Nootropil 200 mg-ml 125 ml oral solution

Compound

Piracetam is the active ingredient of the drug.
The tablets contain 800 or 1200 mg of this substance. Additional elements: macrogol 6000, silicon dioxide, croscarmellose sodium, magnesium stearate.

Capsules of 400 mg of active ingredient. Additional substances: macrogol 6000, silicon dioxide, lactose monohydrate, magnesium stearate.

The oral solution contains 200 or 330 mg of active substance per 1 ml. Additional elements of the composition are: sodium saccharinate, pure water, glycerol , sodium acetate, acetic acid, methyl parahydroxybenzoate, flavorings, propyl parahydroxybenzoate.

Nootropil solution IV and IM contains 200 mg of active substance per 1 ml. Auxiliary elements are: sodium acetate trihydrate, water for injection, glacial acetic acid.

Pharmacodynamics and pharmacokinetics

The active ingredient is piracetam. The use of the drug Nootropil enhances the utilization of glucose, enhances the synthesis of phospholipids and RNA, increases the level of ATP in brain tissue, and stimulates glycolytic reactions . The drug has a positive effect on metabolic processes in brain tissue, facilitates the learning process, improves integrative work and brain activity, and improves memory . Nootropil is able to suppress the aggregation of activated platelets, does not have a vasodilatory effect, but at the same time has a positive effect on microcirculation and the speed of propagation of the excitation wave in brain tissue. In case of brain damage due to intoxication, hypoxia, or electric shock, the drug has a pronounced protective effect, reducing the severity of vestibular nystagmus, reduces delta activity and enhances alpha and beta activity on the electroencephalogram . The medication improves cerebral blood flow, increases mental performance, improves conductivity between synapses in neocortical structures, and has a positive effect on interhemispheric connections. The therapeutic effect of treatment develops gradually. The drug does not have psychostimulating and sedative effects.

The drug is quickly absorbed, is not metabolized, and does not bind to blood proteins. It is excreted unchanged by the kidneys.

Indications for use of Nootropil

Instructions for use of the drug Nootropil recommend prescribing the drug in neurology, narcology and psychiatry.

In neurological practice, the medication is used for pathology of the nervous system, accompanied by disturbances in the emotional-volitional sphere (for example, Alzheimer's disease) and a decrease in intellectual and mental functions. The drug is prescribed after intoxication and traumatic brain damage, for chronic cerebrovascular insufficiency (headaches, severe dizziness, speech disorders, attention, memory), for vascular pathology of brain tissue, for comatose and subcomatose states, during the period of convalescence in order to increase mental and motor activity, with residual effects of cerebral circulatory disorders according to the ischemic variant.

Indications for the use of Nootropil in psychiatry: flaccid apathetic defective conditions (such as psychoorganic syndrome, schizophrenia), asthenodepressive syndrome (with a predominance of ideator inhibition, with senesto-hypochondriacal disorders, asthenic pathology, with adynamia), nephrotic syndrome . Piracetam is prescribed in the complex treatment of depressive conditions that are resistant to the effects of antidepressants, in the treatment of mental pathology that occurs on “organically defective soil.” The drug is recommended for use in cases of intolerance to neuroleptics and antipsychotic medications in order to eliminate mental, neurological and somatovegetative complications. The drug is prescribed for the cortical form of myoclonus.

Nootropil in drug treatment practice is used to relieve alcohol withdrawal syndrome , in acute poisoning with phenamine , barbiturates , morphine, ethanol, in morphine withdrawal syndrome, chronic alcoholism (in combination with intellectual and mnestic disorders, asthenia, persistent mental pathology). The drug can be used as part of combination therapy in the treatment of sickle cell anemia .

In order to eliminate the consequences of perinatal damage to brain structures, to improve the learning process, in case of cerebral palsy , mental retardation, Nootropil can be used in pediatrics.

