Piracetam (capsules 0,4 g)
Capsulae Piracetami 0,4
International unlicensed name
Piracetam.
Pharmacotherapy group
Nootropic agent.
Composition
1 capsule contains piracetam 400 mg.
Pharmacological action
Pharmacodynamics
Piracetam induces metabolic processes in the brain. It increases ATP concentration in the brain tissue, intensifies RNA and phospholipids biosynthesis, stimulates glycolytic processes and increase glucose utilization. The preparation improves the brain integrative activity and memory, as well as protects on various forms of cerebral anoxia and improves the learning process. Piracetam improves feedbacks between cerebral hemispheres and synaptic conduction in the neocortical structures, regenerate and stabilize cerebral functions, especially consciousness, memory and speech, intensifies mental efficiency and increases cerebral blood flow.
Pharmacokinetics
After oral administration piracetam is well absorbed and penetrated into various organs and tissues. Max.concentration in blood is achieved 1 hour after administration. The preparation penetrates through blood-brain barrier and is accumulated in the brain tissue. It is much slower to be excreted from the cerebrospinal fluid than from other tissues, what proves a high tropism in the brain tissue. Piracetam is practically not subject to biotransformation in the organism. It is mainly excreted by the kidney.
Indication
Piracetam is used in neurology, psychiatry and narcology.
In neurology piracetam is mainly used in the cases as follows: vascular diseases of the brain (atherosclerosis, hypertension, vascular parkinsonism) with occurrence of chronic cerebral-vascular failure that leads to disturbances of memory, attention, speech, dizziness, headaches; cerebral blood flow disturbances and states of coma and semicoma after injuries and brain intoxication, as well as in the period of rehabilitation therapy after these states in order to increase motor and mental activity of the patients. Piracetam is used in patients with nervous system diseases accompanied by intellectual and analytical function reduction and emotion and will sphere disturbance.
In psychiatry piracetam is used in patients with neurotic depressive states of various genesis when the clinical presentation contains adynamy, asthenia and сoenesthetic and hypochondriac symptoms, ideational lethargy, as well as on therapy of slow-apathy defective states of senile and atrophic processes, in the complex therapy of various psychiatry diseases proceeding on "organically deficient ground". Besides, piracetam is used as an auxiliary preparation for treatment of depression diseases resistance to antidepressants, as well as in case of intolerance of neuroleptics and other psychotropic agents in order to eliminate or prevent somavegitative, neurologic or psychic complications induced by them. Piracetam can be used as an auxiliary preparation on epilepsy.
In narcology the preparation is used for arresting abstinent, preliminary or delirious states on alcoholism and dru-addiction, as well as in cases of acute alcoholic, morphine, barbiturate, benzedrine intoxication. Besides, piracetam is used for treatment of chronic alcoholism with occurrence of permanent psychic disability (asthenia, intellectual and analytical function, etc.).
In pediatrics the preparation is used to intensify the learning process and liquidate consequences of perinatal brain damage induced by fetal infection, on oligophrenia, hypoxia, birth injury, mental retardation, infantile cerebral paralysis.
Route and dosage
Piracetam is administered before the meals starting with the initial dose 1,2 g (0,4 g 3 times a day) and up to 2,4 g, sometimes — up to 3,2 g and more. A marked therapeutic effect in these cases is achieved in 2—3 from the start of treatment. Then the dose is reduced till 1,2—1,6 g (0,4 g 3—4 times a day). The course of treatment lasts from 2—3 weeks till 2—6 months. When necessary the treatment can be repeated.
Administration of piracetam can be sometimes accompanied by administration of psychotropic, cardiovascular and other medicines.
For children up to 5 years old the preparation is prescribed in the dose of 0,2 g 3 times a day before the meals, for children at the age from 5 till 16 — 0,4 g 3 times a day. Max.daily dose is 1,8 g. In case of the therapy of many years it is recommended to take 2 – 3 courses during the year.
Side effects
Side effects mainly occur when the preparation is administered in the dose more than 5 g per day. Higher irritability, excited state, sleep disturbance, headache, dyspeptic disturbances, sexual stimulation, higher motor activity are possible, and in elderly patients exacerbation of coronary deficiency sometimes is registered. In this case the dose of the preparation shall be decreased, the its administration shall be ceased.
The preparation affects the ability to drive.
Contraindications
Acute kidney failure, depression with anxiety (agitated melancholia), Huntington disease, pregnancy and lactation. The administration of piracetam is contraindicated in kids younger than 1 year old.
Overdosing
Symptoms: side effects may be intensified.
Treatment: cease to administer the preparation or decrease the dose.
Precautions
In patients with kidney failure rest nitrogen and creatinine should be monitored, and in patients with liver diseases – laboratory parameters characterizing liver function.
The preparation shall be taken with care on serious cardiovascular diseases with marked blood hypotension, compromised kidney and liver functions.
Special indications
In patients taking antiepileptic agents piracetam should be administered as a long-term principal antiepileptic therapy, as the threshold of readiness for convulsions may fall down in predisposed patients.
Interaction with other medications
Piracetam intensifies the effects of thyroid hormones, neuroleptics, antidepressants and other psychotropic and stimulating agents increasing cerebral blood flow and indirect anticoagulants; antianginal agents (in elderly patients). It weakens the effect of anticonvulsion agents.
Product form
Capsules 400 m № 30
