Piracetamum - description of the substance, instructions, use, contraindications and formula.

pharmachologic effect

Nootropic drug. It has a positive effect on metabolic processes and blood circulation in the brain. Increases glucose utilization, improves metabolic processes, improves microcirculation in ischemic areas, inhibits aggregation of activated platelets

.
It has a protective effect against brain damage caused by hypoxia, intoxication, and electric shock
.
Improves integrative brain activity
. Does not have a sedative or psychostimulating effect.

Pharmacokinetics

When taken orally, it is quickly and almost completely absorbed from the gastrointestinal tract. Cmax in plasma is achieved after approximately 30 minutes, in cerebrospinal fluid - after 2-8 hours

. The apparent Vd is 0.6 l/kg. Does not bind to blood plasma proteins.

Distributed in all organs and tissues, penetrates the BBB and the placental barrier. Selectively accumulates in the tissues of the cerebral cortex, mainly in the frontal, parietal and occipital lobes, in the cerebellum and basal ganglia.

T1/2 from plasma is 4-5 hours, from cerebrospinal fluid - 6-8 hours. Excreted unchanged by the kidneys

. In renal failure, T1/2 increases.

Indications

Memory impairment, dizziness, decreased concentration, emotional lability, dementia due to cerebrovascular accidents (ischemic stroke), brain injury, Alzheimer's disease, in old age; comatose states of vascular, traumatic or toxic origin; treatment of abstinence and psychoorganic syndrome in chronic alcoholism; learning disabilities in children not associated with inadequate training or characteristics of the family environment (as part of combination therapy); sickle cell anemia (as part of combination therapy).

Dosage regimen

Adults orally - 30-160 mg/kg/day in 2-4 doses. Duration of treatment is 6-8 weeks.

If necessary, apply intramuscularly or intravenously at an initial dose of 10 g/day. When administered intravenously to patients in severe condition, the daily dose can be 12 g. After clinical improvement, the dose is gradually reduced and switched to oral administration.

Children orally - 30-50 mg/kg/day in 2-3 doses. Treatment should be continued for at least 3 weeks.

Side effect

From the digestive system:

rarely - dyspeptic symptoms, abdominal pain.

From the side of the central nervous system:

rarely - nervousness, agitation, irritability, anxiety, sleep disorders, dizziness, headache, tremor; in some cases - weakness, drowsiness.

Other:

increased sexual activity.

Contraindications for use

Hemorrhagic stroke, severe renal failure (with CC<20 ml/min), hypersensitivity to piracetam.

Use during pregnancy and breastfeeding

Adequate and strictly controlled studies of the safety of piracetam during pregnancy have not been conducted. Use is possible only in cases where the expected benefit to the mother outweighs the possible risk to the fetus.

Piracetam appears to pass into breast milk. If it is necessary to use it during lactation, the issue of stopping breastfeeding should be decided.

In experimental studies

In animals, no negative effects of piracetam on the fetus were detected.

Use in children

In children

:

— treatment of dyslexia in children from 8 years of age in combination with other methods;

— relief of sickle cell vaso-occlusive crisis.

Overdose

There may be an increase in possible side effects.

First aid

- gastric lavage, taking activated charcoal.

Drug interactions

A case of interaction of piracetam with simultaneous use with a thyroid extract containing triiodothyronine and tetraiodothyronine is described, when the patient experienced anxiety, irritability and sleep disorders.

When used simultaneously with thyroid hormones, the development of central effects is possible - tremor, anxiety, irritability, sleep disturbances, confusion.

With the simultaneous use of central nervous system stimulants, the psychostimulating effect may be enhanced.

When used simultaneously with antipsychotics, an increase in extrapyramidal disorders is observed.

Conditions for dispensing from pharmacies

On prescription.

Storage conditions and periods

List B. Store in a dry place, out of reach of children, at a temperature not exceeding 25°C

.
Shelf life :
3 years. Do not use after expiration date.

