Pharmacodynamics
Piracetam has positive influence on metabolic processes of the brain. Increases the concentration of ATP in brain tissue, enhances the biosynthesis of ribonucleic acid and phospholipids, stimulates glycolytic processes, enhances glucose utilization. The drug improves the integrative activity of the brain, helps improve memory, and has protective effect at various forms cerebral hypoxia, facilitates the learning process. Piracetam improves connections between the cerebral hemispheres and synaptic conduction in neocortical structures, restores and stabilizes cerebral functions, especially consciousness, memory and speech, increases mental performance, improves cerebral blood flow.
Pharmacokinetics
After intravenous intramuscular injection Piracetam is distributed in all organs and tissues. Penetrates the blood-brain barrier and accumulates in brain tissue. From cerebrospinal fluid is excreted much more slowly than from other tissues, which indicates a high tropism for brain tissue. In the body, piracetam practically does not undergo biotransformation. It is excreted mainly by the kidneys.
Indications for use
Piracetam is used intramuscularly or intravenously for severe cerebral diseases, comatose states, in the treatment of poisoning, relief of withdrawal symptoms, pre- and delirious states, or acute complications during the period of psychopharmacotherapy.
Directions for use and dosage regimen
The drug is administered intramuscularly or intravenously to adults, starting from 2-4 g, quickly increasing the dose to 4-6 g per day. The duration of treatment and the choice of individual dose depend on the severity of the patient’s condition and the rate of reverse dynamics of the clinical picture of the disease. During treatment ischemic stroke Piracetam is prescribed intravenously in doses of 4-12 g per day for 2-4 weeks.
After the condition improves, they proceed to the appointment dosage forms piracetam for oral administration.
In the treatment of acute brain lesions, piracetam is prescribed in combination with other methods of detoxification and rehabilitation therapy, and in the treatment of psychiatric diseases - with appropriate psychotropic drugs.
Treatment with piracetam, if necessary, can be combined with the use of psychotropic, cardiovascular and other medicines.
special instructions
The drug affects the ability to drive vehicles.
Side effect
Side effects are most often observed when the drug is prescribed in doses of more than 5 g per day. Possible increased irritability, agitation, sleep disturbance, headache, dyspeptic disorders, sexual stimulation, increased physical activity, in elderly patients, exacerbation is occasionally observed coronary insufficiency. In these cases, the dose should be reduced or the drug should be discontinued.
Contraindications
Acute renal failure, depression with anxiety (agitated depression), Huntington's disease, pregnancy and breastfeeding. The use of piracetam is contraindicated in children under 1 year of age.
Precautionary measures
In patients with renal failure, residual nitrogen and creatinine should be determined; in patients with liver disease - laboratory parameters, characterizing functional state liver.
Use with caution when serious illnesses of cardio-vascular system with severe arterial hypotension, liver and kidney dysfunction. In patients receiving antiepileptic drugs, piracetam should be used against the background of ongoing primary therapy with antiepileptic drugs, since the seizure threshold may be lowered in predisposed patients.
Interaction with other drugs
Piracetam enhances the effects of hormones thyroid gland, antipsychotics, antidepressants, a number of other psychotropic and stimulant drugs, drugs that increase cerebral circulation and indirect anticoagulants; antianginal drugs (in elderly patients). Weakens the effect of anticonvulsants.
Overdose
In case of overdose, side effects may increase.
Release form
Solution for injection 20% in 5 ml ampoules in blister packs No. 5x1, No. 5x2.
APPROVED
By order of the chairman
Pharmaceutical Control Committee
Ministry of Health
Republic of Kazakhstan
From "____" __________ 200__g
№ _________________
Instructions for medical use
Medicine
PIRACETAM
Tradename
Piracetam
International nonproprietary name
Piracetam
Dosage form
Solution for injection 20% - 5 ml
Compound
1 ml of solution contains
active substance - piracetam - 0.2 g,
Excipients: sodium acetate trihydrate, acetic acid, water for injection.
