Analogues of Cavinton (Vinpocetine, Mexidol, Cinnarizine, etc.)

pharmachologic effect

The drug Cavinton is produced in tablets with a dosage of 5 mg and injections. The main substance is vinpocetine, which has the following therapeutic effects:

• improvement of cerebral circulation and metabolic processes;
• increased consumption of glucose and oxygen by the brain;
• increasing the resistance of nervous tissue to oxygen starvation or hypoxia;
• antioxidant effect;
• decreased blood viscosity;
• improvement of cerebral blood flow;
• increased blood circulation without the effect of stealing in damaged areas;
• increasing the elasticity of blood vessels.

At recommended dosages, the medicine has virtually no effect on blood pressure, heart rate, total peripheral resistance, or minute blood volume. Therefore, it is not contraindicated for arterial hypotension or arrhythmia. In severe forms of the disease, the doctor decides on the advisability of prescribing and replacement options.

Pharmacodynamics and pharmacokinetics

Cavinton selectively improves cerebral circulation: increases the cerebral fraction of minute blood volume, reduces the resistance of the blood vessels of the brain, without affecting the general blood circulation (heart rate, minute volume, blood pressure, peripheral vascular resistance). The drug does not cause steal syndrome. It improves blood supply to the ischemic but viable area of ​​the brain, causing the phenomenon of “reverse steal”. Increases the resistance of brain cells to hypoxia , improves microcirculation, reduces platelet aggregation, resists pathologically high blood viscosity, increases the deformability of erythrocytes, and has a blocking effect on the absorption of adenosine by erythrocytes .

The tablets are absorbed within an hour. It is not metabolized in the intestine. It is excreted in feces and urine in a ratio of 2 to 3.

The concentration of the solution for infusion is therapeutic in plasma in the range of 10-20 ng/ml. It is excreted via the gastrointestinal tract and kidneys in a ratio of 2 to 3.

Indications for use of Cavinton

The medicine is prescribed by a neurologist, therapist, and less often by an ophthalmologist or otolaryngologist. Dispensed with a doctor's prescription.

According to the instructions for use, the medication is effective for the following conditions and diseases:

1. cerebrovascular accident - to reduce neurological and mental manifestations (unsteadiness of gait, memory impairment, attention, migraines and headaches);
2. noise in ears;
3. vascular diseases of the organ of vision;
4. additional remedy for cervical osteochondrosis.

Cavinton - instructions for use

The medicine acts cumulatively, the initial effect develops after a week of continuous use. The dosage and treatment regimen are selected by the doctor. The tablet form is recommended three times a day, 1-2 pieces (at a dosage of 5 mg).

Using the drug for a short period of time is not advisable. The optimal course of treatment is 1–3 months.

Cavinton - before or after meals

To prevent side effects and have a better therapeutic effect, the medicine is taken after meals.

Reviews about Cavinton

Reviews from patients

In general, opinions were divided. Those who have taken the drug say that it helps, but there are statements that no effect was noticed. The advantage is the low price. Side effects have been observed.

Reviews about Cavinton for children

It is important to remember that the drug is contraindicated for children. However, doctors still run the risk of prescribing this medicine. Reviews from parents indicate that when children use the medication, side effects occur, such as irritability and insomnia.

Cavinton's analogues

If the medication is not suitable, you should inform your doctor and find an effective, approved replacement. Analogues of the drug Cavinton are dispensed from pharmacies according to a special prescription, they have restrictions on their use and side effects.

A list of what can replace Cavinton, indicating the form of release, approximate cost and producing country

Noopept

The domestic drug Noopept is a nootropic drug. One of the therapeutic actions is to improve learning, memory, attention, and prevent amnesia. The medication also reduces the frequency of headaches, tachycardia, unsteadiness of gait, and increases the resistance of brain tissue to oxygen starvation and damaging factors.

Pentoxifylline

Imported drugs Trental and Vazonit, the Russian analogue of Cavinton Pentoxifylline are used to restore blood circulation and dilate blood vessels. As a result, medications improve the condition of patients, reduce the frequency of night cramps, headaches, and increase walking distance.

Cerebrolysin and Cerepro

The drugs Cerebrolysin and Cerepro are nootropic drugs and are available in ampoules and capsules. Analogs are prescribed by a doctor for complaints of forgetfulness, deterioration of memory and attention, brain injuries, dementia and some organic diseases.

Mildronate

Mildronate ampoules and capsules tone, improve mental and physical performance, increase blood circulation in the area of ​​ischemia, and dilate blood vessels. They are used as an additional means to improve the quality of life of patients with complaints of fatigue and lack of strength, cardiovascular diseases, and deterioration of blood supply to the brain.

What are the advantages of using analogues

Cavinton has a dilating effect on blood vessels, which improves blood flow and oxygen supply to the brain. At the same time, platelet aggregation is reduced and glucose is better broken down. The complex of plant components included in Cavinton is called “vinpocetine”. Substitutes for Cavinton have the same or similar action.

In addition to lower cost, they have a number of advantages:

• have fewer side effects and contraindications;
• have a wider area of ​​influence;
• are available in other forms.

Analogues of the drug Cavinton are produced by Russian, Ukrainian and Belarusian manufacturers.

Cavinton or Vinpocetine - which is better, reviews from doctors

The pressing question is, what is the difference between Cavinton or Vinpocetine and is it worth overpaying? The two medications contain the substance vinpocetine, which improves cerebral circulation. The cost of analogues varies: the first medicine is up to 4-6 times more expensive.

The effect of the drugs depends on the quality of the raw materials, the technology used, proper storage, and other factors. To create a high-quality effective medicine, the company needs to incur costs. It is for this reason that Cavinton and Vinpocetine are not equivalent.

When using a domestic substitute for Vinpocetine, according to doctors, a decrease in blood pressure and other undesirable reactions is more often observed, and later a therapeutic effect occurs. If possible, it is better to purchase a Hungarian drug.

Mexidol or Cavinton - which is better?

