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Active ingredients
Inosine + Nicotinamide + Riboflavin + Succinic Acid
Release form
Pills
Composition
Active ingredient: succinic acid 300 mg, inosine (riboxin) 50 mg, nicotinamide 25 mg, riboflavin mononucleotide 5 mg Concentration of active substance (mg): 380 mg
Pharmacological effect
Metabolic drug. Pharmacological effects are due to the complex action of the components that make up the preparation Cytoflavin. Succinic acid is an endogenous intracellular metabolite of the Krebs cycle, which performs a universal energy-synthesizing function in the cells of the body. With the participation of the coenzyme flavinadenedinucleotide (FAD), succinic acid, a mitochondrial enzyme succinate dehydrogenase, is rapidly transformed into fumaric acid and further into other metabolites of the tricarboxylic acid cycle. Stimulates aerobic glycolysis and ATP synthesis in cells. The final product of the metabolism of succinic acid in the Krebs cycle is carbon dioxide and water. Succinic acid improves tissue respiration due to the activation of electron transport in mitochondria. Inosine is a purine derivative, the precursor of ATP. It has the ability to activate a number of enzymes of the Krebs cycle, stimulating the synthesis of key enzymes-nucleotides - FAD and NAD. Nicotinamide (vitamin RR), nicotinic acid amide. Nicotinamide in cells, through a cascade of biochemical reactions, is transformed into the form of nicotinamide adenine nucleotide (NAD) and its phosphate (NADP), activating nicotinamide-dependent Krebs cycle enzymes necessary for cellular respiration and stimulation of ATP synthesis. Riboflavin (vitamin B2) is a flavin-containing enzyme enzyme. ), activating succinate dehydrogenase and other redox reactions of the Krebs cycle. Thus, all components of the preparation Cytoflavin are natural metabolites of the body and stimulate tissue dyes Chania Metabolic energy correction, antihypoxic and antioxidant activity of the drug, determining the pharmacological properties and therapeutic effectiveness of the components, due to the complementary effect of succinic acid, inosine, nicotinamide and riboflavin.
Pharmacokinetics
Cytoflavin has a high bioavailability. When ingested, succinic acid is absorbed from the gastrointestinal tract, enters the blood and tissues, participating in energy metabolism reactions, and completely decomposes to the final metabolic products (carbon dioxide and water) after 30 minutes. Inosine is well absorbed from the gastrointestinal tract.Tmax in the blood is 5 h, the average retention time in the blood is 5.5 h, Vd in the equilibrium state is about 20 l. Inosine is metabolized in the liver to form inosine monophosphate, followed by its oxidation to uric acid. In small quantities excreted by the kidneys. Nicotinamide is rapidly distributed in all tissues (Vd in the equilibrium state - about 500 liters). Tmax in the blood is 2 hours, the average retention time in the blood is 4.5 hours. Metabolized in the liver to form N-methylnicotinamide. Excreted by the kidneys. Nicotinamide penetrates the placental barrier. It penetrates into breast milk. Riboflavin is rapidly absorbed from the gastrointestinal tract, is unevenly distributed (the largest amount in the myocardium, liver, kidneys), transformed into flavivadenine mononucleotide (FMN) and FAD in mitochondria. It penetrates the placental barrier. It is excreted in breast milk. Excreted by the kidneys, mainly in the form of metabolites.
Indications
Tablets As part of the complex therapy in adults: - Chronic cerebral ischemia stage 1-2 (cerebral atherosclerosis, hypertensive encephalopathy, the effects of stroke); - asthenic syndrome (malaise and fatigue). Solution for iv administration. In the composition of complex therapy in adults: - acute violation of cerebral circulation; - dyscirculatory (vascular) encephalopathy stage 1-2 and the consequences of cerebral circulation disorders (chronic cerebral ischemia); - toxic and hypoxic encephalopathy in acute and chronic poisoning, endotoxicosis, depression of consciousness after anesthesia.
Contraindications
- lactation (for iv administration); - hypersensitivity to the drug. Patients who are on a ventilator, it is not recommended to prescribe Cytoflavin with a decrease in the partial pressure of oxygen in arterial blood below 60 mm Hg. st. Caution should be given to the solution for on / in the introduction of nephrolithiasis, gout, hyperuricemia. Precautions should be prescribed pills Tsitoflavin for gastrointestinal diseases (erosive gastroduodenitis, peptic ulcer).
Precautionary measures
In patients with diabetes mellitus, treatment should be carried out under the control of the concentration of glucose in the blood.
Use during pregnancy and lactation
It is not recommended to use Cytoflavin during pregnancy and lactation, due to the lack of clinical data on the efficacy and safety of the drug in this category of patients.
Dosage and administration
Pills Inside take 2 tab. 2 times / day for 30 minutes before meals, without chewing with an interval of 8-10 hours (drink 100 ml of water). Course duration - 25 days (100 tab.).Evening administration of the drug is recommended no later than 18 hours. The appointment of a repeated course is carried out with an increase in cerebrovascular insufficiency, but not earlier than 25-30 days after the end of the previous course. The solution for IV injection Tsitoflavin is administered only in / 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 the 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. With prolonged use in high doses: transient hypoglycemia, hyperuricemia, exacerbation of gout are possible. 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. Allergic reactions: itching is possible. Others: with intravenous drip infusion rarely - dysosmia, blanching of the skin of varying severity.
Overdose
To date, no cases of an overdose of the drug Cytoflavin have been established.
Interaction with other drugs
Succinic acid, inosine and nicotinamide, which are part of the drug Cytoflavin, are compatible with other drugs. Riboflavin, which is part of the drug Cytoflavin, reduces the activity of some antibiotics (tetracyclines, erythromycin, lincomycin), is incompatible with streptomycin.Ethanol, tricyclic antidepressants, tubular secretion blockers reduce riboflavin absorption, and thyroid hormones accelerate its metabolism.
special instructions
In case of arterial hypertension, dosage adjustment of antihypertensive drugs may be required. During the period of treatment, intense staining of urine is possible in yellow color. The effect on the ability to drive vehicles and control mechanisms Tsitoflavin does not affect the ability to drive vehicles, to work with moving mechanisms; to work dispatchers and operators.