Cavinton concentrate for solution for infusion 5mg ml 2ml N10
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Active ingredients
Vinpocetine
Release form
Solution
Composition
Vinpocetine 5 mg. Auxiliary substances: ascorbic acid - 0.5 mg, sodium disulfite - 1 mg, tartaric acid - 10 mg, benzyl alcohol - 10 mg, sorbitol - 80 mg, water d / and - up to 1 ml.
Pharmacological effect
A drug that improves cerebral circulation and cerebral metabolism. Improves brain metabolism by increasing the consumption of glucose and oxygen by the brain tissue. Increases the resistance of neurons to hypoxia; enhancing glucose transport to the brain, through the BBB; translates the process of glucose decomposition into an energetically more economical, aerobic way; selectively blocks Ca2 + -dependent phosphodiesterase; increases levels of adenosine monophosphate (AMP) and cyclic guanosine monophosphate (cGMP) of the brain. Increases ATP concentration in brain tissue; enhances the metabolism of norepinephrine and brain serotonin; stimulates the ascending branch of the noradrenergic system, has an antioxidant effect. Reduces platelet aggregation and increased blood viscosity; increases the deforming ability of erythrocytes and blocks the utilization of adenosine by erythrocytes; promotes increase in oxygen return by erythrocytes. Strengthens neuroprotective effect of adenosine. Increases cerebral blood flow; reduces the resistance of cerebral vessels without significant changes in systemic blood circulation (BP, minute volume, heart rate, OPSS). It does not have a robbery effect, increases blood circulation, especially in ischemic brain regions with low perfusion.
Pharmacokinetics
Distribution Therapeutic plasma concentration - 10-20 ng / ml. When parenterally administered Vd - 5.3 l / kg. It easily penetrates through histohematogenous barriers (including BBB). Introduction T1 / 2 is 4.74–5 h. It is eliminated from the kidneys and through the gastrointestinal tract in a ratio of 3: 2.
Indications
- reducing the severity of neurological and psychiatric symptoms in various forms of circulatory insufficiency of the brain (ischemic stroke, a cross, a cross-section of the hemorrhagic stroke, the consequences of a stroke; transient ischemic attack; vascular dementia; vertebrobasilar insufficiency; atherosclerosis of the brain; post-stroke; vascular diseases of the choroid and retina (for example, thrombosis / occlusion / center Flax retinal artery or vein), - for the treatment of hearing loss perceptual type, Meniere's disease,idiopathic tinnitus.
Contraindications
- acute phase of hemorrhagic stroke; - severe form of coronary artery disease; - severe arrhythmia; - pregnancy; - lactation period; - age up to 18 years (due to insufficient data); - hypersensitivity to the components of the drug.
Precautionary measures
Do not exceed recommended doses.
Use during pregnancy and lactation
The drug is contraindicated in pregnancy and lactation.
Dosage and administration
The drug is intended for intravenous drip infusion. Inject slowly, the rate of infusion should not exceed 80 drops / min. Do not enter in / m and / in without dilution. To prepare the infusion, you can use saline or solutions containing dextrose (Salsol, Ringer, Reindex, Reomacrodex). An infusion solution with Cavinton should be used in the first 3 hours after preparation. The usual initial daily dose is 20 mg in 500 ml of infusion solution. Depending on tolerance, within 2-3 days the dose can be increased to no more than 1 mg / kg / day. The average duration of treatment is 10-14 days. The average daily dose for a body weight of 70 kg is 50 mg (in 500 ml of infusion solution). In case of liver and kidney diseases, dose adjustment is not required. At the end of the course of IV therapy, it is recommended to continue treatment with Cavinton Forte pills (1 tab. 3 times / day) or Cavinton (2 tab. 3 times / day).
Side effects
Side effects associated with the use of the drug were rarely detected. From the side of the cardiovascular system: ECG changes (ST depression, prolongation of the QT interval), tachycardia, extrasystole (the causal relationship with taking the drug has not been proven, because in the natural population the same frequency); change in blood pressure (often reduced), reddening of the skin, phlebitis. On the CNS side: sleep disturbances (insomnia, increased sleepiness), dizziness, headache, general weakness (these symptoms may be manifestations of the underlying disease). On the part of the digestive system: dry mouth , nausea, heartburn. Others: skin allergic reactions, increased sweating.
Overdose
Treatment: gastric lavage, taking activated charcoal, conducting symptomatic therapy.
Interaction with other drugs
With simultaneous use is not observed interaction with beta-blockers (chloranolol, pindolol), clopamide, glibenclamide, digoxin, acenocoumarol or hydrochlorothiazide. In rare cases, the simultaneous use of alpha methyldopa is accompanied by some strengthening of the hypotensive effect,when using such a combination, regular blood pressure control is necessary. Despite the lack of data confirming the possibility of interaction, caution is recommended with simultaneous prescribing with centrally acting drugs and antiarrhythmics. Pharmaceutical interaction in one infusion mixture, however, it is possible to simultaneously treat with anticoagulants and vinpocetine. Kavi tone in the form of a concentrate for solution for infusion is not compatible with infusion solutions containing amino acids, so they can not be used for cultivation of Cavinton.
special instructions
The presence of prolonged QT syndrome and taking drugs that prolong the QT interval requires periodic ECG monitoring. The infusion solution of Cavinton contains sorbitol (160 mg / 2 ml), therefore, in the presence of diabetes mellitus, blood glucose should be periodically monitored. In case of fructose intolerance or deficiency of fructose 1,6-diphosphatase should avoid the use of vinpocetine. The effect on the ability to drive vehicles and control mechanisms of the Data on the effect of Vinpocetine on the ability to driving and working mechanisms no.