Mexidol is an analogue of Cavinton in tablets and injections, which has the following range of therapeutic effects:

• reduces tissue susceptibility to oxygen starvation or hypoxia;
• increases the body's resistance to stressful and damaging factors, for example, hypoxia, alcohol intoxication and poisoning with antipsychotics, shock, cerebrovascular accident and ischemia;
• improves cognitive functions (attention, memory, learning);
• reduces the patient's feelings of anxiety and fear;
• protects cell membranes from damage;
• eliminates increased skeletal muscle tone and has an anticonvulsant effect.

Cavinton is also used to improve cognitive functions and stabilize cerebral circulation.

Analogs differ in the range of actions they provide; they are dispensed and used exclusively as prescribed by a doctor. Which is best depends on the diagnosis and severity of the patient's condition. It is possible to use these medications together.

special instructions

Cavinton does not have nephro- and hepatotoxic effects. In patients with lactose intolerance, it is necessary to take into account that 1 tablet contains 83 mg of lactose. In patients with diabetes mellitus, parenteral administration of the drug requires control of blood glucose (the solution contains sorbitol , with intravenous administration it increases the risk of developing arrhythmia and ventricular fibrillation). In case of cerebral hemorrhagic stroke, the drug can be administered parenterally only after the acute effects have subsided (after 5-7 days). The drug is not recommended for use in pediatrics.

Cavinton or Cinnarizine

Cinnarizine is a medicine from the group of “slow” calcium channel blockers. This means that the product dilates blood vessels without affecting blood pressure, improves blood supply to organs and tissues, muscle resistance to oxygen starvation, reduces blood viscosity and increases the elasticity of erythrocyte cell membranes.

In general, the properties of Cavinton and Cinnarizine are similar. Both drugs are prescribed to reduce unsteadiness of gait caused by vestibular disorders, tinnitus, dizziness, headaches and migraines. The analogue Cinnarizine is cheaper and is available only in tablets. What to choose depends on the patient’s condition and is determined by the doctor at the appointment.

Domestic drugs

The list of Cavinton analogues produced by Russian enterprises is quite large:

• Bravinton - this drug also has vinpocetine as an active substance. It works very effectively, but costs 3-4 times less. It is used to improve brain metabolic processes and also as an antispasmodic. In addition, this drug helps with dizziness, headaches, memory impairment, encephalopathy, vascular disorders in the retina, and hearing impairment. Bravinton can be purchased in the form of tablets, solution or concentrate for its preparation for intravenous injection. Cost 65-80 rubles;
• Vinpocetine is the main Russian analogue of Cavinton, which improves blood circulation in the brain, its oxygen supply, and also reduces platelet aggregation. Vinpocetine has the structure and all the characteristics of Cavinton, including effectiveness. The price of a package of tablets is 30-140 rubles, a solution for injections is ~45 rubles;
• Cinnarizine is the cheapest analogue of Cavinton in tablets. You can buy it for 25-55 rubles, but such a low price does not affect its effectiveness at all. The active ingredient, cinnarizine, improves cerebral, coronary and peripheral blood circulation. It is prescribed for dizziness, tinnitus, labyrinthine disorders, vomiting, nausea;
• Telektol - most often used in the acute phase of a stroke. But it cannot be used during pregnancy and breastfeeding. The drug has a vasodilating, antihypoxic, antiplatelet effect, increases blood flow and optimizes the metabolism of brain cells. Price – 130-160 rubles;
• Korsavin - created on the basis of vinpocetine, available in tablets. By dilating blood vessels, it increases blood flow and blood supply to the brain, reducing the risk of stroke;
• Actovegin is a deproteinized calf blood extract containing low molecular weight peptides derived from nucleic acids. The drug activates cellular metabolism due to an increased supply of oxygen and glucose to cells. The price of Actovegin is ~120 rubles. But its main advantage over its analogues is the possibility of not only intravenous and oral use, but also external use;
• Mexidol is a drug with ethylmethylhydroxypyridine succinate as an active substance. This is a new generation antioxidant. It is often used in parallel with Caventin for cerebrovascular disorders in patients. The price of tablets is 200 rubles, solution – 400 rubles.

Article on the topic: Instructions for use of the drug Benzonal and its analogues

Which is better - Cavinton or Cavinton forte

Cavinton and Cavinton forte products are identical in properties and composition, with one difference. The first form is produced in ampoules and tablets containing 5 mg of active substance. The second is tablets with a higher dose of 10 mg.

To improve the patient’s condition and have a lasting effect, it is better to first use injections, then the tablet form. Moreover, the tablets are taken either 2 pieces per dose, or 1 enhanced formula. Most often, a medicine with the prefix forte is prescribed for this.

Cavinton price, where to buy

The price of Cavinton in 5 mg tablets is about 150 rubles per pack of 50 pieces.

The price of Cavinton ampoules is about 300 rubles for 10 pieces of 10 mg/2 ml, and 400 rubles for 10 pieces of 25 mg/5 ml.

In Kharkov you can buy tablets at a price of 200 UAH. Ampoules 10 mg/2 ml No. 10 - for about 300 UAH.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Cavinton Forte tablets 10 mg 90 pcs. Gedeon Richter-RUS ZAO
  RUB 361 order
• Cavinton conc. for prig solution for inf. 5mg/ml 5ml 10 pcs. JSC Gedeon Richter

  RUB 324 order

• Cavinton comfort tab. dispers. 10 mg n90 JSC Gedeon Richter

  RUR 446 order

• Cavinton Comfort tab. dispers. 10 mg No. 30 JSC Gedeon Richter

  RUB 229 order

• Cavinton tablets 5 mg 50 pcs. Gedeon Richter-RUS ZAO

  107 RUR order

Pharmacy Dialogue

• Cavinton (table 5 mg No. 50) Gedeon-Richter-RUS ZAO

  98 RUR order

• Cavinton (amp. 5 ml No. 10)Gedeon-Richter

  RUB 315 order

• Cavinton Forte (10 mg tablet No. 90) Gedeon-Richter-RUS ZAO

  RUB 354 order

• Cavinton Comforte (table dispenser 10 mg No. 90)Gedeon-Richter

  RUR 431 order

• Cavinton Forte (tab. 10 mg No. 90)Gedeon-Richter-RUS ZAO/Gedeon-Richter

  RUB 337 order

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Pharmacy24

• Cavinton 5 mg No. 50 tablets VAT "Gedeon Richter", Ugorshchina
  166 UAH. order
• Cavinton forte 10 mg No. 30 tablets VAT "Gedeon Richter", Ugorshchina

