Active substanceCiticolineCiticoline
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  • Dosage form: & nbspsolution for intravenous and intramuscular administration
    Composition:

    Composition per 1 ampoule

    Dosage of 125 mg / ml

    active substance: citicoline sodium 522.5 mg (in terms of citicoline 500 mg);

    Excipients: sodium hydroxide solution 1 M or hydrochloric acid solution 1 M (to pH 6.5-7.1); water for injection up to 4 ml.

    Dosage of 250 mg / ml

    active substance: citicoline sodium 1045 mg (in terms of citicoline 1000 mg);

    Excipients: sodium hydroxide solution 1 M or hydrochloric acid solution 1 M (to pH 6.5-7.1); water for injection up to 4 ml.

    Description:Transparent colorless solution (dosage of 125 mg / ml); transparent from a colorless to a greenish-yellowish color solution (dosage of 250 mg / ml).
    Pharmacotherapeutic group:Nootropic remedy
    ATX: & nbsp

    N.06.B.X.06   Citicoline

    Pharmacodynamics:

    Citicoline, being the predecessor of the key ultrastructural components of the cell membrane (mainly phospholipids), has a wide spectrum of action - it helps to repair damaged cell membranes, inhibits the effect of phospholipases, prevents excessive formation of free radicals, and also prevents cell death by affecting the mechanisms of apoptosis. In an acute period of a stroke citicoline reduces the amount of damage to the brain tissue, improves cholinergic transmission. With craniocerebral trauma reduces the duration of post-traumatic coma and the severity of neurologic symptoms, besides, it helps to reduce the duration of the recovery period.

    With chronic hypoxia of the brain citicoline effective in the treatment of cognitive disorders such as memory loss, lack of initiative, the difficulties encountered in carrying out daily activities and self-care. Increases the level of attention and consciousness, and also reduces the manifestation of amnesia.

    Citicoline is effective in the treatment of sensitive and motor neurological disorders of degenerative and vascular etiology.
    Pharmacokinetics:

    Suction. Citicoline is well absorbed by intravenous and intramuscular injection.

    Metabolism. With intravenous and intramuscular injection citicoline metabolized in the liver with the formation of choline and cytidine. After administration, the concentration of choline in the blood plasma is significantly increased.

    Distribution. Citicoline is largely distributed in the structures of the brain, with the rapid introduction of choline fractions into structural phospholipids and cytidine fractions into cytidine nucleotides and nucleic acids. Citicoline penetrates into the brain and actively integrates into cellular, cytoplasmic and mitochondrial membranes, forming part of the fraction of structural phospholipids.

    Excretion. Only 15% of the administered dose of citicoline is excreted from the human body; less than 3% - by the kidneys and through the intestine and about 12% - with exhaled CO2.

    In excretion of citicoline with urine, two phases can be identified: the first phase, lasting about 36 hours, during which the rate of elimination rapidly decreases, and the second phase, during which the rate of excretion decreases much more slowly. The same is observed in exhaled CO2 - the elimination rate decreases rapidly after about 15 hours, and then decreases much more slowly.

    Indications:

    - Acute period of ischemic stroke (as part of complex therapy);

    - the recovery period of ischemic and hemorrhagic strokes;

    - craniocerebral trauma (CCT), acute (as part of complex therapy) and the recovery period;

    - cognitive and behavioral disorders in degenerative and vascular diseases of the brain.

    Contraindications:

    Do not prescribe to patients with severe vagotonia (predominance of the parasympathetic part of the autonomic nervous system) and hypersensitivity to any of the components of the drug.

    Due to the lack of sufficient clinical data,not recommended for use in children under 18 years of age.

    Pregnancy and lactation:

    Sufficient data on the use of citicoline in pregnant women are absent. Although no adverse effects have been identified in animal studies, during the pregnancy, the drug Ceresil® Canon is prescribed only in cases where the expected benefit to the mother exceeds the potential risk to the fetus.

    When prescribing Ceresil® Canon during lactation, women should stop breastfeeding, as there is no data on the isolation of citicoline with human milk.

    Dosing and Administration:

    The drug is administered intravenously or intramuscularly.

