Piracetam, 200 mg, film-coated tablets, 60 pcs.

Indications for piracetam

Piracetam, the instructions for use indicate this, is in demand to combat many neurological, psychiatric and drug addiction problems. The wide scope of use is associated with the following properties:

• Positive effect on metabolic processes.
• The ability to improve blood circulation in the brain.

Indications for use are:

• Headaches and dizziness of various etiologies.
• The need to protect the brain from the effects of various damaging factors: intoxication, trauma, etc.
• The occurrence of cognitive impairment against the background of various diseases, which is manifested by memory deterioration.

The drug is used in the complex treatment of various mental illnesses and depressive conditions. It is also used in the treatment of chronic alcoholism, when persistent disorders of brain activity occur. When using the drug, it is possible to recover faster from brain injuries. This remedy improves the condition of patients with the development of dementia resulting from cerebral circulatory disorders. It is recommended for the prevention of Alzheimer's disease.

The drug is approved for the treatment of children in cases of confirmed dyslexia and other painful conditions, the symptoms of which are learning difficulties. The drug is indicated for perinatal brain damage. It is used for oligophrenia, cerebral palsy, and mental retardation.

Piracetam

Trade name: Piracetam International name: Piracetam

Release form: capsules 0.4 g (polymer jars, contour cell packaging)

Ingredients: piracetam 400 mg

Pharmacological group: nootropic agent

Pharmacological group according to ATK: N06BX03 (Piracetam)

Pharmacological action: metabolic, nootropic, improving blood supply to the brain, antiepileptic, antihypoxic,

Indications: Neurology: vascular diseases of the brain, chronic cerebrovascular insufficiency (impaired memory, attention, speech, dizziness, headache), residual effects of cerebral circulatory disorders (ischemic type), comatose and subcomatous states (including after injuries and brain intoxications), convalescence (to increase motor and mental activity), diseases of the nervous system, accompanied by a decrease in intellectual-mnestic functions and disorders of the emotional-volitional sphere (including Alzheimer's disease). Psychiatry: neurotic syndrome, asthenodepressive syndrome (of various origins, with a predominance in the clinical picture of adynamia, asthenic and senesto-hypochondriacal disorders, ideator inhibition), flaccid apathetic defective states (schizophrenia, psychoorganic syndrome), complex therapy: mental illnesses occurring in the “organically defective” soil", depressive states resistant to antidepressants, poor tolerance to antipsychotic drugs (neuroleptics), to eliminate or prevent the somatovegetative, neurological and mental complications caused by them, cortical myoclonus. Narcology: alcohol withdrawal syndrome, pre- and delirious states, morphine withdrawal syndrome, acute poisoning with ethanol, morphine, barbiturates, phenamine, chronic alcoholism (with symptoms of persistent mental disorders, asthenia, intellectual-mnestic disorders). Sickle cell anemia (as part of combination therapy). In pediatric practice: if necessary, speed up the learning process and eliminate the consequences of perinatal brain damage caused by intrauterine infections, hypoxia, birth trauma, mental retardation, mental retardation, and cerebral palsy.

Dosage regimen: Inside, intravenously. Parenterally - intravenously, in an initial dose of 10 g, in severe conditions - intravenous drip, over 20-30 minutes - up to 12 g / day, after improvement, the dose is gradually reduced and switched to oral administration. Orally, at the beginning of treatment - 800 mg in 3 doses, before meals, as the condition improves, the single dose is gradually reduced to 400 mg, the duration of treatment is 6-8 weeks. Daily dose - 30-160 mg/kg, frequency of administration - 2 times a day, if necessary - 3-4 times a day. The duration of treatment ranges from 2-3 weeks to 2-6 months. If necessary, it can be repeated after 6-8 weeks. For long-term therapy of psychoorganic syndrome in the elderly - 1.2-2.4 g/day, loading dose during the first weeks of therapy - up to 4.8 g/day. When treating cerebrovascular disorders in the acute phase, it should be prescribed as early as possible, at a dose of 12 g/day for 2 weeks, and then 4.8-6 g/day. For cortical myoclonus, treatment begins with a dose of 7.2 g/day, every 3-4 days the dose is increased by 4.8 g/day until a maximum dose of 24 g/day is reached, 2-3 times a day, orally or parenterally. Every 6 months the dose should be reduced by 1.2 g every 2 days. When treating dizziness, the dose is 2.4-4.8 g/day in 2-3 doses. For sickle cell anemia, the daily dose is 160 mg/kg, divided into 4 equal portions. During a crisis - up to 300 mg/kg. For alcoholism - 12 g/day during the period of manifestation of ethanol "withdrawal" syndrome, maintenance dose - 2.4 g. In the treatment of comatose states, in the post-traumatic period, initial dose - 9-12 g/day, maintenance dose - 2.4 g, course of treatment - 3 weeks . Children are prescribed a dose of 30-50 mg/day. Treatment should be long-term. Oral solution: daily dose - 3.3 g (8 ml of 20% solution or 5 ml of 33% solution) 2 times a day (before breakfast and dinner). Can be added to fruit juice or other drinks. For chronic renal failure with CC 50-79 ml/min, 2/3 of the usual dose is prescribed in 2-3 doses, with CC 30-49 ml/min - 1/3 of the dose in 2 doses, less than 30 ml/min - 1/6 of the usual dose , once.

