstract only. | Writer: Kymata Health EditorialTrigger: A–Z audit against docs/supplements/AUDIT-STANDARD.md |
| all | Initial editorial evidence review. Every PMID checked against NCBI E-utilities esummary (title, year, journal; none retracted) and each cited abstract read; numbers taken from the abstracts (full text used only where noted for participant counts or funding). Funding: the 2024 IV-vs-oral trial reports no specific funding (full text); the 2020 meta-analysis author previously consulted for Merz Pharmaceuticals and others (CIHR grant listed on PubMed); the 2024 meta-analysis authors declare no competing interests; the other abstracts name no funder (disclosed as not stated). No LOLA-specific page exists on our approved safety sources (ODS, NCCIH, LactMed, LiverTox, Health Canada, EMA), so safety rows use only NCCIH's general supplement guidance. Where to buy: Nutricology L-Ornithine-L-Aspartate powder (label checked 2026-10-15). | Writer: Kymata Health EditorialTrigger: new page |
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