Notes[ | ]

1. ↑ 1 2 3
   Piracetam
   (undefined)
   .
   Encyclopedia of Medicines
   . Register of Medicines of Russia (2002). Access date: October 27, 2011.
2. Search in the drug database, search options: INN - Piracetam
   , flags
   “Search in the register of registered drugs”
   ,
   “Search TKFS”
   ,
   “Show lekforms” (undefined)
   (inaccessible link).
   Circulation of medicines
   . Federal State Institution “Scientific Center for Expertise of Medical Products” of Roszdravnadzor of the Russian Federation (March 27, 2008). — A standard clinical and pharmacological article is a by-law and is not protected by copyright in accordance with part four of the Civil Code of the Russian Federation No. 230-FZ of December 18, 2006. Access date: May 3, 2008. Archived September 3, 2011.
3. Dr. Corneliu E. Giurgea – The Father of Nootropics
4. ↑ 12
   Mashkovsky, 2005, pp. 111-113.
5. S. Shorvon. Pyrrolidone derivatives // The Lancet, 2001, V. 358, P. 1885-1892.
6. ↑ 1 2 3 4 Flicker, L.
   Piracetam for dementia or cognitive impairment: [English] / L. Flicker, EJ Grimley // Cochrane Database of Systematic Reviews. - 2001. - No. 2. - Art. No. CD001011. - doi:10.1002/14651858.CD001011.
7. ↑ 1 2 3 Cohen, PA
   Presence of Piracetam in Cognitive Enhancement Dietary Supplements: [English] / PA Cohen, I. Zakharevich, R. Gerona // JAMA Internal Medicine: journal. — 2022. — Vol. 180, no. 3. - P. 458–459. - doi:10.1001/jamainternmed.2019.5507. - PMID 31764936. - PMC 6902196.
8. Vostrikov, V.V.
   The place of piracetam in modern practical medicine // Reviews on clinical pharmacology and drug therapy: journal. — 2022. — No. 1. — pp. 14–25. — UDC 615.21(G). - doi:10.17816/RCF15114-25.
9. |title=UCB's piracetam approved in Japan |edition=The Pharma Letter |year=1999 |month=11 |day=25 |link=https://www.thepharmaletter.com/article/ucb-s-piracetam-approved-in -japan }}
10. Nootropil Tablets 800 mg: [arch. May 1, 2021] / UCB Pharma Limited // EMC. — 2022. — September 2.
11. Karkishchenko, Nikolai Nikolaevich. Psychounitropism of drugs - M.: Medicine, 1993. ISBN 5-225-02213-8
12. RESOLUTION of the Meeting of the Presidium of the Formal Committee of the Russian Academy of Medical Sciences on March 16, 2007, RAMS
13. ↑ 1 2 Al Hajeri, A.
    Piracetam for reducing the incidence of painful sickle cell disease crises. : [English] / A. Al Hajeri, Z. Fedorowicz // The Cochrane Database Of Systematic Reviews. — 2016. — Vol. 2. - Art. noCD006111. - doi:10.1002/14651858.CD006111.pub3. — PMID 26869149. []
14. ↑ 1 2 Farooq MU, Min J., Goshgarian C., Gorelick PB
    Pharmacotherapy for Vascular Cognitive Impairment. (English) // CNS Drugs. — 2022. — September (vol. 31, no. 9). — P. 759—776. - doi:10.1007/s40263-017-0459-3. — PMID 28786085. []
15. Brain science, addiction and drugs : [English] : [arch. April 20, 2021] : report / An Academy of Medical Sciences working group report chaired by Professor Sir Gabriel Horn FRS FRCP. - Academy of Medical Sciences, 2008. - May. — P. 145. — 216 ​​p. — ISBN 978-1-903401-18-7. — ISBN 1-903401-18-6.
16. Peter Paul De Deyn, Jacques De Reuck, Walter Deberdt, Robert Vlietinck, Jean-Marc Orgogozo.
    Treatment of Acute Ischemic Stroke With Piracetam (English) // Stroke (English) (Russian. - Lippincott Williams & Wilkins (English) (Russian, 1997. - Vol. 28, no. 12. - P. 2347 -2352. - ISSN 0039-2499. - doi:10.1161/01.STR.28.12.2347.
