Piracetam

Пирацетам Drug photo

The description is actual on 23.06.2016

  • Latin name: Piracetam
  • ATH code: N06BX03
  • Active ingredient: Piracetam (Piracetam)
  • Producer: JSC Dalkhimfarm, LLC Ellara, JSC Novosibkhimfarm, JSC Biokhimik, JSC Sintez, JSC Organika, CJSC Farmproyekt, JSC Biosintez, JSC HFK "Quinacrine, CJSC Severnaya star (Russia); PAO NPTs Borshchagovsky HFZ, JSC Galichfarm, LLC Nicko, JSC Himfarmzavod Krasnaya star, JSC Farmak, CJSC Darnitsa, LLC Zdorovye (Ukraine)

Structure

According to medical Wikipedia the medicine Piracetam includes in the structure as active ingredient nootropic substance with are similar the name piracetam (MNN – Piracetam) in a different mass fraction depending on a dosage form of drug: 1 milliliter of solution for injections – 200 mg, 1 capsule – 200 mg or 400 mg, 1 tablet – 200 mg, 400 mg, 800 mg or 1200 mg.

The additional composition of ingredients can differ a little depending on the manufacturer which is letting out drug that the attending physician appointing this or that medicine also has to consider.

Release form

Pharmaceutical plants of the former Soviet Union make this remedy in three dosage forms: in injection solution in ampoules on 5 milliliters No. 5, No. 10 or No. 20; in capsules No. 10-№120; in tablets No. 10-№600.

Pharmacological action

Neurometabolic (nootropic), psychogogic.

Pharmacodynamics and pharmacokinetics

The summary to Piracetam carries its active ingredient to cyclic derivative GAMK (piperidic acid) which possess the nootropic and psychogogic properties which are well influencing a human brain by means of improvement of its cognitive (cognitive) functionality thereby increasing ability of the person to training, improving his memory, attention and increasing intellectual working capacity.

Today several mechanisms of impact of drug on TsNS from which distinguish are studied: acceleration of metabolic transformations in nervous cells; modulation of speed of carrying out excitement in brain cells; microcirculation improvement, owing to impact on the rheological blood characteristics which are not followed by vasodilating effects.

Also pricks of Piracetam and the tablet Piracetam well influence synaptic conduction in brain neocortical structures and promote improvement of communication between parencephalons; suppress aggregation of thrombocytes; reduce adhesion of erythrocytes and renew elasticity of erythrocyte membranes. The entered piracetam intravenously or intramusculary, as well as orally accepted drug in capsules or tablets (for example, Obolenskoye's Piracetam), in a dose of 9,6 grams lowers the content of fibrinogen and number of factors of Villibrandt for 30-40%, and also increases bleeding duration. At intoxication, a hypoxia and carrying out an electroshock therapy which led to disturbances of functionality of a brain the recovering and tire-tread effect of drug is shown. At a vestibular nystagmus decrease in its duration and expressiveness is noted.

It is unconditional that such extensive effect of Piracetam is demanded in therapy of many diseases / disturbances connected with a brain from what pricks of medicine and its oral administration it is widely applied in modern domestic medicine.

At introduction of 2 grams of piracetam in/in or its Cmax in oil in plasma is observed approximately in half an hour, in cerebrospinal fluid this indicator is noted within 2-8 hours and 40-60 mkg/ml equal. At oral administration of a similar dose time of achievement of Cmax increases approximately twice from what the tablets Piracetam begin to work later. Bioavailability is close to absolute (about 100%). Vd approximately makes 0,6 l/kg. T1/2 from plasma takes 4-5 hours, from cerebrospinal fluid – 6-8 hours. Neither linkng of drug with plasma proteins, nor its metabolic transformations in a human body is noted. Within 80-100% of the accepted dose, by means of glomerular filtering, it is excreted by kidneys in not changed form.

The renal clearance is equal to about 86 ml/minute. Penetration of active ingredient of medicine through placental/hematoencephalic barriers and membranes of filters used when carrying out a hemodialysis is noted. Researches on animals showed the selective accumulation of piracetam in a brain which is observed mainly in its frontal, occipital parietal zones, basal gangliya and a cerebellum.

