Hepakast Hepakast is an oral formulation containing branched-chain amino acids (L-Leucine, L-Isoleucine, and L-Valine) designed for nutritional support in hepatic disorders. Branched-chain amino acids modulate protein turnover by stimulating protein synthesis via activation of the mammalian target of rapamycin (mTOR) signaling pathway and suppressing hepatic and skeletal muscle protein breakdown. In patients with advanced liver disease or cirrhosis, BCAAs help restore normal Fischer ratios (BCAA to aromatic amino acids), promote ammonia detoxification into glutamine in skeletal muscle, improve serum albumin levels, and reduce the risk or severity of hepatic encephalopathy. Hepakast is indicated for the dietary management and clinical nutritional support of patients with chronic liver diseases, liver cirrhosis, hepatic encephalopathy, and protein-calorie malnutrition associated with hepatic impairment.