Ensame-400 Tablet belongs to the class of medication called Nutritional supplements primarily used to treat S-adenosylmethionine deficiency. Some patients with depression, Alzheimer's disease, dementia, Parkinson's disease treated with levodopa, disorders of folate metabolism, and other illnesses cause S-adenosylmethionine deficiency. Ensame-400 Tablet is a synthetic form of a chemical that occurs naturally in cells, tissue, and body fluids, primarily used to treat depression, reduce pain and swelling in the joints conditions such as osteoarthritis, biliary cholangitis (an autoimmune disease of the liver), excess cholesterol in bile and biliary and liver diseases caused by cystic fibrosis. Additionally, it is also used to treat liver disease during pregnancy, improves symptoms in people with fibromyalgia, and treats nerve problems in people with AIDS or sexual dysfunction in men with depression.

Ensame-400 Tablet contains S-adenosylmethionine, which is a naturally-occurring substance found in cells, tissue, and body fluids. It is produced from methionine (amino acid) and used to treat liver disease, depression, and osteoarthritis. Ensame-400 Tablet ensures sufficient levels of glutathione in the liver are maintained to minimize liver damage. It also prevents the increase of lipids associated with cirrhosis outside the liver. It also affects certain chemical messengers (serotonin) in the brain, which communicate between brain cells, thereby regulating mood and treating depression. It stimulates the production of parts of cartilage, reduces the inflammatory mediator, and has painkilling properties.

Take Ensame-400 Tablet as recommended by your doctor. In some cases, you may experience certain common side-effects such as abdominal discomfort, abdominal pain, diarrhea, nausea, dizziness, insomnia. Most of these side-effects do not require medical attention and will resolve gradually over time. However, you are advised to talk to your doctor if you experience these side effects persistently.

Do not discontinue Ensame-400 Tablet without consulting your doctor. Do not take Ensame-400 Tablet if you are pregnant or breastfeeding unless advised. Ensame-400 Tablet can be given to children with extreme caution if recommended by the doctor. Avoid consuming alcohol along with Ensame-400 Tablet as it could lead to increased drowsiness and liver damage. Keep your doctor informed about your health condition and medicines to rule out any side effects.

The Ensame-400 Tablet contains S-adenosylmethionine, a naturally-occurring substance found in cells, tissue, and body fluids. It is produced from methionine (amino acid) and used to treat liver disease, depression, and osteoarthritis. In liver disease, Ensame-400 Tablet ensures sufficient glutathione levels in the liver to minimize liver damage. It also prevents the increase of lipids associated with cirrhosis outside the liver. In depression, it affects certain chemical messengers (serotonin) in the brain, which communicate between brain cells, thereby regulating mood and treating depression. In osteoarthritis, It stimulates the production of cartilage parts, reduces the inflammatory mediator, and has painkilling properties. Ensame-400 Tablet is also effective in treating liver disease during pregnancy, improving symptoms in people with fibromyalgia, treating nerve problems in people with AIDS, or sexual dysfunction in men with depression.

• Headache
• Dizziness
• Feeling anxious
• Vomiting
• Stomach upset
• Diarrhea
• Constipation
• Insomnia (sleep problem)
• Increased sweating

Do not take Ensame-400 Tablet if you are allergic to any of its contents, if you have used an MAO inhibitor in the past 14 days, inflammation of gall bladder and bile ducts, narrowing or blockage bile ducts, biliary colic, calcified gallstones, improper constriction of the gallbladder, gastric or duodenal ulcer. Inform your doctor if you have heart disease, seizure disorders, bone marrow suppression, diabetes, schizophrenia, bipolar disorder, acute alcohol intoxication, glaucoma, thyroid problems, kidney and liver problems. Do not take Ensame-400 Tablet if you are pregnant or breastfeeding unless advised. Ensame-400 Tablet can be given to children with caution if recommended by the doctor. Avoid consuming alcohol along with Ensame-400 Tablet as it could lead to increased drowsiness and liver damage. Keep your doctor informed about your health condition and medicines to rule out any unpleasant side-effects. 

