Vinpocetine

General characteristics. Structure:

Active agent: Vinpocetine of 5 mg.

Excipients - lactose (sugar milk),  starch, silicon dioxide colloid (aerosil), talc (magnesium hydrosilicate), magnesium stearate.

Description. Tablets of color, white or white with a yellowish shade, a ploskotsilindrichesky form with risky and a facet.

Pharmacological properties:

Pharmacodynamics. Improves metabolism of a brain, increasing consumption  of glucose and oxygen brain tissue.  Increases resistance of neurons to a hypoxia; strengthens glucose transport to a brain, through a blood-brain barrier; transfers process of disintegration of glucose to energetically more economical, aerobic way; selectively blocks Sa 2+ - dependent phosphodiesterase; increases levels of adenosinemonophosphate, a cyclic guanozinmonofosfat and adenosinetriphosphate of a brain. Strengthens exchange of noradrenaline and serotonin of a brain; stimulates the ascending branch of noradrenergichesky system, has antioxidant effect. Reduces aggregation of thrombocytes and the increased viscosity of blood; increases the deforming ability of erythrocytes and blocks utilization by adenosine erythrocytes; promotes increase in return by oxygen erythrocytes. Increases a cerebral blood stream; reduces resistance of vessels of a brain without essential change of indicators of system blood circulation. Does not render effect of "burglarizing" and strengthens blood supply, first of all, in ischemic sites of a brain. Gets through a placental barrier. 
  
Pharmacokinetics. It is quickly soaked up. Time of achievement of the maximum concentration in a blood plasma – 1 hour. Absorption happens, mainly, in proximal departments of digestive tract. When passing through a wall of intestines is not exposed to metabolism. The maximum concentration in fabrics is noted in 2-4 hours after intake. Communication with proteins - 66%,  bioavailability at intake – 7%. The clearance of 66,7 l/h, exceeds the plasma volume of a liver (50 l/h) that demonstrates extrahepatic metabolism. At repeated receptions the kinetics has linear character. An elimination half-life at the person of 4,83± 1,29 h. It is removed by kidneys and through intestines  in the ratio 3:2.

Indications to use:

- reduction of expressiveness of neurologic and mental symptoms at various forms of insufficiency of cerebral circulation (including a recovery stage of an ischemic and hemorrhagic stroke, an effect of the had stroke; tranzitorny  ischemic attack; vascular dementia; vertebrobazilyarny insufficiency; atherosclerosis of vessels of a brain; posttraumatic and hypertensive encephalopathy);

-  chronic vascular diseases of a choroid and retina of an eye;

-  decrease in hearing of perceptual type, Menyer's disease, idiopathic sonitus.

Route of administration and doses:

Inside, after food,  3 times a day. The initial daily dose makes 15 mg. Maximum daily dose of 30 mg.  Duration of a course of treatment up to 3 months. At diseases of kidneys and a liver drug is appointed in a usual dose.

Features of use:

Existence of a syndrome of the prolonged interval of QT  and administration of drugs causing lengthening of an interval of QT demands  periodic control of an ECG. In case of a lactose intolerance it is necessary to consider that lactose is a part of drug. There are no data on influence of a Vinpocetine on ability to driving and performance of work demanding speed of psychomotor reactions.

Side effects:

From cardiovascular system: change of an ECG (ST depression, lengthening of an interval of QT), tachycardia,  premature ventricular contraction, lability of arterial pressure, feeling of inflows.

From the central nervous system: sleep disorders (sleeplessness or the increased drowsiness), dizziness, a headache.

From system of digestion:: dryness in a mouth, nausea, heartburn.

Others: allergic reactions, the general weakness, the increased sweating.

Interaction with other medicines:

Interaction is not observed at simultaneous use with  β-blockers ((((((((((хлоранолол, Pindololum), Clopamidum, glibenclamide, digoxin, atsenokumaroly and Hydrochlorthiazidum, Imipraminum

Simultaneous use of a Vinpocetine and  α-Methyldopums sometimes caused some strengthening of hypotensive effect therefore at such treatment regular control of arterial pressure is required.

Despite the absence of the data confirming a possibility of interaction it is recommended to show care at co-administration with drugs of the central, antiarrhythmic and anticoagulating action.

Contraindications:

- the acute phase of a hemorrhagic stroke expressed to coronary heart disease, the expressed arrhythmias, hypersensitivity  to any of drug components.

-  pregnancy (perhaps placental bleeding and spontaneous abortions probably as a result of strengthening of placental blood supply).

-  the lactation period (at use of drug it is necessary to stop breastfeeding).

- children up to 18 years (in connection with insufficiency of data).

Overdose:

Symptoms: strengthening of expressiveness of side effects.

Treatment: gastric lavage, reception of absorbent carbon, symptomatic therapy. 

Storage conditions:

In the dry, protected from light place. To store in the place, unavailable to children. Period of validity 2 years. Not to use after the period of validity specified on packaging.

Issue conditions:

According to the recipe

Packaging:

Tablets of 5 mg. On 10 tablets in a blister strip packaging.  2  or 5 blister strip packagings together with the application instruction in a pack from a cardboard.