T1/2 of drug is extended at renal pathologies for what patients with insufficiency of renal function should appoint piracetam in the lowered doses. The pharmacokinetics of this remedy at patients insufficiency of hepatic function did not change.

Indications to Piracetam use

For adult patients of the indication to use of Piracetam in pricks (for the purpose of stopping of acute symptoms), as well as indications to use of tablets (for example, Obolenskoye's Piracetam) or capsules (for prevention and treatment) include:

  • dementia (weak-mindedness) which arose owing to disturbances of blood circulation of a brain (an ischemic stroke);
  • comas of the traumatic, vascular or toxic nature;
  • brain injuries;
  • cortical myoclonia;
  • Alzheimer's disease;
  • the psychoorganic syndrome proceeding with decrease in attention, memory, ability to concentration and activity, frustration of behavior, change of mood, gait disturbance;
  • sickemia, including vazookklyuzionny crisis;
  • vertigo (dizziness) and the balance disturbances interfaced to it (an exception dizzinesses of psychogenic and vasculomotor genesis make);
  • psychoorganic syndrome and abstinence and at alcoholism of chronic character.

Drug is shown to children on purpose:

  • treatments of a dyslexia and the similar painful states which are shown learnability disturbance which is not connected with features of the intra family relations or with inadequate teaching (since 8 years, at some producers since 5 years);
  • therapies of symptomatology of a sickemia, including vazookklyuzionny crisis (since the first year of life).

Contraindications on Piracetam

Contraindications to use of any of dosage forms of drug include:

  • personal hypersensitivity:
  • to trochee of Gentington (Huntington);
  • feeding by a breast;
  • heavy HPN (at KK it is less than 20 ml/min.);
  • pregnancy;
  • hemorrhagic stroke in an acute stage;
  • age till 1st year (it is not appointed for newborns);
  • psychomotor excitement.

Carefully it is necessary to use drug at:

  • disturbances of a hemostasis;
  • HPN (at KK of 20-80 ml/min.);
  • carrying out extensive/serious surgeries;
  • heavy bleedings.

Side effects of Piracetam

In certain cases when carrying out treatment observed the following negative side effects:

Most often side effects of Piracetam passed independently even in the course of carrying out therapy or disappeared at its termination.

Application instruction of Piracetam (Way and dosage)

Piracetam pricks, application instruction

The ampoules including medicine solution are intended for carrying out injections intramusculary (in oil) and intravenously (in/in). Before accepting Piracetam in/in recommend to carry out the test for personal hypersensitivity of the patient to ingredients drugs. Ampoules with injection solution, irrespective of the producer, include 1000 mg (200 mg / 5 ml) active ingredient of a remedy.

Therapy of symptomatology of a psychoorganic syndrome of a chronic current takes from 10 to 15 days. Initially in days, depending on weight of negative displays of a disease, enter 2000-4000 mg with gradual increase of this dosage to 4000-6000 mg.

Treatment of difficulties of perception or comas with the injured brain demands carrying out from patients a minimum of a three-week therapeutic course with introduction of an initial daily dose of 9000-12000 mg and with transition to the supporting treatment in a daily dose of 2000 mg.

Therapy of effects of a stroke carry out in a chronic stage of a disease state for 10-15 days in a daily parenteral dosage 4800 mg. If necessary it is possible to carry out similar course treatment in 6-8 weeks.

Stopping of an abstinence alcoholic syndrome is carried out in an initial daily dose of 12000 mg. Further treatment of this state proceeds using the supporting daily dosage of 2400 mg.

Therapy vertigo and the disturbances of balance interfaced to it takes place the course borrowing 10-15 days with administration of drug in a daily dosage of 2400-4800 mg.

Preventive treatment of drepanocytic anemia consists in daily use of 160 mg of drug, expected kilogram of weight of the patient and entered 4 times at 24 o'clock in equivalent doses. During vazookklyuzionny crisis (including children from 1st year of life) intravenous daily administration of 300 mg/kg is shown.

Capsules and tablets of Piracetam, application instruction

The application instruction of capsules of this remedy is identical to the description of drug in tablets, for example capsules on 200 mg it is necessary to take the take a pill on 200 mg.

