Escortropyl - instructions for use, doses, side effects, contraindications

Pyracetam is a nootropic agent. It directly affects the brain, improving cognitive (cognitive) processes, such as learning ability, memory, attention, and mental performance. Pyracetam has an effect on the central nervous system (CNS) in various ways: it changes the rate of spread of excitation in the brain, improves metabolic processes in nerve cells, improves microcirculation, affects the rheological characteristics of the blood, while not having a vasodilating effect.

The drug improves the connection between the cerebral hemispheres and synaptic conductivity in neocortical structures, improves cerebral blood flow.

Piracetam inhibits platelet aggregation and restores the configuration properties of the outer membrane of rigid red blood cells, as well as the ability of the latter to pass through the vessels of the microcirculatory bed. In a dose of 9.6 g reduces the concentration of fibrinogen and von Willebrand factor by 30-40 % and prolongs bleeding time.

Piracetam has a protective and restoring effect when brain function is impaired due to hypoxia and intoxication. Pyracetam reduces the severity and duration of the vestibular nystagmus.

Pharmacokinetics:

Apparent volume of distribution (V_d) - about 0.6 l / kg. Penetrates through blood-brain and placental barriers; is removed during hemodialysis.In animal experiments piracetam selectively accumulates in the tissues of the cerebral cortex, mainly in the frontal, parietal and occipital lobes, in the cerebellum and basal nuclei.

Does not bind to plasma proteins, it is not metabolized.

80-100% of pyracetam is excreted by the kidneys unchanged by glomerular filtration. The total clearance is 80-90 ml / min. The half-life of piracetam from plasma is 4-5 hours, of cerebrospinal fluid 8.5 hours. The half-life is prolonged for chronic renal failure (CRF): with terminal CRF, up to 59 hours. Hepatic insufficiency does not affect the pharmacokinetics of pyracetam.

Indications:

In adults: symptomatic treatment of psycho-organic syndrome, accompanied by a decrease in memory, a decrease in concentration and activity, mood changes, behavioral disorder, gait disturbance; treatment of dizziness (vertigo) and associated disorders of equilibrium (with the exception of vertigo of the vasomotor and psychogenic origin); cortical myoclonus (monotherapy or as part of complex therapy); sickle-cell vaso-occlusive crisis.

In children: dyslexia in children from the age of 8 in combination with other methods; sickle-cell vaso-occlusive crisis.

Contraindications:

Hypersensitivity, severe CRF (creatinine clearance less than 20 ml / min), hemorrhagic stroke, psychomotor agitation, Huntington's chorea, pregnancy, lactation.

Carefully:

Violation of hemostasis, extensive surgical interventions, severe bleeding, CRF (KK 20-80 ml / min).

Dosing and Administration:

Enter slowly! Piracetam solutions are injected intravenously at a rate of 30-40 drops per minute.

The last dose is administered no later than 17 hours (to prevent sleep disturbance).

The daily dose is divided into 2-4 injections.

Symptomatic treatment of chronic psychoorganic syndrome: 4.8 g / day for the first week, then go to the maintenance dose -1.2-2.4 g / day.

Treatment of dizziness and related imbalances: on 2,4-4,8 g / day.

Treatment of cortical myoclonia: begin with a dose of 7.2 g / day, every 3-4 days the dose is increased by 4.8 g / day until the maximum dose of 24 g / day is reached. Treatment continues throughout the period of the disease. Every 6 months.attempts should be made to reduce the dose or discontinue the drug, gradually reducing the dose by 1.2 g / day every 2 days. With little or no therapeutic effect, treatment is discontinued.

With sickle-cell vaso-occlusive crisis (in adults and children): intravenously at 300 mg / kg / day, divided into 4 equal doses.

When treating dyslexia in children older than 8 years (as part of complex therapy) at 30-50 mg / kg / day, divided into 2 equal doses.

Dosing to patients with impaired renal function.

Because the piracetam is excreted from the body by the kidneys, care should be taken when treating patients with renal insufficiency in accordance with this dosing regimen.

Renal insufficiency	CK (ml / min)	Dosing regimen
Absent	>80	Usual Dose
Lightweight	50-79	2/3 of the usual dose in 2-3 injections
Average	30-49	1/3 of the usual dose in 2 injections
Heavy	20-30	1/6 of the usual dose, once
The final stage	<20	Contraindicated

Elderly, the dose is corrected in the presence of kidney failure. With prolonged therapy, it is necessary to monitor the functional state of the kidneys.

Dosing to patients with impaired liver function.

Patients with a dysfunction of the liver do not need a dose adjustment. If the renal and hepatic functions are impaired simultaneously, the dosing is performed according to the scheme given (see section "Dosing to patients with impaired renal function").

Side effects:

From the side of the central nervous system: motor disinhibition, irritability, drowsiness, depression, asthenia, headache, insomnia, mental agitation, imbalance, ataxia, exacerbation of epilepsy, anxiety, hallucinations, confusion.

From the digestive system: nausea, vomiting, diarrhea, abdominal pain.

From the side of metabolism: increase in body weight.

From the sense organs: Vertigo.

From the skin: dermatitis, itching, urticaria.

Allergic reactions: hypersensitivity, anaphylactic reaction, angioedema.

Local reactions: pain in the injection site, thrombophlebitis.

Other: fever, lowering blood pressure.

Overdose:

Symptoms: abdominal pain, diarrhea. In case of overdose, symptomatic therapy, hemodialysis (efficacy 50-60%) is recommended. There is no specific antidote.

Interaction:

When used simultaneously with iodine-containing hormones of the thyroid gland, confusion, irritability and sleep disturbance may occur.

In high doses (9.6 g / day) in patients with venous thrombosis increases the effect of indirect anticoagulants (more pronounced decrease in platelet aggregation, fibrinogen content, von Willebrand factor, viscosity of blood and plasma).

Pharmaceutically compatible with solutions of dextrose (5%, 10%, 20%), fructose (5 %, 10 %, 20 %), 0,9 % solution of sodium chloride, Ringer's solution, 20% mannitol solution, solutions of hydroxyethyl starch (6%, 10%).

Special instructions:

Be wary appoint patients with a violation of hemostasis, before the forthcoming surgical interventions or in patients with symptoms of severe bleeding.

In the treatment of cortical myoclonia, sudden cessation of treatment should be avoided, this can cause a resumption of seizures.

With prolonged therapy in elderly patients, regular monitoring of kidney function is recommended; if necessary, dose adjustment is performed depending on the creatinine clearance.

Effect on the ability to drive transp. cf. and fur:

During the treatment period, care should be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Form release / dosage:

Solution for infusions 50 mg / ml and 100 mg / ml.

Packaging:

For 50 or 100 ml in glass bottles for blood, transfusion and infusion preparations with a capacity of 50 ml and 100 ml respectively.

One bottle with instructions for medical use is placed in a pack of cardboard.

For 28 bottles with an equal number of instructions for medical use are placed in boxes of corrugated cardboard with gaskets and nest boxes made from corrugated cardboard (for hospitals).

Storage conditions:

In the dark place at a temperature of no higher than 25 ° C. Keep out of the reach of children.

Shelf life:

2 years. Do not use after the expiration date indicated on the package.

Terms of leave from pharmacies:On prescription

Registration number:LP-000095

Date of registration:21.12.2010

The owner of the registration certificate:ESKOM NPK, OAO ESKOM NPK, OAO Russia

Manufacturer: & nbsp

ESKOM NPK, OAO Russia

Information update date: & nbsp15.10.2015

Illustrated instructions

Instructions

The escotropel (Escotropil)