  191 UAH order

• Cavinton forte 10 mg No. 90 tablets VAT "Gedeon Richter", Ugorshchina

  545 UAH. order

• Cavinton 10 mg 2 ml No. 10 con, Ugorshchina

  195 UAH order

PaniPharmacy

• Cavinton tablets Cavinton tablets. 5mg No. 50 Hungary, Gedeon Richter

  187 UAH order

• Cavinton forte tablets Cavinton forte tablets. 10 mg No. 30 Hungary, Gedeon Richter

  191 UAH order

• Cavinton ampoule Cavinton concentrate for solution for infusion 10 mg ampoules 2 ml No. 10 Hungary, Gedeon Richter

  225 UAH order

  Read also:  Rinostop Aqua with sea water: instructions for use
• Cavinton forte tablets Cavinton forte tablets. 10 mg No. 90 Hungary, Gedeon Richter

  511 UAH order

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Actovegin or Cavinton

An analogue of Cavinton in ampoules and tablets is Actovegin. The medicine is based on the active substance isolated from the blood of calves.

The similarity of the two analogues lies in their effectiveness in cerebrovascular accidents, especially in atherosclerosis and ischemia.

There are differences in indications. Which is better depends on the patient's complaints and the severity of the condition. Actovegin is used for vascular atherosclerosis, trophic changes, and peripheral angiopathy. Cavinton is often prescribed to eliminate unsteadiness of gait as a consequence of impaired coordination and vestibular apparatus, tinnitus and dizziness.

Piracetam or Cavinton

Piracetam is a drug in injections, capsules and tablets to improve memory, attention and concentration, and facilitate the learning process. The analogue is cheaper than Cavinton, protects brain cells from damage by toxins, alcohol, due to shock, hypoxia and other factors.

Cavinton also has nootropic and damage-protective effects. However, the main purpose of the drug is to improve blood circulation in the brain and eliminate associated symptoms.

Which is better, Cavinton or Piracetam, depends on the patient’s complaints and condition. Combined use is possible; pharmacies also offer complex preparations containing both piracetam and vinpocetine, for example: Omaron, Phezam.

Sermion or Cavinton - which is better?

The drugs Sermion and Cavinton are analogues. Both medications improve blood supply and metabolism in the brain and blood properties. The first remedy further increases blood flow in the lower extremities.

Cavinton is often prescribed for the treatment of dizziness and tinnitus. What to choose should be discussed with your doctor based on complaints, age, concomitant diseases, and other characteristics.

Fezam or Cavinton

Fezam and its analogue in composition Omaron belong to the group of nootropic drugs. Medicines combine the properties of two components - piracetam and cinnarizine.

Cavinton also has a nootropic effect. The property of improving blood circulation and metabolism in the brain is more pronounced. Analogs differ in their mechanism of action, active substances, properties, indications and limitations.

Foreign drugs

There are also imported analogues of Cavinton, but their price is higher than that of domestic analogues, as well as substitutes from neighboring countries. Here they are:

• Cavinton Comforte (Hungary) - the drug is similar in composition and effect to Cavinton, but is more harmless and less toxic. A distinctive feature is the special composition of the tablets, which allows them to quickly dissolve with saliva. This makes it much easier for patients with swallowing disorders to take the medicine. Price – 300-600 rubles;
• Betaserc (France, Netherlands) - produced on the basis of betahistine dihydrochloride. It is used for problems with the vestibular system, hearing impairment, dizziness, and relieving migraine headaches (400-600 rubles);
• Vicebrol (Poland) - similar in composition and effects to vinpocetine. Price 175–210 rubles;
• Oxopotin (Finland) – its active substance is captopril. The drug has a pronounced hypotensive effect. (210–440 rub.).

Cavinton and its analogues, being nootropic medications, are almost always available with a prescription. Self-medication with these drugs is strictly prohibited. These medications can only be taken as prescribed and under the supervision of a physician.

Tanakan or Cavinton

Both drugs are prescribed for pathology of cerebral circulation and deterioration of memory and attention. There are differences between analogues:

• Cavinton is a chemical preparation based on vinpocetine. Tanakan - based on the ginkgo biloba plant.
• The first medication has a quick orally soluble formula called Comforte.
• different manufacturers - in the first case, Hungary, in the second, Russia.
• excellent incidence of side effects.

Thus, Tanakan is a safe analogue and is less likely to lead to undesirable consequences. In serious cases, doctors give preference to Cavinton, using the analogue for prophylactic purposes or as an additional measure.

Patient reviews on the choice of Cavinton analogues

To determine the degree of effectiveness and safety of drugs, you should read reviews from specialists and patients:

Marina, 26 years old: “For more than 8 months I was tormented by dizziness after an injury. The treatment seemed to be successful, but the unpleasant symptoms often returned. Doctors recommended Cavinton. I completed the course, however, I did not notice any improvement in my condition. Then I changed it to Dendrix. After a little time I noticed improvements. Does not cause problems with use. True, my mother is a doctor, she gave me injections.”

Nadezhda, 32 years old: “My son was diagnosed with VSD at the age of 6 and was prescribed Cavinton. For me, this drug turned out to be a little expensive. Having studied the instructions, I discovered that it is made on the basis of vinpocetine. I immediately remembered that I took this medicine back in my teens, when my nose was bleeding. I consulted with my doctor and he allowed me to change the prescribed medication. The effectiveness of these medications is the same, but the cost of Vinpocetine is several times lower.”

Cavinton and its substitutes should be prescribed only by qualified specialists after examination and diagnosis on an individual basis. The choice of medicine depends not only on price and composition, but also on the characteristics of each patient’s body.