17. Major Ongoing Stroke Trials. (English) // Stroke (English) (Russian. - Lippincott Williams & Wilkins (English) (Russian, 2000. - Vol. 31, no. 6. - P. 1474-1480. - ISSN 0039- 2499. - doi:10.1161/01.STR.31.6.1474.
18. Graeme J. Hankey, Stefano Ricci, Maria Grazia Celani, Teresa Anna Cantisani, Enrico Righetti.
    Piracetam for Acute Ischemic Stroke (English) // Stroke (English) (Russian.. - Lippincott Williams & Wilkins (English) (Russian, 2006. - Vol. 37, no. 8. - P. 2191-2192 - ISSN 0039-2499 - doi:10.1161/01.STR.0000231643.42650.a9.
19. Ricci, S.
    Piracetam for acute ischemic stroke: [English] / S. Ricci, MG Celani, TA Cantisani ... // The Cochrane Database Of Systematic Reviews. - 2012. - No. 9. - Art.no CD000419. - doi:10.1002/14651858.CD000419.pub3. — PMID 22972044. []
20. Hofmeyr, GJ
    Piracetam for fetal distress in labor: [English] / GJ Hofmeyr, R. Kulier // The Cochrane Database Of Systematic Reviews. - 2012. - No. 6. - Art. no CD001064. - doi:10.1002/14651858.CD001064.pub2. — PMID 22696322. []
21. Veselyekiy I. Sh., Voronyuk M. I.
    The effect of piracetam on central hemodynamics in patients with atherosclerosis with discircular encephalopathy. // Wedge. Med. - 1986. - No. 6. - P. 41-44
22. Sharava E.V., Potapov A.A., Kulikov M.A.
    The effect of piracetam on the functional activity of the brain in patients with traumatic brain injury. // Journal. neuropathol. and a psychiatrist. - 1988 - No. 5. - P. 42-48
23. Eninya G.I.
    Timofeeva T. N. Piracetam and indicators of cerebral hemodynamics, lipid metabolism and rheological properties of blood in initial forms of cerebrovascular accident. // Journal. neuropathol. and a psychiatrist. - 1990. - No. 11 - P. 20-23.
24. Pimenov L. T., Kalinina S. A., Churshin A. D.
    Clinical and hemodynamic effectiveness of piracetam (nootropil) in patients with coronary heart disease in the elderly and senile at the outpatient stage of rehabilitation. // Cardiol. - 1992. - No. 5. - P. 35-38
25. Pimenov L. T., Churshin A. D., Ezhov A. V.
    On the ability of piracetam and tocopherol acetate to potentiate the clinical effectiveness of antianginal drugs in patients with coronary heart disease. // Wedge. honey. - 1997. - No. 1. - P. 32-35.
26. Niss A.I., Umansky K.G. et al.
    On the effectiveness of treatment of acute viral neuroinfections with piracetam. // Journal. neuropathol. and a psychiatrist. - 1985. - No. 2. - P. 189-195.
27. Entin G. M.
    Treatment of alcoholism. - M.: Medicine, 1990.
28. Mashkovsky M. D., Andreeva N. I., Parshin V. A.
    The effect of piracetam on the effect of antidepressants. // Journal. neuropathol. and a psychiatrist. - 1989. - No. 2. - P. 129-131.
29. Leshchinsky L. A., Pimenov L. T., Fedorov V. S.
    Therapeutic use of piracetam in patients with myocardial infarction. // Cardiol. - 1987. - No. 2 - P. 46-49.
30. Malykh AG, Sadaie MR
    Piracetam and piracetam-like drugs: from basic science to novel clinical applications to CNS disorders (English) // Drugs (English) (Russian. - Adis International, February 2010. - No. 70 (3 ) - P. 287-312.
31. A.H. Gouliaev, A. Senning.
    Piracetam and other structurally related nootropics // Brain Research. Brain Research Reviews. - May 1994. - No. 19(2). — P. 180—222.