Description
Transparent colorless or slightly colored liquid.
Pharmacotherapeutic group
Other psychostimulants and nootropics.
PBX code N06BX03
Pharmacokinetics.
After administration, piracetam is well absorbed and penetrates into various organs and fabrics. The maximum concentration in human blood is observed 1 hour after intramuscular administration. Penetrates the blood-brain and placental barriers; selectively accumulates in the cerebral cortex (mainly in the frontal, parietal lobes, cerebellum and basal ganglia) as well as in internal organs. Accumulates in brain tissue within 1 to 4 hours. It is excreted from the cerebrospinal fluid much more slowly than from other tissues, which indicates a high tropism for brain tissue. In the body, piracetam practically does not undergo biotransformation and is excreted unchanged by the kidneys. The half-life is 4.5 - 5 hours. Bioavailability, regardless of the dosage form, is about 100%. In patients with renal failure, the half-life is prolonged.
Pharmacodynamics
Piracetam is nootropic drug. Has a positive effect on the metabolic processes of the brain. Increases the concentration of ATP in brain tissue, enhances the biosynthesis of ribonucleic acid and phospholipids, stimulates glycolytic processes, enhances glucose utilization. The drug improves the integrative activity of the brain, helps improve memory, has a protective effect in various forms of cerebral hypoxia, and facilitates the learning process. The effect develops gradually. It has virtually no sedative or psychostimulating effects.
Indications for use
In neurological practice:
Vascular diseases of the brain (atherosclerosis, arterial hypertension, vascular parkinsonism), with symptoms of chronic cerebrovascular insufficiency, manifested in disturbances of memory, attention, speech, dizziness and headache)
Violations cerebral circulation
Post-traumatic comatose and subcomatous states of vascular, traumatic and various origins
Memory impairment, decreased concentration in old age
In psychiatric practice:
Depressive states with a predominance in clinical picture signs of adynamia, asthenic and senesto-hypochondriacal disorders, phenomena of idiomotor retardation
Sluggish-apathetic defective states
Senile and atrophic processes
Mental illnesses (as part of complex therapy)
Epilepsy
Cortical myoclonus
In drug treatment practice:
Relief of withdrawal, pre- and delirious states in alcoholism and drug addiction - acute poisoning alcohol, morphine, barbiturates, phenamine, etc.
Chronic alcoholism with symptoms of persistent mental disorders.
In pediatric practice:
Consequences perinatal lesion central nervous system
Children's cerebral paralysis
Low learning ability in psychoorganic syndrome
Delay mental development, mental retardation, speech disorder, memory impairment, intellectual disability, cerebrovascular disease
Sickle cell anemia (as part of combination therapy).
Directions for use and doses
Piracetam is administered intramuscularly and intravenously, starting from 2-4 g, quickly increasing the dose to 4-6 g per day.
At acute conditions intravenously via drip, over 20-30 minutes - up to 12 g/day; after improvement, the dose is gradually reduced and switched to oral administration.
For stroke - 12 g per day for 2 weeks, maintenance dose 4.8 g per day; at long-term therapy psychoorganic syndrome in elderly patients - 4.8 g per day for several weeks, then 1.2-2.4 g per day.
For cortical myoclonus, treatment begins with a dose of 7.2 g/day, every 3-4 days the dose is increased by 4.8 g/day until maximum dose 24 g/day 2-3 times a day, orally or parenterally. Every 6 months the dose should be reduced by 1.2 g every 2 days. Abrupt withdrawal of the drug may cause resumption of attacks.
At chronic alcoholism- 12 g per day during the period of manifestation of withdrawal syndrome, maintenance dose of 2.4 g.
For sickle cell anemia - 160 mg/kg/day in 4 divided doses.
