Noozam

General characteristics. Structure:

Active agent: 400 mg of piracetam and 25 mg of cinnarizine;

Excipients: lactoses monohydrate, silicon dioxide colloid anhydrous, magnesium stearate.

Pharmacological properties:

Pharmacodynamics. Noozam – the combined medicine which effect is caused by pharmacological properties of two of its active components (piracetam and cinnarizine).
Piracetam positively influences metabolism in nervous cells, increases energy potential due to acceleration of the address of ATP, activation of adenylatecyclase and oppression of a nukleotidfosfataza. Drug strengthens synthesis of dopamine in brain tissues, increases the maintenance of noradrenaline, acetylcholine level in synapses and density of holinoretseptor; improves cholinergic, glyutamatergichesky and GABA-ergic momentum transfer in TsNS. Antiischemic activity of piracetam is caused by its influence on metabolism and rheological properties of blood (oppression of aggregation of thrombocytes, decrease in viscosity of blood).
Piracetam improves integral activity of a brain, processes of training and consolidation of memory. At cerebral disturbances of vascular genesis drug improves regional blood circulation, increases consumption of oxygen and utilization of glucose in the sites of a brain affected with ischemia. At injuries of a brain (owing to a hypoxia, poisoning, an injury, etc.) piracetam prevents loss of memory and recovers cognitive functions (ability to assimilation of information).

Cinnarizine – the selection blocker of calcium channels of the IV class. Drug slows down transport of calcium ions through cellular membranes, reduces a tone of smooth muscles of arterioles; reduces sensitivity to sosudosuzhayushchy mediators (catecholamines, angiotensin, bradikinin); improves cerebral, coronary circulation; stimulates metabolic processes in nervous cells and increases their resistance to a hypoxia. Reduces excitability of a vestibular mechanism. It is characterized by high-permeability in brain vessels. Improves microcirculation, increasing elasticity of erythrocytes and reducing the increased viscosity of blood. Has moderate antihistaminic and sedative activity.
The combined drug Noozam has the expressed anti-hypoxemic properties. Both active components of drug mutually exponentiate the action directed to decrease in vascular resistance of a brain and increase in activity of a cerebral blood-groove.

Pharmacokinetics. After oral administration Noozam is quickly and completely soaked up in a digestive tract. Biological availability of active components of drug approaches 100%. The maximum concentration of piracetam and cinnarizine in a blood plasma is reached for 30–60 minutes. Piracetam does not contact blood proteins. Gets through hematoencephalic and placental barriers, collects preferential in a cerebral cortex. In an organism is not exposed to biotransformation, it is almost completely removed by kidneys in not changed look. The piracetam elimination half-life of a blood plasma makes about 4-5 hours, of cerebrospinal fluid - from 6 to 8 hours.
After intake the maximum concentration of cinnarizine in plasma is noted in 1–3 hours.
Cinnarizine actively contacts proteins of plasma (to 91% of the entered dose). Cinnarizine is completely metabolized, a cinnarizine elimination half-life about 4 hours. It is allocated in the form of metabolites: 1/3 – kidneys, 2/3 – through intestines.

Indications to use:

Organic and functional disturbances of activity of the central nervous system, namely:

- disturbances of cerebral circulation (at atherosclerosis of vessels of a brain which is followed by an ischemic stroke, in the rehabilitation period after a hemorrhagic stroke and craniocereberal injuries);
- disturbance of memory, ability to concentration of attention and training;
- disturbances of mood (condition of depression, irritability, etc.);
- encephalopathies of various origin;
- labyrinthopathies of various origin: dizziness, sonitus, nystagmus, nausea, vomiting;
- Menyer's syndrome;
- for improvement of training and memory at children with a bradygenesis of cognitive and mnestichesky functions;
- prevention of "disease of the movement" (kinetoz);
- prevention of attacks of migraine.

Route of administration and doses:

The adult Noozam appoint 1–2 capsules 3 times a day, to children 5 years – on 1–2 capsules 1–2 times a day are aged more senior. Duration of a course of treatment makes from 1 to 3 months (the term of use of drug is defined for each patient individually, depending on age and the general condition of the patient, character, weight and the clinical course of a disease).
Exceeding of the maximum single and daily dose of drug, and also the recommended treatment duration (3 months) is not allowed.
Carrying out 2–3 courses of treatment by Noozam within a year is possible.