Betaserk or Cavinton

Betaserc based on betahistine and Cavinton are used to treat tinnitus, hearing loss, dizziness, accompanied by nausea and vomiting. Both analogues are original, clinically tested products. Which one is better depends on the patient’s medical history, the characteristics of the symptom and the cause. The choice is made by the doctor.

Vasobral or Cavinton - which is better?

The analogues Cavinton and Vazobral are similar in their effect, but differ in the mechanism:

• improvement of blood viscosity parameters;
• increased metabolic processes and blood circulation in the brain;
• increasing mental and physical performance.

Additionally, the analog Vasobral reduces the feeling of fatigue and reduces the permeability of the vascular wall. The choice of drug is made based on medical history.

Nootropil or Cavinton

Nootropil is a piracetam-based drug that has a nootropic effect. Compared to it, Cavinton has a wide range of medicinal effects. In addition to affecting memory and attention, the medicine improves blood supply to the brain, increases the elasticity of blood vessels and modifies blood viscosity parameters. What to choose depends on the desired effect and indications.

Cytoflavin or Cavinton

Cytoflavin is an analogue of Cavinton 10 mg and is a metabolic agent. Contains succinic acid, riboflavin, inosine and nicotinamide. As a result, the product improves metabolism in body tissues, reduces susceptibility to oxygen starvation, and is used to eliminate the consequences of a heart attack, cerebrovascular accidents and neurasthenia.

Cavinton has a wider spectrum of action and is used to eliminate impaired blood circulation in brain tissue, symptoms of dizziness, tinnitus, unsteadiness of gait, memory impairment and attention.

Substitutes for Cavinton in other dosage forms

So that the patient can choose the most suitable medicine in the most convenient form, a wide range of drugs in the form of tablets, capsules, and solutions is presented to his attention.

If there is a need or desire to replace the prescribed drug, you can familiarize yourself with existing analogues and, after consulting with your doctor, begin treatment.

The most effective and popular drugs that can be used instead of Cavinton include:

• Bravinton;
• Actovegin;
• Lutsetam;
• Farmakson;
• Mexidol;
• Somaxon.

Before starting a therapeutic course, you should study the features of the administration. It is important to follow the advice of a qualified professional.

Bravinton

A medication from the group of cerebral blood flow correctors. The active substance is vinpocetine. Available in the form of tablets and concentrate, which is used for preparing infusions. As a result of taking the medicine, regression of memory impairment, relief of dizziness, and improvement of intellectual activity are observed. Asthenic and cephalgic syndrome decreases.

Under the influence of the medication, blood pressure is normalized, blood flow is restored in the ischemic area of ​​the brain, and the concentration of cyclic AMP increases.

The main indications for use are:

• transient ischemia;
• cerebral infarction;
• post-stroke condition;
• secondary glaucoma;
• encephalopathy (post-traumatic);
• Meniere's disease;
• decreased hearing acuity.

It is not recommended to take the drug if you are intolerant of its components, severe arrhythmia, pregnancy or during breastfeeding.

The solution is used for intravenous administration with an initial dose of 20 mg per 1000 ml of saline solution. If the patient’s body tolerates the drug well, the amount of Bravinton is gradually increased to 30 mg. Towards the end of the course, the dosage is reduced and the patient should switch to the tablet form.

Despite the fact that Bravinton is a structural analogue of Cavinton, its cost is several times lower. The degree of effectiveness and safety are identical.

Actovegin

Actovegin is a tissue regeneration stimulator. The main substance is actovegin concentrate (dry deproteinized hemoderivative of calf blood). The solution has a positive effect on the transport and utilization of glucose, saturates the brain with oxygen, exhibiting antihypoxic properties. Reduces the level of pain in diabetes mellitus and improves mental health.

Used for vascular or metabolic dysfunctions of the brain, venous/arterial disorders, diabetic polyneuropathy. Promotes wound healing. The medicine is also used in the prevention and treatment of radiation injuries to the mucous membranes and skin obtained during radiation therapy.

The list of conditions that prohibit the use of this medication includes:

• hypersensitivity to the main or excipients;
• pulmonary edema;
• heart failure;
• anuria, oliguria, impaired excretion of fluid from the body.

The manufacturer's instructions indicate that the drug is injected into the muscle, intravenously or intra-arterially. When administered infusionally, 10-20 ml of the drug is diluted in 200-300 ml of the main solution. Injected at a rate of 2 ml per minute. The exact dose is calculated by the attending physician depending on the severity of the disease.

The original and the substitute are used for similar indications. Compared to Cavinton, Actovegin has a more aggressive effect.

Lutsetam

The nootropic drug is available in the form of an injection solution and film-coated tablets. The mechanism of action is due to the presence of piracetam in the composition. Penetrating inside the body, it affects the nervous system. With long-term use, there is an improvement in concentration, increased cognitive function, inhibited platelet aggregation and erythrocyte rigidity.

The list of indications for use includes cortical myoclonus and mnestic-intellectual disorders.

It is prohibited to take medications for hemorrhagic stroke, renal failure, or intolerance to components. With increased caution, it is allowed to prescribe to patients during bleeding, after surgery and in case of hemostasis disorders.

The injections are intended for intravenous or intramuscular administration. Per 1 kg of patient weight, 30-160 mg. There can be from 2 to 4 injections per day.

Lucetam and the original product differ in composition, but have a similar effect. Often they are used simultaneously to speed up the recovery of the patient with brain disorders.

Farmakson

Farmakson is a psychostimulant medication. The role of the main substance is citicoline. It goes on sale in the form of a solution, packaged in ampoules of 2 or 4 ml. Under the influence of LP, the biosynthesis of structural phospholipids is stimulated in the neuronal membrane. The drug protects membrane systems from damage; in case of focal stroke, preventive neuroprotective properties are manifested.

The drug helps eliminate the consequences of traumatic brain injury. Prescribed for diagnosing the acute stage of circulatory disorders in the brain, motor, cognitive and sensory disorders.

Doctors include the following in the list of contraindications:

• intolerance to drug components;
• increased tone of the nervous system (parasympathetic);
• pregnancy.

Farmakson is administered intramuscularly over 3-5 minutes. The rate of intravenous drip administration should not exceed 60 drops in 1 minute. The dosage is gradually increased from 500 to 2000 mg.