Use for renal impairment

Contraindicated in severe renal failure (creatinine clearance <20 ml/min).

Use with caution in patients with renal failure. Continuous monitoring of renal function indicators is recommended.

special instructions

Use with caution in patients with severe hemostatic impairment, during major surgical operations and severe bleeding; with renal failure.

Continuous monitoring of renal function indicators is recommended.

If sleep disturbances occur, it is recommended to stop taking piracetam in the evening and add this dose to the daytime dose.

https://www.youtube.com/watch?v=37qtLbddlZQ

Piracetam is the first drug discovered in the group of nootropics; it is actively used in treatment. The product improves metabolic processes, enhances glucose utilization, production of phospholipids and ribonucleic acid, activates glycolytic processes and increases the concentration of ATP in brain tissue

. Positive effects include facilitating the learning process, consolidating memory and improving brain function. Piracetam and analogues improve microcirculation, the rate of brain excitation changes, while the vessels do not dilate, and activated platelets do not clot so quickly.

The range of positive properties of the drug is wide, but in certain cases it is impossible to achieve the desired therapeutic effect due to individual intolerance. In such situations, it is preferable to consider substitutes.

Side effects

1. Sense organs: vertigo;
2. Local reactions: thrombophlebitis, pain at the injection site;
3. Digestive system: vomiting, nausea, abdominal pain, diarrhea;
4. Metabolism: increased body weight;
5. Skin: itching, rashes, dermatitis;
6. Allergic reactions: angioedema, hypersensitivity, anaphylactic reactions;
7. Central nervous system: insomnia, imbalance, anxiety, irritability, depression, motor disinhibition, headache, drowsiness, ataxia, asthenia, hallucinations, mental agitation, exacerbation of epilepsy, confusion;
8. Other reactions: decreased blood pressure, fever, increased sexual activity.

In children, especially with mental retardation, the following side effects are possible when taking Piracetam: restlessness, fussiness, imbalance, increased conflict, anxiety, decreased ability to concentrate, motor disinhibition, irritability.

TOP 20 analogues of Piracetam

We highlight the following medications.

1. Memotropil gradually stimulates metabolic processes in brain tissue and has a broad spectrum of action.
2. Lucena is inexpensive, but it has more contraindications. The spectrum of action is also wide.
3. Noocetam is cheaper and does not cause side effects such as psychostimulation and sedation.
4. Nootropil is much more expensive and contains an increased dosage of the main component. The drug is indispensable if the speed of achieving a therapeutic effect is important.
5. Piratropil does not have such a wide spectrum of action. It is effective in combination with other medications.
6. Pyrabene is a purified product without many side effects.
7. Biotropil and Noopept are analogues of Piracetam, devoid of all side effects, but are used in the treatment of adult patients.
8. Cerebril provokes neurometabolic stimulatory side effects. It costs more than Piracetam.
9. Stamin is an analogue in tablets that has a broad effect on the body in the treatment of mental problems. The cost is affordable.
10. Phenotropil has a wide range of effects in the treatment of the central nervous system.

11. Pantogam is cheaper, but affects the occurrence of an allergic reaction. Treatment of children is allowed. Produced in the form of tablets, syrup and capsules.
12. Vinpocetine is a product of the synthesis of Vincamine. Used as an addition to other medications. The medicine belongs to the category of food additives and helps improve the functioning of the body's vascular system.
13. Mexidol is a new drug in the middle price category. It can be used by both children and adults, which indicates the versatility of the drug. Most often it is an addition to Actovegin.
14. Exotropil acts in a targeted manner, improves brain activity, the range of applications is limited. The price category is more affordable than Piracetam.
15. Phenibut is more expensive and has a wide range of effects on the body of a child and an adult patient. The effect demonstrates significant effectiveness, so antipsychotics and tranquilizers are additionally prescribed with it.
16. Omarone is more expensive and is indicated to support blood circulation in brain tissue after a stroke.
17. Phezam is part of the group of combined antibiotics and nootropics. It is used to reduce the productivity of blood vessels and organs of the nervous system, and deterioration of blood circulation.
18. Cinnarizine is a central nervous system sedative that costs less than Piracetam. If the presence of a quick mental and physical reaction is important, it is better to take the drug with caution.
19. Cavinton and Nootrobil are analogues of Piracetam without side effects. It has a wide range of effects in the treatment of mental and neurological pathologies. The only drawback of Cavinton is its incompatibility with Heparin and its high cost.

