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

Nicotinic acid is a specific anti-pelagic agent. Has a pronounced short vasodilating effect, improves carbohydrate and nitrogen metabolism, has lipid-lowering activity, reduces the content of total cholesterol, low-density lipoproteins, triglycerides, increases the high-density lipoprotein content, improves microcirculation. In organism a nicotinic acid turns into nicotinamide, which binds to the coenzymes of codohydrazine I and codehydrase II (NAD and NADPH), which carry hydrogen. Participates in the metabolism of fats, proteins, amino acids, purines, tissue respiration, glycogenolysis, synthetic processes.

Replenishes vitamin PP deficiency (vitamin 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:

With parenteral administration, it is quickly 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 is converted into an amine that is embedded in nicotinamide adenine dinucleotide (NAD), which is a prosthetic group of enzymes that carry hydrogen and carry out oxidation-reduction processes.

The main metabolites are H-methyl-2-pyridone-3-carboxamide and N-methyl-2-pyridone-5-carboxamide, which do not possess pharmacological activity.

It can be synthesized in the intestine by a bacterial flora from the tryptophan that came with food (60 mg of tryptophan produces 1 mg of 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 receiving high doses - mostly unchanged. Kidney clearance depends on the level of nicotinic acid in the blood plasma and can decrease with a high concentration of it in the plasma.

Indications:

- Hypovitaminosis PP, avitaminosis PP (pellagra).

- In the combination therapy:

with ischemic stroke; obliterating diseases of the vessels of the extremities (obliterating endarteritis, Raynaud's disease); neuritis of the facial nerve; diabetes mellitus, including its complications (diabetic polyneuropathy, microangiopathy).

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

Contraindications:

Atherosclerosis, hypersensitivity to nicotinic acid, peptic ulcer of the stomach and duodenum (at the stage of exacerbation), gout, hyperuricemia, hepatitis, cirrhosis, uncompensated diabetes mellitus.

Carefully:

Hemorrhagia, glaucoma, hyperacid gastritis, peptic ulcer of the stomach and duodenum (outside the stage of exacerbation), arterial hypotension, pregnancy, lactation, children's age.

Pregnancy and lactation:

Taking into account the injection route of the drug, 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, breast-feeding should be discontinued.

Dosing and Administration:

When pellagra, adults are prescribed parenterally (intravenously, intramuscularly or subcutaneously) 1 ml of 1% (10 mg) solution 2-3 times a day for 10-15 days.

With ischemic stroke, 10 mg of solution is slowly injected intravenously.

For other indications indicated in the section "Indications for Use" - 10 mg 1-2 times a day, for 10-15 days.

Higher doses for adults: single dose - 100 mg, daily - 300 mg.

Disease Hartnup 40-200 mg per day.

Side effects:

From the side of the cardiovascular system: sensation of "tidal" blood to the scalp, hyperemia of the facial skin and upper body, orthostatic hypotension, collapse, sensation of fever, headache. With rapid intravenous administration, a significant reduction in blood pressure, dizziness.

From the side central and 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, asthenia, increased content in the blood of aspartate aminotransferase, lactate dehydrogenase, alkaline phosphatase.

Local Reactions: subcutaneous and intramuscular injections are painful.

Other: allergic reactions (skin rash, itchy skin, breathy breath, urticaria).

Overdose:

High doses of nicotinic acid can cause a temporary rush of blood to the head and upper half of the trunk, itching, gastrointestinal disorders.

Treatment: symptomatic.

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 decrease in the concentration of high-density cholesterol and lipoproteins.

Special instructions:

To prevent complications from the liver it is recommended to include in the diet products rich in methionine (cottage cheese), or use methionine, lipoic acid and 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.

Form release / dosage:

Solution for injection 10 mg / ml.

Packaging:

1 ml per ampoule of colorless neutral glass type I with a colored break ring or with a colored dot and a notch or without a kink ring, a colored dot and a notch. One, two or three color rings and / or a two-dimensional barcode, and / or alphanumeric coding, or without additional color rings, a two-dimensional bar code, or alphanumeric coding, can additionally be applied to the ampoules.

5 ampoules per circuit cell packaging made of polyvinylchloride film and aluminum foil foil or polymer film or without foil and without film. Or 5 ampoules are placed in a prefabricated form (tray) made of cardboard with cells for laying ampoules.

One or two contour squares or cardboard trays, together with an instruction for use and a scarifier or knife, ampoule, or without a scarifier and a knife ampullum, are placed in a cardboard package (bundle).

Storage conditions:

In the dark place at a temperature of no higher than 25 ° C.

Do not freeze.

The drug should be stored in places inaccessible to children.

Shelf life:3 years. After the expiration date should not be applied.

Terms of leave from pharmacies:On prescription

Registration number:LP-002404

Date of registration:19.03.2014 / 17.08.2015

Expiration Date:19.03.2019

The owner of the registration certificate:ATOLL, LLC ATOLL, LLC Russia

Manufacturer: & nbsp

OZONE, LLC Russia

Information update date: & nbsp20.06.2018

Illustrated instructions

Instructions

A nicotinic acid (Nicotinic acid)