Intravenously. Intramuscularly.
Parenteral administration of piracetam is prescribed when it is not possible to use oral forms of the drug (unconsciousness, difficulty swallowing). Intravenous administration is preferred.
Intravenous infusion of a daily dose is performed through a catheter at a constant rate for 24 hours a day (for example, in the initial stage of treatment with severe myoclonia).
Preliminary preparation is diluted in one of the compatible infusion solutions: Dextrose 5%, 10% or 20%; Fructose 5%, 10%, 20%; Sodium chloride 0.9%; Dextran 40 10% (in sodium chloride solution 0.9%); Ringer's solution; A solution of mannitol 20%.
The total volume of solution intended for administration is determined taking into account the clinical indications and the patient's condition.
Bolus intravenous administration (for example, emergency treatment of crisis in sickle cell anemia) is performed for at least 2 minutes, the daily dose is then divided into several injections (2-4) at regular intervals so that the dose per injection does not exceed 3 g.
Intramuscularly the drug is administered if the introduction through the vein is difficult or the patient is overexcited. The volume of the solution administered intramuscularly can not exceed 5 ml. The frequency of administration of the drug is similar to that of its intravenous or oral administration.
If there is an opportunity, they switch to oral administration of the drug (see instructions for the medical use of the appropriate forms of release of the drug). The duration of treatment is determined by the doctor depending on the disease and taking into account the dynamics of the symptoms.
Symptomatic treatment of chronic psychoorganic syndrome - 2,4-4,8 g / day.
Treatment of dizziness and related disorders of balance - 2,4-4,8 g / day.
Cortical myoclonia
Treatment begins 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. In the absence of effect or a slight therapeutic effect, treatment is discontinued.
Sickle cell anemia
The daily preventive dose is 160 mg / kg body weight divided into 4 equal doses. During the crisis - 300 mg / kg intravenously, divided into 4 equal doses.
Dosing to patients with impaired renal function
The dose should be adjusted depending on the amount of creatinine clearance (CC): The creatinine clearance for men can be calculated based on the serum creatinine concentration, according to the following formula:
CK (ml / min) = [140 - age (years) х body weight (kg)]/[72 х ККserum (mg / ml)]
The creatinine clearance for women can be calculated by multiplying the obtained value by a factor of 0.85.
| Renal insufficiency | CK (ml / min) | Dosing regimen |
| Norm | >80 | usual dose |
| Lightweight | 50-79 | 2/3 of the usual dose in 2-3 doses |
| Average | 30-49 | 1/3 of the usual dose in 2 divided doses |
| Heavy | 20-30 | 1/6 of the usual dose once |
| The final stage | <20 | contraindicated |
Elderly patients are adjusted the dose in the presence of renal 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. Patients with impaired function of the kidneys and liver, dosing is carried out according to the scheme (see the section "Dosing to patients with impaired renal function").