Contraindications

The medication is not used for hemorrhagic stroke , with severe pathology of the renal system, or with intolerance to the main substance piracetam. During pregnancy, severe bleeding , after extensive surgical interventions, with pathology of hemostasis and during breastfeeding, Nootropil is prescribed with caution, assessing the possible risks.

Pregnancy and lactation

Adequate and strictly controlled studies of the safety of piracetam during pregnancy have not been conducted. Use is possible only in cases where the expected benefit to the mother outweighs the possible risk to the fetus.

Piracetam appears to pass into breast milk. If it is necessary to use it during lactation, the issue of stopping breastfeeding should be decided.

Experimental studies on animals did not reveal any negative effects of piracetam on the fetus.

Side effects

There are the following side effects during treatment: vomiting, nausea, disturbances in concentration, imbalance, motor disinhibition, mental agitation, gastralgia , sleep disturbances, anxiety, appetite disturbances, stool disturbances, increased sexual activity, convulsive syndrome , extrapyramidal disorders, headache, dizziness, tremors of extremities. When angina is diagnosed, the course of the disease worsens. Most often, side effects are recorded when the recommended dose of 5 g per day is exceeded.

Drug interactions

A case of interaction of piracetam with simultaneous use with a thyroid extract containing triiodothyronine and tetraiodothyronine is described, when the patient experienced anxiety, irritability and sleep disorders.

When used simultaneously with thyroid hormones, the development of central effects is possible - tremor, anxiety, irritability, sleep disturbances, confusion.

With the simultaneous use of central nervous system stimulants, the psychostimulating effect may be enhanced.

When used simultaneously with antipsychotics, an increase in extrapyramidal disorders is observed.

Instructions for use of Nootropil (Method and dosage)

The drug is prescribed intravenously, intramuscularly and orally.

Instructions for the solution

The initial dosage of the drug for parenteral intravenous administration is 10 g. In severe pathology, the medication is administered intravenously by drip up to 12 g per day, the duration of the infusion is 20-30 minutes. Once the therapeutic effect is achieved, the amount of the drug is reduced with a gradual transition to oral administration.

Nootropil tablets, instructions for use

The drug is taken twice a day, the daily dosage is 30-160 mg per 1 kg. It is possible to increase the frequency of administration to 3-4 times a day if necessary. The course of treatment under this regimen is up to 2-6 months.

When treating memory disorders and cognitive disorders, the medication is prescribed orally at the initial stages of therapy, 1600 mg three times a day, then the amount of the drug is reduced to 800 mg.

Treatment of cerebrovascular diseases in the acute stage should begin as soon as possible with a dose of 12 g per day for two weeks, then switch to a dosage of 6 g per day.

Therapy for cortical myoclonus begins with 7.2 g per day with a gradual increase in the amount of active substance by 4.8 g per day every 3-4 days. The maximum dose is 24 grams in 24 hours.

The daily dosage for sickle cell anemia is 160 mg per 1 kg (4 doses). During a crisis period, the dose is increased to 300 mg per 1 kg.

In case of renal dysfunction, the drug is used with caution. The dose is prescribed by the doctor.

How to take a drug to improve memory?

You need to take the medicine 2 times a day. The following dosage is recommended to improve memory - 8 ml of a 20% solution for oral administration.

Efficiency[ | ]

The clinical use of piracetam is not justified by scientific data; there is no reliable evidence of effectiveness for it [6][7][13][14].

Research[ | ]

Some studies have suggested that piracetam may provide some benefit, but overall there is limited evidence of its effectiveness for dementia or non-dementia cognitive impairment. A 2004 Cochrane review based on a pooled analysis of data from 24 studies with 11,959 participants showed that piracetam, when compared with placebo, did not significantly improve the condition of patients with dementia, including vascular and Alzheimer's disease, or improve cognitive impairment, not meeting diagnostic criteria for dementia. The authors of the review conclude that further study of the drug is necessary[6].

In 2008, a working group of the British Academy of Medical Sciences noted that many trials of piracetam for dementia were flawed[15]. Published in the journal CNS Drugs

(English) (Russian) in 2022 it was noted that there is no evidence of the benefit of piracetam in vascular dementia[14].

The randomized multicenter placebo-controlled PASS (Piracetam in Acute Stroke Study) trial showed the lack of effectiveness of piracetam in the treatment of acute ischemic stroke. The observed results of using piracetam are similar to those of placebo. In this study, patients received piracetam at a dose of 12 grams per day, therapy began within the first 12 hours from the onset of stroke. Upon additional analysis, however, it was found that the positive effect of piracetam still manifests itself in a subgroup of patients with earlier (up to 7 hours) initiation of therapy for moderate and severe (Orgogozo score less than 55 out of 100 points) stroke [16]. Another study, PASS II, was conducted with the inclusion of 800 patients and the administration of piracetam in the first 7 hours after the onset of stroke [17]. The results of the study were never published by the sponsor[18].