Children are prescribed at a dose of 30-50 mg/kg/day. After clinical improvement, the dose is gradually reduced and switched to oral administration. The duration of treatment ranges from 7-10 days to 2 weeks, then it is advisable to switch to oral dosage forms. If sleep disturbances occur, it is recommended to discontinue the evening dose of the drug and add this dose to the daytime dose.
During the period of taking the drug, constant monitoring of kidney function indicators is recommended. In chronic renal failure with a creatinine clearance of 50-79 ml/min, 2/3 of the usual dose is prescribed in 2-3 doses, with a creatinine clearance of 30-49 ml/min - 1/3 of the dose in 2 doses, with a creatinine clearance of 20-30 ml /min -1/6 dose once.
Mental agitation, motor disinhibition, irritability, imbalance, decreased ability to concentrate, anxiety, insomnia or drowsiness, depression, hyperkinesis, ataxia, dizziness, headache, extrapyramidal disorders, convulsions, tremor
Gastralgia, nausea, vomiting, constipation or diarrhea, decreased appetite
Arterial hypo- or hypertension, worsening angina pectoris
Dermatitis, itching, rash
Increased sexual activity
Weight gain, asthenia.
Side effects are most often observed when using doses above 5 g/day.
Contraindications
Hypersensitivity to the drug
Hemorrhagic stroke
Severe renal failure (creatinine clearance less than 20 ml/minute)
Depression with anxiety
Huntington's disease
Hemostasis disorders
Latin name
Release form
Injection
1 solution contains:
active substance: piracetam - 200.0 g
excipients: sodium acetate, diluted acetic acid - to pH 5.0-5.8, water for injection
Package
10 ampoules of 5 ml
pharmachologic effect
Piracetam activates in the central nervous system associative processes, improves mood, memory and mentality in patients and healthy people. Stimulates intellectual activity and integrative activity of the brain, facilitates learning processes, improves connections between the cerebral hemispheres and synaptic conduction in the cortex, increases mental performance, stabilizes and restores impaired brain functions (memory, consciousness, speech). Piracetam normalizes the ratio of ADP and ATP (inhibits nucleotide phosphatase and activates adenylate cyclase), increases the activity of phospholipase A, stimulates bioenergetic and plastic processes in nervous tissue, and accelerates the exchange of neurotransmitters.
Piracetam increases the resistance of brain tissue to toxic effects and hypoxia, enhances the synthesis of phospholipids and nuclear RNA, enhances glycolytic processes and glucose utilization in the brain. Piracetam blocks platelet aggregation, improves microcirculation, optimizes the ability of red blood cells to pass through microvessels and the conformational properties of the red blood cell membrane, and increases regional blood flow in ischemic areas of the brain. Piracetam increases beta and alpha activity on the EEG and decreases delta activity. Reduces vestibular nystagmus. During hypoxia, intoxication, trauma, electroconvulsive effects have a neuroprotective effect.
Due to its antihypoxic effect, piracetam is effective in complex treatment myocardial infarction. Piracetam does not have anxiolytic or sedative effects.
Piracetam is absorbed almost completely and quickly after oral administration. Bioavailability is 100%. When taken orally 2 g of the drug maximum concentration in plasma is 40-60 mcg/ml after 30 minutes. Piracetam does not bind to plasma proteins. After 2-8 hours, the maximum concentration in the liquor is created. Piracetam penetrates into all tissues and organs, and penetrates the placental barrier. Almost not metabolized. Selectively accumulates in the cerebral cortex, mainly in the parietal, frontal and occipital lobes, basal ganglia and cerebellum. The half-life of piracetam from plasma is 4-5 hours; from the cerebrospinal fluid is 6-8 hours. More than 95% of the drug is excreted unchanged by the kidneys after 30 hours. In patients with renal failure, the half-life is prolonged.