Drug-Drug Interactions: Ensame-400 Tablet may have interaction with monoamine oxidase inhibitors (medicines used to treat depression) (moclobemide, phenelzine, iproniazid, isocarboxazid, nialamide, tranylcypromine, selegiline), an antidepressant (bupropion, duloxetine, fluoxetine, sertraline), antiparkinsons (levodopa), pain killers (tramadol, trazodone, hydrocodone, oxycodone, acetaminophen).

Drug-Food Interactions: No interactions found/established.

Drug-Disease Interactions: Ensame-400 Tablet may have interactions with bipolar depression, Parkinson's disease, biliary obstruction and liver impairment, variceal bleeding (high blood pressure in portal veins), ascites (excess abdominal fluid), liver encephalopathy.

• MOCLOBEMIDE
• PHENELZINE
• IPRONIAZID
• ISOCARBOXAZID
• NIALAMIDE
• TRANYLCYPROMINE
• SELEGILINE
• BUPROPION
• DULOXETINE
• FLUOXETINE
• SERTRALINE
• LEVODOPA
• TRAMADOL
• TRAZODONE
• HYDROCODONE
• OXYCODONE
• ACETAMINOPHEN

Liver disease:

• Include foods such as bell peppers, citrus fruits, leafy vegetables, tomatoes, milk, fish, low-fat dairy, beans, nuts, lentils, tofu, and tempeh in your diet.
• Foods rich in Vitamin B, C, and calcium, are good for the gallbladder.
• Plant-based protein foods such as beans, nuts, lentils, tofu, and tempeh help prevent gallbladder disease.
• Avoid high-fat, trans-fat, and processed foods, white bread, white pasta, and sugars.
• Avoid tobacco and alcohol consumption.

Depression:

• Maintain a healthy diet and exercise regularly helps in improving overall health and boosts self-esteem.
• Perform meditation and yoga. This helps in relieving stress and provides relaxation.
• Follow a regular sleep pattern to improve the amount and quality of sleep you get.
• Include foods rich in omega fatty acids such as fish, nuts, fresh fruits, vegetables, and olive oils.
• Neurotransmitters are made up of amino acids. Amino acid-rich foods such as meat, dairy products, and certain fruits and vegetables help in the proper maintenance of neurotransmitters. 
• Avoid smoking and alcohol consumption.

Osteoarthritis:

• Physical activity helps in strengthening muscles and relieves joint stiffness. Gentle activities like 20-30minutes of walking or swimming would be helpful.
• Performing yoga may also help in improving joint flexibility and pain management.
• Follow heat or cold therapy, apply a cold or hot compress on the joints for 15-20minutes regularly.

• Your doctor may advise a regular liver function test to monitor the liver's function and the progress of the treatment.
• Do not use Ensame-400 Tablet if you have used an MAO inhibitor (antidepressant) in the past 14 days, as a dangerous drug interaction could occur.

Primary biliary cholangitis: Primary biliary cholangitis, formerly known as primary biliary cirrhosis, is an autoimmune disease caused by bile duct damage in the liver. Bile ducts are the small channels that carry the bile (digestive fluid) from the liver to the small intestine, where it breaks down fats and aids in its absorption. Biliary cirrhosis causes a build-up of bile in the liver, which leads to liver damage.

Depression: It is a mood disorder characterized by the feeling of sadness, unhappiness, anger, hopelessness, or loss that interferes with a person’s daily activities. Depression can also influence some chronic health conditions and relationships. The exact cause of depression is unknown, but it may be associated with mental problems, trauma, family history, drug use, and medical conditions.

Osteoarthritis: It is a degenerative joint disease in which the two ends of the joints come together due to the breakdown of a protective covering of cartilage. Due to the absence of this protective covering, the joints rub against each other, leading to pain and stiffness. Symptoms of osteoarthritis include pain, stiffness, inflammation, and tenderness. The main reason for osteoarthritis is age, the older you are, the more likely you could get osteoarthritis, thus known as degenerative disease, meaning that the joints wear-out as a person ages. Other reasons include a past injury such as torn cartilage, dislocated joints, and ligament injuries.