What is the difference between intravenous or intramuscular administration of Actovegin? Actovegin in the form of injections for intravenous use Actovegin, which is better intravenous or intramuscular

The drug Actovegin (lat. Actovegin) is a deproteinized (released) extract obtained from the blood of calves. In medical practice it is usually called hemoderivative.

Features of the effect on the body

Taking the medicine helps activate the metabolic process at the cellular level. This is due to the ability to increase the volume of transfer and accumulation of oxygen and glucose in cells, which in turn contributes to their intracellular utilization. As a result, there is an acceleration of the metabolism of adenosine triphosphoric acid (ATP), as well as an increase in the energy resources of cells.

The effectiveness of the drug is relevant when it is necessary to improve metabolism (the process of metabolism in the body) and anabolism (the process of assimilation of incoming substances). As an additional positive effect, it is worth highlighting the strengthening of the blood supply function in the body.

A doctor may prescribe Actovegin intravenously or intramuscularly when diagnosing:

• hypoxia (oxygen starvation of cells due to insufficient supply or disruption of the absorption process);
• the need for accelerated wound healing, tissue regeneration (restoration).

Indications for use of the drug

Actovegin for intravenous administration or any other method of administration is allowed after consulting a doctor. He also controls the dosage of the drug and the total duration of the treatment course. Among the main indications for the use of the drug are:

1. Lack of blood circulation in the brain area.
2. An ischemic stroke caused by a lack of oxygen supplied to the tissues and disturbances in the circulatory process.
3. Existing traumatic brain injuries.
4. Failures of the peripheral circulatory process (both venous and arterial).
5. Trophic disorders (in the processes of supplying the skin with necessary substances).
6. Angiopathy is a disorder of tone in the vascular system.
7. Manifestation of varicose veins on the legs.
8. Ulcers of various forms.
9. Burns and bedsores.

Taking the drug is also assessed as effective prevention of radiation injuries to the body and their direct therapy.

Rules for preparing the drug for further use

The main rule for successfully introducing the drug into the patient’s body concerns the prohibition of performing the procedure independently. Either a doctor or nurse must administer the injection. The medication must be administered at a slow pace, no more than 2 ml over one minute. Even before the procedure is done, it is necessary:

• prepare a syringe and the medicine itself in an ampoule or in the form of a solution;
• above the biceps in the area of ​​the elbow joint, tighten the tourniquet and find a vein;
• To make the veins swell, you need to make several fist squeezes;
• the injection site is treated with a disinfectant, for example, alcohol;
• the needle is slowly inserted into the vein against the direction of blood flow;
• the tourniquet is removed;
• the medicine is administered slowly and in equal volumes;
• after the needle is pulled out, cotton wool or a napkin with a disinfectant is applied to the injection site;
• after the injection, the arm should be bent at the elbow for 2–5 minutes.

The procedure must be performed by medical personnel, since an incorrectly placed injection can cause the manifestation and development of many different diseases and unpredictable consequences.

As for the dose and rules for preparing the solution, everything depends on the nature of the diseases being diagnosed and their severity. The drug can be administered orally in the form of pills, as a solution for droppers, or by injection. When taking orally, it is extremely important not to chew the tablets and take them with plenty of water. The dosage is usually 1-2 pieces three times a day.

The drug is administered intravenously at 10–20 ml initially, and then the amount should decrease to 5 ml. Injections are carried out once a day.

To prepare the solution, you can use 200–300 ml of saline or glucose. The dosage of Actovegin is determined by the doctor and can be 10, 20 or 50 ml. The duration of the general course with intramuscular injections and dosage is determined exclusively by the attending physician.

Possible side effects of the drug and contraindications for use

Actovegin should not be injected or taken orally if the patient has hypersensitivity to the components of the drug. According to the instructions, the medicine is contraindicated during pregnancy and lactation, as well as with simultaneous consumption of alcohol. Side effects of use include itching, urticaria, increased sweating, and an uncharacteristic increase in body temperature. Caution in the use of the drug should be observed when treating elderly patients.

Features of intravenous use of the drug

The medication can be administered intravenously by stream or drip. The first option is rather an exception and is prescribed if it is necessary to quickly eliminate the pain symptoms that appear. Before use, the drug is dissolved in saline or 5% glucose concentration. If Actovegin is administered intravenously, the daily dose should not exceed 20 mg of the drug.

The optimal dosage and duration of treatment itself is determined by the doctor individually in each individual case. As a rule, intravenous administration of the drug is carried out daily for a week. In cases of complications and in more serious stages of disease, the capacity of the administered drug can be increased to 20–50 ml for the first few days in order to improve the patient’s condition.

Increasing intravenous doses is also allowed during exacerbation of chronic ailments. In this case, the drug is administered in containers of 5–20 ml for 14 days. Actovegin can be prescribed for routine use by the patient. In this case, it is planned to administer 2–5 ml of the substance over 24 hours. The duration of the treatment course, as a rule, is a month and a half.

The exclusive administration of the drug intravenously is observed when a patient is diagnosed with diabetes mellitus. The instructions in this case provide for the need to administer the drug once a day for at least 4 months.

Purpose of intramuscular injections

If there is no need to immediately eliminate pain, the drug can be administered intramuscularly. The exact dosage and duration of the therapeutic course is determined by the attending physician and directly depends on the patient’s existing condition. Depending on the purpose of using the medication, Actovegin can be dissolved in a 5% glucose concentration or in 0.9% sodium chloride. The medication can be taken 1 to 3 times a day. The duration of treatment is controlled solely by the doctor.

Alternatively, the drug may be used in the form of oral tablets or medicated gels and ointments. Before using the medicine in any form of release, you must obtain clear advice from your doctor.

There are people who do not accept vitamins in the form of drugs that need to be taken. These substances, useful and necessary for the body of every person, are not always absorbed by the gastrointestinal tract. Therefore, in order to deprive yourself of these vital elements, you have to administer vitamins intramuscularly or intravenously.

It’s good if it is possible for a specialist to carry out the injection procedures, but if this is not possible, you can inject vitamins yourself, but the main thing is to know how and where. And many people have a question: how to inject vitamins correctly and when is it needed?

What vitamins can be injected and when is it necessary?

Often, when treating many diseases, it is recommended to take several vitamins together, this mainly refers to B vitamins, which is why doctors prescribe vitamins in the form of injections. Sometimes the reason for an injection can be a dietary restriction - this is when a person is a vegetarian or adheres to some kind of diet in which the body does not receive vitamins of one group or another, and in particular B.

It is also necessary to administer vitamins intramuscularly, rather than drink, when a person is taking certain medications (anti-tuberculosis drugs, etc.), or after surgery on the gastrointestinal tract. If the body has been exposed to toxic substances, it is very important to undergo acupuncture of B vitamins. Sometimes the reason for administering vitamins intramuscularly are some genetic diseases, as well as a number of neurological diseases.

It is most effective to inject vitamins to replenish their deficiency and in case of illness, diabetic polyneuropathy, as well as for the treatment of pain syndromes.

Which vitamins to take and which ones to inject?

• All B vitamins;
• Vitamin C;
• Vitamin E;
• Vitamin K;
• PP (nicotinic acid).

These vitamins can be injected or drunk, but group B drugs are better injected. But vitamins: D, F, H and P, are taken internally in the form of preparations and externally in the form of ointments and creams.

How to inject vitamins intramuscularly?

Intramuscular injection does not pose a danger to the human body, so you can do it yourself at home. Almost anyone can do it, the main thing is to understand how. For this you will need:

• A syringe and a needle of 3-4 cm, for intramuscular injections;
• Cotton swab;
• Alcohol or cologne.

It is advisable to have another needle to take the medicine, this is because the needle that comes with the syringe needs to be opened at the very last moment, so as not to cause an infection.

First, you need to open the syringe and remove the original needle, without removing the plastic cap from it, and instead put on a needle to take the medicine. After which you need to open the ampoule with the drug, making a small cut with a special file and breaking off its tip. Then you need to move on to taking the drug, inserting a syringe into the ampoule, preferably with a needle, so that no air gets in when taking the drug.

As a result, bubbles form, which, when they get under the skin, cause discomfort. If bubbles do get into the syringe, you need to get rid of them. After this, you need to remove the needle for taking the drug and put on your own one, make a control injection and the syringe is ready for injection.

An intramuscular injection is usually given in the buttock, but it is inconvenient to do it yourself; the best option in this case is the thigh, the injection is injected into its upper half. Since the muscle mass and subcutaneous tissue, together with fat, are much thinner than on the buttocks, the skin needs to be pulled back a little and where to prick so that the needle does not hit the bone or periosteum, thereby causing injury.

The area designated for the injection must be disinfected with a cotton swab soaked in alcohol. After which you should check whether air is coming from the syringe and then you can safely proceed to the procedure itself. The syringe needs to be held like a pen, inserting a few millimeters of the needle and leaving some part outside in case it breaks so that it can be removed, although this happens very rarely.

After inserting the needle, the drug should be injected slowly; if pain occurs, you can pause the process and then continue. The injection site of the syringe must be treated with an alcohol solution.

How to inject vitamins intravenously?

Intravenous injections are more difficult to do than intramuscular ones, so it is better if a specialist does it. If this is not possible, the procedure can be carried out independently, but you must strictly follow the antiseptic rules:

• Sterility of syringes;
• Skin disinfection;
• Hand washing before the procedure;

The optimal place for injection is the veins of the elbow, due to their relatively large size. These veins are clearly visible because the layer of skin covering them is quite thin. Often, injections are given into the veins of the hand and forearm. But theoretically, vitamins can be injected into any vein on the body. It depends on the degree of palpation of the veins. There are several types of veins:

• Uncontoured vein - it is not palpable and not visible, sometimes this happens, but very poorly;
• Poorly contoured vein - this type of vein is palpated and visible. It hardly protrudes above the skin;
• A well-contoured vein is clearly visible, quite thick and clearly protrudes from under the skin.

The procedure for administering the drug intravenously

It will be more convenient if someone helps you give an intravenous injection, since carrying out the procedure yourself is quite problematic.

First of all, the person who will perform this procedure needs to wash their hands thoroughly with soap and then put on rubber gloves treated with alcohol. To carry out the procedure you will need:

• Rubber band;
• Cotton balls soaked in alcohol;
• Drug for administration.

