Винпотропил®

General characteristics. Structure:

Active agents: Vinpocetine of 5 mg, piracetam of 400 mg; excipients: lactose (sugar milk), talc.
Structure of the case of a gelatin capsule: titanium dioxide, dye quinolinic yellow, dye sunset yellow, gelatin;
structure of a lid of a gelatin capsule: titanium dioxide, dye azoruby, gelatin.

Description: capsules No. 0 of yellow color with a lid of red color. Contents of capsules - powder of white or almost white color. Existence of separate crystals and lumps is allowed.

Pharmacological properties:

Pharmacodynamics. Винпотропил® - the combined drug. Has the properties characteristic of the means improving a brain blood stream (Vinpocetine) and for nootropic means (piracetam).
As the means improving a brain blood stream:
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 Sa2+-zavisimuyu phosphodiesterase; increases levels of adenosinemonophosphate (AMF), a cyclic guanozinmonofosfat (tsGMF) and adenosinetriphosphate (ATP) 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 elasticity 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.
As nootropic means:
Exerts positive impact on exchange processes of a brain, slightly increases concentration of ATP in a brain, strengthens synthesis of RNA and phospholipids, stimulates glycoclastic processes, strengthens glucose utilization; improves integrative activity of a brain, promotes memory consolidation, facilitates training process; changes the speed of spread of activation in a brain, improves microcirculation, without having at the same time vasodilating effect, inhibits aggregation of the activated thrombocytes; has protective action at the injuries of a brain caused by a hypoxia, intoxications, an electroshock; strengthens alpha and beta activity, reduces delta activity on the electroencephalogram, reduces expressiveness of a vestibular nystagmus; improves bonds between cerebral hemispheres and synaptic conduction in neocortical structures, increases intellectual activity, strengthens a brain blood stream; has no sedative, psychogogic influence. The effect develops gradually.
Has the expressed effect concerning symptoms of initial manifestations of cognitive disturbances of cerebral and vascular genesis at patients of advanced and senile age. It is recommended in psychogeriatric practice.

Pharmacokinetics. The Vinpocetine 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 h 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.
Piracetam after intake is well soaked up and gets into various bodies and fabrics. Bioavailability makes about 95%. The maximum concentration in blood is reached in 0,5-1,0 h after intake. Gets through a blood-brain barrier, collects in brain fabric in 1-4 h after intake. Out of spinnoyomozgovy liquid it is brought much more slowly, than out of other fabrics. Practically is not exposed to biotransformation and on 2/3 it is allocated with kidneys in an invariable look during 30 h. Plasma elimination half-life - 4,5 h, from a brain of-7,7 h.

Indications to use:

Insufficiency of cerebral circulation (the recovery period of an ischemic and hemorrhagic stroke), encephalopathies of various genesis including at alcoholism; parkinsonism of vascular genesis, intoxication, a brain injury and other diseases of the central nervous system which are followed by decrease intellectual мнестических functions; a psychoorganic syndrome with dominance of signs of an adynamy and adynamia, an asthenic syndrome; labyrinthopathies, Menyer's syndrome; prevention of migraine and kinetoz.

Route of administration and doses:

For patients of 18 years is also more senior: inside, before food on 1-2 capsules 2-3 times a day. The last reception - in 4 hours prior to a dream. A maintenance dose-1 capsule 3 times a day. Duration of a course of treatment makes from 2-3 weeks to 2-6 months. Before cancellation the dose of drug should be reduced gradually.

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 one tablet contains about 225 mg of lactose.
Influence on ability to driving of motor transport and to control of mechanisms: in view of possible side effects, it is necessary to be careful when driving the car and performing work with mechanisms.

Side effects:

From cardiovascular system: change of an ECG (ST segment 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, a headache, dizziness, a hyperphrenia, motive disinhibition, irritability, disbalance, decline in the ability to concentration of attention, uneasiness, a depression, an ataxy, extrapyramidal disturbances (including a hyperkinesia), spasms, a tremor.
From system of digestion: a gastralgia, nausea, vomiting, diarrhea, dryness in a mouth, heartburn.
Others: allergic reactions, increase in sexual activity, deterioration in a course of stenocardia, increase in body weight, an adynamy, the general weakness, the increased sweating.

Interaction with other medicines:

Raises: risk of a hemorrhagic complication against the background of a geparinoterapiya, effects of hormones of a thyroid gland, antipsychotic means (neuroleptics), indirect anticoagulants, psychostimulants.
Weakens: effect of anticonvulsant drugs (reduces a convulsive threshold).
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 action.

Contraindications:

Hypersensitivity, pregnancy, the lactation period, the expressed disturbances of a heart rhythm, coronary heart disease (heavy current), acute stage of a hemorrhagic stroke, renal and/or liver failure, children up to 18 years (in connection with insufficiency of data).
Patients with rare hereditary diseases, such as intolerance of a galactose, deficit of lactase or glyukozo-galaktozny malabsorption should not accept drug.

With care:
Disturbance of a hemostasis, heavy bleeding, high-quality hyperbilirubinemias (including Gilbert's syndrome), viral hepatitis, alcoholic damage of a liver, alcoholism, deficit glyukozo-6-fosfatdegidrogenazy, epilepsy, advanced age.

Overdose:

Symptoms: strengthening of expressiveness of side effects.
Treatment: gastric lavage, reception of absorbent carbon, symptomatic therapy.

Storage conditions:

Period of validity 4 years. Not to use after the period of validity specified on packaging. List B. In the dry, protected from light place at a temperature not above 25 °C. To store in the place, unavailable to children.

Issue conditions:

According to the recipe

Packaging:

Capsules.
On 10 or 15 capsules in a blister strip packaging.
On 2, 3, 5 or 10 blister strip packagings on 10 capsules or on 2, 4, 6 or 8 blister strip packagings on 15 capsules together with the application instruction in a pack from a cardboard.