Overdose

Cases of overdose have been observed rarely, since a sufficiently large amount of the drug can be taken per day. If the permitted dose is significantly exceeded, the following reactions are possible:

1. Insomnia.
2. Tremor.
3. Increased severity of side effects.
4. Exacerbation of heart failure.

There is no specific antidote to Piracetam. Patients are advised to drink more fluids to quickly eliminate excess medication in the urine. In severe cases, hemodialysis is performed, but its effectiveness is only 50%, since the drug is able to penetrate filter membranes.

A little history of piracetam

Almost all medicines are created to treat some kind of disease. Piracetam appeared back in 1973, the drug was positioned as a medicine for the treatment of the brain, namely: for circulatory disorders, memory loss, Alzheimer's disease, etc.

Unfortunately, for sick people, the drug, for the most part, turned out to be a placebo, a “dummy”. Nootropic of its kind . That is, a drug that potentially improves brain function, and we will prove that it is effective. Refers to pyrrolidone derivatives.

How and how much to take Piracetam 400 correctly

In the early stages of treatment, the dose per 1 dose is 800 mg. Capsules are taken before meals three times a day. Gradually reduce the dose to 400 mg. The average daily dose varies from 30 to 160 mg/kg body weight. Treatment with Piracetam 400 can last from 2 weeks to six months, depending on the disease. Often 2 courses of treatment are required.

In old age, with the development of psychoorganic syndrome, the daily dose is 1.2-2.4 g. To eliminate the symptoms of withdrawal syndrome, the medicine is prescribed in a dosage of 12 g/day. The maintenance dose is 2.4 g. Children over 5 years old should take 1 capsule 3 times a day. The maximum permissible dose per day is 1.8 g. In order to prevent sleep disturbances in adults, the last dose of medication should be no later than 5 pm.

In order to prevent sleep disturbances in adults, the last dose of medication should be no later than 5 pm.

Recommended dosage

Piracetam is not sold as a dietary supplement in the United States. However, it can be easily purchased online. Current dosage recommendations are as follows:

Adults over 16 years of age: Oral administration of 1.6-4.8 grams of the drug. Some studies use higher doses (up to 9.6 grams). However, the maximum effective recommended dosage is 1600 milligrams three times a day, that is, 4800 milligrams per day. A number of studies have found that a high dose of the drug is required for any positive effect. It was also found that, for reasons that are not fully understood, people react differently to the same dose of piracetam. ()

At the moment, in most cases, piracetam is not recommended for children under 16 years of age. This is especially true in cases where you have not sought advice from your doctor.

Always consult your doctor before taking any new supplement. In some studies, piracetam was prescribed to children to treat conditions such as affective-respiratory paroxysm and dyslexia.

In these trials, dosages in the range of 40-100 milligrams per kilogram of body weight have been determined to be safe for children (however, the most commonly recommended minimum dosage is 40-50 milligrams per kilogram of body weight).

Piracetam can be taken at any time, regardless of meals. It is water soluble, so it will be digested even if taken on an empty stomach.

What is Piracetam for and when is the drug prescribed?

Piracetam has a wide range of applications; this medication is prescribed for the treatment of disorders in neurology, pediatrics, psychiatry and addiction. Let's take a closer look at why Piracetam is prescribed for various pathologies.