Contraindications: Hypersensitivity, severe renal failure (creatinine clearance less than 20 ml/min), hemorrhagic stroke.

Side effects: Mental agitation, motor disinhibition, irritability, imbalance, decreased ability to concentrate, anxiety, sleep disturbances, gastralgia, nausea, vomiting, constipation or diarrhea, decreased appetite, dizziness, headache, extrapyramidal disorders, convulsions, tremor, increased sexual activity, worsening angina. Side effects are most often observed at doses above 5 g/day.

Pharmacodynamics: Nootropic drug. It has a positive effect on the metabolic processes of the brain: it increases the concentration of ATP in brain tissue, enhances the synthesis of RNA and phospholipids, stimulates glycolytic processes, and enhances glucose utilization. Improves the integrative activity of the brain, promotes memory consolidation, and facilitates the learning process. Changes the speed of propagation of excitation in the brain, improves microcirculation without having a vasodilating effect, and suppresses the aggregation of activated platelets. It has a protective effect against brain damage caused by hypoxia, intoxication, electric shock, enhances alpha and beta activity, reduces delta activity on the EEG, and reduces the severity of vestibular nystagmus. Improves connections between the cerebral hemispheres and synaptic conduction in neocortical structures, increases mental performance, and improves cerebral blood flow. The effect develops gradually. It has practically no sedative or psychostimulating effect. .

Pharmacokinetics: After oral administration, it is well absorbed and penetrates into various organs and tissues. Bioavailability, regardless of dosage form, is about 95%. TCmax - 0.5-1 hour. Penetrates through the BBB, accumulates in the brain tissue 1-4 hours after ingestion. It is excreted from the CSF much more slowly than from other tissues. Practically not metabolized. T1/2 - 4.5 hours (7.7 hours - from the brain). Excreted by the kidneys - 2/3 unchanged within 30 hours.

Special instructions: It is recommended to constantly monitor indicators of renal function (especially in patients with chronic renal failure) - residual nitrogen and creatinine, and in patients with liver diseases - the functional state of the liver. Treatment with piracetam, if necessary, can be combined with the use of psychoactive, cardiovascular and other drugs. In the treatment of acute brain lesions, it is prescribed in combination with other methods of detoxification and rehabilitation therapy, and in the treatment of psychiatric diseases - with appropriate psychoactive drugs. When treating patients with cortical myoclonus, abrupt discontinuation of the drug should be avoided (risk of resumption of attacks). In case of sleep disturbances, it is recommended to cancel the evening dose and add this dose to the daytime dose. Penetrates through the filter membranes of hemodialysis machines. During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions. Carefully. Impaired hemostasis, extensive surgical interventions, severe bleeding, pregnancy and lactation.

Interaction: Increases the effectiveness of thyroid hormones, antipsychotic drugs (neuroleptics), indirect anticoagulants (against the background of high doses of piracetam), psychostimulants. When prescribed with antipsychotics, it reduces the risk of extrapyramidal disorders.

Drug registration number: P No. 001713/01-2002

Date of registration (re-registration) of the drug: 10/11/2002

Contraindications and side effects

Since piracetam is used in the treatment of various pathologies, the instructions focus on this, only a doctor should prescribe its use, based on the patient’s condition and the presence of contraindications. Do not use the drug if you are hypersensitive to the active substance or other components included in its composition. The medicine is not used to treat children under one year of age, as well as during pregnancy and lactation.

Piracetam tablets, the instructions indicate this, are not used in the presence of the following pathologies:

• Huntington's chorea, which is a genetic disease and is characterized at the initial stage of development by impaired coordination of movements.
• Chronic renal failure in severe form.
• Hemorrhagic stroke.
• Psychomotor agitation.