Sequence of procedure

• The patient should take a comfortable position (sitting, lying down), and then bend his arm at the elbow to the maximum;
• A tourniquet must be applied to the middle of the patient’s shoulder (over clothing or a napkin);
• To better fill the vein with blood, you should clench and unclench your fist several times;
• Draw the solution for administration into the syringe and check for the presence of air in it, then put the cap on the needle;
• Treat the patient's skin with a cotton swab soaked in alcohol;
• With your free hand, fix the skin in the puncture area;
• Direct the syringe parallel to the vein and pierce the skin, inserting the needle with the cut up a third of its length (while the fist is clenched);
• Change the direction of the needle, without stopping fixing the vein, and pierce it until you feel it entering a void;
• Untie the tourniquet by pulling the free end, while the patient must unclench the hand;
• Carefully, slowly, introduce the vitamin, without changing the direction of the syringe;
• Press the place where the injection was made with a cotton swab, and then remove the needle from the vein;
• Place a cotton ball soaked in alcohol at the injection site and bend your arm at the elbow joint. Stay in this position for a few minutes;
• Throw away the syringe and unused materials.

If complications of any complexity arise, you should immediately consult a doctor.

Actovegin is an effective modern drug used in many branches of medicine. With its help, they improve nutrition and cell regeneration, eliminate oxygen starvation and circulatory failure. The medication is available in different forms: ointment, cream, tablets, solution for injection and infusion.

Which form to choose or combine several is decided jointly by the doctor and the patient, depending on the expected effect of the treatment. Each form has its own characteristics.

The effect of Actovegin on the body

Actovegin is made from natural ingredients and has virtually no contraindications. Widely used in medicine, cosmetology and sports. Promotes saturation of tissues with oxygen and absorption of glucose, stimulates metabolic processes.

Used in the treatment of:

• circulatory disorders in the vessels of the brain (including after a stroke);
• ulcers of various origins;
• peripheral nerves;
• varicose veins;
• thrombophlebitis;
• endarteritis;
• diseases of the retina.

In addition, the drug is used for skin transplants, radiation injuries, for healing wounds, burns and bedsores.

Features of intravenous use of the drug

Actovegin is available in ampoules of 2 ml, 5 ml and 10 ml. 1 ml contains 40 mg of active substance. Intravenously, it is injected into a vein by drip or jet (in cases where pain is urgently needed). When administered by drip, the medication is mixed with saline or glucose. It is allowed to administer no more than 10 ml of Actovegin per day, in severe cases - up to 50 ml. The number of injections and dose are determined by the attending physician based on the patient’s disease and the body’s reaction. The course is at least a week and reaches 45 days.

For diabetes, treatment is prescribed only by 2 ml drips. Therapy lasts about 4 months.

The order of injections:

1. Prepare a syringe, cotton wool, disinfectant, tourniquet, medicine.
2. Tighten the tourniquet above the elbow - the patient clenches his fist. Palpate the vein.
3. Clean the needle insertion site with alcohol and insert it.
4. Remove the tourniquet and administer the injection or adjust the operation of the dropper.
5. After the procedure, remove the needle and apply sterile cotton wool.
6. The patient keeps the elbow flexed for about 4 minutes.

The injection is simple, but it must be performed by a specialist to avoid unpleasant consequences and infection in the bloodstream.

For drip administration, mixing Actovegin with other medications, except saline solution and glucose 5%, is prohibited.

Purpose of intramuscular injections

When using Actovegin injections, you need to make sure that the liquid in the ampoule is clear and does not contain sediment. Once opened, the medication from the ampoule cannot be used; You should not buy high-dose ampoules for injection.

The injection can be given in the buttock, shoulder, thigh and abdomen. Actovegin should be administered slowly, because the sensations are painful.

Before carrying out a course of treatment, a test for an allergic reaction is carried out. To do this, they give a test injection and monitor the patient’s condition for several hours.

Intramuscular injections of 5 mg are prescribed for 10 days to treat wounds and against exacerbation of chronic diseases. In terms of therapeutic effects, they are considered less effective than intravenous ones.

How best to take Actovegin: intravenously or intramuscularly

Each type of Actovegin injection (intravenous or intramuscular) has its own indications. Intravenous injections should be performed by a qualified medical professional, and intramuscular injections should be performed by anyone at home after familiarizing themselves with the simple rules.

After an intramuscular injection, the medicine is gradually absorbed through a network of blood vessels into the bloodstream. The effect of the injection will be gradual and long-lasting. And after administering the medicine intravenously, the effect is immediate and short, the effect is more pronounced.

Actovegin is best taken intravenously, because intramuscular injections are quite painful. But if it is not possible to visit a clinic or call a nurse at home for treatment, you can inject the drug into the buttock.

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Heptral belongs to the group of medicinal drugs, the action of which is aimed at regenerating and normalizing liver functions. It also normalizes the flow of bile and has the most positive effect on its composition and structure. Thanks to this, both the general condition of the liver and its functioning are significantly improved. To a large extent, Heptral is able to reduce the degree of damage to liver cells by serious diseases, such as cirrhosis, hepatitis and others. Thanks to the sedative and mild antidepressant effect, the patient’s mental state noticeably improves during therapy, which is also important.

Compound

The active component of the drug is ademetionine. The substance belongs to the group of coenzymes - substances that are necessarily present in enzymes and affect the course of various reactions in the human body. Ademetionine is directly involved in the transport of molecules of methyl group substances throughout the body. During the functioning of the body, this coenzyme is synthesized in many tissues and fluid forms of the body.

Ademetionine was discovered in the 50s of the last century by the Italian chemist Cantoni. The substance obtained as a result of synthesis stabilizes the volume of substances and also promotes the synthesis of coenzyme in the liver and brain. Because of this, the lack of substances is completely replenished.

It is believed that good absorption of ademetionine does not occur without B vitamins (B-12 is especially important here) and folic acid.

The tablet form of Heptral is equipped with many excipients. It is noteworthy that in the case of lyophilisate, such substances are not used for dissolution. However, some additional components are contained only in the solvent itself. It consists of:

• water without impurity ions, that is, deionized.
• sodium hydroxide
• lysine is an amino acid that is part of proteins.

The powder is painted white, a slight yellow tint is allowed - other shades are not possible. The consistency must be uniform, without all kinds of foreign inclusions and impurities.

The powder is placed in a transparent bottle and a solvent is included with it. It is a transparent, colorless liquid, sometimes having a faint yellowish tint. The solvent is also sealed in a transparent glass bottle.

If, when opening a package of medicine, it is discovered that there is sediment or foreign substances in the solvent, then it is not used to dilute the powder.

The packaging of the drug for injection includes 5 bottles with a powdery substance and the same number of ampoules with liquid to dissolve it.

Mechanism of action

The action of Heptral is aimed at replenishing the deficiency of ademetionine in the body by stimulating its synthesis, especially in the human brain and liver. It also increases the amount of the amino acid glutamine in the liver, and cysteine ​​and taurine in the blood plasma. Under the influence of the drug, the concentration of methionine in the blood serum, on the contrary, decreases, thereby promoting liver metabolism.

It has a choleretic effect, which can persist for three months after discontinuation of treatment.

Heptral is extremely effective for poisoning with hepatotoxic drugs (these are drugs in which the higher the dosage, the higher the hepatotoxic effect).

Important! For patients with drug addiction to opiates, who have obvious liver damage, Heptral is indicated to improve its functioning.

The antidepressant effect of the drug is noticeable from the very first week of its use.

Indications for use

Heptral injections are prescribed in the following cases:

• Fatty liver is a chronic disease in which liver cells turn into fat.
• Chronic hepatitis.
• Toxic liver damage. Moreover, the factors can be completely different: alcohol poisoning, the harmful effects of viruses and other medications. For example, antitumor drugs (they are very toxic and harmful to the liver), antibiotics, anti-tuberculosis and antiviral drugs, as well as some antidepressants and oral contraceptives.
• Chronic cholecystitis without stone formation.
• Inflammation of the bile ducts – cholangitis.
• Liver cirrhosis (more precisely, either a condition preceding cirrhosis, or cirrhosis itself of 1st degree of severity).
• During pregnancy, it is used for stagnation of bile in the ducts (intrahepatic cholestasis).
• Encephalopathy caused by liver failure.
• Conditions that occur when you stop taking any medication, taking alcohol or drugs (withdrawal syndrome).
• Prolonged depressive symptoms.
• Damage to hepatocytes – stable liver cells.
• Reduced or increased aggressiveness of bile acids.
• Liver poisoning by toxic elements and poisons.

Contraindications

The instructions for use of heptral injections describe the following contraindications:

• Two initial trimesters of pregnancy.
• The period of breastfeeding a baby.
• Children and youth up to 18 years of age.
• Individual intolerance to individual components of the drug.
• Genetic disorders.
• Failure of vitamin B-12 metabolism.
• Allergic reactions to ademetionine or other components of the drug.
• Lack of cystionine beta-cystase in the body.

Use with caution in cases of:

• Bipolar affective disorders.
• Advanced age (over 65 years).
• Manic-depressive syndrome.
• Kidney failure.

Medicinal properties

1. The neuroprotective effect is aimed at protecting nerve cells from all kinds of negative interventions. In this case, when using Heptral, the risk of developing liver encephalopathy is significantly reduced.
2. Cholekinetic – that is, a choleretic effect. The use of this drug promotes normal excretion of bile.
3. Regenerating - restoring. Heptral helps to increase the division of liver cells (hepatocytes). This action is due to the acceleration of recovery processes in the liver.
4. The antioxidant effect is the stimulation of the production of amino acids in the amount necessary for regenerative processes in the liver.
5. Antidepressant - the vitality of neurons increases, the necessary transmission of nerve impulses is restored.

Heptral injections

The dosage form of Heptral in ampoules is made specifically for intravenous or intramuscular infusions. As mentioned earlier, the package contains the leophilisate itself and its solvent. There are no differences in preparing the solution for intramuscular and intravenous use - all steps are absolutely identical.

The course of treatment using injections (jet) is 2 weeks. If there is a need to continue treatment, the drug is prescribed in tablet form. They, in turn, should not be drunk for more than a month after the injections.

Important! The best therapeutic effect is observed with intravenous infusion; it is believed that this minimizes the possibility of side effects.

The injection solution cannot be prepared in advance - this is done immediately before the procedure itself. You should be careful about the prepared solution, because if it sits in its finished form but is never used, it will have to be thrown away.

• To open the bottle with lyophilisate, you need to remove the top metal cap. The solvent ampoule is opened by sawing off the top of the ampoule. Using a syringe, the required amount of solvent is taken out. The rubber stopper of the bottle containing the powder is then pierced with a syringe needle, and the dissolving liquid is poured into the bottle.
• All ingredients are thoroughly mixed until a homogeneous mixture is obtained. It is white in color, with a slight yellow tint allowed. Undissolved lumps of powder should not be allowed. It is recommended to perform shaking without removing the needle from the rubber stopper.
• A solution with unknown inclusions or undissolved powder is considered unsuitable for injections.
• After dissolution is successfully completed, you need to take the entire mixture into the syringe.
• The injection site must be wiped with alcohol. You need to inject in the upper part of the buttock or in the shoulder (the upper part is outside). Intravenous infusion of Heptral is made into the veins in the arms, but such injections are given only by a doctor.
• After removing the needle, the injection site is disinfected again.

