Treatment of acute cerebral ischemias: paroxysmal transient ischemia (TIA) and ischemic stroke and post-stroke conditions when parenteral therapy is needed. Treatment of chronic circulatory disorders in choroid and retina (eg thrombosis, central artery occlusion or retinal vein). Treatment of senile dementia of hearing of vascular origin or caused by toxic effects of drugs or other types of senile hearing dullness (spontaneous as a result of noise), Meniere's disease and tinnitus.
Composition:
1 amp. (2 ml) contains 10 mg of vinpocetine. The product contains: sorbitol, benzyl alcohol, sodium metabisulfite.
Action:
Vinpocetine is a compound with a complex mechanism of action, positively influencing brain metabolism and blood flow in the brain, as well as the rheological properties of blood. Stimulates brain metabolism: increases Glucose transport across the blood-brain barrier, increases the consumption of glucose and oxygen by the brain tissue, increases the cell's tolerance to hypoxia. It accelerates the metabolic cycle of norepinephrine and serotonin in the brain. It inhibits platelet aggregation, reduces pathologically increased blood viscosity, increases the ability to deform erythrocytes and inhibits the uptake of adenosine by erythrocytes, facilitates the transport of oxygen to the brain tissue by reducing the affinity of oxygen to erythrocytes. Selectively increases blood flow through cerebral vessels. It does not have the effect of stealing - it causes the perfusion of areas with impaired blood supply, without causing changes in places with proper blood flow. In addition, Vinpocetine has a protective effect on the nervous tissue: it alleviates the detrimental effect of cytotoxic reactions caused by amino acids, has antioxidant effects. T0,5 vinpocetine is 4.83 ± 1.29 h. The drug is excreted mainly in urine (60%) and faeces (40%).
Contraindications:
Hypersensitivity to vinpocetine or to any of the excipients. Pregnancy and breastfeeding. Children (no clinical trials in this age group). Acute haemorrhagic stroke. Severe ischemic heart disease. Severe heart rhythm disturbances.
Precautions:
In patients with increased intracranial pressure, patients taking anti-arrhythmic drugs, and patients with an irregularity and QT prolongation syndrome, the drug can only be used after careful consideration of the benefit to the possible risk of therapy. In patients with long QT syndrome or those taking drugs that prolong the QT interval, ECG monitoring is recommended. Due to the sorbitol content in the solution (160 mg / 2 ml), the blood glucose level should be determined in diabetic patients treated with the preparation. Do not use in patients with fructose intolerance or fructose-1,6-diphosphate phosphatase deficiency. Due to the content of benzyl alcohol (20 mg / 2 ml), the preparation may cause poisoning and anaphylactoid reactions in infants and children up to 3 years old; do not give to premature babies and newborns. Due to the content of sodium metabisulfite, the preparation may cause severe allergic reactions and bronchospasm.
Pregnancy and lactation:
Use during pregnancy and breastfeeding is contraindicated.
Side effects:
Common: changes in blood pressure (mainly lowering of pressure), head blows, phlebitis. Uncommon: sleep disorders (insomnia, drowsiness), headache and dizziness, weakness, sweating, ST depression, QT prolongation, tachycardia and additional heart contraction, nausea, heartburn, dry mouth, increased liver enzymes, skin reactions hypersensitivity. Rare: abdominal pain, leukopenia.
Dosage:
Intravenously, only in a slow drip infusion. Adults: the initial daily dose is usually 20 mg diluted in 500 ml of infusion solution. The dose can be increased to 1 mg / kg / day, over 2-3 days, depending on the patient's tolerance. The infusion rate should not exceed 80 drops / min. The duration of treatment is usually 10-14 days, and the usual daily dose for a patient of about 70 kg is 50 mg / day (5 amp in 500 ml solution for infusion).No dose adjustment is required in patients with impaired hepatic or renal function. The preparation can be diluted in physiological infusion solutions containing sodium chloride or glucose. The solution for infusion should be used within 3 hours after preparation. Do not administer the injection by intramuscular injection. Do not administer intravenously undiluted preparation. After completion of intravenous therapy, it is recommended to continue treatment with Cavinton in the oral form, at a dose of 1 tablet. Cavinton Forte (10 mg) 3 times a day or 2 tablets. Cavinton (5 mg) 3 times a day.
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