The decision to take piracetam should be made with extreme caution in case of hemostasis disorders, severe bleeding, or after major surgical operations.

Various side effects were observed when taking the drug. Patients most often experienced the following body reactions:

• Nausea and vomiting.
• Headache.
• Hives.
• Diarrhea.

As a rule, such side effects disappear on their own during therapy. More dangerous symptoms while taking the drug are decreased blood pressure, abdominal pain, depression, hallucinations, dermatitis, and confusion. Sometimes during treatment with the drug, motor disinhibition, increased libido, drowsiness or insomnia, and a constant feeling of internal anxiety occur. Overdose may increase side effects.

Buy Piracetam solution intravenously and intramuscularly 20% 5ml No. 10 in pharmacies

Pharmacological action The active component is piracetam, a cyclic derivative of gamma-aminobutyric acid (GABA). Piracetam is a nootropic that directly affects the brain, improving cognitive processes such as learning, memory, attention, and mental performance. Piracetam affects the central nervous system in various ways: by changing the speed of propagation of excitation in the brain, it improves metabolic processes in nerve cells, improves microcirculation, and affects the rheological characteristics of the blood without having a vasodilating effect. Improves communication between the cerebral hemispheres and synaptic conduction in neocortical structures, improves cerebral blood flow. Piracetam inhibits platelet aggregation and restores the configurational properties of the outer membrane of rigid erythrocytes, as well as the ability of the latter to pass through microcircular vessels. At a dose of 9.6 g, it reduces the concentration of fibrinogen and von Willebrand factors by 30-40% and prolongs bleeding time. Piracetam has a protective and restorative effect in cases of impaired brain function due to hypoxia and intoxication. Piracetam reduces the severity and duration of vestibular nystagmus.

Indications In adults: - symptomatic treatment of psychoorganic syndrome, accompanied by memory loss, decreased concentration and activity, mood changes, behavior disorder, gait disturbance; - treatment of dizziness (vertigo) and related balance disorders (with the exception of dizziness of vasomotor and psychogenic origin); — treatment of cortical myoclonus (monotherapy or as part of complex therapy); — relief of sickle cell vaso-occlusive crisis. In children: - treatment of dyslexia in children from 8 years of age in combination with other methods; — relief of sickle cell vaso-occlusive crisis.

Contraindications - severe chronic renal failure (creatinine clearance (CK) less than 20 ml/min); - hemorrhagic stroke; - psychomotor agitation; - Huntington's chorea; - pregnancy; - lactation period. With caution: impaired hemostasis; extensive surgical interventions; heavy bleeding; chronic renal failure (KK 20-80 ml/min).

Use during pregnancy and lactation Contraindicated during pregnancy and lactation.

Special instructions Prescribe with caution to patients with impaired hemostasis, before upcoming major surgical interventions or in patients with symptoms of severe bleeding. When treating cortical myoclonus, abrupt cessation of treatment should be avoided, as this may cause a recurrence of attacks. During long-term therapy in elderly patients, regular monitoring of renal function is recommended; if necessary, dose adjustment is carried out depending on QC. Penetrates through the filter membranes of hemodialysis machines. Impact on the ability to drive vehicles and operate machinery During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Method of administration and dose: IV stream or drip, IM. The daily dose is divided into 2-4 doses. Symptomatic treatment of psychoorganic syndrome: 4.8 g/day during the first week, then switch to a maintenance dose of 1.2-2.4 g/day. Treatment of dizziness and related balance disorders: 2.4-4.8 g/day. Treatment of cortical myoclonus: start with a dose of 7.2 g/day, every 3-4 days the dose is increased by 4.8 g/day until a maximum dose of 24 g/day is reached. Treatment is continued throughout the entire period of the disease. Every 6 months you should try to reduce the dose or discontinue the drug, gradually reducing the dose by 1.2 g/day every 2 days. If there is little or no therapeutic effect, treatment is stopped. For sickle cell vaso-occlusive crisis (in adults and children): IV 300 mg/kg/day, divided into 4 equal doses. Treatment of dyslexia in children over 8 years of age (in combination with other treatment methods) - 3.2 g, divided into 2 equal doses. For mild chronic renal failure (KK 50-79 ml/min) - 2/3 of the dose divided into 2-3 doses; moderate degree (KK 30-49 ml/min) - 1/3 of the dose, divided into 2 doses; severe (KK 20-30 ml/min) -1/6 dose once.