In pediatrics it is used for the following conditions:

1. Difficulties in the learning process;
2. Dyslexia (impaired ability to read and write) in combination with other methods;
3. Perinatal brain damage;
4. Mental retardation;
5. Cerebral palsy (cerebral palsy);
6. Oligophrenia;
7. As part of the combined treatment of sickle cell anemia.

In psychiatry they are used for various pathological mental states:

1. Epilepsy;
2. Depression of various origins with a predominance of hypochondriacal and asthenic disorders, accompanied by phenomena of lethargy;
3. Apathetic states in schizophrenia;
4. Prevention of mental, autonomic and neurological complications associated with poor tolerance of psychotropic drugs and neuroleptics;
5. Complex therapy of mental disorders and depressive conditions.

In narcology it is used when there are such indications:

1. Chronic alcoholism with persistent mental disorders (intellectual-mnestic disorders, asthenia);
2. Relief of pre- and delirious, withdrawal states in alcoholism and drug addiction, as well as in the case of acute poisoning with morphine, phenamine, barbiturates and alcohol.

In neurological practice it is used for the following conditions:

Acute and chronic circulatory disorders in the brain; Treatment of patients with Alzheimer's disease; Comatose states resulting from intoxication or brain injury; Disturbances in the functioning of the nervous system, accompanied by emotional disturbances and decreased intellectual abilities; Diseases of the brain of a vascular nature (hypertension, atherosclerotic changes), which are complicated by the phenomena of chronic vascular insufficiency (memory impairment, distracted attention, speech difficulties, dizziness, impaired coordination of movements, migraines).

Piracetam is used as part of complex treatment for Parkinson's disease, severe depression, schizophrenia, neuroses and other mental disorders. The medicine has confirmed its effectiveness in the treatment of alcohol and drug poisoning; it is used to relieve attacks of delirium tremens and to restore brain activity in people suffering from chronic alcoholism.

Beneficial features

Based on current research, scientists note the following most notable benefits of this drug:

Regulating cognitive decline

A meta-analysis reviewing the results of human clinical trials showed that piracetam can improve the condition of patients (especially older people) experiencing cognitive decline. However, this does not appear to apply to healthy people with normal brain function. ()

The mechanisms of action of piracetam include increasing the uptake of glucose and oxygen in the brain, which leads to improved cognitive function.

A high dose of this drug is usually required to noticeably reduce the rate of cognitive decline (also known as age-related memory loss), such as anxiety, paranoia, and memory loss.

Typically, a course of treatment lasting from 6 to 12 weeks is prescribed, which in some cases may cause unwanted side effects.

Researchers believe that some patients with cognitive decline require long-term use of piracetam to slow the rate of disease progression. ()

Not all studies have shown that piracetam causes significant improvements in cognitive function. In a number of studies, the effect of this drug was completely absent or was practically indistinguishable from placebo. ()

Preventing blood clots

Research suggests that piracetam may be helpful in recovery from cardiovascular injury because, like aspirin, it helps prevent blood clots.

It has also been shown to have a protective effect in patients undergoing coronary artery bypass grafting. ()

In addition, piracetam affects blood flow by improving blood circulation and preventing constriction of blood vessels.

Because this drug prevents the formation of blood clots, it is being actively studied as a means to reduce the risk of stroke. It is known to improve recovery in stroke patients, including speech function, in some, but not all, studies. ()

However, due to mixed research results, regular use of piracetam is still not recommended for patients recovering from acute ischemic stroke. ()

Protecting the body from oxidative stress

There is evidence that piracetam can increase the fluidity of brain cell membranes and reduce the rigidity associated with oxidative and lipid stress. Piracetam appears to help normalize membrane fluidity and mitochondrial function, which are compromised by brain damage caused by free radicals, inflammation, injury, and age-related changes.

Researchers also link a deterioration in normal mitochondrial fluidity to a decline in cognitive function.

Supports short-term memory and learning ability

In one study, researchers found that taking piracetam for 14 days resulted in significant improvements in word recall and short-term memory.

