Cytoflavin ampoule solution 10ml N5
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Active ingredients
Inosine + Nicotinamide + Riboflavin + Succinic Acid
Release form
Solution
Composition
Ingredients Solution for iv injection clear, yellow color. 1 liter of succinic acid 100 g inosine (Riboxin) 20 g nicotinamide 10 g riboflavin sodium phosphate (riboflavin) 2 g Excipients: meglumin (N-methylglucamine) - 165 g, sodium hydroxide - 34 g, water d / and - up to 1 l .
Pharmacological effect
Metabolic drug. Pharmacological effects are due to the complex effect of the components contained in the preparation Cytoflavin. Stimulates the processes of cellular respiration and energy production, improves the utilization of oxygen by tissues, restores the activity of enzymes that provide antioxidant action. The drug activates intracellular protein synthesis, promotes the utilization of glucose, fatty acids and GABA resynthesis in neurons through a Roberts shunt. It has a positive effect on the bioelectrical activity of the brain. Cytoflavin improves cerebral and coronary blood flow, activates metabolic processes in the central nervous system, reduces reflex disorders, helps to restore impaired sensitivity and intellectual-mnestic brain functions. Positive effect on the parameters of the neurological status: reduces the severity of asthenic, cephalgic, vestibular-cerebellar, cochleo-vestibular syndrome, and also levels the disorders in the emotional-volitional sphere (reduces anxiety, depression). Improves cognitive-mnestic functions and quality of life. When a / in the introduction contributes to the restoration of disturbed consciousness. It has a quick awakening effect in post-anesthetic depression of consciousness. When using Cytoflavin in the first 12 hours from the onset of stroke, there is a favorable course of ischemic and necrotic processes in the affected area (reduction of the focus), restoration of neurological status and a decrease in the level of disability in the long-term period.
Pharmacokinetics
With intravenous infusion at a rate of about 2 ml / min (in terms of undiluted cytoflavin), succinic acid and inosine are utilized almost instantly and are not detected in the blood plasma. Inosine is metabolized in the liver with the formation of hypoxanthine and subsequent oxidation to uric acid.In small quantities excreted by the kidneys. Nicotinamide is rapidly distributed in all tissues, penetrates the placental barrier, is excreted in breast milk. Metabolized in the liver to form nicotinamide-N-methylnicotinamide, excreted by the kidneys. T1 / 2 of plasma is about 1.3 h, Vss is about 60 l, total clearance is about 0.6 l / min. Riboflavin is unevenly distributed: the largest number is in the myocardium, liver, and kidneys. T1 / 2 of plasma is about 2 h, Vss is about 40 liters, total clearance is about 0.3 l / min. Gets through a placental barrier, it is allocated with breast milk. Plasma protein binding - 60%. Excreted by the kidneys, partly as a metabolite; when used in high doses, mostly unchanged.
Indications
Solution for iv administration. As part of complex therapy in adults: Acute cerebrovascular accident. Circulatory (vascular) encephalopathy stage 1-2 and consequences of cerebral circulation disorder (chronic cerebral ischemia). Toxic and hypoxic encephalopathy in acute and chronic poisoning, endotoxicosis, depression of consciousness after anesthesia.
Contraindications
Lactation. Increased sensitivity to the components of the drug. Patients on mechanical ventilation are not recommended to prescribe Cytoflavin when the partial pressure of oxygen in arterial blood is lower than 60 mm Hg. Caution should be given to the solution for on / in the introduction of nephrolithiasis, gout, hyperuricemia.
Precautionary measures
On the part of the digestive system: with a / in the introduction rarely - short-term pain and discomfort in the epigastric region, nausea. On the part of the respiratory system: with intravenous drip infusion rarely - transient pain and discomfort in the chest, difficulty breathing, tingling sensation in the nose. From the side of the central nervous system: if taken orally, transient headache is possible; with IV drip infusion rarely - headache, dizziness.
Use during pregnancy and lactation
If necessary, you can use the drug inside during pregnancy and lactation (breastfeeding) in the absence of allergic reactions to the components of the drug. In / in the introduction of the drug during pregnancy is allowed, during lactation (breastfeeding) - is contraindicated.
Dosage and administration
Solution for iv administration Cytoflavin is administered only intravenously in a drip in a dilution of 100–200 ml of 5–10% glucose solution, 0.9% sodium chloride solution. In acute cerebrovascular accident, the drug is administered as early as possible from the onset of the development of the disease in a volume of 10 ml per injection with an interval of 8-12 hours for 10 days. In the case of severe disease, a single dose is increased to 20 ml. In case of dyscirculatory encephalopathy and the consequences of cerebral circulation disorders, Cytoflavin is administered in a dose of 10 ml of solution per 1 injection 1 time / day for 10 days. In case of toxic and hypoxic encephalopathy, the drug is administered in a dose of 10 ml of solution per injection 2 times / day after 8-12 hours for 5 days. In a comatose state, the drug is administered in a volume of 20 ml for administration at a dilution of 200 ml of glucose solution. When depression of consciousness after anesthesia, the drug is administered once in the same doses.
Side effects
With the rapid on / in a drip, possible hyperemia of the skin of varying severity, feeling of heat, bitterness and dry mouth, sore throat. These adverse reactions do not require discontinuation of the drug. Transient hypoglycemia, hyperuricemia, exacerbation of gout are possible during long-term high-dose administration. / in drip infusion rarely - short-term pain and discomfort in the chest, difficulty breathing, tingling sensation in the nose. On the side of the central nervous system, transient headache is possible when ingesting. with intravenous drip infusion rarely - headache, dizziness. Allergic reactions may cause itching. Others with intravenous drip infusion rarely - dysosmia, blanching of the skin of varying severity.
Overdose
Symptoms of an overdose of the drug Tsitoflavin not detected.
Interaction with other drugs
Succinic acid, inosine and nicotinamide (active ingredients of the drug Cytoflavin) are compatible with other drugs. Cytoflavin is compatible with hematopoietic stimulants, antioxidants and anabolic steroids. With simultaneous use of Cytoflavin, it should be noted that the riboflavin in its composition reduces the activity of doxycycline, tetracycline, oxytetracycline, erythromycin and lincomycin; incompatible with streptomycin.When combined with Cytoflavin chlorpromazine, imizin, amitriptyline, blockade of flavinokinase disrupts the inclusion of riboflavin in flavivinenin mononucleotide and flavinadin din dinucleotide and increases its excretion in the urine. With the simultaneous use of thyroid hormones accelerate the metabolism of riboflavin. When used together, Cytoflavin reduces and prevents the development of side effects of chloramphenicol (impaired hematopoiesis, optic neuritis).
special instructions
In critical conditions, intravenous drug administration is possible after the normalization of central hemodynamics. During treatment, plasma glucose levels should be monitored. On the background of the introduction of the drug may stain urine in a light yellow color. Influence on ability to drive motor transport and control mechanisms: When administered the drug does not affect the ability to concentrate.