Mexidol

Mexidol is part of the pharmacotherapeutic group of antioxidants. The mechanism of action is determined by ethylmethylhydroxypyridine succinate. Penetrating into the body, the drug has a wide spectrum of effects - it has antihypoxic, anticonvulsant, antioxidant, hypolipidemic, membrane-protective, anxiolytic and nootropic properties.

The medicine increases the concentration of dopamine in the brain, stabilizes cell membranes, reduces platelet aggregation, and lowers cholesterol levels.

Mexidol pilyule_ana-049 is prescribed to patients with symptoms:

• autonomic dysfunctions;
• withdrawal syndrome;
• panic attacks;
• psychopathy;
• concussions;
• neurasthenic conditions;
• chronic/acute encephalopathy.

The list of contraindications includes intolerance to the components, renal failure, pregnancy, breastfeeding. The drug is also not used in children.

Mexidol is prescribed for intravenous and intramuscular administration. The rate of drip administration is 50-60 drops/minute; the medicine must be injected in a stream within 5-7 minutes. The dosage is prescribed individually, depending on the characteristics and severity of the disease. The maximum allowable amount is 1200 mg per day.

The original medicine and its substitute have similar indications and therapeutic effects. However, they differ in composition, contraindications and negative reactions.

Somaxon

The nootropic drug is sold in the form of a solution intended for injection. Citicoline is used as the main active ingredient. It has anti-edematous properties, has an inhibitory effect on phospholipases, and prevents excessive formation of free radicals.

During the recovery period after a traumatic brain injury, it shortens the duration of coma and reduces the severity of neurological signs.

Somaxon is prescribed for the following conditions:

• hemorrhagic stroke;
• ischemic stroke;
• motor, sensory and cognitive failures of neurodegenerative and vascular origin.

Treatment with this medication should be avoided in patients under 18 years of age, with increased sensitivity to the components or severe vagotonia.

Adult patients are prescribed intravenous injections, the duration of which is 5 minutes. Single dose – 2 ml. The drug is infused dropwise at 40-60 drops per minute. The maximum permissible daily dose is 2000 mg. The dosage is determined by the attending physician.

See also:

TOP 6 cheap Phezam analogues - structural substitutes for the drug

Picamilon or Cavinton

Picamilon is a nootropic analogue in ampoules and tablets. Similar in effect to Cavinton, differs in mechanism:

• increasing physical and mental performance;
• improving blood supply to the brain and metabolic processes;
• vasodilation;
• positive effect on memory, attention, and other cognitive abilities.

Additionally, the analogue has a calming effect - reduces feelings of fatigue, anxiety, irritability, nervousness, and improves sleep.

Which is better - Cavinton or the analogue Picamilon, depends on the diagnosis. The first remedy is aimed at eliminating circulatory disorders, the second at improving cognitive functions.

The choice of Cavinton analogues is carried out strictly by a doctor, since there are specific prescriptions, restrictions and possible adverse reactions. If side effects occur, you should visit the specialist again and provide information.

Analogues of the drug for therapeutic action

A separate group contains medications that have a similar effect on the body as Cavinton. Despite the fact that they contain other active substances, such drugs can be used to replace the original medication.

The selection of substitutes should be carried out by a qualified specialist. Since self-medication can negatively affect the course of the disease and the patient’s condition.

Often, the following are prescribed to replace Cavinton:

• Dendrix;
• Neuroxon;
• Piracetam;
• Pantogam;
• Nootropil.

Important! When carrying out treatment with analogues, it is necessary to follow the doctor’s recommendations.

Dendrix

The nootropic drug is produced on the basis of citicoline. Under its influence, the biosynthesis of structural phospholipids is stimulated and the functionality of membranes improves. Dendrix increases memory and performance, helps reduce the level of amnesia, as well as unpleasant symptoms that occur with cerebral dysfunction.

Conditions for which this drug is prescribed:

• TBI and its consequences;
• cerebral blood flow disorders;
• brain stroke.

If the tone of the parasympathetic nervous system is increased, the drug is not used. Also a contraindication is hypersensitivity to the components.

The dosage is selected by the doctor, based on the characteristics of the disease and the patient’s condition. The standard regimen involves twice-daily administration of 2 ml dropwise (up to 60 drops per minute) or stream (duration of administration - up to 5 minutes).

Unlike its analogue, the original medicine has a wider spectrum of action. They differ in the components they contain.

Neuroxon

Injection solution from the medicinal group of psychoanaleptics. The mechanism of action of the drug is determined by citicoline. Neuroxon has an inhibitory effect on some phospholipases and prevents the release of free radicals. Prevents cell death, restores affected tissue areas, and helps improve cholinergic transmission.

Indications for use include various forms of circulatory disorders in the brain (CB), TBI, and neurological disorders.

The use of the drug should be avoided in case of individual intolerance to its components and excessive tone of the parasympathetic nervous system.

The standard instructions contain information regarding application features. It indicates that the solution is suitable for intramuscular and intravenous administration. The daily dose is from 500 to 2000 mg. The duration of the therapeutic course depends on the patient's condition.

Despite the fact that the original and the substitute contain different components, they are prescribed for the same conditions. The drugs differ in cost and release form. Neuroxon goes on sale only in the form of a solution packaged in ampoules.

Piracetam

Medicine from the group of nootropics is available in the form of capsules, solution and tablets. The main substance is piracetam. It has a psychostimulating and neurometabolic effect. LP has a positive effect on metabolic transformations in nerve cells, modulates the speed of excitation in brain cells, and improves the level of communication between the two hemispheres of the brain.

Main indications for use:

1. Alzheimer's disease.
2. Traumatic brain injuries (TBI).
3. Coma.
4. Dementia.
5. Psychoorganic syndrome.
6. Sickle cell anemia.
7. Cortical myoclonus.
8. Stroke.

In childhood, medicine may be prescribed for the diagnosis of dyslexia or other pathologies that lead to a decrease in learning ability.

It is strictly forbidden to take medications if:

• Huntington's chorea;
• hypersensitivity to components;
• acute hemorrhagic stroke;
• psychomotor agitation;
• pregnancy;
• lactation.

