Nootropil pills 800mg №30

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Indications and usage

Symptomatic treatment of psychoorganic syndrome, in particular in elderly patients, accompanied by decreased memory, dizziness, decreased concentration and decreased overall activity, mood changes, behavioral disorders, gait disturbances, as well as patients with Alzheimer's disease, senile dementia of the Alzheimer's type;
treatment of the consequences of ischemic stroke, such as impaired speech, disturbed emotional sphere, decreased motor and mental activity;
chronic alcoholism - for the treatment of psychoorganic and abstinence syndromes;
recovery period after coma, incl. after injuries and intoxications of the brain;
treatment of vertigo and related balance disorders, with the exception of vertigo of vascular and mental origin;
in the complex therapy of low learning in children with psychoorganic syndrome;
treatment of cortical myoclonus as a mono- or complex therapy;
as part of complex therapy of sickle cell anemia.

Contraindications

Hypersensitivity to Piracetam or a derivative of pyrrolidone, as well as other components of the drug;
psychomotor agitation at the time of administration of the drug; Huntington's chorea; acute cerebrovascular accident (hemorrhagic stroke); end-stage renal disease (Cl creatinine <20 ml / min); children's age up to 1 year (solution for oral administration) and up to 3 years (coated capsules and tablets).
Carefully:
violation of hemostasis;
extensive surgical interventions;
heavy bleeding.

Dosage and administration

Inside, parenterally, during a meal or on an empty stomach; capsules and pills should be taken with liquid (water, juice).
The daily dose is 30–160 mg / kg of body weight, the dose rate is 2–4 times a day.
When treating chronic psychoorganic syndrome, depending on the severity of symptoms, Nootropil® 4.8 g / day is prescribed for the first week, and then transferred to a maintenance dose of 1.2–2.4 g / day.
In the treatment of the effects of stroke - 4.8 g / day.
With alcohol withdrawal syndrome - 12 g / day in 2-3 doses. Maintenance dose - 2.4 g / day.
In the treatment of dizziness and related balance disorders - 2.4-4.8 g / day.
In the treatment of comatose conditions, as well as the difficulties of perception in persons with brain injuries, the initial dose is 9–12 g / day, supporting - 2.4 g / day. Treatment continues for at least 3 weeks.
For the correction of low learning, Nootropil® is prescribed to children at a dose of 3.3 g / day (approximately 8 ml of oral solution twice a day). Treatment continues throughout the school year.
With 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 the maximum dose of 24 g / day is reached. Treatment continues throughout the entire period of the disease. Every 6 months, you should attempt to reduce the dose or cancel the drug, gradually reducing the dose of 1.2 g / day every 2 days. In the absence of effect or a slight therapeutic effect, treatment is stopped.
In sickle cell anemia, the daily prophylactic dose is 160 mg / kg body weight, divided into 4 doses.
Since Nootropil® is excreted by the kidneys, when prescribing the drug to patients with renal insufficiency and elderly patients, the dose should be adjusted depending on the value of Cl creatinine.
Renal failure Cl creatinine, ml / min
Missing (normal)> 80 Usual Dose
Light 50–79 2/3 usual dose in 2-3 doses
Average 30–49 1/3 of the usual dose in 2 doses
Severe <30 1/6 normal dose once
Terminal stage <20 Contraindicated
Patients with impaired liver function dose adjustment is not required.
Patients with impaired renal function and liver dosing is carried out according to the table above.

Adverse Effects

CNS and peripheral nervous system: motor disinhibition (1.72%), irritability (1.13%), drowsiness (0.96%), depression (0.83%), asthenia (23%). These side effects often occur in older patients who received the drug in a dose of more than 2.4 g / day. In most cases, it is possible to achieve a regression of these symptoms by reducing the dose of the drug.In isolated cases - dizziness, headache, ataxia, exacerbation of the course of epilepsy, extrapyramidal disorders, tremor, instability, decreased ability to concentrate, insomnia, agitation, anxiety, hallucinations, increased sexuality.

Cardiovascular: rarely - decrease or increase in blood pressure.

Gastrointestinal: in rare cases - nausea, vomiting, diarrhea, abdominal pain (including gastralgia).

Metabolism: weight gain (1.29%) - more common in elderly patients who received the drug at a dose of more than 2.4 g / day.

From the skin: in rare cases - dermatitis, pruritus, rash, angioedema.

Special notes

In connection with the effect of piracetam on platelet aggregation, the drug should be prescribed with caution to patients with impaired hemostasis, during extensive surgical interventions, or patients with symptoms of severe bleeding.
When treating cortical myoclonus, abrupt interruption of treatment should be avoided, which may cause a resumption of seizures.
With prolonged therapy in elderly patients, regular monitoring of renal function indicators is recommended, and if necessary, dose adjustment is carried out depending on the results of the Cl study of creatinine.
Gets through the filtering membranes of hemodialysis machines.
Taking into account possible side effects, care should be taken when driving a car and performing work with machinery.

Drug interactions

Piracetam increases the effectiveness of thyroid hormones and antipsychotic drugs (neuroleptics).
With simultaneous appointment with neuroleptics piracetam reduces the risk of extrapyramidal disorders.
With simultaneous use with drugs that have a stimulating effect on the central nervous system, it is possible to enhance the stimulating effect on the central nervous system.
High-dose piracetam (9.6 g / day) increases the effectiveness of indirect anticoagulants in patients with venous thrombosis (there was a more pronounced decrease in the level of platelet aggregation, fibrinogen level, von Willebrand factor, blood and plasma viscosity compared with the use of only indirect anticoagulants).
The possibility of changing the pharmacodynamics of piracetam under the influence of other drugs is low, because 90% of the drug is excreted unchanged in the urine.
In vitro, piracetam does not inhibit cytochrome P450 isoenzymes, such as CYP1A2, 2B6, 2C8, 2C9, 2C19, 2D6, 2E1, and 4A9 / 11 at 142, 426, and 1422 µg / ml. At a concentration of 1422 µg / ml, slight inhibition of CYP2A6 (21%) and 3A4 / 5 (11%) was observed. However, the Ki level of these two isoenzymes is sufficient when exceeding 1422 μg / ml. Therefore, metabolic interaction with other drugs is unlikely.
No interactions with clonazepam, phenytoin, phenobarbital, sodium valproate.
Reception of piracetam in a dose of 20 mg / day did not change the peak and the curve of the level of concentration of antiepileptic drugs in serum (carbamazepine, phenytoin, phenobarbital, valproate) in epilepsy patients receiving the drug in a constant dose.
Co-administration with ethanol did not affect the level of serum pyracetam concentration; the concentration of ethanol in the serum did not change when taking 1.6 g of piracetam.

Overdosage

Symptoms: after oral administration of piracetam in a dose of 75 g, dyspeptic phenomena, such as diarrhea with blood and abdominal pain, are noted.

Treatment: immediately after taking the drug inside, you can flush the stomach or cause artificial vomiting. Symptomatic therapy, which may include hemodialysis, is recommended. There is no specific antidote. The effectiveness of hemodialysis for piracetam is 50-60%.

Storage conditions

At temperatures not above 25 ° C.

5 years