A 2012 Cochrane review also found that there was no evidence of benefit for piracetam in acute ischemic stroke[19].

Another 2012 Cochrane review found that there was insufficient evidence to evaluate the use of piracetam for fetal distress during labor[20], and a 2016 Cochrane review found that there was insufficient evidence to evaluate the effectiveness of piracetam when used to prevent painful crises in sickle cell disease[13]. .

special instructions

Treatment with Nootropil requires regular monitoring of the functioning of the renal and hepatic systems, the state of peripheral blood , the level of creatinine and residual nitrogen. Drug therapy can be combined with psychoactive drugs and medications for the treatment of cardiovascular diseases. Treatment of acute lesions of tissues and structures of the brain is recommended to be carried out in combination with methods of restorative medicine and detoxification therapy . For psychiatric diseases, psychoactive drugs are simultaneously prescribed. Abrupt discontinuation of the medication is unacceptable, especially when treating patients suffering from cortical myoclonus ( due to the high risk of recurrence of seizures and seizures). If side effects such as insomnia or excessive drowsiness develop, it is recommended to stop taking the medication in the evening. During hemodialysis, Nootropil penetrates through special filter membranes in the device. Piracetam affects the ability to drive a vehicle.

The drug is not described in Wikipedia.

Contraindications[ | ]

Hypersensitivity to piracetam and pyrrolidone derivatives; hemorrhagic stroke, severe renal failure (creatinine clearance less than 20 ml/min), agitated depression, Huntington's disease, pregnancy, breastfeeding, children under 1 year of age [1].

Restrictions on use[ | ]

Impaired hemostasis, severe bleeding, during major surgical operations; hyperthyroidism; epilepsy.

People with severe cerebral atherosclerosis should not take the drug, since an increase in metabolism in the nervous tissue under the influence of the drug can lead to increased symptoms of dementia and irreversible deterioration of cognitive functions. This condition occurs due to the inability of the brain vessels to provide a sufficient flow of metabolites.

Persons prone to neurotic reactions should take into account that the drug, with long-term use, causes an increase in the level of anxiety, which can lead to sleep disturbances (mainly insomnia) and an indirect decrease in intellectual functions due to deterioration in concentration.

Use during pregnancy and breastfeeding: contraindicated during pregnancy; breastfeeding should be stopped during treatment.

Analogues of Nootropil

Level 4 ATX code matches:
Bravinton

Acefen

Carnicetine

Pyracesin

Nooclerin

Semax

Piracetam

Olatropil

Fezam

Vinpocetine

Cerebrocurin

Cavinton Forte

Calcium hopantenate

Glutamic acid

Cephabol

Olanzapine

Cerebrolysate

Pramistar

Sidnocarb

Vinpotropil

Analogues are the following drugs: Biotropil , Lucetam , Piracetam .

The price of Nootropil analogues is lower and higher. For example, Piracetam costs less.

Which is better: Nootropil or Piracetam?

The medicines are generics, that is, they contain one active substance, piracetam, and have a similar effect on the body. The drug Piracetam is domestically produced and therefore costs less, however, it is also considered less purified.

Reviews about Nootropil

According to reviews of Nootropil on the forums, memory pills are very useful. They improve brain activity, help memorize large amounts of information, add energy and invigorate.

The drug also helps for its intended purpose, but does not act immediately. Based on reviews for children who used this medication, Nootropil is also useful for delayed speech development in a child.

The disadvantages include a bitter taste, individual intolerance to the drug, as well as side effects, for example, headaches.

Nootropil price, where to buy

The price of Nootropil tablets is 275 rubles for 30 pieces of 800 mg each. You can buy Nootropil in the same release form in Ukraine for 80-100 hryvnia.

The price of Nootropil 20% solution ampoules of 5 ml is 315 rubles for 12 pieces. In Ukraine - 170 hryvnia.

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