Indications
- Chronic cerebrovascular insufficiency ( hypertonic disease, atherosclerosis, vascular parkinsonism), which is accompanied by impaired attention, memory, speech, headache and dizziness;
- ischemic stroke and its consequences;
- psychoorganic disorders;
- dementia ( senile dementia, Alzheimer's disease, vascular dementia);
- traumatic brain injury;
- acute viral neuroinfection;
- intoxication ( recovery period, comatose and subcomatose state);
- diseases of the nervous system, which are accompanied by a decrease in the level of wakefulness, intellectual-mnestic functions, behavioral disturbances and emotional-volitional sphere;
- dizziness;
- vestibular nystagmus;
- lethargic state;
- aphasia;
- cortical myoclonus;
- epilepsy (as aid);
- senile and atrophic processes;
- depressive states who are resistant to treatment with antidepressants;
- prevention or elimination of neurological, somatovegetative, mental complications of treatment with antipsychotics and others psychotropic drugs;
- neurotic depression with a predominance in the clinical picture of senesto-hypochondriacal and asthenic disorders, adynamia, and phenomena of ideomotor retardation;
- psychoorganic syndrome in chronic alcoholism;
- relief of pre- and delirious, withdrawal states in drug addiction and alcoholism;
- acute intoxication with morphine, ethanol, amphetamine, barbiturates;
- in children - cerebral palsy, consequences of perinatal damage to the central nervous system, mental retardation, low learning ability in psychoorganic syndrome, speech disorder, mental retardation, memory impairment, cerebrovascular disease, intellectual disability;
- sickle cell anemia (as part of complex treatment).
Contraindications
Hypersensitivity (including to pyrrolidone derivatives), severe renal failure (with creatinine clearance less than 20 ml/min), hemorrhagic stroke, Huntington's disease, agitated depression, breastfeeding, pregnancy, age under 1 year.
Use during pregnancy and breastfeeding
Taking piracetam is contraindicated during pregnancy. When taking piracetam, you should stop breast-feeding, since the drug passes into breast milk.
Directions for use and doses
The drug is prescribed intramuscularly or intravenously.
Use of piracetam in adults:
In the treatment of cerebrovascular disorders in acute phase the drug should be prescribed as early as possible, at a dose of 12 g per day for 2 weeks, and then 4.8-6 g per day.
For cortical myoclonus, treatment begins with a dose of 7.2 g per day, every 3-4 days the dose is increased by 4.8 g per day until a maximum dose of 24 g per day is reached, 2-3 times a day, orally or parenterally. Every 6 months the dose should be reduced by 1.2 g every 2 days.
For sickle cell anemia daily dose- 160 mg/kg, divided into 4 equal portions. During a crisis - up to 300 mg/kg.
For alcoholism - 12 g per day during the period of manifestation of ethanol “withdrawal” syndrome; maintenance dose - 2.4 g.
When treating comatose states, in the post-traumatic period, the initial dose is 9-12 g per day, maintenance dose is 2.4 g, the course of treatment is 3 weeks.
Side effects
Nervous system and sensory organs: hyperkinesia, drowsiness, increased irritability, depression, agitation, asthenia, aggressive behavior, dizziness, sleep disorder, headache, tremor, increased sexuality;
Digestive system: nausea, diarrhea, vomiting, abdominal pain;
Dosage form
The solution for intravenous and intramuscular administration is transparent, colorless or slightly colored.
Compound
1 ml 1 amp.
Piracetam 200 mg 1 g
Excipients: sodium phosphate monosubstituted, potassium phosphate disubstituted, water d/i.
Pharmacodynamics
Nootropic drug. It has a positive effect on metabolic processes and blood circulation in the brain. Increases glucose utilization, improves flow metabolic processes, improves microcirculation in ischemic areas, inhibits aggregation activated platelets. It has a protective effect against brain damage caused by hypoxia, intoxication, and electric shock. Improves integrative brain activity. Does not have a sedative or psychostimulating effect.
Pharmacokinetics
When taken orally, it is quickly and almost completely absorbed from the gastrointestinal tract. Cmax in plasma is reached after approximately 30 minutes, in cerebrospinal fluid - after 2-8 hours. The apparent Vd is 0.6 l/kg. Does not bind to blood plasma proteins.