With maximum caution, the use of drugs is allowed in the presence of hemostasis disorders, bleeding, and extensive surgical interventions.

A single amount of medication depends on the patient’s body weight and is approximately 30-160 mg. Take two to four times a day. To avoid problems with sleep, you should time your appointments so that the last one is no later than 18 hours. The maximum dose of the drug depends on the characteristics of the pathology and is determined by the doctor.

Piracetam differs from the original medicine in its active ingredient. In this regard, it has a slightly different purpose. However, these drugs can be prescribed in combination.

Pantogam

The nootropic drug is available in tablet form. The main substance is calcium hopantenate. The drug is characterized by nootropic and anticonvulsant properties. Under the influence of the medication, the protective function of the brain increases, the degree of motor excitability decreases, and physical and intellectual performance is activated.

Pantogam is used for alcohol dependence to improve the metabolism of gamma-aminobutyric acid. Experts also prescribe the drug for:

1. Extrapyramidal disorders (complications of neuroinfections, head injury, neurotic disorders).
2. Schizophrenia, which is accompanied by organic cerebral insufficiency.
3. Epilepsy.
4. Cerebrovascular insufficiency.
5. Mental fatigue, perintal encephalopathy or cerebral palsy in children.
6. Psycho-emotional stress.

The list of contraindications includes:

• kidney dysfunction;
• intolerance to components;
• pregnancy/lactation period.

The tablets are taken orally 20 minutes after meals. An adult single dose ranges from 0.25 to 1 g, the maximum daily amount is 3 g. For the treatment of children over three years of age, 0.25-0.5 g is prescribed three times a day. The duration of the therapeutic course can be 1-4 months.

Of the general conditions for the use of drugs Cavinton and Pantogam, only head injury and vascular pathologies are distinguished. They differ in composition, spectrum of action and degree of safety. Unlike the original, the substitute is used in the field of pediatrics.

Nootropil

Nootropil represents a group of nootropic medications. It is developed on the basis of piracetam. This substance is a derivative of gamma-aminobutyric acid. Its main effect is aimed at the level of performance of the GM, increasing memory, attention, and improving thought processes.

It is recommended to use this drug to eliminate:

• consequences of a stroke;
• psychoorganic syndrome;
• learning problems in children;
• sickle cell anemia;
• complications after coma;
• treatment of chronic alcoholism.

Patients who are allergic to its components are prohibited from taking the drug if they have end-stage renal failure. Nootropil may cause feelings of anxiety or fear.

Tablets are used to treat children from 3 years of age, and a solution for internal use from 1 year of age:

1. The initial amount of solution is 10 g (i.m. or i.v.). It is administered by drip over 20 minutes.
2. Tablets are taken twice a day with a dose of 30 to 160 mg per 1 kg of patient’s body weight.

Important! Treatment of young children is carried out under the supervision of a doctor with individually selected dosages.

Since Nootropil is a nootropic, it is often prescribed in combination with Cavinton to increase its therapeutic effect. The original drug is better tolerated.

See also:

TOP 7 analogues of Picamilon - Russian and foreign substitutes for the drug

Answers on questions

1. Does Cavinton increase or decrease blood pressure?
   

   The drug, if you follow the doctor's recommendations and dosages, does not affect blood pressure; in some cases, a decrease in levels is possible.

2. Can Cavinton be used for epilepsy or not?
   

   It is possible for a doctor to prescribe medication for this diagnosis if there are no contraindications. However, Cavinton in this case is prescribed as an adjuvant to the main treatment to improve cerebral circulation.

3. Is it possible or not to use the drug for oncology?
   

   The medicine is not prescribed specifically for the treatment of cancer. The choice in favor of Cavinton is made by a doctor based on the indications and existing restrictions.

4. What is better – Cavinton or Cavinton comfort?
   

   The second form is more effective because it contains twice as much active substance and is a dispersible (orally soluble) tablet. Consequently, the drug has a much faster and more pronounced therapeutic effect.

Over the past 15 years, data accumulated in the field of neuroscience have led to a complete reorganization of knowledge in this field and to a new understanding of the functioning of the nervous system. Changes in fundamental ideas about the basic physiological and pathological processes occurring in nervous tissue have forced a new look at the clinic, pathogenesis and treatment of many neurological diseases.

Regardless of the causative factor, the mechanisms of neuronal damage can be specific or nonspecific. Nonspecific alteration mechanisms include disturbances in the energy supply of neurons; protein synthesis disorders; imbalance of ions and fluid in neurons; membrane damage due to lipid peroxidation; apoptosis. The pathogenetic basis of most forms of specific damage to neurons is a violation of neuron-specific metabolic processes of neurotransmitters (synthesis, axonal transport, secretion, removal and utilization). The mechanisms of neuronal damage are closely interconnected and often potentiate each other, forming a vicious circle, and therefore, for the treatment of neurological disorders, a drug that prevents as many mechanisms of neuronal alteration as possible, while having a positive effect on the level of cerebral blood flow and microcirculation, would be promising. One of the drugs that has similar effects is vinpocetine (Cavinton) [1].

The main indication for the use of vinpocetine is chronic cerebrovascular disorders [1, 2], but the issue of using the drug both in acute cerebrovascular accidents [3] and in neurodegenerative diseases (Alzheimer’s disease) is being actively discussed [4, 5].

Vinpocetine was synthesized in the late 60s of the 20th century and registered as a drug under the commercial name Cavinton (Gedeon Richter) in 1978. The drug is a semi-synthetic derivative of the alkaloid vincamine, contained in the periwinkle plant ( Vinca minor L. and Vinca erecta Rgl. et Schmalth

) of the mulberry family (
Apocynaceae
). The alkaloid vincamine (methyl ester of vincamic acid), devincane, isolated from periwinkle, has been proposed for use as a vasodilator. As a result of clinical studies, it was found that Devincan is especially effective in cerebrovascular disorders; later, on its basis, Hungarian scientists created the drug Vinpocetine. Currently, vinpocetine is widely used in clinical practice in 47 countries, including Hungary, Japan, Germany, Poland and Russia [6].

