Nicotinic acid - instructions for use, dose, side effects, contraindications

Nicotinic acid is a specific anti-pelagic agent. It has a pronounced short vasodilating effect, improves carbohydrate and nitrogen metabolism, improves microcirculation. Participates in the metabolism of fats, proteins, amino acids, purines, tissue respiration, glycogenolysis, synthetic processes. Replenishes vitamin PP deficiency (B₃). Has vasodilating effect at the level of small vessels (including the brain), improves microcirculation, has a weak anticoagulant effect (increases fibrinolytic activity of the blood).

Pharmacokinetics:

When the parenteral route of administration is rapidly distributed in the tissues of the body. It accumulates mainly in the liver, as well as in adipose tissue and in the kidneys.

In the liver a nicotinic acid turns into nicotinamide, which is embedded in nicotinamide adenine dinucleotide (NAD), which is a prosthetic group of enzymes,transferring hydrogen and carrying out oxidation-reduction processes. The main metabolites are Nmethyl-2-pyridone-3-carboxamide and N-methyl-2-pyridone-5-carboxamide, which do not possess pharmacological activity.

Can be synthesized in the intestine by a bacterial flora from the tryptophan that came with food (of 60 mg of tryptophan formed 1 mg nicotinic acid) with the participation of pyridoxine (vitamin B₆) and riboflavin (vitamin B₂).

The elimination half-life is 45 minutes.

It is excreted from the body by the kidneys, in unmodified form and in the form of metabolites, when high doses are administered, mostly in unmodified form.

Kidney clearance depends on the concentration of nicotinic acid in the blood plasma and can decrease with a high concentration of it in the plasma.

Indications:

Avitaminosis PP (pellagra).

Complex therapy: ischemic stroke, obliterating diseases of the vessels of the extremities (obliterating endarteritis, Raynaud's disease), neuritis of the facial nerve.

Hartnup disease (hereditary disease, accompanied by a violation of the assimilation of certain amino acids, including tryptophan).

Contraindications:

Hypersensitivity to nicotinic acid or other components of the drug.

Severe arterial hypertension, atherosclerosis, stomach and duodenal ulcer (at the stage of exacerbation), gout, hyperuricemia, hepatitis, cirrhosis, uncompensated diabetes mellitus, children's age (under 18 years).

Carefully:Hyperacid gastritis, peptic ulcer and duodenum (outside the stage of exacerbation).

Arterial hypotension.

Period pregnancy and lactation.

Pregnancy and lactation:

Taking into account the injection route of the drug and its side effects, the use during pregnancy strictly according to the doctor's prescription, if the expected effect of therapy for the mother exceeds the potential risk to the fetus.

If you need to use the drug during lactation, breastfeeding should be discontinued.

Dosing and Administration:

Intravenous, intramuscular or subcutaneous.

With pellagra (avitaminosis PP) 1 ml of 1% (10 mg) solution 2-3 times a day for 10-15 days.

With ischemic stroke 1 ml of a 1% solution (10 mg) of solution is injected intravenously slowly.

With obliterating diseases of the vessels of the extremities (obliterating endarteritis, Raynaud's disease) 1 ml (10 mg) 1-2 times a day for 10-15 days.

With neuritis of the facial nerve 1 ml (10 mg) 1-2 times a day for 10-15 days.

Maximal doses: single 0.1 g, daily 0.3 g.

With Hartnup disease 40-200 mg per day.

Side effects:

From the side of the cardiovascular system: hyperemia of the scalp and upper half of the trunk with a sensation of tingling and burning (sensation of "tidal" blood), with rapid intravenous administration, a significant reduction in blood pressure, dizziness, orthostatic hypotension, collapse.

From the central nervous system and the peripheral nervous system: paresthesia, dizziness.

From the digestive system: with prolonged use - fatty degeneration of the liver.

From the side of metabolism: with prolonged use - hyperuricemia, a decrease in glucose tolerance, an increase in blood levels of aspartate aminotransferase (ACT), lactate dehydrogenase (LDH), alkaline phosphatase (AFP).

Local Reactions: pain in the place of subcutaneous and intramuscular injection.

Other: allergic reactions (skin rash, skin itching, breathy breath, hives).

Overdose:

High doses of nicotinic acid can cause flushing of the scalp and upper Half of the body with a sensation of tingling and burning (sensation of "hot flashes" of blood), as well as skin itching and gastrointestinal disorders.

Treatment: dose reduction or withdrawal of the drug, symptomatic therapy. There is no specific antidote.

Interaction:

When combined with the drugs, sulfonylureas can increase blood glucose levels.

When administered with lovastatin increases the risk of myopathy.

Care should be taken when combining with antihypertensive drugs, anticoagulants and ascorbic acid.

Reduces the toxicity of neomycin and prevents the induced reduction in the concentration of high-density cholesterol and lipoproteins.

Special instructions:

During the treatment, liver function should be monitored regularly. To prevent hepatotoxicity, it is necessary to include in the diet products rich in methionine (cottage cheese), or the appointment of methionine, lipoic acid or other lipotropic drugs.

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

During the period of treatment it is recommended to refrain from driving vehicles and practicing other potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions, taking into account the possible development of adverse reactions.

Form release / dosage:

Solution for injection, 10 mg / ml.

Packaging:

1 ml per ampoule of neutral glass.

For 10 ampoules with instructions for use and a vial for opening ampoules or a scarifier ampoule is placed in a box of cardboard for consumer packaging.

5 or 10 ampoules are placed in a contoured cell pack of a polyvinylchloride film or polyethylene terephthalate tape and aluminum foil or paper with a polyethylene coating or without a foil, or without paper.

By 1 or 2 contour cells with instructions for use and a knife for opening ampoules or a scarifier ampullum are placed in a pack of cardboard.

When you pack the ampoules with a break ring or break point, the ampoule opener or ampoule scapper is not put in.

Storage conditions:

In the dark place at a temperature of 2 to 25 FROM.

Keep out of the reach of children.

Shelf life:

3 years.

Do not use after the expiration date.

Terms of leave from pharmacies:On prescription

Registration number:LP-004066

Date of registration:10.01.2017

Expiration Date:10.01.2022

The owner of the registration certificate:NOVOSIBHIMFARM, OJSC NOVOSIBHIMFARM, OJSC Russia

Manufacturer: & nbsp

NOVOSIBHIMFARM, OJSC Russia

Representation: & nbspNOVOSIBHIMFARM, OJSCNOVOSIBHIMFARM, OJSC

Information update date: & nbsp29.01.2017

Illustrated instructions

Instructions

A nicotinic acid (Nicotinic acid)