To ensure that after the intramuscular injection of Heptral there are no bruises or abscesses, the injection is carried out very slowly. When performing a subsequent injection, you need to step back from the previous one by 1 cm and so on.

Excess of the drug, both dry and solvent, and ready-made - everything must be destroyed.

When administered intravenously, 100% bioavailability of the drug is observed. This means that 100% of the administered drug substance will reach the required place in the body and be absorbed. The maximum level of drug concentration in the blood is observed already on days 2-6 from the start of treatment. In the liver, Heptral undergoes a biological transformation and is excreted from the body by the kidneys over the next hour and a half.

During treatment with the drug, it is necessary to monitor kidney activity.

If drip therapy has been carried out for a long time, then the level of creatinine, urea and nitrogen in the blood may change - both down and up.

To correctly calculate the dosage of a medicine, the doctor must take into account the individual characteristics of the patient: age characteristics, the presence of chronic diseases, metabolic processes. Self-prescription of the drug is strictly prohibited.

When treating pathological processes in the liver, appropriate dietary nutrition must be prescribed.

The consumption of alcoholic beverages during treatment is strictly prohibited. This even applies to tinctures of medications that contain alcohol.

If there is a need for intensive therapy, it is carried out for 2-3 weeks using intravenous or intramuscular injections.

When treating patients with withdrawal syndrome, which is related to giving up alcoholic beverages, Heptral injections are part of complex therapy and protect liver cells and help neutralize the toxic effects. This therapy significantly improves the patient's condition. In case of severe withdrawal syndrome, intravenous infusions of the drug are prescribed, intramuscular infusions are much less common.

Since even elderly patients tolerate treatment with Heptral well, a dose reduction will not be required for them. But at the same time, it is better to start therapy with minimal dosages and gradually increase them.

During treatment, the patient's anxiety increases, however, this condition quickly disappears when the dose of the medication is changed to a lesser extent.

No discontinuation of the drug is required.

When treating cirrhosis, you need to periodically take a biochemical blood test to detect the level of nitrogen, urea and creatinine.

When treated with the drug, patients are strongly recommended to take B vitamins (in particular B-12) and folic acid. This must be done for the reason that if there is a shortage of them in the body, Heptral will be less absorbed.

Due to treatment with this drug, the patient feels dizzy, so you need to be extremely attentive and careful when performing work associated with increased concentration, and if possible, then completely stop doing it for a while.

Overdose and interaction

No cases of overdose were observed with intravenous or intramuscular injections of the drug Heptral.

Clinical trials also revealed no interactions with other medications. However, since the active component of Heptral is ademetionine, you need to be extremely careful when taking tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), as well as some herbs that contain tryptophan.

Side effects

Despite the high effectiveness of parenteral injections for intravenous administration, the drug has a number of side effects. Moreover, both minor and quite serious. Most often they manifest themselves in the form of abdominal pain, nausea and diarrhea.

Regardless of the form of the drug taken, the following deviations in the functioning of systems and organs are sometimes noticed:

• Musculoskeletal system – muscle spasms and joint pain.
• Digestive system - flatulence, diarrhea, abdominal pain, dry mouth. Less commonly - bleeding in the digestive organs, difficult or painful digestion.
• Cardiovascular system – phlebitis of superficial veins, changes in the functioning of blood vessels and the heart.
• Nervous system – headaches and dizziness, sleep disorders, clouding of consciousness, excessive anxiety.
• The occurrence of infectious diseases, especially urinary tract infections.
• Skin – some reactions are possible at the intravenous injection site: urticaria, erythema, itching. Skin necrosis in this area is unlikely, but not excluded. Excessive sweating is much more common.
• Respiratory system - swelling of the larynx poses an immediate threat to the patient’s life.
• Immune system – anaphylactic shock. This is a very dangerous condition, characterized by pressure surges, pain in the chest and back, shortness of breath, narrowing of the bronchi due to muscle contraction (bronchospasm).
• Other complications – fever, chills, asthenic syndrome.

Interaction with alcohol

Treatment with Heptral occurs with complete abstinence from alcohol-containing and low-alcohol drinks. The diet prescribed before the start of therapeutic procedures implies a complete ban on alcohol. Otherwise, various unpleasant consequences for the body may occur.

The use of alcohol significantly reduces the benefits of the treatment received, and sometimes the treatment may go completely unnoticed.

Abstinence from alcohol is especially important when therapy is prescribed to treat diseases caused by alcohol dependence.

Drinking alcohol while receiving Heptral injections leads to heart rhythm disturbances and increased blood pressure.

The combined use of alcohol and Heptral negatively affects the activity of the nervous system: clouding of consciousness, signs of depression, and sleep disorders are possible.

Quincke's edema is listed among the side effects of the drug, however, most often, it develops when ethanol and Heptral enter the blood at the same time. In general, alcohol greatly increases the possibility of any side effects. Complications such as phlebitis, bleeding in internal organs, renal failure and others can especially often occur.

It is popularly believed that this course of injections is more effective than taking medications orally and “does not affect” the liver. Today I will try to tell you why this opinion is not entirely true.

What are the different ways to administer drugs?

Methods of drug administration are divided into 2 large groups: enteral route of administration and parenteral path. Separately allocate local use of medications.

Enteral route (from the Greek enteron - intestine) is associated with the gastrointestinal tract (gastrointestinal tract):

• ingestion (swallowing through the mouth - per os);
• through the rectum (per rectum) - this way they are administered rectal suppositories(rectal suppositories), especially for young children;
• under the tongue (sublingual, from Latin sub - under lingva - language),
• by the cheek (buccal, from Latin bucca - cheek), tablets of medicine are placed and adhered to the mucous membrane of the mouth, this is how nitrates are used to treat angina.

When they say " the drug is taken 3 times a day", usually mean taken INTERALLY.

Parenteral route of drug administration (from the Greek para - near) has nothing to do with the gastrointestinal tract. There are many parenteral routes of administration; I will list only the most well-known:

• externally (cutaneously - transdermally) - in the form of ointments or patches with medicine,
• intramuscularly,
• intravenously,
• subcutaneously
• intraosseous - since the bone marrow is well supplied with blood, this route of administration is used in pediatrics and for emergency care when it is not possible to administer the medicine intravenously,
• intradermally (intradermally) - for the Mantoux test, vaccination against the herpes simplex virus,
• nasally (intranasally - into the nasal cavity) - IRS-19 vaccine, cromoglycic acid; nasal administration can also be classified as topical application,
• intra-arterial - usually used in chemotherapy of malignant tumors,
• epidurally - into the space above the dura mater,
• intrathecally (endolumbarally) - into the cerebrospinal fluid (CSF) under the arachnoid membrane of the brain in diseases of the central nervous system.

Intravenous administration is:

• in the form of a bolus (Greek bolos - lump) - jet administration of the drug in a short period of time (3-6 minutes),
• in the form of an infusion - a slow, long-term administration of a drug at a certain speed,
• mixed - first bolus, then infusion.

People call the injection injection, infusion - " drip».

There are local and systemic effects of drugs.

• When applied topically, the drug acts primarily at the site of contact with tissue (for example, nasal instillation, injection of the drug into the abscess cavity, etc.).
• The drug has a systemic effect after entering the systemic bloodstream, that is, when it is distributed throughout the body (and not isolated in some limited place).
• When applied topically, part of the medicine can be absorbed through the mucous membranes (subject to resorption, from the Latin resorbeo - absorbing), spread through the blood and affect the entire body; this action is called resorptive.

Which route of drug administration is best?

1. naturally,
2. cheap (no need for syringes, dosage forms are cheaper),
3. simple and accessible (no appropriate qualifications or equipment required),
4. there is less risk of inflammatory complications (after intramuscular administration, an abscess or abscess may occur, and after intramuscular administration of an irritating drug, thrombophlebitis, or inflammation of the vein),
5. less risk of fatal allergic reactions (when taken orally, they develop more slowly than when administered parenterally),
6. no sterility required (you won’t be able to get infected with HIV or parenteral hepatitis B and C),
7. a large selection of dosage forms (tablets, capsules, dragees, powders, pills, decoctions, mixtures, infusions, extracts, tinctures, etc.).

Differences between tinctures and infusions:

• tinctures contain alcohol,
• infusions are alcohol-free.

Who needs parenteral drug administration?

Treatment of the vast majority of chronic diseases was specially developed with the expectation of long-term regular oral administration of drugs (arterial hypertension, coronary artery disease, etc.).

• insulin for type 1 diabetes mellitus,
• albumin and antibodies(immunoglobulins),
• enzymes for lysosomal storage diseases, etc.

Insulin, antibodies, and many enzymes are useless to take orally, because, being proteins in chemical structure, they are simply digested in the gastrointestinal tract under the influence of the patient’s digestive enzymes.

Thus, most chronic diseases do not require a planned course of parenteral drug administration. Their regular intake is sufficient. Often, “preventive” courses of injections are useless or even harmful. They take up time from the patient (to get to the treatment room of the clinic) and resources from the healthcare system. Since obese people are more likely to get sick and have to undergo treatment, and their veins are “bad” (hard to reach), then after an unnecessary course of intravenous infusions the veins will be punctured or many subcutaneous hematomas will appear around due to the release of blood from the damaged vessel. If after some time the patient develops a complication that requires intensive treatment, then it will be more difficult for health workers to obtain venous access (the ambulance workers are skilled, but experience does not come immediately). In some cases (eg fatal arrhythmias) this will cost the life of an unwise patient.

This is what the skin looks like after intravenous injections of a highly irritating substance (in this case, the drug “krokodil”). This substance can only be injected into a specific vein once, after which the vein is severely (often irreversibly) damaged. There aren't enough veins, and drug addicts have to inject any visible veins in their arms and legs.

Photo source: http://gb2.med75.ru/pages/page/%D0%9A%D1%80%D0%BE%D0%BA%D0%BE%D0%B4%D0%B8%D0%BB/

This is perhaps the “softest” photo. People with nerves of iron can, if they wish, independently find on the Internet other (shocking) photos of people after parenteral administration of this drug - with deep purulent wounds to the bone and hanging pieces of meat.

Parenteral administration of drugs is justified in the following situations:

1. if you need a quick effect in acute diseases or exacerbation of chronic ones (treatment of myocardial infarction, hypertensive crisis, etc.),
2. if the patient has impaired consciousness (cannot swallow consciously),
3. if the swallowing process is impaired (muscle weakness or damage to the nervous system),
4. if the absorption of the drug in the gastrointestinal tract is impaired,
5. if the medicine, due to the peculiarities of its chemical structure, is fundamentally unable to be absorbed through the gastrointestinal tract,
6. if the exact dosage is important, which will not depend on the characteristics of the patient’s gastrointestinal tract.

Replies to other people's arguments

Fans of parenteral treatment have their own arguments, which I want to answer.

“no stress on the stomach”

It is not entirely clear what “load” on the stomach is meant. Most likely, this refers to the irritant effect of the drugs or their ability to cause damage to the gastric mucosa. For example, aspirin or diclofenac can cause gastritis and even ulcers. However, this side effect is due to the very mechanism of action of drugs in this group, therefore the parenteral route of administration diclofenac will not protect you from ulcers, and taking enteric-coated aspirin will only slightly reduce your risk. Replacement would be much better diclofenac to a more modern drug from the NSAID group (selective COX-2 inhibitor), which has minimal effect on the stomach ( nimesulide, meloxicam, celecoxib etc.) or at least parallel use of a proton pump blocker.

In general, highly irritating substances are not administered parenterally (sometimes only as a long-term slow infusion), because they can cause irritation and necrosis (death) of surrounding tissues, including vein walls with the development of inflammation - thrombophlebitis. In other words, if the drug is well tolerated in the form of an injection, then in the dosage form for oral administration it will not cause local irritation.

"does not affect the liver"

Our body is designed in such a way that all blood flowing from the stomach and intestines (with the exception of the lower half of the rectum) first passes through the liver barrier. The liver checks this blood for safety and sends it into the systemic circulation (the inferior vena cava, which goes to the heart). Part of the systemic bloodstream always passes through the liver, and the drug there gradually undergoes biotransformation under the action of liver enzymes. Therefore, over time, the effect of the drug decreases, and you have to take another dose of the medicine. Thus, the difference between injections and tablets is small: when absorbed from the gastrointestinal tract, any drug must initially pass through the liver barrier in order to enter the systemic bloodstream. And when injected, the drug immediately enters the bloodstream, bypassing the liver, but then still has to pass through the liver barrier many times.

All venous blood from the gastrointestinal tract collects in the portal vein (lat. vena portae - porte vein) and enters the liver.

If you have serious problems with the liver, then it is advisable, together with your doctor, to select drugs that are minimally metabolized (destroyed) there. For example, among ACE inhibitors it is lisinopril.

Refusing necessary treatment due to fear " transplant liver", remember: although an artificial liver has not yet been invented, the average risk of dying from cardiovascular diseases is much higher than from liver diseases.

“do not cause dysbacteriosis”

It's a delusion. When administered parenterally, antibiotics enter the intestinal tissue from the blood. Magazine " Attending doctor"with reference to Vanderhoof J. A., Whitney D. B., Antonson D. L., Hanner T. L., Lupo J. V., Young R. J. Lactobacillus GG in the prevention of antibiotic-associated diarrhea in children // J Pediatr 1999; 135: 564–568 writes that with parenteral administration amoxicillin/clavulanate, erythromycin and other antibiotics from the groups macrolides, cephalosporins and penicillins the risk of developing diarrhea caused by dysbacteriosis is equal to the same risk when taking these antibiotics orally.

Thus, the parenteral route of antibiotic administration compared to the oral route (per os - through the mouth) does not reduce the frequency of dysbiosis and diarrhea as complications.

Read more: " Mechanisms of development and ways of correction of antibiotic-associated diarrhea", http://www.lvrach.ru/2014/06//

Can be used to prevent antibiotic-associated diarrhea. enterol, probiotics, lactulose in bifidogenic doses. It has been proven that enterol reduces the frequency of diarrhea while taking antibiotics by 2-4 times (prescribed 1 capsule or 1 powder 1-2 times a day during the course of antibiotic treatment). Read more about enterol Read the topic about the treatment of diarrhea.

“In the hospital they mainly treat with injections”

If the hospital does not prescribe parenteral injections, it turns out that they are keeping you there in vain. With the same success (taking all the medications internally) you could be treated at home. However, not all patients in the hospital are treated diligently. There is a joke: “ Doctor, my sick leave is quickly running out because of your pills! I don't want to accept them" The pills may not be taken or thrown away, unlike the injections given by the nurse. For example, my mother claims that when I was alone in the hospital as a preschooler, I secretly collected the pills that I was given to take into the hospital bedside table until this was discovered. It’s good that I didn’t think of drinking them all at once.

Are injections really more effective than pills?

There are many ways to introduce drugs into the body, but most often we use oral forms or injections. What's better? Both options have both supporters and opponents. But more often you hear that injections are much more effective and have fewer side effects than tablets or other oral forms. Let's try to figure out whether injections are really superior to tablet forms in everything or is this just another myth.

Why is an injection better than a pill?

Most often, defenders of the injection method of drug administration recall as the main argument in favor that tablets can harm the stomach and digestive tract, such as aspirin and other popular drugs. In addition, no less often they talk about harm to the liver and kidneys, which have to remove the medicine that has entered the gastrointestinal tract. Indeed, taking pills increases the load on these organs.

Patient being vaccinated

Also, opponents of oral forms argue their position by recalling antibiotics, which can cause dysbiosis and disorders of digestion, stool and the entire functioning of the gastrointestinal tract. And many medications have a frankly disgusting taste and can be difficult to swallow.

Of course, against the background of such disadvantages, the advantages of injections become more obvious, because their use frees you from the need to swallow something tasteless. In this case, the mucous membrane of the stomach and digestive tract will not suffer. And the medicine administered by injection begins to act much faster. In addition, this method is suitable for patients who are unconscious or in a coma.

Cons of injections

Unfortunately, injections also have many disadvantages, and the first of them is pain when administering the medicine. Anyone who has tried the antibiotic Ceftriaxone in water rather than Lidocaine will confirm that dysbiosis and stool disorders are much easier to tolerate after taking the tablets. And after injections, abscesses and infiltrates often remain. By the way, when antibiotics are administered intramuscularly, a person’s own microflora suffers in the same way as when administered orally.

Not everyone likes injections

The fact that antibacterial agents harm the body less, since they do not burden its organs, is also nothing more than a myth, since with any method of administering the drug, it is sooner or later eliminated by the kidneys and liver. In addition, with intramuscular, and even more so intravenous, administration of drugs, the likelihood of severe allergic reactions - for example, anaphylactic shock - increases many times.

What to choose?

What method of drug administration should you choose? This depends on the patient’s condition and the characteristics of the drug itself.

If the patient is conscious and able to swallow, then in most cases preference should be given to oral forms, if, of course, they exist. For example, insulin is only administered by injection, since it is broken down in the stomach. Contrary to popular belief, most drugs are no more effective when administered intramuscularly than when administered any other way.

Injections or pills?

Moreover, injections are often less effective. You should not administer NSAIDs, muscle relaxants and chondroprotectors intramuscularly, since in tablets they have the same bioavailability, are just as well absorbed and act. Considering that treatment with such drugs is often long-term, injecting a person for several months would be a real mockery.

Nothing more than a myth and the absolute harmfulness of tablets for the gastrointestinal tract. Most drugs that are potentially harmful to the mucous membrane have long been produced in tablets coated with a special coating that protects the surface of the digestive tract from negative effects.

The effectiveness of injections in the treatment of any chronic diseases is low. Typically, this situation requires the medicine to act gradually and over a long period of time, and after injections it enters the bloodstream and is then eliminated too quickly.

When are injections more effective?

Undoubtedly, intramuscular injections are necessary when the patient simply cannot swallow the medicine: for example, he is unconscious or in an inadequate state. In this case, an injection is the only way to quickly deliver the necessary medicine into the blood. But for any chronic or mild acute diseases, preference should be given to taking medications orally.

Consilium at the patient's bedside

Another situation when you need to choose injections is if you need to deliver medicine to a specific place. This is, for example, used when carrying out local injection therapy or blocking the area of ​​inflammation with non-steroidal anti-inflammatory drugs. But such treatment is rarely carried out today.

There is a version that the legend about the exceptional effectiveness of injections was created at a time when doctors had to fulfill the plan for hospital beds by any means. The need to systematically carry out injections forced even those patients who could easily be treated at home to stay in the hospital.

There are few situations where injections work better than tablets, so we can confidently say that the notorious high effectiveness of drugs when administered by injection is nothing more than a myth.

Is the effect of intravenous and intramuscular administration of the drug the same?

Injections can be intramuscular, subcutaneous, intravenous, etc. Each type of injection has its own indications.

Some drugs, when administered subcutaneously, cause pain and are poorly absorbed, which leads to the formation of infiltrates. When using such drugs, as well as in cases where a faster effect is desired, subcutaneous administration is replaced by intramuscular administration.

Intravenous administration of drugs requires the presence of a highly qualified nurse; it is not recommended to do them at home.

Intramuscular injections can be done at home. Moreover, anyone can and should learn how to do them, especially if there are sick or elderly people in the family. After all, you won’t have to call a healthcare worker to your home every time or go to the clinic.

Some even learn to give intramuscular injections to themselves.

Muscles have a wider network of blood and lymphatic vessels, which creates conditions for rapid and complete absorption of drugs. With intramuscular injection, a depot is created from which the drug is slowly absorbed into the bloodstream, and this maintains its required concentration in the body, which is especially important in relation to antibiotics.

Another advantage of the injections is that the medicine does not irritate the stomach and has no digestive effects.

If this drug can be administered both intravenously and intramuscularly then:

If you need emergency help, it is better to do it intravenously, the effect will be strong but short. And when administered intramuscularly, the effect will be gradual and long-lasting.

Can Actovegin be injected intramuscularly?

Actovegin is a drug that activates metabolism, improves trophism, reduces tissue hypoxia and stimulates regeneration. Actovegin is used intramuscularly, intravenously, orally and externally. There is a separate dosage form for each method of application.

Characteristics of the medicine

For the production of Actovegin, the blood of dairy calves is used, from which a deproteinized hemoderivative is obtained through dialysis and ultrafiltration. It contains amino acids, macroelements, microelements, fatty acids, oligopeptides and other important physiological components.

Having received a doctor’s prescription for therapy with the ampoule form of the drug, many wonder whether Actovegin can be injected intramuscularly or whether an intravenous infusion will be required. The answer can be obtained either from a doctor or pharmacist, or by reading the package insert for the medicine - the drug is used for intramuscular use.

Actovegin is produced in several dosage forms: solution for injection, ointment, tablets, cream, solution for infusion and gel. This allows each patient to choose the ideal product.