Peroral dosage forms are intended for internal reception on an empty stomach or during food, washing down with water, juice or other soft drinks. The daily dosage to adult patients, at the rate on kilogram of weight, varies within 30-160 mg, with reception 2-4 times at 24 o'clock. The last recommended dosage, for the purpose of the prevention of sleep disorders, has to be accepted by the patient no later than 17 hours.

Therapy of symptomatology of a psychoorganic syndrome of a chronic current, depending on expressiveness of negative manifestations, takes place in a daily dose 1200-2400 mg, and for the first 7 days in a dose of 4800 mg.

Treatment of postinsultny states demands a daily dosage of 4800 mg.

The abstinence alcoholic syndrome moves therapies in the first shock daily dose of 12000 mg, with the subsequent transition to the supporting treatment in a dosage of 2400 mg at 24 o'clock.

Prevention of drepanocytic anemia is carried out in the daily dose of 160 mg/kg divided into four equivalent receptions.

Therapy vertigo and the disturbances of balance interfaced to it takes place 2400-4800 mg in a daily dosage.

The initiation of treatment of a cortical myoclonia occurs in a daily dose of 7200 mg. Further each 3-4 days raise a daily dose on 4800 mg, up to achievement of the dosage of 24000 mg which is considered as maximum. Therapy is carried out throughout all painful period. Each half a year attempt of reduction of the dosing mode or full drug withdrawal, with gradual, once at 24 o'clock, reduction of a dose on 1200 mg, for prevention of a possible attack follows. In case of insufficient efficiency of the carried-out treatment, reception of a remedy is stopped.

At the treatment of a dyslexia and similar painful states which are shown learnability disturbance the daily dosage to children makes 3300 mg. Therapy continues for all current academic year. Before accepting Piracetam for improvement of memory it is necessary to be convinced of absence at the child of other causes of problems with learnability, including features of the intra family relations or inadequate teaching.

Insufficiency of renal function demands purpose of the lowered drug dosages depending on CC (clearance of creatinine), so at indicators of 50-79 ml/min. 2-3-fold use a day 2/3 doses is shown; at 30-49 ml/min. twice in day appoint 1/3 doses; at KK of 20-30 ml/min. once at 24 o'clock accept 1/6 doses.

Overdose

Overdose by Piracetam (at use more than 75000 mg) can become the reason of forming of abdominal pains and developments of bloody diarrhea.

The recommended therapy includes a complex of necessary procedures in such cases (cleaning of a gastrointestinal tract, reception of sorbents and so forth) and a further symptomatic treatment using a hemodialysis at which 50-60% of drug are removed.

Interaction

Parallel use with the drugs including hormones of a thyroid gland (T3+T4) can become the reason of an acrimony, sleep disorders and the patient's disorientations.

Purpose of high dosages of Piracetam (over 9600 mg/days) leads to increase in efficiency of an atsenokumarol at patients with the diagnosed venous thrombosis, at the same time it is noted: more expressed decrease in aggregation of thrombocytes, reduction of viscosity of blood, Villebrand's factors and level of fibrinogen.

The combined use with stimulators of TsNS can lead to strengthening of their psychogogic effects.

Co-administration with neuroleptics can cause increase in extrapyramidal disturbances.

Because of removal more than 90% of Piracetam with urine in an invariable form, a possibility of influence on its pharmacodynamics of other remedies are improbable.

The injection form of drug pharmaceutical is compatible to such solutions: NaCl (0,9%), Dextrose (5-20%), Ringera, Fructose (5-20%), Mannitolum (20%), Gidroksietilkrakhmal (6%, 10%).

Terms of sale

Acquisition of any dosage form of Piracetam requires the recipe.

Storage conditions

Parenteral and peroral forms of drug need to be kept at a temperature up to 25 °C.

Period of validity

In dependence about the producer the period of validity of drug fluctuates within 2-5 years (it is recommended to be guided by the final date of use specified on packaging).

Special instructions

Because of impact of drug on aggregation of thrombocytes, its careful use patients with need of carrying out serious surgeries, and also patients with disturbance of a hemostasis or symptomatology of heavy bleeding demand.