Capsules should be accepted inside after food; to swallow without chewing, to wash down with water.

Features of use:

To patients with diseases of kidneys and/or a liver Noozam appoint with extra care. In case of existence of a slight or moderate renal failure it is recommended to reduce a therapeutic dose or to increase an interval between administrations of drug (especially at clearance of creatinine less than 60 ml/min.). At patients with an abnormal liver function it is necessary to define indicators of activity of liver enzymes periodically.

Also carefully use drug at patients with Parkinson's disease and at increase in intraocular pressure. It is necessary to avoid the sudden termination of treatment by Noozam at patients with clonic spasms.

At purpose of drug the patient with disturbances of a hemostasis or with bleeding symptoms, and also before carrying out surgeries it is necessary to consider effect of piracetam on aggregation of thrombocytes.

At the athletes using Noozam determination of oshibochnopolozhitelny results when carrying out doping control is possible.

During treatment by Noozam it is necessary to avoid alcohol intake and drugs.

Pregnancy and lactation
Despite the lack of experimental data of rather teratogenic effect of drug, Noozam's use during pregnancy is not recommended. Piracetam videlyatsya with breast milk therefore the combined drug should not be accepted in the period of a lactation (feeding by a breast).

Influence on ability to manage vehicles
The possibility of sedation of drug should be considered at its appointment to drivers and other persons whose work demands bystry mental and physical reaction.

Side effects:

Disturbances from TsNS: a headache, dizziness, hyperkinesias, nervousness, drowsiness, depressive frustration, a disorientation, convulsive attacks, after drug withdrawal – a recurrence of clonic spasms at patients with epilepsy. Prolonged use of drug by patients of advanced age can lead to development of the extrapyramidal phenomena.
Disturbances from a digestive tract: the increased salivation, pain in epigastriums, diarrhea, nausea, vomiting.
Allergic reactions: rashes, vasculomotor hypostasis, an itch, photosensitivity reactions, it is very rare – an erythematic lupus and red flat deprive.
Others: the general weakness, thrombophlebitis, pseudoanaphylactic reactions, lowering of blood pressure, pallor of skin, fever, a leukocytosis, a hypopotassemia, increase in body weight (at a long course of treatment).

Interaction with other medicines:

Simultaneous use of neuroleptics, tranquilizers, anxiolytics, tricyclic antidepressants, drugs and alcohol strengthens Noozam sedations.

Drug exponentiates action nootropic, anti-hypertensive and vasodilators. Use together with vasodilating drugs strengthens Noozam's action, and existence in composition of drug of cinnarizine reduces activity of hypertensive means.

Noozam increases activity of thyroid hormones and can cause a tremor and a condition of nervous excitement.

Strengthening of effect of peroral anticoagulants under the influence of Noozam is possible.

Contraindications:

Noozam is contraindicated to persons with hypersensitivity to any of drug components, patients with heavy renal to a nedostatochnosye (clearance of creatinine less than 20 ml/min.), to women during pregnancy and feeding by a breast, to children under 5 years.

Overdose:

Messages on cases of overdose of Noozam at adults did not arrive. At children at exceeding of the recommended doses of drug excitement reactions – sleeplessness, concern, euphoria, irritability, a tremor, occasionally – hallucinatory frustration, a tremor or clonic spasms prevail.

Right after overdose it is necessary to wash out a stomach or to cause vomiting in the patient. There is no specific antidote. Actions of a symptomatic and maintenance therapy are recommended (according to a clinical condition of the patient). The most effective therapeutic actions – carrying out a hemodialysis and artificial diuresis.

Storage conditions:

To store in the place, unavailable to children, in original packaging, at a temperature from 15 °C to 25 °C.

Issue conditions:

According to the recipe

Packaging:

On 10 capsules in a blister strip packaging; on 2, 6 or 10 blister strip packagings in a pack from a cardboard.