The basis of the vascular effect of vinpocetine (Cavinton) is the effect on the metabolism of cyclic nucleotides in the smooth muscle cells of the vascular wall by inhibiting Ca2+/calmodulin-dependent phosphodiesterase type 1 [7]. This effect leads to the predominance of cAMP over cGMP, which promotes relaxation of cerebral vessels, reduces platelet aggregation [8] and pathologically increased blood viscosity [9], and normalizes the deformability of erythrocytes [10, 11].

It is important that vinpocetine (Cavinton) selectively increases cerebral blood flow [12-14], reduces cerebral vascular resistance without affecting the systemic circulation (virtually without affecting blood pressure, minute volume, heart rate, total peripheral resistance) [15 , 16]. It does not cause the “stealing” phenomenon, but, on the contrary, improves blood supply to the affected area, and the blood flow in the intact area of ​​the brain remains unchanged [16-18].

When taking vinpocetine (Cavinton) orally in elderly and senile patients with symptoms of senile dementia for 3 weeks at a dose of 15-30 mg per day, in parallel with an increase in the concentration of ATP in erythrocytes, an increase in the affinity of hemoglobin for oxygen and its ability to release oxygen is observed [19] . The drug activates deficient metabolism and increases the energy capacity of the brain by improving the utilization of glucose, oxygen and the rate of ATP synthesis. Positron emission tomography has shown an increase in glucose delivery (uptake and release) across the blood-brain barrier [20, 21].

The neuroprotective effects of vinpocetine (Cavinton) are most likely mediated by several mechanisms. Inhibition of voltage-dependent sodium channels during the administration of vinpocetine under experimental conditions leads to a slowdown in the accumulation of sodium in the cell, thereby reducing the toxic effect of oxidative stress during anoxia and damage during reperfusion [22-24]. The antioxidant effect of the drug is manifested due to a decrease in the activity of lipid peroxidation in synaptosomes [25, 26]. Under conditions of experimental ischemia, vinpocetine reduced the size of the focus of necrosis of nervous tissue by 60% [22]; In terms of antioxidant activity in animal studies, vinpocetine was significantly superior to pentoxifylline and piracetam [27, 28].

Also, while taking vinpocetine, a decrease in excitotoxicity and apoptosis was noted due to blocking NMDA receptors and reducing the flow of Ca2+ ions into the cell [29-31].

An additional important factor is the strengthening of the structural dynamics of the dendrites of cortical cells in the form of enlargement and elongation of spines, which leads to an increase in the plasticity of neurons, especially in the hippocampus [32, 33], and probably underlies the enhancement of cognitive functions during the administration of vinpocetine [34 ]. The effect appears to be a consequence of blocking the entry of calcium and sodium ions into the cell and increasing the activity of neuronal cytoskeletal elements [35, 36].

In addition to the vascular and neuroprotective effect, vinpocetine has an effect on the neurotransmitter systems of the brain, enhancing the intracerebral exchange of norepinephrine and serotonin [37] and stimulating the ascending noradrenergic system, in particular the blue nucleus of the brainstem [38].

Studies on the effectiveness of vinpocetine (Cavinton)

To date, 7 double-blind, placebo-controlled studies have been conducted to demonstrate the effectiveness of vinpocetine (Cavinton).

The first study of vinpocetine (Cavinton) in comparison with placebo was conducted by G. Lipani in 1984 [39]. The study included 44 patients with chronic cerebral ischemia, transient ischemic attacks and moderate cognitive impairment, divided into 2 groups: 22 patients received vinpocetine at a dose of 30 mg per day for 1 month, then 15 mg per day for the next 2 months, the other 22 patients received placebo for 3 months. The results were assessed using the Clinical Global Impression (CGI), the Sandoz Clinical Assessment Geriatric Scale (SCAG), the Mini Mental State Examination (MMSE), and neurological status indicators. Significant differences in indicators were obtained in the vinpocetine group compared to placebo on the 30th and 90th days of the study.

The study by M. Peruzza and M. DeJakobis [40] included 40 patients with degenerative diseases of the central nervous system, divided into 2 groups of 20 people. The design and assessment methods were similar to the study

G. Lipani. On the CGI scale at the end of treatment, there was a decrease in score in 80% of patients receiving vinpocetine versus 0 in the placebo group (p<0.001). Similar differences were obtained for the SCAG and MMSE scales. When assessing the neurological status, there was a significant (p<0.001) improvement in the clinical picture in the main group, most pronounced in the motor and speech areas.

A study similar in design and number of patients (n=40) was conducted by E. Manconi et al. [41]. At the end point of the study, 87% of patients in the main group treated with vinpocetine had a decrease in CGI scores versus 11% in the placebo group (p<0.001); when assessing the neurological status, pronounced improvements were observed in 59% of patients receiving vinpocetine, versus 6% in the placebo group (p<0.001). Similar differences were obtained for the SCAG and MMSE scales.

In a study by E. Fenzl et al. [42] included 201 patients with moderate psychoorganic syndrome of ischemic and neurodegenerative nature; 105 patients of the main group received vinpocetine at a dose of 60 mg per day for 1 year, 96 patients of the comparison group received placebo. The CGI scale, Syndrome short test (SST) and Condition-index (CI) were used to evaluate the results. CGI indicators after 6 and 12 months of treatment were significantly lower in the vinpocetine group, and the activity index was significantly higher. Clinical improvement in neurological status after 12 months was observed in 86.7% of patients in the main group versus 54.2% in the placebo group (p<0.001).

A study by R. Balestreri et al. [43] was consistent in design with previously conducted studies [40-42], the significant difference of this study was the inclusion of only patients with chronic cerebral ischemia (n=80). The reduction in CGI score after 90 days of treatment with vinpocetine was 44% versus 13% in the placebo group (p<0.001). Improvement was also observed on the SCAG and MMSE scales, with the scores being significantly higher in the main group.