At therapy of a cortical myoclonia sharp drug withdrawal can lead to resuming of attacks.

Carrying out therapy of a sickemia in dosages less than 160 mg/kg or non-systematic use of drug can become the reason of an exacerbation of a disease.

Long treatment of elderly patients demands regular tracking of indicators of functionality of kidneys and correction of the dosages of drug depending on clearance of creatinine.

Possible above-stated side effects of drug can influence adequacy of behavior of the patient when performing of dangerous works by it and driving of the car.

Analogs

Analogs of Piracetam are provided by monodrugs:

In turn good comments are received by the combined analogs of drug including piracetam with Cinnarizine, the Vinpocetine or Tiotriazolin.

Piracetam and Cinnarizine are a part of such medicines as:

  • Fezam;
  • Nookam;
  • Kombitropil;
  • Omaron;
  • Festsetam;
  • Piratsezin.

The combination with the Vinpocetine is characteristic of Vinpotropil, and with tiotriazoliny of Tiotsetam.

Piracetam and its analogs are also often applied in complex therapy with medical drugs with similar main action, for example Actovegin and Meksidol.

Piracetam and Actovegin compatibility of which, as well as compatibility of Piracetam and Meksidol is not subject to doubt, not bad proved in treatment of such painful states as: dementia (especially at the beginning of its development), alcoholism, ischemia and so forth. Data of a combination with success use for treatment, both elderly patients, and the children, for example, suffering from cerebral spastic infantile paralysis.

Zdravzona

  • Piracetam 400 of mg No. 60 HFK Capsule/quinacrine/quinacrine of joint stock company
  • Piracetam 400 of mg No. 60 of a capsule (Vertexum) Vertexum of closed joint stock company
  • Piracetam of 20% solution for injections of 5 ml No. 10 of an ampulyfarmstandart-Ufavit of joint stock company
  • Piracetam 200 of mg No. 60 tablet/ozone/ozone of Ltd company
  • Piracetam 400 of mg No. 20 kaps. (synthesis) Synthesis of joint stock company

Drugstore of IFC

  • Piracetam kaps 400 mg No. 60, Ooorossiya's Ozone
  • Piracetam tbl p / about 200 mg No. 60, Ooorossiya's Ozone
  • Piracetam solution for in 20% 5 ml No. 10 *, Borisovsky ZMP (Borisov) Belarus
to show still

Apteka24

  • Piratsetamfarmak (Ukraine, Kiev)
  • Piratsetamdarnitsa (Ukraine, Kiev)
  • Piratsetamgalichfarm (Ukraine, Lviv)
  • Piratsetamdarnitsa (Ukraine, Kiev)
  • Piratsetamborshchagovsky HFZ (Ukraine, Kiev)

Paniapteka

  • Piracetam kaps. 0.4g No. 30farmak
  • Piracetam kaps. 0.4g No. 30farmak
  • Piracetam kaps. 0.4g No. 30farmak
  • Piracetam kaps. 0.4g No. 30farmak
  • Piracetam kaps. 0.4g No. 30farmak

BIOSPHERE

  • Piracetam of 200 mg/ml 5 ml No. 10 solution for in.amp. Belmedpreparata (Belarus)
  • Piracetam of 400 mg No. 10 kaps.
  • Piracetam of 400 mg No. 10 kaps. Borisovsky ZMP (Belarus)
  • Piracetam 20%/5 of ml No. 10 solution for in.amp. Borisovsky ZMP (Belarus)
  • Piratsetam-Darnitsa 20%/5 ml No. 10 solution for in.amp. Darnitsa (Ukraine)
to show still
Section: For a nervous system
in more detail

Education: Graduated from the Vinnytsia national medical university of N. I. Pirogov, pharmaceutical faculty, the higher pharmaceutical education – the specialty "Pharmacist".

Experience: Work in Koneks and Bios-Media pharmacy chains as "Druggist". Work as "Pharmacist" in Avicenna pharmacy chain of the city of Vinnytsia.

PAY ATTENTION! Information on drugs on the website is help generalizing, collected from public sources and can form the basis for making decision on use of medicines it is not aware of treatment. Before medicine use Piracetam surely consult with the attending physician.