The effect of piracetam was also tested among children with dyslexia. Although the results have been somewhat mixed and difficult to replicate, certain studies have shown that taking this drug daily for eight weeks leads to improvements in reading speed, verbal learning, and comprehension. ()

Mood boost

In terms of mood enhancement, more research into the effects of piracetam is needed in this area. It is believed to help stabilize mood and mental health, improve concentration and verbal abilities, and increase energy levels and motivation. However, scientific evidence for these hypotheses is still extremely limited.

Also, recent studies have shown that piracetam can potentially act as an antidepressant, increasing the brain's ability to "reinforce" and reducing the negative effects on the central nervous system of drug/alcohol withdrawal.

However, there are concerns that while piracetam has the potential to temporarily improve mood, this may require a high dose of the drug, which may subsequently lead to dependence and withdrawal symptoms that occur after stopping the medication. ()

Release form and composition

Available in several dosage forms.

• Tablets, coated, white or almost white, oval, biconvex, scored on one side. Slight surface roughness is allowed. At the fracture, two layers are visible - a white or almost white core and a film shell. Packed in blisters of 10, 20 and 30 pieces and polymer jars of 10, 20, 30, 40, 50, 60, 80, 90, 100 and 120 pieces.
• Syrup 20% is available in glass bottles of 100 ml.
• Capsules are hard gelatin, size No. 1, with a black cap and a red body. The contents of the capsules are white or almost white powder. Packed in blisters of 10, 15 and 20 pieces.
• The solution for intravenous and intramuscular administration is a slightly yellowish, transparent, colorless liquid. Packaged in ampoules of 5 ml.

Nootropil

Piracetam in injections can be replaced with Nootropil in ampoules. This drug is an analogue of Piracetam, but more effective for many neurological pathologies .

The composition of the Piracetam analogue - Nootropil includes the organic compound non-proteinogenic aminobutyric acid, sodium salt of acetic acid, sodium chloride, food grade ethanoic acid, sterile liquid.

This analogue of Piracetam is available in several forms:

• liquid for injection Nootropil – 0.2 g per 1 ml of the drug. 1 ampoule contains 5 ml of solution – 1000 mg of the organic compound piracetam;
• solution for drip administration – 0.2 g in 1 ml. 1 bottle contains 15 ml of the main substance piracetam, which corresponds to 12 g of the drug.

Indications for the use of the Piracetam analogue Nootropil are:

• severe, unconscious state of various origins, as well as rehabilitation after a coma;
• unsteadiness of gait, impaired memory process, initial stages of dementia, inability to concentrate, mood changes;
• death of brain cells in Alzheimer's disease;
• alcohol dependence during withdrawal symptoms;
• comprehensive treatment of children with poor concentration;
• dyscirculatory and dysmetabolic encephalopathy;
• the use of a Piracetam analogue in the complex therapy of hereditary hemoglobinopathy;
• sudden, sharp and very rapid convulsive muscle contractions.

The effect of the drug is due to the main substance - piracetam, which affects the ability to learn, remember, concentrate and improves brain activity. Promotes the process of suppressing platelet adhesion, which in turn leads to a reduction in thrombus formation. Due to this, blood circulation improves.

By prescribing the drug Nootropil instead of Piracetam, you can confidently expect a positive, fast, high-quality and effective result from the analogue.

Release form and composition

Pharmaceutical factories in the post-Soviet space produce this medicinal product in three dosage forms: in an injection solution in ampoules of 5 milliliters No. 5, No. 10 or No. 20; in capsules No. 10-No. 120; in tablets No. 10-No. 600.

Piracetam includes as an active ingredient a nootropic substance with a similar name to piracetam (INN - Piracetam) in different mass fractions depending on the dosage form of the drug: 1 milliliter of solution for injection - 200 mg, 1 capsule - 200 mg or 400 mg, 1 tablet – 200 mg, 400 mg, 800 mg or 1200 mg.

