The preparation in parenteral forms is indicated in: treatment of cognitive disorders in dementia syndromes excluding Alzheimer's disease and treatment of cortical myoclonus.
Composition:
1 ampoule (15 ml) contains 3 g of piracetam.
Action:
Nootropic medicine - a ring derivative of gamma-aminobutyric acid (GABA), which does not exert sedative or stimulant action. Piracetam improves cognitive abilities (memory, learning, concentration, consciousness) in healthy people and in patients with various types of brain injuries, such as those caused by hypoxia or poisoning. The mechanism of action of the drug has not been thoroughly understood. Piracetam improves the stability of cell membranes, enhances signaling processes through neurons, primarily through modulation of density and receptor activity behind the synapse. In addition, piracetam reduces platelet aggregation, improves erythrocyte elasticity, reduces adhesion to the endothelium of blood vessels and inhibits capillary spasms. Piracetam does not bind to plasma proteins. It penetrates into all tissues (except for adipose tissue). It penetrates the blood-brain barrier and the placental barrier. The maximum concentration in the cerebrospinal fluid reaches after about 5 hours. It is not metabolised in the body. It is excreted mainly in the urine in unchanged form. T0,5 in adults it is about 5 hours after both oral and intravenous use.
Contraindications:
Hypersensitivity to piracetam or other pyrrolidone derivatives and to other components of the preparation. Brain hemorrhage. End-stage renal failure (creatinine clearance less than 20 ml / min). Huntington's chorea.
Precautions:
Exercise caution in patients with haemostatic disorders who undergo major surgery and in patients with severe hemorrhage. Use with caution in patients with impaired renal function. In elderly patients with long-term use, regular creatinine clearance and possible dose modification are necessary. Do not suddenly stop taking piracetam in patients with myoclonus (risk of sudden return of myocloni or generalized seizures).
Pregnancy and lactation:
The drug should not be used during pregnancy unless there are clear indications. Avoid use during breastfeeding.
Side effects:
Common: hyperkinesia, nervousness, weight gain. Uncommon: drowsiness, depression, asthenia. In addition, there were: dizziness, abdominal pain, epigastric pain, diarrhea, nausea, vomiting, ataxia, disturbances of balance, worsening of epilepsy symptoms, headache, insomnia, drowsiness, agitation, anxiety, confusion, hallucinations, pruritus, urticaria , dermatitis, angioneurotic edema, anaphylactoid reactions. There have been rare reports of pain at the injection site, phlebitis with thrombosis, fever or hypotension after intravenous administration.
Dosage:
Intravenously injections.Treatment of cognitive disorders in dementia syndromes with the exception of Alzheimer's disease: 4.8 g daily in 2-3 doses divided by the first weeks of therapy, then reduce the dose by 1.2 g / day to 2.4 g / day.Treatment of cortical myoclonus: the therapy starts with a dose of 7.2 g daily, every 3-4 days the dose is increased by 4.8 g to the maximum dose - 24 g a day. The drug is used in 2-3 divided doses. Every 6 months an attempt should be made to reduce the dose or discontinuation of the drug: the dose should be reduced by 1.2 g every 2 days. Intravenous injection should last several minutes. In renal failure, the dose decreases depending on the degree of inefficiency: at a creatinine clearance of 40-60 ml / min, one-half of the usual dose is used, and at a clearance of 20-40 ml / min - 1/4 of the dose usually used. At the clearance below 20 ml / min, the drug is contraindicated.