    Intravenously, the drug is administered in the form of a slow intravenous injection (within 3-5 minutes, depending on the prescribed dose) or intravenous drip infusion (40-60 drops per minute).

    Intravenous route of administration is preferable to intramuscular. When intramuscular introduction should be avoided repeated administration of the drug in the same place.

    Recommended dosing regimen

    Acute period of ischemic stroke and craniocerebral trauma (CCI) \ 1000 mg every 12 hours from the first day after the diagnosis, duration of treatment is not less than 6 weeks. 3-5 days after the start of treatment (if the swallowing function is not broken), it is possible to switch to oral forms of the preparation Ceresil® Canon

    The recovery period of ischemic and hemorrhagic strokes, the recovery period of TBI, cognitive and behavioral disorders in degenerative and cerebrovascular diseases of the brain:

    500-2000 mg per day. Dosage and duration of treatment, depending on the severity of the symptoms of the disease. It is possible to use oral forms of the preparation Ceresil® Canon. If there is a suspicion of continuing intracranial hemorrhage, it is recommended not to exceed the dose of Tserasil® Kanon 1000 mg per day, the drug is injected intravenously at a rate of 30 drops per minute.

    Elderly patients

    When prescribing the drug Ceresil® Canon to elderly patients, dose adjustment is not required.

    The solution in the ampoule is intended for single use. It should be used immediately after opening the ampoule.

    The drug is compatible with all types of intravenous isotonic solutions and dextrose solutions.

    Side effects:

    Frequency of adverse reactions: very rare (less than 1/10 000, including individual cases)

    Allergic reactions: rash, skin itching, anaphylactic shock.

    Other: feeling of heat, swelling, shortness of breath.

    From the side of the central nervous system and the peripheral nervous system: insomnia, headache, dizziness, tremor, numbness in the paralyzed limbs, stimulation of the parasympathetic nervous system.

    From the side of mental disorders: hallucinations, excitement.

    From the cardiovascular system: short-term change in blood pressure.

    From the digestive system: nausea, decreased appetite, vomiting, diarrhea altered activity of hepatic enzymes. .

    If any of the side effects indicated in the manual are aggravated, or any other side effects not indicated in the instructions were noticed, you should inform your doctor about it.

    Overdose:Given the low toxicity of the drug, overdose cases have not been described.
    Interaction:

    Citicoline increases the effects of levodopa.

    Do not use simultaneously with medicines containing meclophenoxate.

    Special instructions:

    The drug Ceresil® Canon is injected intravenously slowly (3-5 minutes depending on the dose). When intravenous drip introduction, the infusion rate should be 40-60 drops per minute.

    With persistent intravenous hemorrhage, it is recommended not to exceed the dose of Tserasil® Kanon 1000 mg / day, the drug is injected intravenously at a rate of 30 drops per minute.

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

    During the treatment period, care should be taken when performing potentially hazardous activities requiring special attention and quick reactions (driving and other vehicles, working with moving mechanisms, dispatcher and operator work, etc.).

    Form release / dosage:Solution for intravenous and intramuscular injection 125 mg / ml, 250 mg / ml.
    Packaging:

    By 4 ml in ampoules for medicines, made of medical glass grades HC-1 or HC-3 or 1-hydrolytic class. By 3, 5 or 10 ampoules per contour cell pack of film polyvinyl chloride. For 1 contour cell package of 3 ampoules or 1, 2 circuit packs of 5 ampoules or 1 contour pack of 10 ampoules together with the instructionon application put in a pack of cardboard.

    Storage conditions:

    At a temperature of no higher than 25 ° C in the manufacturer's packaging.

    Keep out of the reach of children.

    Shelf life:

    2 years.

    Do not use after the expiration date.

    Terms of leave from pharmacies:On prescription
    Registration number:LP-004473
    Date of registration:28.09.2017
    Expiration Date:28.09.2022
    The owner of the registration certificate:CANONFARMA PRODUCTION, CJSC CANONFARMA PRODUCTION, CJSC Russia
    Manufacturer: & nbsp
    Information update date: & nbsp18.10.2017
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