Side effects From the central nervous system: motor disinhibition, irritability, drowsiness, depression, asthenia, headache, insomnia, mental agitation, imbalance, ataxia, exacerbation of epilepsy, anxiety, hallucinations, confusion. From the digestive system: nausea, vomiting, diarrhea, abdominal pain. Metabolism: increased body weight. From the senses: vertigo. From the skin: dermatitis, itching, rashes. Allergic reactions: hypersensitivity, anaphylactic reactions, angioedema. Local reactions: pain at the injection site, thrombophlebitis. Other: fever, decreased blood pressure. Drug interactions When used simultaneously with iodine-containing thyroid hormones, confusion, irritability and sleep disturbance may occur. In high doses (9.6 g/day) in patients with venous thrombosis, it increases the anticoagulant effect of indirect anticoagulants (a more pronounced decrease in platelet aggregation, fibrinogen content, von Willebrand factor, blood and plasma viscosity). Pharmaceutically compatible with solutions of dextrose (5%, 10%, 20%), fructose (5%, 10%, 20%), 0.9% sodium chloride solution, Ringer's solution, 20% mannitol solution, hydroxyethyl starch (6%, 10%) .

Overdose Symptoms: abdominal pain, diarrhea mixed with blood. Treatment: induction of vomiting, gastric lavage, symptomatic therapy, hemodialysis (effectiveness 50-60%). There is no specific antidote.

Storage conditions Store in a place protected from light, at a temperature not exceeding 25°C. Keep out of the reach of children.

Shelf life: 5 years.

Instructions for use, price, reviews analogues

Piracetam must be taken in accordance with the instructions for use, as tablets and capsules are intended for internal use. The daily dosage is calculated depending on the patient’s weight and is 30-160 mg per kilogram of weight. The drug is taken 2-4 times a day, but to prevent the occurrence of insomnia, the last dose should be no later than 17 hours before bedtime.

The dosage regimen is developed by the doctor. It may vary depending on the pathology. Thus, the drug is used in complex methods of rehabilitation therapy in the treatment of serious brain damage. For recovery from complex psychotic disorders, it is used in combination with psychotropic drugs.

The price of pirocetam may vary depending on the manufacturer. But in any case, it is accessible. Today you can buy analogues of the drug in pharmacies. They are presented as single drugs and complex drugs. When prescribing such drugs, the doctor must take into account their interaction with other medications.

All nootropic drugs are highly effective, as evidenced by numerous patient reviews. First of all, they note the cumulative effect of the drug. Many note the ability to withstand heavy loads without losing concentration. You can also often find positive reviews about the treatment of children.

Piracetam, 200 mg, film-coated tablets, 60 pcs.

Inside. Take liquid during meals or on an empty stomach.

If oral administration is not possible, the drug is administered intravenously in the same dose.

For intellectual-mnestic disorders : 24-48 g/day in 2-3 doses.

Treatment of cortical myoclonus : treatment begins with a dose of 72 g/day, every 3-4 days the dose is increased by 48 g/day to a maximum dose of 24 g/day in 2-3 doses.

The use of other drugs for the treatment of myoclonus should be continued at the same dosage. Depending on the effect obtained, the dose of these drugs should be reduced if possible.

Treatment with piracetam should be continued as long as symptoms of the disease persist.

In patients with acute episodes of myoclonus, spontaneous improvement may occur, so attempts should be made to reduce the dose or discontinue the drug every 6 months. To do this, gradually reduce the dose by 12 g/day every two days (in the case of Lance-Adams syndrome, every 3-4 days to prevent a possible sudden relapse or withdrawal syndrome).

Dosing in patients with renal impairment: Piracetam is eliminated almost exclusively by the kidneys. Caution should be used when treating patients with renal impairment or requiring monitoring of renal function. The half-life increases in direct proportion to the deterioration of renal function and creatinine clearance; this is also true in the elderly, in whom creatinine excretion varies with age.

The dose should be adjusted depending on the creatinine clearance.

Creatinine clearance for men can be calculated from the serum creatinine concentration (CSC) using the following formula:

CC (ml/min) = [140 - age (years)] x body weight (kg) / [72 x Serum (mg/dl)]

Creatinine clearance for women can be calculated by multiplying the resulting value by a factor of 085.

In elderly patients, the dose is adjusted in the presence of renal failure; long-term therapy requires monitoring of the functional state of the kidneys.

Dosing in patients with impaired liver function: patients with impaired liver function do not require dose adjustment.

For patients with impaired renal and liver function, dosing is carried out according to the scheme (see subsection “Dosing for patients with impaired renal function”).