Cocarnit powder 187,125mg amps #3 + 2ml amps #2

Instruction for Cocarnit

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Composition

In 1 ampoule nicotinamide 20 mg, cocarboxylase 50 mg, cyanocobalamin 0.5 mg, adenosine triphosphate 10 mg.
Glycine, methyl parahydroxybenzoate, propyl parahydroxybenzoate, - as auxiliary substances.

Form of issue

Lyophilizate for solution preparation + lidocaine solvent in ampoules.

pharmachologic effect

Metabolic.

Pharmacodynamics and pharmacokinetics

Pharmacodynamics

It is a complex of vitamins and substances that affect metabolism. On the mechanism of action provides a neurometabolic, analgesic effect and affects the emotional-vegetative sphere.
Nicotinamide has a beneficial effect on nitrogen and carbohydrate metabolism, participates in oxidation-reduction reactions and facilitates the delivery of ATP to the cells. It has a sedative effect, therefore it is effective in neuropsychic disorders, anxiety, depression, and loss of attention.
Kokarboksilaza - is a coenzyme that plays a big role in carbohydrate metabolism, improves trophism of tissues, affects the synthesis of nucleic acids, proteins and lipids, promotes the absorption of glucose.
Cyanocobalamin promotes the synthesis and accumulation of protein, activates the exchange of fats and carbohydrates. The result of this action is lowering cholesterol and preventing fatty hepatosis. Cyanocobalamin increases the regenerative capacity of cells, is necessary for the functioning of the hematopoietic organs, the nervous system and the liver.
Adenosine triphosphate is an adenosine derivative, stimulates metabolic processes and is the main energy substrate of the cell. With ischemia, an energy deficit develops, which decreases due to adenosine triphosphate. Its transportation to the cells is carried out by nicotinamide. Adenosine triphosphate has antiarrhythmic, vasodilating and hypotensive action.

Pharmacokinetics

Not studied.

Indications for use

    neuralgia of different origin;
    neuritis;
    lumbago, sciatica, radiculitis;
    Neuropathy (for example, diabetes mellitus);
    myalgia, tendinitis, bursitis;
    IHD, myocardiopathy, myocarditis;
    during pregnancy apply, if the benefit to the mother is more risk to the fetus.

Contraindications

    hypersensitivity;
    erythrocytosis, erythremia;
    severe form of hypertension and hypotension;
    psoriasis;
    conduction disorders and severe heart failure;
    myocardial infarction in an acute period.
With caution is prescribed for gastritis, peptic ulcer, gout, liver damage. Data on use in children are absent.
Additionally, contraindications for the solvent - 0.5% lidocaine hydrochloride: sinus node weakness syndrome, Adams-Stokes syndrome and Wolff-Parkinson-White syndrome, stress angina, epileptiform convulsions associated with taking lidocaine, myasthenia gravis, porphyria, severe renal failure should also be taken into account.

Side effects

    headache, weakness of dizziness;
    tachycardia;
    skin rashes, itching;
    anaphylactic shock;
    hives;
    sweating;
    diarrhea;
    pulmonary edema;
    peripheral vascular thrombosis.
Persons with hypersensitivity before the introduction of the drug are given an intradermal test.

Cocarnit, instructions for use (Method and dosage)

Intramuscularly injected 1-2 ampoules daily. Cocarnit injections are performed by courses, the duration of which depends on the severity of the disease.
The solution is used immediately after preparation, it must be red. If the color has not changed, it can not be applied.
Instructions for Cocarnit contains a warning about the need to monitor platelets and erythrocytes, clotting time, bilirubin, uric acid and transaminases.

Overdose

Cocarnit with accidental ingestion can cause a manifestation of toxicity, which is expressed by itching, flushing of the skin, headache, nausea, heartburn, and vomiting.
Chronic intoxication is expressed by an increase in the level of glucose, uric acid, the appearance of duodenal ulcers.

Interaction

The cocarboxylase, which is part of the drug, strengthens the cardiotonic effect of cardiac glycosides.
Nicotinamide potentiates the anticonvulsant effect of antiepileptic drugs (diazepam, carbamazepine, Valproate).
Adenosine triphosphate with potassium-sparing diuretics, ACE inhibitors and potassium preparations increases the risk of hyperkalemia. Strengthens the antianginal effect of β-adrenoblockers and nitrates.
When taken with dipyridamole, vasodilating action is enhanced.
There is antagonism when used in conjunction with caffeine and Teofillin.
Xanthinal nicotinate reduces the effect of adenosine triphosphate, and carbamazepine enhances its effect.
Reduces the absorption of cyanocobalamin aminoglycosides, potassium preparations, salicylates, antiepileptic drugs and colchicine.
Absorption of cyanocobalamin also decreases with the use of Kanamycin, Neomacin, Polymyxin, Tetracycline.
Incompatible cyanocobalamin with ascorbic acid, pyridoxine, riboflavin, salts of heavy metals.
Oral contraceptives reduce the concentration of cyanocobalamin in the blood.

Storage conditions

At a temperature of 15 to 25 ° C.
Shelf life - 3 years.

Reviews of Cocarnit

The doctors' comments on the injections of Cocarnit mostly testify to the effectiveness of the drug in neurological, neurosurgical and cardiosurgical practice.
In scientific research of Belarusian scientists who used Cocarnit in cardiosurgical practice in the postoperative period, the conclusions were drawn that the drug significantly reduces the amount of wound detachable, vertebrogenic pains, and the use of non-steroidal anti-inflammatory drugs.
Studies have shown that the state of the myocardium during cardiopulmonary bypass during the operation was better in patients who took this drug in the preoperative period.
A number of studies were conducted in patients with myofascial dysfunction, which was prescribed this drug. On the 10th day of treatment, there was a positive trend: pain and muscle-tonic syndrome decreased. The vegetative and emotional sphere of patients improved: mood was normalized, activity appeared, anxiety decreased.
The drug has proved itself in the complex treatment of patients with discogenic lumbosacral radiculitis. Cocarnit was used intramuscularly at 2.0 ml per day from 14 to 21 days. Clinical effect occurred after 3 days. The regression of the pain syndrome was noted at 3-5 days. Patients did not notice any side effects.