The additional composition of the ingredients may vary somewhat depending on the manufacturer producing the drug, which should also be taken into account by the attending physician prescribing this or that drug.

The drug Piracetam

Piracetam is a drug that stimulates brain activity, has the ability to help the body adapt to adverse external influences, and activates internal processes.

The drug Piracetam is presented by the pharmacological industry in several types or forms - these are tablets, capsules and injections.

Piracetam has found its use in neurology for the following pathological conditions, such as astheno-neurotic syndrome, vegetative-vascular dystonia, brain injuries, dyscirculatory and dysmetabolic encephalopathies, and acute cerebrovascular accidents. Piracetam should also be prescribed for prevention - during severe physical and mental stress.

But this nootropic is not a panacea. There are substitutes for Piracetam, which come in different forms - from tablets to injections.

Special instructions when taking Piracetam 400

When using Piracetam 400 for the treatment of mental disorders, the medicine is prescribed in combination with psychotropic medications. If the patient has myoclonus, the drug should be withdrawn gradually

Capsules should be used with caution in cases of hemostasis disturbances, massive bleeding and after surgery.

In old age

When treating elderly people, dose adjustments are made if necessary.

When treating elderly people with piracetam, the dose is adjusted if necessary.

For impaired renal function

If the glomerular filtration rate is less than 20 ml/min, Piracetam at a dosage of 400 mg is not used. While taking the medication, it is necessary to monitor kidney function.

Applications and dosages

for adults

The ampoule solution can be administered intravenously or intramuscularly. This method of administration is resorted to if the patient is unable to take the drug in tablets. In oral form, the medicine is taken before meals. The daily dose prescribed by the doctor is divided into several doses (2-4). The exact amount of the drug required for treatment is determined in each specific case, but standard regimens may be as follows:

1. For psychoorganic syndrome, the patient is administered 2.4-4.8 g of piracetam per day. As a rule, an increased dose is used in the first week of treatment, and then it is reduced to a maintenance dose.
2. Therapy for dizziness involves 2.4-4.8 g of piracetam per day.
3. In the treatment of cortical myoclonus, increased doses of the drug are used. Start with the introduction of 7.2 g per day, increasing the dose every 3 days. The maximum daily amount is 24 g. The course lasts until a positive clinical result is obtained. The drug is also discontinued gradually so as not to provoke a deterioration in the patient’s condition. It is recommended to repeat the course every six months until the disease disappears or its severity decreases.
4. When relieving a vaso-occlusive crisis, the daily dose is calculated taking into account the patient’s body weight (300 mg per kilogram of weight). It is also administered to the patient in several doses.

If the patient has impaired renal function, creatinine clearance is used to calculate the dose.

Old age is not a reason to reduce the dose, unless the patient is diagnosed with other diseases that will lead to this need.

The duration of therapy is determined by the doctor, assessing the patient’s positive dynamics and the severity of clinical manifestations.

for children

1. When treating dyslexia, a child is prescribed 3.2 g of the drug per day, which is divided into two equal doses.
2. To relieve a crisis in sickle cell anemia, the dose is calculated based on the child’s weight.

Contraindications for use

When taking Piracetam, you should strictly adhere to the dosage. If the patient consumes a larger amount of the drug, this may have a negative (if not worse) effect on his health. An overdose of the drug leads to irritability, deterioration of the heart muscle and insomnia. Before taking pills, you should study which medications interact and which cannot be prescribed in parallel in order to avoid unpleasant situations.

When using the drug and other medications simultaneously, care must be taken when driving and other activities that require increased concentration and attention. You should also not take Piracetam if you have a hemorrhagic stroke, kidney failure, or individual intolerance to the drug. It is forbidden to take the drug for pregnant women and women during lactation.

The medicine may cause the following side effects:

• nausea;
• vomiting;
• weakness;
• drowsiness;
• headache;
• anxiety;
• restlessness;
• imbalance;
• apathy.