Distributed in all organs and tissues, penetrates the BBB and the placental barrier. Selectively accumulates in the tissues of the cerebral cortex, mainly in the frontal, parietal and occipital lobes, in the cerebellum and basal ganglia.
T1/2 from plasma is 4-5 hours, from cerebrospinal fluid - 6-8 hours. It is excreted unchanged by the kidneys. In renal failure, T1/2 increases.
Side effects
From the outside digestive system: rarely - dyspeptic symptoms, abdominal pain.
From the side of the central nervous system: rarely - nervousness, agitation, irritability, anxiety, sleep disorders, dizziness, headache, tremor, in some cases - weakness, drowsiness.
Other: increased sexual activity.
Selling Features
prescription
Special conditions
Use with caution in patients with pronounced violation hemostasis, with large surgical operations and severe bleeding; with renal failure.
Indications
Memory impairment, dizziness, decreased concentration, emotional lability, dementia due to cerebrovascular accidents (ischemic stroke), brain injury, Alzheimer's disease, in old age; comatose states of vascular, traumatic or toxic origin; treatment of abstinence and psychoorganic syndrome in chronic alcoholism; learning disabilities in children not associated with inadequate training or characteristics of the family environment (as part of combination therapy); sickle cell anemia (as part of combination therapy).
Contraindications
Hemorrhagic stroke, severe renal failure (with CC<20 мл/мин), повышенная чувствительность к пирацетаму.
Drug interactions
A case of interaction of piracetam with simultaneous use with a thyroid extract containing triiodothyronine and tetraiodothyronine is described, when the patient experienced anxiety, irritability and sleep disorders.
When used simultaneously with thyroid hormones, central effects may develop - tremor, anxiety, irritability, sleep disturbances, and confusion.
With the simultaneous use of central nervous system stimulants, the psychostimulating effect may be enhanced.
When used simultaneously with antipsychotics, an increase in extrapyramidal disorders is observed.
Prices for Piracetam in other cities
Buy Piracetam,Piracetam in St. Petersburg,APPROVED
By order of the chairman
Pharmaceutical Control Committee
Ministry of Health
Republic of Kazakhstan
From "____" __________ 200__g
№ _________________
Instructions for medical use
medicine
PIRACETAM
Tradename
Piracetam
International nonproprietary name
Piracetam
Dosage form
Solution for injection 20% - 5 ml
Compound
1 ml of solution contains
active substance - piracetam - 0.2 g,
Excipients: sodium acetate trihydrate, acetic acid, water for injection.
Description
Transparent colorless or slightly colored liquid.
Pharmacotherapeutic group
Other psychostimulants and nootropics.
PBX code N06BX03
Pharmacological properties
Pharmacokinetics.
After administration, piracetam is well absorbed and penetrates various organs and tissues. The maximum concentration in human blood is observed 1 hour after intramuscular administration. Penetrates the blood-brain and placental barriers; selectively accumulates in the cerebral cortex (mainly in the frontal, parietal lobes, cerebellum and basal ganglia) as well as in internal organs. Accumulates in brain tissue within 1 to 4 hours. It is excreted from the cerebrospinal fluid much more slowly than from other tissues, which indicates a high tropism for brain tissue. In the body, piracetam practically does not undergo biotransformation and is excreted unchanged by the kidneys. The half-life is 4.5 - 5 hours. Bioavailability, regardless of the dosage form, is about 100%. In patients with renal failure, the half-life is prolonged.
Pharmacodynamics
Piracetam is a nootropic drug. Has a positive effect on the metabolic processes of the brain. Increases the concentration of ATP in brain tissue, enhances the biosynthesis of ribonucleic acid and phospholipids, stimulates glycolytic processes, enhances glucose utilization. The drug improves the integrative activity of the brain, helps improve memory, has a protective effect in various forms of cerebral hypoxia, and facilitates the learning process. The effect develops gradually. It has virtually no sedative or psychostimulating effects.