In particular, Actovegin injections are carried out intramuscularly using an injection solution. It is a transparent liquid, yellowish in color or completely colorless. The drug is sold in ampoules of 2, 5 and 10 ml. The active component is included in the solution in an amount of 40 mg per ml. Thus, 2 ml contains 80 mg of hemoderivat, 5 ml - 200 mg, and 10 ml - 400 mg. Excipients are water for injection and sodium chloride.

Indications of the medicine

The drug has a complex mechanism of action that provides a variety of its pharmacological effects, therefore it is used in the treatment of many diseases in different fields of medicine. Its purpose is justified when it is necessary to improve the nutrition of body tissues, increase their resistance to hypoxia, which ensures a minimum amount of damage to the structures of the body’s cells in conditions of oxygen deficiency.

Actovegin according to the instructions for intramuscular injection is used for:

• abnormal dilatation of cerebral vessels;
• retinal damage;
• dyscirculatory encephalopathy;
• ischemia and oxygen starvation of organs;
• vascular atherosclerosis;
• ischemic strokes;
• vascular angiopathy;
• extensive burns of chemical and thermal nature;
• cerebral insufficiency;
• wounds and bedsores;
• diabetic polyneuropathies;
• frostbite;
• traumatic brain injuries;
• radiation and radiation damage to the skin and mucous membranes.

How to use

Depending on the severity of the disease, intramuscular or infusion medication is prescribed. The decision about this, as well as about the dosage of the drug, is made by the doctor.

Instructions for administering injections intramuscularly:

• Before carrying out the manipulation, you should thoroughly wash your hands with soap and treat with an antiseptic;
• The ampoule needs to be slightly warmed in your hand before administration;
• Holding the ampoule vertically and lightly tapping it so that all the solution is in the lower part, break off its tip along the line with the red dot;
• Take the medicine with a sterile syringe, then turn it upside down and release a drop of the solution to make sure that all the air has come out;
• Visually divide the buttock into 4 parts and insert a needle into the upper outer square, having previously treated the skin with a cotton swab and alcohol;
• The drug is administered slowly;
• After the injection, clamp the injection site with cotton wool or a napkin moistened with alcohol.

In injections, according to the instructions for use, Actovegin is used at 2-5 milliliters per day. Administration can be carried out from 1 to 3 times a day.

The attending physician, based on the presence of indications, the severity of the disease and the effectiveness of the treatment, may change the recommended doses in one direction or another. If it is necessary to administer the drug in doses exceeding 5 ml, it is recommended to use Actovegin intravenously.

The following doses of the drug are usually prescribed:

• In case of cerebral circulatory insufficiency, 5 ml of medication is used for 14 days. Next, a tablet form is prescribed to support the effect;
• To speed up the process of tissue regeneration in case of wounds, frostbite and other damage to the epidermis, daily injections of 5 ml of Actovegin solution are indicated. Additionally, local forms of the drug are used - ointment, cream or gel.

Intramuscular administration is used for mild to moderate diseases, while in more complex cases, infusions into a vein are required.

Precautionary measures

To ensure maximum effectiveness and safety when treating with Actovegin injections, you must adhere to the rules for its use.

Before starting full therapy, the presence of individual intolerance should be determined. To do this, 2 ml of medication is injected intramuscularly over 1-2 minutes. Long-term administration allows you to observe the body's response to the drug and, if anaphylaxis develops, you can stop the injection in time and begin resuscitation of the patient.

From the above, the following rule of admission follows: injections must be given in a medical institution, where, if necessary, emergency care can be obtained. If home treatment is still intended, then at least the first dose should be administered in the hospital under the supervision of medical staff.

Actovegin can be administered intramuscularly in a dose not exceeding 5 ml, since the solution is hypertonic and can provoke a sharp jump in blood pressure.

It is important to create the most sterile conditions possible when administering the drug. An open ampoule must be used immediately, since the medicine does not contain preservatives that would ensure longer storage. Therefore, the drug should be purchased in ampoules of the volume that needs to be injected at a time. After all, storing an opened ampoule is prohibited.

Actovegin should be stored in the refrigerator, so before use, the ampoule should be slightly warmed in your hands to ensure more comfortable administration.

A solution with visible sediment or if it is cloudy must not be used. The contents of the ampoule should be yellowish in color and transparent.

Actovegin may be included in complex treatment regimens for diseases, since no negative interaction reactions with other medications have been established. It should be borne in mind that mixing it with other drugs in one bottle or syringe is strictly prohibited. An exception is solutions of sodium chloride and glucose, which are recommended for the preparation of infusion solutions. It is also prohibited to drink alcohol during treatment with the drug.

Side effects

Actovegin is well tolerated. The most common negative effect during its treatment is allergic reactions, including angioedema. Much less common are:

• redness or paleness of the skin;
• dizziness;
• chest pain;
• indigestion;
• increased frequency and difficulty breathing;
• general weakness;
• increased blood pressure;
• muscle and joint soreness;
• increased heart rate;
• fever;
• paresthesia;
• attacks of suffocation.

If any undesirable reactions of the body to the use of the drug occur, therapy with Actovegin should be stopped and symptomatic treatment prescribed.

When using Actovegin injections intramuscularly, you need to take into account that this is a rather unpleasant and painful procedure. Therefore, it is preferable to administer it intravenously along with a solution of glucose or sodium chloride.

Contraindications

Actovegin has a high safety profile, which allows it to be used in a wide range of patients. However, there are exceptions. Intramuscular injections of Actovegin are prohibited for:

• hypersensitivity to the components of the product;
• heart failure;
• disturbances in the outflow of urine;
• pulmonary edema;
• kidney diseases.

Use of the drug in special groups of patients

According to the instructions, the drug should not be prescribed in pediatrics due to the lack of a sufficient number of relevant studies. But in practice, many doctors use Actovegin to treat infants and children.

Intramuscular injections of the drug are practically not used in this category of patients due to the painfulness of the procedure. The exception is infants with consequences of intrauterine hypoxia. But such injections are administered only in a hospital setting under constant medical supervision.

Actovegin is prescribed to pregnant women with caution, after assessing the possible consequences for the fetus. If it is necessary to administer the drug to such patients, preference is given to intravenous administration at the beginning of treatment, with a further transition to intramuscular administration or taking tablets when the condition improves.

Indications for use include: threat of miscarriage, feto-placental insufficiency, placental abruption, Rh conflict, slow fetal weight gain or low motor activity.

The use of the drug during lactation is also allowed, but only if its therapeutic effect on the mother’s body exceeds the potential risk for the baby.

In geriatrics, the drug is used quite often. At the same time, judging by the reviews, it is in old age that the positive effect of Actovegin is best manifested.

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Actovegin /

Actovegin activates cellular metabolism (metabolism) by increasing the transport and accumulation of glucose and oxygen, enhancing their intracellular utilization. These processes lead to an acceleration of ATP (adenosine triphosphoric acid) metabolism and an increase in the energy resources of the cell. Under conditions that limit the normal functions of energy metabolism (hypoxia / insufficient supply of tissue with oxygen or impaired absorption /, lack of substrate) and with increased energy consumption (healing, regeneration / tissue restoration /), Actovegin stimulates the energy processes of functional metabolism (metabolic process in body) and anabolism (the process of absorption of substances by the body). The secondary effect is increased blood supply.

Indications for use:

Cerebrovascular insufficiency, ischemic stroke (insufficient supply of brain tissue with oxygen due to acute cerebrovascular accident); traumatic brain injuries; disorders of peripheral circulation (arterial, venous); angiopathy (impaired vascular tone); trophic disorders (skin nutritional disorders) with varicose veins of the lower extremities (changes in the veins, characterized by an uneven increase in their lumen with the formation of a protrusion of the wall due to dysfunction of their valve apparatus); ulcers of various origins; bedsores (tissue death caused by prolonged pressure on them due to lying down); burns; prevention and treatment of radiation injuries.

Doses and route of administration depend on the type and severity of the disease. The drug is prescribed orally, parenterally (bypassing the digestive tract) and locally.

1-2 tablets are prescribed orally 3 times a day before meals. Do not chew the pills, wash them down with a small amount of water.

For intravenous or intraarterial administration, depending on the severity of the disease, the initial dose is ml. Then 5 ml is prescribed intravenously slowly or intramuscularly, 1 time per day every day or several times a week. 250 ml of solution for infusion is injected intravenously at a rate of 2-3 ml per minute once a day every day or several times a week. You can also use 10, 20 or 50 ml of injection solution diluted with glucose or saline. Total for a course of treatment: infusions. It is not recommended to add other drugs to the infusion solution.

The cream is used to improve wound healing, as well as weeping wounds. Used after the formation of bedsores and prevention of radiation injuries.

Eye gel. Squeeze 1 drop of gel directly from the tube into the affected eye. Apply 2-3 times a day. After opening the package, the eye gel can be used for no more than 4 weeks.

Allergic reactions: urticaria, feeling of a rush of blood, sweating, increased body temperature. Itching, burning in the area of ​​application of the gel, ointment or cream; when using eye gel - lacrimation, scleral injection (redness of the sclera).

Hypersensitivity to the drug. Prescribe the drug with caution during pregnancy. During breastfeeding, the use of Actovegin is undesirable.

Dragee forte in a package of 100 pieces. Solution for injection in ampoules of 2.5 and 10 ml (1 ml - 40 mg). Solution for infusion 10% and 20% with saline in 250 ml bottles. Gel 20% in tubes of 20 g. Cream 5% in tubes of 20 g. Ointment 5% in tubes of 20 g. Eye gel 20% in tubes of 5 g.

In a dry place at a temperature not exceeding +8 * C.

Protein-free (deproteinized) extract (hemoderivate) from the blood of calves. Contains 40 mg of dry matter in 1 ml.

Which injections are more difficult - intramuscular or intravenous?

Injections can be intravenous, intramuscular, or subcutaneous.

For each type of manipulation there is its own algorithm.

If we consider complexity, the most complex, of course, are intravenous, since not everyone has a well-developed subcutaneous peripheral venous network. It sometimes seems that the veins are “swollen, lumpy,” well defined, but so mobile, with an elastic wall, that it is very difficult for the nurse to “catch” the vein wall with a needle and pierce it. Sometimes the vein wall is so sclerotic that it is punctured with a crunch. When blood pressure drops, the peripheral veins collapse, then technically such manipulation is very difficult.

If the intravenous injection technique is not followed, blood (hematoma) will enter the subcutaneous space, the medicine will be absorbed painfully, and an infiltrate will occur. And if calcium chloride gets in, necrosis of the subcutaneous tissue generally occurs.

If the rules of asepsis and antiepsis are not followed, phlebitis of the cubital vein may occur, which is fraught with a serious complication - thrombosis. Setting up an intravenous injection requires experience, dexterity and the correct placement technique.

With intramuscular injection (into the upper outer quadrant of the gluteal muscle), there may also be painful infiltrates, which can sometimes result in suppuration and phlegmon. The same applies to subcutaneous injections.

Well, in general, everything can be endured and tolerated. Nowadays, vasokans - a peripheral catheter - are widely used; in emergency and severe cases, resuscitators perform CPV - catheterization of the subclavian vein, colloquially called the “subclavian vein”.

Is it possible to administer Actovegin intramuscularly?

Is it possible to administer Actovegin intramuscularly and how to do it correctly is a common question among people who have been prescribed this drug as a course of injections to treat a particular pathology. It is especially important to know the answer when it comes to treating pregnant women or children.

Is it possible to administer the drug Actovegin intramuscularly and why are these injections prescribed at all? Actovegin is one of those drugs that are available in various pharmaceutical forms. These can be dragees, capsules, ointment, gel and injection ampoules. As a rule, the latter are prescribed when the disease has reached a severe stage and other forms of the drug are no longer effective. Or the patient’s condition is very serious and he needs quick help.

It is believed that this medicine is safe, since the raw material for it is a natural biological product.

Main components of the drug:

• extract from the blood of calves;
• purified water;
• sodium chloride.

Injections of the drug can be given even to children and pregnant women. But, like any medication, Actovegin can cause unwanted side effects; in rare cases, it causes severe allergies.

The effect of the drug on the body of a child or expectant mother has not yet been fully studied. Therefore, it is quite understandable that patients are interested in whether Actovegin can really be administered intramuscularly and how to do it correctly.

When are injections needed?

Actovegin solution for injection intramuscularly is an ampoules with a clear or slightly yellowish liquid. The ampoule can be 2.5 or 10 ml. The main property of the drug is to accelerate metabolic processes in cells, due to which oxygen and glucose are better absorbed. It is prescribed for the treatment and prevention of oxygen starvation, for wound healing after injury or surgery. It is also used in neuralgia.

The main indications for intramuscular administration of Actovegin are:

• oxygen starvation of tissues and organs, including in pregnant women and children;
• serious metabolic disorders;
• cerebral vascular insufficiency;
• diabetes mellitus and its complications;
• extensive burns;
• bedsores;
• poorly healing wounds;
• radiation damage to the skin or mucous membranes;
• ulcers of any origin.

How to administer the drug correctly

You can do intramuscular injections with this drug, intravenous and intra-arterial infusions. Infusions can only be administered by a doctor in a medical facility. Many patients do the injections themselves at home.

Important: before starting therapy, the doctor must conduct a trial test. To do this, 2 ml of the drug is injected over one minute. This length allows you to observe the patient’s body’s reaction to the drug and, if adverse events occur, immediately stop administering the drug. That's why you can't start giving injections yourself at home - the first injection is always given by a medical professional.

Basic rules for Actovegin injections:

• a single daily dose should not exceed 5 ml;
• The maximum duration of treatment is 20 procedures and no more.

The algorithm for administering the drug intramuscularly is as follows:

1. First, wash your hands thoroughly with warm water and soap.
2. Remove the ampoule from the refrigerator and warm it in your hands.
3. Place the ampoule in a vertical position and tap the bottom with your finger so that the liquid sinks to the bottom.
4. Prepare a disposable syringe, break off the upper tip of the ampoule and carefully draw the medicine into the syringe.
5. Turn the syringe over with the needle facing up and press the plunger slowly until a drop of the drug hangs on the needle.
6. Prepare the patient's buttock. Divide it roughly into four parts. Injections are made into the upper quarter closer to the outside.
7. Wipe the skin with alcohol, stretch it with two fingers and insert the needle three-quarters at a right angle.
8. Slowly inject the medicine - the rate of administration should not exceed 2 ml per minute.
9. Quickly remove the needle after completing the injection and rub the injection site with a cotton swab.

Contraindications and application features

This drug is prescribed with great caution to pregnant women and children under three years of age. The decision on the advisability of using Actovegin is always made by the doctor, based on the severity of the disease and the patient’s well-being.

• acute heart failure;
• difficulty removing fluid from the body;
• serious kidney pathologies;
• pulmonary edema;
• intolerance to the drug.

If intramuscular injections are allowed at home, the patient must follow certain rules so as not to harm his health. Actovegin in any form, and especially intramuscularly or intravenously, is incompatible with alcoholic beverages. The action of these two substances is completely opposite, so the most unpredictable reaction can occur.

Ampoules should be stored strictly in the refrigerator on the door or bottom shelf. If flakes appear in the solution or a precipitate forms, it can no longer be used. It is also important to monitor the patient's electrolyte metabolism - edema is one of the most common side effects when treated with this drug.

The drug is rarely prescribed to children in the form of injections due to the high risk of an allergic reaction and pain. It is used in obstetrics to prevent fetal hypoxia, but the course of treatment is carried out only in a hospital setting under constant medical supervision.

Actovegin is generally well tolerated by patients of any age. But this does not mean that you can use it for injections at home without control. If you want to get a good effect and not harm the body even more, it is better to entrust the injections to a specialist in a medical institution - it will be smarter and safer.

What is the best way to use Actovegin intravenously or intramuscularly?

Intravenously. This way the drug will quickly enter the bloodstream and begin its therapeutic effect. The only difficulty here is that not everyone can give such injections. To do this you need to go to the clinic. This is not always possible.

The drug Actovegin is available in various forms: gel for external use, dragees for oral use, solution for intravenous infusion, solution for intravenous and intramuscular injections, as well as an eye gel for rapid healing of the retina and cornea.

If you inject intramuscularly, you need to keep in mind that the injection is quite painful, but tolerable. If injected intramuscularly, the effect occurs quite quickly, but with intravenous administration the effect will be more pronounced.

It is better to inject Actovegin into a vein, or even better to put in an IV. The problem is that it is difficult to do this yourself at home. It is much easier to give an injection intramuscularly.

Actovegin should not be combined with other drugs.

Almost any drug is best taken intravenously (if you have a choice). Actovegin is no exception; this drug is better and faster transferred through the blood vessels. Consequently, the effect will be achieved faster. In addition, Actovegin is very painful if injected intramuscularly. Although, it is prescribed even to newborns intramuscularly.

It is better to use Actovegin as prescribed by the doctor. Only he, after collecting all your complaints and looking at the examination data, can decide how and in what dosage the medicine should be used.

The doctor told me that the best effect will be achieved if Actovegin is injected into a vein, supposedly it passes through the vessels faster and gets to the right place. I took the course, but I don’t know if this Actovegin has any effect at all.

It is better not to use it if you value your health. It has long been banned in many countries, but here we are still debating how to inject it. Just look at the website of its manufacturers, where they sell it - only to China, South Korea, and to you and me. Prion disease may not develop immediately, but after many years of using a drug with animal components, which is Actovegin.

Actovegin is best administered intravenously. Then the drug is administered in a stream, in the form of droppers. Previously, I came across not only ampoules with Actovegin, but already diluted Actovegin in bottles. You cannot inject more than 5 ml of solution intramuscularly. It is best to administer only a test dose intramuscularly to make sure that a person does not experience allergic reactions due to Actovegin.

Mexidol

Description current as of 09/04/2014

• Latin name: Mexidolum
• ATX code: N07XX
• Active ingredient: Ethylmethylhydroxypyridine succinate (Aethylmethylhydroxypyridini succinas)
• Manufacturer: Ellara LLC, Armavir Biofactory, Moscow Endocrine Plant, Mir-Pharm, ZiO-Zdorovye, ALSI Pharma (Russia)

Compound

The composition of the drug in the form of an injection solution includes ethylmethylhydroxypyridine succinate as an active substance (50 mg per 1 ml) and auxiliary components:

One Mexidol tablet contains 125 mg of the active ingredient ethylmethylhydroxypyridine succinate, as well as a number of auxiliary components:

• lactose monohydrate;
• sodium carboxymethylcellulose (sodium carmellose);
• magnesium stearate.

Each tablet is coated with a white or creamy white film consisting of:

• Opadry II white (macrogol polyethylene glycol);
• polyvinyl alcohol;
• talc;
• titanium dioxide.

Release form

The drug Mexidol has two forms of release: in ampoules and tablets.

Mexidol in ampoules is intended for infusions and intramuscular injections. The solution is produced in ampoules made of colorless or light-protected glass, on which the breaking point is marked in blue or white and three marking rings, the top of which is yellow, the middle - white, the bottom - red.

Ampoules have a capacity of 2 or 5 ml and are packaged in 5 pieces in blister packs. The cardboard packaging is completed with 1 or 2 contour packages, as well as instructions for the medical use of the drug.

For hospital inpatient units, Mexidol solution is packaged in 4, 10 or 20 blister packs.

One tablet of Mexidol weighs 125 mg and is intended for oral administration. Tablets are produced packaged in 10 pieces in blister packs made of PVC film and aluminum foil or 90 pieces in plastic jars made of food grade plastic.

For inpatient medical institutions, tablets are produced in plastic jars made from food-grade plastic, 450 or 900 pieces each.

Description of the drug in the form of a solution for injection

Mexidol in ampoules has the form of a clear liquid, which can be either colorless or slightly yellowish.

Description of the tablet form of Mexidol

The tablets are biconvex, round in shape, coated, the color of which can vary from white to white with a slightly creamy tint.

pharmachologic effect

The medicine Mexidol belongs to the pharmacological group of drugs that affect the nervous system.

In addition, it has a pronounced stress-protective effect (that is, it increases the body’s resistance to stress), improves memory, has the ability to prevent or stop seizures, and also reduces the concentrations of certain lipid fractions (in particular, low-density lipoproteins) in various tissues and body fluids.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

The pharmacological properties of Mexidol are determined by the activity of ethylmethylhydroxypyridine succinate, which is part of it.

According to Wikipedia, this substance belongs to the category of drugs that prevent or slow down the processes of peroxidation of membrane lipids in cells.

Ethylmethylhydroxypyridine succinate belongs to the class of 3-hydroxypyridines and is a pyridine derivative with the general formula C5H4_nN(OH)n.

The substance has the form of colorless crystals, which are characterized by the ability to easily dissolve in ethanol and acetone, moderately dissolve in water and limitedly in diethyl ether, benzene and ligroin.

The mechanism of action of ethylmethylhydroxypyridine succinate is determined by its antioxidant and membrane protective properties.

Acting as an antioxidant, it slows down and suppresses oxidative chain reactions in which active free radicals, represented by peroxide (RO2*), alkoxy (RO*) and alkyl (R*) forms of oxygen, take part.