In some cases, after taking the drug, allergic reactions, sleep disturbances, and inattention may occur. In elderly patients, the drug sometimes causes coronary insufficiency. Patients taking Piracetam should be informed about side effects and interactions with other drugs.

Find out what other memory tablets are out there.

Contraindications and side effects

Among the contraindications to the drug it should be noted:

• allergy to medication components,
• pregnancy and lactation,
• hemorrhagic stroke,
• renal pathologies,

The drug should be prescribed with caution to patients after major surgical interventions and large blood loss. Relative contraindications include:

• chronic renal failure,
• violation of hemostasis.

Overdose of the drug is observed in rare cases. Side effects from the drug may occur when the drug is repeated or administered intramuscularly after a short period of time. If the dose is exceeded, patients experience:

• insomnia,
• nervousness,
• involuntary muscle contraction.

You should know! In case of significant overdose, patients may require gastric lavage.

Side effects from the drug include:

• headache,
• irritability,
• worsening mood,
• emotional instability,
• hallucinations,
• epilepsy attack,
• impaired bowel movements and bloating,
• decrease in blood pressure,
• skin rashes,
• increase in body weight.

Drug interactions

Before you start using the drug, read the special instructions:

1. With the simultaneous use of central nervous system stimulants, the psychostimulating effect may be enhanced.
2. When used simultaneously with antipsychotics, an increase in extrapyramidal disorders is observed.
3. A case of interaction of piracetam with simultaneous use with a thyroid extract containing triiodothyronine and tetraiodothyronine is described, when the patient experienced anxiety, irritability and sleep disorders. When used simultaneously with thyroid hormones, central effects may develop - tremor, anxiety, irritability, sleep disturbances, and confusion.

Comparative characteristics

Be sure to study the instructions for use of Piracetam synonyms in order to make a comparative description and determine the advantages and disadvantages of the product. The pros and cons will vary for specific treatment strategies.

1. Piracetam and Nootropil are analogues, and there are no fundamental differences between them in terms of effects on the body: activation of mental activity, improvement of brain performance. In terms of cost, Piracetam is cheaper and is an unrefined synonym; the drug causes side effects on the liver and kidneys. Nootropil is safer; it is prescribed during rehabilitation after a stroke or in the treatment of alcohol addiction to eliminate negative emotions.
2. The purpose of Lucetam is to quickly restore the functioning of the central nervous system and improve memory. A consultation with a neurologist is required first. Lucetam stimulates brain activity as a sedative or psychostimulant. If you compare dosages, Piracetam should be taken 12 tablets per day. The course of rehabilitation therapy after treatment with Lucetam is less than 3 weeks.
3. Cinnarizite is used for general treatment with Piracetam in the presence of pathologies such as incoordination, hypertension, dizziness, acute cerebral ischemia, cognitive deficit or circulatory problems. The antihypoxic effect is expressed when taking the medicine in combination with Piracetam. Additional effects include a nootropic response of the body and vasodilation. The ischemic area is characterized by increased blood flow. The response to biogenic agents that constrict blood vessels is reduced. Pay attention to the need to optimize tone in the body when taking Angiotensin, Vasopressin, Serotonin, Epinephrine or Dopamine.
4. When choosing analogues of Piracetam in tablets, you should pay attention to Cavinton, which is better to give preference if it is necessary to increase metabolism in tissues. Blood circulation in the hemispheres increases selectively, due to which the cerebral fraction in the minute volume of blood increases, and vascular resistance decreases. Moreover, there is no direct effect on the circulatory system.
5. It is also better to take Vinpocetine in combination with Piracetam if we are talking about pathologies of the central nervous system. Indications include the rehabilitation period after a stroke, brain problems, deterioration of cognitive function, Meniere's syndrome and accompanying injuries, predisposition to severe headaches and prevention of akinetosis.
6. When choosing analogues and substitutes of Piracetam for treatment, pay attention to Mexidol, but if you have individual sensitivity and kidney or liver dysfunction, you should stop taking it.
7. Phenotropil is more effective than Piracetam, the clinical result is pronounced. In pharmacies, the drug is also presented by other names (Phenylpiracetam, Carphedon or Phenylpiracetam). Antidepressant and psychostimulating effects are observed, which are not observed in many Piracetam substitutes. The main action is nootropic and mnemotropic.
8. Pathogam acts differently on the patient's body. Brain tension decreases, as does anxiety. Additionally, motor skills and behavior are streamlined. Both mental and physical activity increase to the same extent.