Indications for use
In neurological practice:
Vascular diseases of the brain (atherosclerosis, arterial hypertension, vascular parkinsonism), with symptoms of chronic cerebrovascular insufficiency, manifested in memory impairment, attention, speech, dizziness and headache)
Cerebrovascular disorders
Post-traumatic comatose and subcomatous states of vascular, traumatic and various origins
Memory impairment, decreased concentration in old age
In psychiatric practice:
Depressive states with a predominance in the clinical picture of signs of adynamia, asthenic and senesto-hypochondriacal disorders, phenomena of idiomotor retardation
Sluggish-apathetic defective states
Senile and atrophic processes
Mental illnesses (as part of complex therapy)
Epilepsy
Cortical myoclonus
In drug treatment practice:
Relief of withdrawal, pre- and delirious states in alcoholism and drug addiction - acute poisoning with alcohol, morphine, barbiturates, phenamine, etc.
Chronic alcoholism with symptoms of persistent mental disorders.
In pediatric practice:
Consequences of perinatal damage to the central nervous system
Cerebral palsy
Low learning ability in psychoorganic syndrome
Mental retardation, mental retardation, speech disorder, memory impairment, intellectual disability, cerebrovascular disease
Sickle cell anemia (as part of combination therapy).
Directions for use and doses
Piracetam is administered intramuscularly and intravenously, starting from 2-4 g, quickly increasing the dose to 4-6 g per day.
In acute conditions, intravenously via drip, over 20-30 minutes - up to 12 g/day; after improvement, the dose is gradually reduced and switched to oral administration.
For stroke - 12 g per day for 2 weeks, maintenance dose 4.8 g per day; for long-term therapy of psychoorganic syndrome in elderly patients - 4.8 g per day for several weeks, then 1.2-2.4 g per day.
For cortical myoclonus, treatment begins with a dose of 7.2 g/day, every 3-4 days the dose is increased by 4.8 g/day until a maximum dose of 24 g/day is reached, 2-3 times a day, orally or parenterally. Every 6 months the dose should be reduced by 1.2 g every 2 days. Abrupt withdrawal of the drug may cause resumption of attacks.
For chronic alcoholism - 12 g per day during the period of manifestation of withdrawal syndrome, maintenance dose of 2.4 g.
For sickle cell anemia - 160 mg/kg/day in 4 divided doses.
Children are prescribed at a dose of 30-50 mg/kg/day. After clinical improvement, the dose is gradually reduced and switched to oral administration. The duration of treatment ranges from 7-10 days to 2 weeks, then it is advisable to switch to oral dosage forms. If sleep disturbances occur, it is recommended to discontinue the evening dose of the drug and add this dose to the daytime dose.
During the period of taking the drug, constant monitoring of kidney function indicators is recommended. In chronic renal failure with a creatinine clearance of 50-79 ml/min, 2/3 of the usual dose is prescribed in 2-3 doses, with a creatinine clearance of 30-49 ml/min - 1/3 of the dose in 2 doses, with a creatinine clearance of 20-30 ml /min -1/6 dose once.
Side effects
Mental agitation, motor disinhibition, irritability, imbalance, decreased ability to concentrate, anxiety, insomnia or drowsiness, depression, hyperkinesis, ataxia, dizziness, headache, extrapyramidal disorders, convulsions, tremor
Gastralgia, nausea, vomiting, constipation or diarrhea, decreased appetite
Arterial hypo- or hypertension, worsening angina pectoris
Dermatitis, itching, rash
Increased sexual activity
Weight gain, asthenia.
Side effects are most often observed when using doses above 5 g/day.
Contraindications
Hypersensitivity to the drug
Hemorrhagic stroke
Severe renal failure (creatinine clearance less than 20 ml/minute)
Depression with anxiety
Huntington's disease
Hemostasis disorders
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