Thanks to this, against the background of using Mexidol:

• the activity of the antioxidant enzyme superoxide dismutase (SOD) increases;
• the ratio of proteins and lipids increases;
• The viscosity of cell membranes decreases and, accordingly, their fluidity increases.

The drug regulates and normalizes the activity of membrane-bound enzymes (in particular, the main enzyme of the cholinergic system acetylcholinesterase, the enzyme of the lyase class of adenylate cyclase and calcium-independent PDE (phosphodiesterase)), as well as the activity of receptor complexes (for example, the GABA-benzodiazepine receptor complex).

• membrane-binding enzymes and receptor complexes increase their ability to bind ligands;
• normal indicators of the structural and functional organization of biological membranes are maintained;
• the processes of transport of neurotransmitters are normalized;
• indicators of synaptic transmission of neurotransmitters improve.

Mexidol tablets and injections can increase the body's resistance to the influence of various aggressive factors and pathological conditions associated with oxygen deficiency.

The drug effectively eliminates symptoms caused by oxygen starvation, shock, ischemia, cerebral circulatory disorders, as well as symptoms of general poisoning of the body with drugs (in particular, antipsychotic drugs) or alcohol.

After a course of treatment with Mexidol (intravenously, intramuscularly or orally):

• the content of dopamine in the brain increases;
• the course of metabolic processes in the brain is normalized;
• cerebral blood supply is normalized;
• blood microcirculation improves;
• blood rheological parameters improve;
• platelet aggregation decreases;
• membranes of postcellular blood structures (erythrocytes and platelets) are stabilized during hemolysis;
• total cholesterol levels decrease;
• LDL levels decrease;
• the severity of symptoms of pancreatogenic toxemia (general blood poisoning) decreases;
• the severity of the syndrome of endogenous intoxication caused by acute pancreatitis decreases;
• the compensatory activity of aerobic glycolysis increases;
• under conditions of oxygen starvation, the degree of inhibition of oxidative processes in the tricarboxylic acid cycle (Krebs cycle) decreases;
• the content of adenosine triphosphate (ATP) and creatine phosphoric acid (creatine phosphate) increases;
• energy synthesis by cellular mitochondria is activated;
• cell membranes are stabilized;
• the course of metabolic processes in the areas of the myocardium affected by ischemia is normalized;
• the area of ​​the necrosis zone decreases;
• the electrical activity of the heart and its contractility are restored and improved (in patients with reversible cardiac dysfunction);
• blood flow increases in areas of the myocardium affected by ischemia;
• the severity of the consequences of reperfusion syndrome caused by acute coronary insufficiency decreases.

Treatment with Mexidol IV or IM allows preserving ganglion cells, as well as nerve fibers of sensitive cells of the retina of the eye in patients with progressive forms of neuropathy caused by ischemic disease and hypoxia.

At the same time, patients experience a significant increase in the functional activity of the retina and optic nerve, and visual acuity increases.

The anti-stress effect of treatment with Mexidol tablets is expressed as:

• normalization of behavior after suffering stress;
• disappearance of symptoms of somatovegetative disorders;
• normalization of sleep and wake cycles;
• restoration (partial or complete) of impaired learning abilities;
• memory restoration;
• reducing the severity of dystrophic and morphological changes in various parts of the brain.

Mexidol is also a remedy that effectively eliminates the symptoms that occur during withdrawal states.

It relieves manifestations of intoxication caused by alcohol withdrawal (both neurological and neurotoxic), restores behavioral disorders, normalizes autonomic functions, removes or reduces the severity of cognitive impairment caused by prolonged alcohol consumption or abrupt cessation of it.

Pharmacokinetics

After intramuscular injection, the active substance Mexidol is determined in the blood plasma for another four hours. The time during which maximum plasma concentration is achieved ranges from 0.45 to 0.5 hours.

Mexidol is quickly absorbed from the bloodstream into various tissues and organs and is just as quickly eliminated from the body: the average retention time of ethylmethylhydroxypyridine succinate varies from 0.7 to 1.3 hours.

Biotransformation of ethylmethylhydroxypyridine succinate occurs in the liver. As a result, phosphate-3-hydroxypyridine, glucurone conjugates and other metabolic products are formed. Moreover, some of them are characterized by pharmacological activity.

The drug is excreted primarily in the urine and mainly in glucuron-conjugated form. A small amount of it is excreted unchanged.

According to the annotation for Mexidol, there are no significant differences in the pharmacokinetic profiles of ethylmethylhydroxypyridine succinate when taking a single dose and undergoing a course of treatment.

After oral administration of Mexidol ethylmethylhydroxypyridine succinate tablets, it is quickly absorbed, quickly distributed in various tissues and organs, and quickly eliminated from the body.

After 4.9 to 5.2 hours after taking the tablet, its active substance is no longer detectable in the patient’s blood plasma.

After biotransformation in the liver through conjugation with glucuronic acid, five metabolites are formed. Specifically, phosphate-3-hydroxypyridine, which is then broken down by alkaline phosphatase into 3-hydroxypyridine and phosphoric acid.

In addition, a pharmacologically active substance is formed in large quantities, which is determined in the patient’s urine even hours after taking the drug, two glucuron conjugates and a substance that is excreted from the body in large quantities in the urine.

The half-life of Mexidol after oral administration varies from 2 to 2.6 hours.

The substance is excreted mainly in the urine in the form of metabolites (this process is especially intense in the first four hours after administration) and only a small part of it is excreted unchanged.

Excretion rates in urine of the drug in unchanged form and in the form of metabolic products are characterized by individual variability.

Indications for use of Mexidol

Indications for the use of Mexidol injections (intravenously or intramuscularly):

• acute circulatory disorders in the brain;
• traumatic brain injuries (injections of the drug are also prescribed to relieve or reduce the severity of the consequences of traumatic brain injuries);
• slowly progressive insufficiency of cerebral blood supply (dyscirculatory encephalopathy);
• neurocirculatory (vegetative-vascular) dystonia syndrome;
• mild forms of cognitive dysfunction of atherosclerotic origin;
• anxiety disorders that accompany neurotic and neurosis-like (pseudo-neurotic) conditions;
• acute myocardial infarction (the drug is prescribed from the first days in the form of droppers or intramuscular injections as part of a complex of therapeutic measures);
• open-angle glaucoma of the primary type (Mexidol in ampoules is intended for the treatment of the disease at various stages, complex therapy is considered the most effective);
• alcohol withdrawal syndrome, characterized by a predominance of pseudoneurotic and vegetative-vascular disorders;
• symptoms of intoxication of the body with antipsychotic drugs;
• purulent-inflammatory processes occurring in an acute form in the abdominal cavity (including necrotizing pancreatitis or peritonitis; the drug is prescribed as part of a complex of therapeutic measures).

Indications for the use of Mexidol tablets:

• consequences of acute circulatory disorders in the brain, including the consequences of TIA (transient ischemic attack), as well as as a prophylactic agent at the stage of decompensation of diseases caused by cerebral circulatory disorders;
• minor traumatic brain injuries and their consequences;
• non-inflammatory brain diseases (encephalopathies) of various origins (for example, dyscirculatory or post-traumatic);
• anxiety disorders that accompany neurotic and pseudoneurotic conditions;
• ischemic disease (as part of a complex of therapeutic measures);
• alcohol withdrawal syndrome, manifested mainly in the form of pseudoneurotic, vegetative-vascular and post-abstinence disorders;
• symptoms of antipsychotic drug poisoning;
• asthenic syndrome.

Also, an indication for the use of the drug in tablet form is the presence of a sympomocomplex in the patient, caused by the impact of stress factors on the body.

In addition, for preventive purposes, Mexidol is indicated for patients who have a high risk of developing somatic diseases due to exposure to extreme factors and stress.

The mechanism of action of Mexidol is determined by its antihypoxic, antioxidant and membrane protective properties. Therefore, to the questions “What are Mexidol tablets for?” and “When is Mexidol solution effective?”, experts answer that prescribing the drug is considered the most appropriate and successful for:

Contraindications for Mexidol

Contraindications to the use of the drug are:

• hypersensitivity to ethylmethylhydroxypyridine succinate or any of the auxiliary components;
• acute liver failure;
• acute renal failure.

Side effects of Mexidol

The drug is well tolerated and quite rarely provokes certain undesirable effects.

Side effects, which in some cases may occur after taking Mexidol in solution form:

Side effects that are potentially possible after taking Mexidol tablets include:

Also, the drug sometimes increases or decreases blood pressure, provokes emotional reactivity, distal hyperhidrosis, impaired coordination and the process of falling asleep.

Instructions for use of Mexidol: method and dosage

Mexidol injections, instructions for use. How to administer intramuscularly and intravenously

The drug in the form of an injection solution is intended for administration intramuscularly or into a vein (by jet or drip infusion). If Mexidol is prescribed for intravenous administration, the contents of the ampoule should be diluted in an isotonic sodium chloride solution.

A jet infusion involves administering a solution over five to seven minutes; the drug is administered by drip at a rate of forty to sixty drops per minute. In this case, the maximum permissible dose should not exceed 1200 mg per day.

Before injecting intramuscularly or administering the drug intravenously, you should read the instructions. The optimal dosage of Mexidol in ampoules is selected individually in each specific case, depending on the patient’s diagnosis and the nature of the course of his disease.

Dosing of Mexidol in solution form

Acute cerebral circulatory disorders: from 200 to 500 mg by drip into a vein two to four times a day for days.

Next, the drug should be administered intramuscularly. As indicated in the instructions, this method of treatment is the most effective. The solution is administered intramuscularly for two weeks, two or once a day, at a dose of 200 to 250 mg.

Elimination of the consequences of traumatic brain injuries: the drug is administered by drip in a dose of 200 to 500 mg. The frequency of administrations is from 2 to 4, the duration of treatment is from 10 to 15 days.

Slowly progressive insufficiency of cerebral blood supply at the stage of decompensation: the drug is administered by drop or jet method once or twice a day for two weeks.

The dose is selected individually and varies from 200 to 500 mg. Further treatment involves the appointment of intramuscular injections: over the next 14 days, the patient is administered from 100 to 250 mg of Mexidol per day.

As a prophylactic against discirculatory encephalopathy: the drug is prescribed for injection into the muscle, the daily dose is from 400 to 500 mg, the frequency of administration is 2, the duration of the therapeutic course is two weeks.

Mild cognitive impairment in elderly patients and anxiety disorders: the solution is injected into the muscle, the daily dose varies from 100 to 300 mg, the duration of the therapeutic course is from two weeks to one month.