In a study by N. Fuchs and H. Erzigkeit [44], 3 groups of patients with moderate psychoorganic syndrome without differentiation by etiology were compared (n=165): 2 main groups receiving vinpocetine in doses of 60 and 30 mg per day (55 and 56 patients, respectively) and the placebo group (n=54). The duration of the study was 16 weeks. When assessing the results, the CGI, SST and CI scales were used. After 16 weeks of treatment, the CGI score was significantly lower in both main groups compared to the placebo group (p<0.001). The CI level was not significantly different.

L. Blaha et al. [45] conducted a study in 4 parallel groups (n=213), receiving vinpocetine at doses of 60, 30 and 15 mg per day and placebo for 12 weeks (53, 55, 50 and 55 patients, respectively). In addition to the CGI and SST scales, the Erlangen depression scale (EDS) was used. After 3 months of therapy, the CGI score was significantly lower in all groups receiving vinpocetine compared with placebo (p<0.001). The EDS score in the treatment groups was lower than in the placebo group, but the significance of the differences had threshold values.

The results of all 7 studies were summarized in a meta-analysis that included data on 731 patients [46].

Separately, data from Italian studies with a similar design (n=204) were analyzed for the CGI indicator, and a significant decrease of 1.22 points was obtained (confidence interval, CI - 1.01-1.43; p<0.001) in the main group compared with the placebo group on day 30 and by 1.1 points (CI - 0.89-1.31; p<0.001) on day 90 of the study.

The second part of the meta-analysis included the results of 3 studies of patients with moderate psychoorganic syndrome against the background of chronic cerebral ischemia, conducted in Germany (n=527). Given the differences in study design, only the results of the first 12 weeks of treatment were included in the analysis, and the significance of the differences between all groups treated with vinpocetine (30 and 60 mg per day) versus placebo groups was assessed. The CGI scale revealed a significant decrease in score compared to placebo - by 0.52 points (CI - 0.35-0.7; p<0.001). Similar results were demonstrated by the short SST data - a decrease of 0.66 points (CI 0.08-1.24; p = 0.027). CI scores also improved, but varied in level of statistical significance across studies (p<0.001 to p=0.073). EDS depression scores differed between treatment groups, but the effect was at threshold levels.

The effectiveness of vinpocetine (Cavinton) has also been proven in a number of open and comparative studies.

A. Szobor and M. Klein [47] studied the effectiveness of vinpocetine in a group of patients with cerebral atherosclerosis, hypertensive encephalopathy, and chronic cerebrovascular insufficiency. The study included 100 patients who received vinpocetine at a dose of 30-45 mg per day orally and in combination (orally and infusion). The study results revealed a significant improvement in the clinical condition in the study group.

In a study by E. Burtsev et al. [2], published in 1992, summarized the results of a 10-year study of the use of vinpocetine in patients with various forms of cerebrovascular diseases. The review included data from 967 patients. The best results were obtained in patients with early forms of chronic diseases (vegetative dysfunction, early stages of dyscirculatory encephalopathy).

Safety studies of Vinpocetine (Cavinton)

In an open clinical trial conducted by T. Perényi et al. [48], 100 patients received vinpocetine at a dose of 15 mg per day for 1 year, while ECG monitoring did not reveal significant changes or cases of arrhythmia. A study conducted in Japan as part of a phase III clinical trial of vinpocetine, which included about 8000 patients in 1420 centers, had similar results [49].

To clarify the arrhythmogenic effect of vinpocetine, C. Farsang et al. [50] conducted a 2-year, double-blind, randomized, placebo-controlled study that included data on 85 patients suffering from various chronic heart diseases. According to the results of the study, it was concluded that neither vinpocetine nor placebo affected heart rate, the duration of the PQ, QRS, QT and ST intervals, did not cause extrasystoles and did not change the shape of the T peak, i.e. Long-term oral administration of vinpocetine does not lead to arrhythmias.

In 1998, a meta-analysis of Hungarian and international literature found that neither oral nor intravenous treatment with vinpocetine had any significant effect on heart rate and conduction, even in the presence of arrhythmia risk factors [46].

However, in cases of chronic heart disease (especially left ventricular hypertrophy, ischemia or low left ventricular ejection fraction), electrolyte disturbances (hypokalemia, hypomagnesemia), prolongation of the QT interval, use of drugs that block potassium channels (amiodarone, sotalol ) or cytochrome P450 inhibitors (cimetidine, clarithromycin, fluoxetine, etc.), parenteral therapy with vinpocetine should be carried out under ECG monitoring. Since vinpocetine is usually used in increasing doses (starting from 20-25 mg and reaching 60 mg per day), an ECG is recommended after the first infusion and after reaching the maximum dose. In case of prolongation of the QT interval (which is normally rare), the possibility of reducing the dose of Cavinton or discontinuing the drug should be considered.

An important aspect of the use of vinpocetine (Cavinton) is the absence of an effect on liver function, including the system of enzymes that metabolize drugs, as well as the absence of an effect on normal and pathologically altered kidney functions [46]. In specially conducted studies, no interaction of Cavinton with beta-blockers (chloranolol, pindolol), clopamide, methyldopa, digoxin and hypothiazide was found. The drug can be used in normal doses in patients with renal and hepatic insufficiency; it has no cumulative effect.

Cavinton for infusion is chemically incompatible with heparin, so these drugs cannot be administered in the same syringe, although sequential administration is possible.

E.I. Chukanova conducted a pharmacoeconomic study of neurometabolic drugs in 2003 [51], which included data on 532 patients with dyscirculatory encephalopathy stages I and II. It has been shown that the use of Cavinton promotes regression or stabilization of the progression of neurological disorders, while the drug has a good tolerability profile, the cost of a course of treatment and the cost-effectiveness ratio were the most favorable compared to other drugs.

Thus, despite the long history of the use of Cavinton in widespread clinical practice (more than 30 years), interest in studying the mechanisms of its action among biochemists, molecular biologists, and clinicians does not fade, and every year previously unknown properties of the drug are revealed, opening up new prospects for its applications. It is the multiplicity of points of application of Cavinton, combined with high clinical effectiveness and safety of use, that allows it to compete for a long time and successfully with an ever-increasing number of new drugs on the pharmacological market.