In each individual case, the effectiveness of analogues and substitutes is ambiguous, as is the presence of specific side effects and contraindications. Medicines have an individual effect on each body, so it is necessary to discuss the advisability of replacement with your personal physician.

Why is Piracetam 400 prescribed?

Preparations based on piracetam in a dosage of 400 mg are prescribed for:

Atherosclerosis of the brain. This pathology is characterized by blockage of arteries with plaque and impaired blood flow.

The result is tissue hypoxia. Hypertension (a disease in which the pressure is more than 139/89 mmHg). Parkinsonism of vascular origin. Chronic disorder of cerebral blood flow. Ischemic stroke. Diseases that affect memory, intelligence and attention. Emotional disorders. Vascular dementia. Alzheimer's diseases. Deep depression of consciousness (coma) due to poisoning and traumatic brain injury. Asthenic syndrome.

Depressions of various origins.

Epileptic seizures. Gait disorders associated with central nervous system damage. Mental disorders against the background of organic pathology. Apathy due to mental illness (schizophrenia). Intolerance to neuroleptics. Slowing down the pace of thinking and speech due to mental disorders.

Alcoholism to relieve attacks of withdrawal and delirium (psychosis).

Alcohol intoxication. Poisoning with drugs from the group of barbiturates and morphine. Sickle cell anemia. Oligophrenia (mental retardation). Mental retardation in childhood. Cerebral palsy. Brain damage in the weeks before birth. Psychoorganic syndrome.

Encephalopathy.

What is piracetam?

Piracetam is a drug/supplement of the racetam class of psychoactive nootropic substances that is derived from the neurotransmitter gamma-aminobutyric acid (GABA).

Racetams are synthetic substances that are used to improve brain function.

However, for the most part they have a fairly mild effect. Piracetam is one of the first drugs of this kind. Its formula was originally developed by the Belgian company UCB Pharma.

How does piracetam affect the brain? It has a number of physiological effects due to its ability to regulate neurotransmitter systems, including cholinergic and glutamatergic pathways.

Researchers believe that piracetam has positive effects on cognitive function and mental health due to its neuroprotective and anticonvulsant properties, its ability to improve blood circulation and enhance neuroplasticity (the brain's ability to form and reorganize synaptic connections, especially in response to information and perceived events). ()

In different countries, piracetam - which is the generic name for this drug - is distributed under different names: Dinagen, Myocalm, Nootropil and Qropi.

Indications for use of piracetam

How to use piracetam for the purpose of “biohacking” and maintaining good health in general?

At this time, more research is still needed to confirm the safety and effectiveness of this substance.

However, based on existing data, the following areas of application of piracetam : ()

1. Increasing the fluidity of cell membranes, necessary for proper functioning, viability, growth and division of cells
2. Prevention of neurological diseases such as Alzheimer's disease and dementia
3. Preventing Memory Loss
4. Reduced symptoms of anxiety and depression
5. Help in controlling epilepsy, including its type, cortical myoclonus
6. Improving recovery from stroke and traumatic brain injury
7. Prevents vasospasm (narrowing of blood vessels) and improves blood circulation
8. Prevention of blood clots and deep vein thrombosis, in part by reducing the adhesion of red blood cells to the vascular endothelium (cells inside blood vessels)
9. Help with systemic vertigo
10. Support for rehabilitation after alcohol and drug (including heroin) addiction
11. Help with dyslexia
12. