Neupilept 100mg/ml 100ml #1

Neupilept user manual

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Composition

Composition (1 ml / 1 amp.):
    active ingredient: citicoline sodium (in terms of citicoline) 125 mg / 250mg / 500 mg;
    excipients: hydrochloric acid 1M or sodium hydroxide solution 1M - to pH 6.5-7.5, water d / and - up to 4 ml.
Packaging - in the package 5pcs.

pharmachologic effect

Selectively blocks (characterized by high affinity) 5-HT2-serotonergic, D2-dopaminergic, alpha1-adrenergic, to a lesser extent alpha2-adrenergic and histamine H1 receptors in the CNS. It has a poorly pronounced affinity for 5-HT1A-, 5-HT1C-, 5-HT1D-serotonergic, D1-dopaminergic receptors and haloperidol-sensitive binding sites of sigma, low affinity for 5-НТ1В- and 5-НТ3 receptors. Does not have the ability to interact with m-cholinergic and beta1, beta2-adrenergic receptors.
It has antipsychotic, sedative, antiemetic and hypothermic effects. The antipsychotic effect is due to the blockade of the D2-dopaminergic receptors of the mesolimbic and mesocortical systems. Sedative action is a consequence of blockade of adrenoreceptors of the reticular formation of the brain stem, antiemetic - blockade of the D2-dopaminergic receptors of the trigger zone of the vomiting center, hypothermic - blockade of the dopamine receptors of the hypothalamus. Suppresses delirium, hallucinations, reduces the feeling of fear, reduces aggressiveness. To a lesser extent than classical neuroleptics, it inhibits motor activity, induces catalepsy and less often causes the appearance of extrapyramidal symptoms. May cause hyperprolactinemia, ADH hypersecretion. Changes the structure of sleep, enhances deep slow-wave sleep (antiserotonin effect). Blocking alpha-adrenoreceptors causes dose-dependent hypotension and reflex tachycardia. It has potential proarrhythmogenic effect, since extends the QT interval. There is evidence of a decrease or suppression of risperidone secretion of saliva, which contributes to the development of caries, periodontal diseases and oral candidiasis; however, some patients had hypersalivation.
Citicoline is a natural endogenous compound that is an intermediate metabolite in the synthesis of phosphatidylcholine - one of the main structural components of the cell membrane.
It has a wide spectrum of action - helps to restore damaged cell membranes, inhibits the action of phospholipases, prevents excessive formation of free radicals, and also prevents cell death, affecting the mechanisms of apoptosis. In the acute period of a stroke, citicoline reduces the amount of damage to brain tissue, improves cholinergic transmission. When TBI reduces the duration of post-traumatic coma and the severity of neurological symptoms, in addition, reduces the duration of the recovery period.
In chronic cerebral hypoxia, citicoline is effective in the treatment of cognitive disorders, such as memory impairment, lack of initiative, difficulties encountered in performing daily activities and self-care. Increases the level of attention and consciousness, and also reduces the manifestation of amnesia.
Citicoline is effective in treating sensory and motor neurological disorders of degenerative and vascular etiology.

Metabolism

After iv administration, citicoline is rapidly hydrolyzed to choline and cytidine and delivered to various tissues of the body.

Distribution

After the introduction of citicoline is widely distributed in brain structures with the rapid inclusion of the choline fraction in the structural phospholipids and cytidine fractions in the cytidine nucleotides and nucleic acids. Having reached the brain, citicoline is embedded in the cellular, cytoplasmic and mitochondrial membranes, taking part in the construction of the phospholipid fraction.

Removal

Only a small amount of the dose is excreted by the kidneys and through the intestines.

Neupilept, indications for use

Schizophrenia (acute and chronic) and other psychotic states with a predominance of productive (delusions, hallucinations, aggressiveness), negative (dull affect, emotional and social detachment, speech scarcity) or affective (anxious depression) symptoms; behavioral disorders on the background of dementia (with the onset of symptoms of aggressiveness, impaired activity or psychotic symptoms) or mental retardation or a reduced level of intelligence (with the dominance of destructive behavior); mania for bipolar disorders (adjuvant therapy).
    The acute period of ischemic stroke (as part of complex therapy);
    recovery period of ischemic and hemorrhagic strokes;
    traumatic brain injury, acute (as part of complex therapy) and the recovery period;
    cognitive and behavioral disorders in degenerative and vascular diseases of the brain.

Contraindications

    Hypersensitivity to any of the components of Neupilept;
    should not be prescribed to patients with severe vagotonia (high tone of the parasympathetic part of the autonomic nervous system);
    due to the lack of sufficient clinical data, it is not recommended for use in children under 18 years of age.

Dosage and administration

/ m, in / in, jet (slowly, over 3-5 min, depending on the dose prescribed) or drip (infusion rate - 40-60 drops / min).
In / in the route of administration is preferable to the / m. When in / m the introduction should be avoided repeated administration of Neupilept in the same place.
Neupilept should be used immediately after opening the ampoule.

Recommended Dosing Regimen

The acute period of ischemic stroke and TBI: 1000 mg of citicoline every 12 hours from the first day after diagnosis, the duration of treatment is at least 6 weeks. The maximum daily dose is 2000 mg.
Recovery period for ischemic and hemorrhagic strokes, recovery period for traumatic brain injury, cognitive and behavioral disorders in degenerative and vascular diseases of the brain: 500–2000 mg of citicoline daily i.v. or v / m. Dosage and duration of treatment - depending on the severity of symptoms of the disease .
Elderly patients. In the appointment of the drug Neupilept elderly patients dose adjustment is not required.
Neupilept is compatible with all types of IV isotonic solutions and dextrose solutions.

Use during pregnancy and lactation

When using citicoline during lactation, women should stop breastfeeding, since data on the excretion of citicoline in breast milk are not available.

Side effects

From the nervous system and sensory organs: sleep disturbance, incl. insomnia or drowsiness, irritability, fatigue, impaired attention, anxiety, anxiety, headache, vertigo (in elderly predisposed patients), blurred vision.
Since the cardiovascular system and blood (hematopoiesis, hemostasis): orthostatic hypotension, reflex tachycardia, arterial hypertension, neutroma and thrombopenia, thrombocytopenic purpura.
On the part of the digestive tract: nausea, vomiting, dyspeptic symptoms, abdominal pain, constipation, increased levels of hepatic transaminases.
On the part of the urogenital system: dysmenorrhea, amenorrhea, impotence, erectile dysfunction and ejaculation, anorgasmia, decreased libido, priapism, polyuria, urinary incontinence, edema.
Allergic reactions: skin rash, angioedema.
Other: rhinitis, galactorrhea, gynecomastia, weight gain, hypervolemia (due to polydipsia or syndrome of inadequate secretion of ADH), hyperglycemia (in patients with diabetes).

special instructions

Neupilept is slowly injected into the jet (3-5 min, depending on the dose). With IV drip infusion should be 40-60 drops per minute.
In case of persistent intracranial hemorrhage, it is recommended not to exceed a dose of Neupilept 1000 mg / day, the drug is administered intravenously in a drip at a rate of 30 drops per minute.
Influence on ability to steer vehicles, mechanisms
During the use of Neupilept should be careful when driving and when engaged in other potentially hazardous activities that require high concentration of attention and speed of psychomotor reactions.

Interaction

Citicoline enhances the effects of levodopa.

Overdose

In view of the low toxicity of the Neupilept drug, overdose cases are not described.

Storage conditions

Shelf life - 2 years.

    At a temperature not higher than 25 ° C.
    Keep out of the reach of children.

Terms of sell

You can buy Neupilept without a prescription.