Acute myocardial infarction (in combination with other therapeutic measures): the medicine is injected into a muscle or vein over two weeks in combination with traditional measures taken to treat patients with myocardial infarction.

In the first five days of the therapeutic course, it is recommended to administer the drug intravenously by drip infusion, then you can switch to intramuscular injections (injections continue to be given for nine days).

When administered by infusion, Mexidol is diluted in an isotonic solution of sodium chloride or in a 5% glucose solution. The recommended volume is from 100 to 150 ml, the infusion time can vary from half an hour to an hour and a half.

In cases where this is necessary, the solution can be administered by drip (the duration of the infusion should be at least five minutes).

Both intravenously and intramuscularly, the drug should be administered three times a day with an interval of eight hours. The optimal dose is from 6 to 9 mg per day per kilogram of the patient’s body weight. Accordingly, a single dose is 2 or 3 mg per kilogram of body weight.

In this case, the maximum permissible daily dose should not exceed 800 mg, and a single dose should not exceed 800 mg.

Open-angle glaucoma (for various stages of the disease in combination with other therapeutic measures): the drug is administered intramuscularly for two weeks, the daily dose varies from 100 to 300 mg, the frequency of injections is from 1 to 3 during the day.

Alcohol withdrawal: method of administration - drip infusion or intramuscular injections, daily dose varies from 200 to 500 mg, frequency of injections - 2 or 3 per day. The duration of the therapeutic course is from 5 to 7 days.

Intoxication with antipsychotic drugs: route of administration - intravenously, daily dose - from 200 to 500 mg, duration of the therapeutic course - from one to two weeks.

Acute purulent inflammatory processes of the abdominal cavity: the drug is indicated for use both on the first day before surgery and on the first day after the operation. Method of administration: intravenous drip and intramuscular injection.

The dose is selected depending on the severity and form of the disease, the extent of the lesion, and the characteristics of the clinical picture. It varies from 300 (for mild necrotizing pancreatitis) to 800 mg (for extremely severe disease) per day.

Discontinuation of the drug should be carried out gradually and only after achieving a stable positive clinical and laboratory effect.

Mexidol tablets, instructions for use

Mexidol tablets are intended for oral administration. The daily dose varies from 375 to 750 mg, the frequency of doses is 3 (one or two tablets three times a day). The maximum permissible dose is mg per day, which corresponds to 6 tablets.

The duration of treatment depends on the disease and the patient’s body’s response to the prescribed treatment. As a rule, it ranges from two weeks to one and a half months. In cases where the drug is prescribed to relieve symptoms of alcohol withdrawal, the duration of the course is from five to seven days.

In this case, abrupt discontinuation of the drug is unacceptable: treatment is stopped gradually, reducing the dose over two to three days.

At the beginning of the course, the patient is prescribed to take one or two tablets per dose, once or twice a day. The dose is gradually increased until a positive clinical effect is obtained (it should not exceed 6 tablets per day).

The duration of the therapeutic course in patients diagnosed with ischemic disease is from one and a half to two months. If necessary, a second course may be prescribed as prescribed by a doctor. The optimal time to prescribe a repeat course is autumn and spring.

Overdose

The instructions warn that a medicine such as Mexidol, if the recommended dose is exceeded, can provoke the development of drowsiness.

Interaction

The drug is compatible with all drugs that are used to treat somatic diseases.

When used simultaneously with benzodiazepine derivatives, antidepressant, neuroleptic, tranquilizing, anticonvulsant (for example, carbamazepine) and antiparkinsonian (levodopa) drugs, their effect on the body increases.

This allows you to significantly reduce the doses of the latter, as well as reduce the likelihood of the development and severity of unwanted side effects (which is why Mexidol is prescribed to certain categories of patients).

The drug reduces the severity of the toxic effects of ethanol.

Mexidol and Piracetam: compatibility

Piracetam as an active component is included in the drug Nootropil, which is used to improve cognitive processes of the brain.

The combined administration of Nootropil and Mexidol allows one to achieve better results in increasing mental abilities in children, restoring patients after an ischemic stroke or coma, treating chronic alcoholism, psycho-organic syndrome (including in elderly patients with reduced memory, mood lability, behavioral disorders) etc..

It should be noted, however, that in contrast to nootropic drugs (and, in particular, Nootropil), Mexidol does not have an activating effect on the body, does not provoke sleep disturbances or increased convulsive activity.

In terms of its therapeutic effectiveness, it is significantly superior to Piracetam.

Compatibility of Mexidol and Actovegin

Mexidol and Actovegin have a similar mechanism of action, so they are often prescribed in combination with each other. However, since Actovegin is made from calf blood, it is somewhat more likely than Mexidol to provoke certain side effects.

Actovegin at the molecular level accelerates the processes of utilization of oxygen and glucose, thereby increasing the body's resistance to hypoxic conditions and helping to increase energy metabolism.

Compatibility of Cavinton and Mexidol

The active component of Cavinton is Vinpocetine, which is synthesized from vincamine, an alkaloid of the perennial plant Vinca minor. The substance has the ability to dilate blood vessels, improve blood circulation in the brain, and has a pronounced antiaggregation and antihypoxic effect.

In addition, Vinpocetine is able to influence metabolic processes occurring in brain tissue and reduces platelet aggregation (or, in other words, sticking together), thereby improving its rheological properties.

Terms of sale

The drug is classified as a prescription drug.

Storage conditions

Mexidol should be stored in a dry place, protected from light and out of reach of children, at a temperature of no more than 25°C.

Best before date

Mexidol tablets and solution are suitable for use for 3 years. After the expiration of the period indicated on the packaging, their use is prohibited.

special instructions

Solution for intramuscular and intravenous administration

In patients with a predisposition to allergic reactions, with increased sensitivity to sulfites, as well as in people with bronchial asthma, severe hypersensitivity reactions may develop during treatment.

Mexidol tablets

During the course of treatment with Mexidol tablets, special care should be taken when driving and performing work that poses a danger to health and life. This is due to the fact that the drug has the ability to slow down the speed of psychomotor reactions and reduce concentration.

Mexidol's analogs

Many patients often have the question “What can replace the drug prescribed by a doctor and are there cheaper analogues?”

Analogs of Mexidol in tablets:

Analogues of the drug in ampoules are:

Quite often, patients have a question: which analogue of the drug prescribed to them is better, cheaper, has fewer side effects, etc. Therefore, it is worth considering this topic in detail.

Which is better: Actovegin or Mexidol?

The drugs are used in similar areas of medicine. For this reason, to achieve a more pronounced clinical effect, patients are prescribed them in combination.

Which is better: Cavinton or Mexidol?

Both Cavinton and Mexidol are complementary drugs, so they are often prescribed in combination to eliminate the consequences of circulatory disorders in the brain.

The main requirement is that the drugs should not be mixed in the same dropper or in the same syringe.

Which is better: Mexidol or Mexicor?

Mexicor is a generic (synonym) of Mexidol. Therefore, the drug is used in the same areas of medicine as Mexidol. It is available in the form of gelatin capsules, tablets and solution for injection.

Mexicor effectively relieves anxiety, relieves fears and improves mood, improves memory, attention, increases performance and learning abilities, eliminates symptoms of alcohol intoxication and reduces the pathological consequences of a stroke.

The drug belongs to the group of metabolic cardiocytoprotectors. The mechanism of its action is due to the fusion in its composition of the antihypoxant succinate and the antioxidant emoxypine, which is characterized by a wide spectrum of action.

In combination with other therapeutic measures, Mexicor is indicated for the treatment of myocardial ischemia and ischemic stroke. It is also recommended to be prescribed in the treatment of mild and moderately severe cognitive disorders and to reduce the severity of symptoms of dyscirculatory encephalopathy.

Mexiprim and Mexidol - which is better?

Mexiprim is the German analogue of Mexidol. Its manufacturer is STADA Arzneimittel AG. The main difference between the drugs is the composition of the auxiliary components of the core and shell of the tablets. Their mechanism of action and indications for use are similar.

Mexidol or Mildronate - which is better?

Mildronate belongs to the group of drugs that improve metabolism and energy supply to tissues. It is available in the form of gelatin capsules, solution for injection and syrup for oral administration.

The active ingredient of the drug is meldonium (trimethylhydrazinium propionate), which is similar in structure to gamma-butyrobetaine (a substance present in every cell of a living organism).

Mildronate is used as a vasodilator. In addition, the drug improves the supply of oxygen to organs and tissues, improves humoral and tissue immunity, and reduces blood pressure.

Mexidol and Mildronate, according to the doctor’s decision, can be prescribed as part of combination therapy to treat patients with:

Synonyms

• film-coated tablets and solution for intravenous and intramuscular administration of Medomexi;
• solution for intravenous and intramuscular administration Mexidant;
• film-coated tablets and solution for intravenous and intramuscular administration of Mexiprim;
• Mexifin injection solution and tablets;
• solution for intravenous and intramuscular administration Neurox;
• Mexipridor injection solution and tablets;
• solution for intravenous and intramuscular administration and Mexicor capsules.

Prescription of the drug Mexidol for children

The drug is not prescribed to children and adolescents due to insufficient knowledge of the effect of ethylmethylhydroxypyridine succinate on the children's body.

Mexidol and alcohol

Mexidol is a drug that has a powerful antioxidant effect. For this reason, it is widely used in a wide variety of branches of medicine, including surgery, psychiatry, neurology, etc.

To the question “What is the medicine Mexidol for?” an experienced specialist will answer that the latter effectively restores the function of the neurological and psychological sphere and, in addition, helps to renew and maintain the functional activity of liver cells.

Due to the ability of the drug to have a hepatoprotective and nootropic effect, the prescription of Mexidol is one of the most common methods of treating alcohol withdrawal syndrome, which develops against the background of intoxication of the body with ethyl alcohol.

It is believed that Mexidol and alcohol are compatible. Some are inclined to believe that the drug even partially neutralizes the effect of the latter. However, this opinion is erroneous, since the active substance Mexidol, penetrating into the tissues of the brain and liver, only relieves existing symptoms of intoxication and eliminates pathology, but does not protect cells.

That is, the drug does not prevent the occurrence of unwanted symptoms of alcohol intake, but only eliminates its consequences:

• reduces the severity of headaches;
• reduces the severity of symptoms of intoxication;
• accelerates the process of removing toxic substances and fusel oils contained in alcohol from the liver.

However, Mexidol cannot protect against liver cirrhosis or irreversible mental disorders if a person continues to drink alcohol in the same doses.

Mexidol during pregnancy and lactation

Pregnancy and lactation are contraindications to the use of Mexidol. This is due to the fact that strictly controlled studies of the effect of the drug on pregnant and lactating women have not been conducted.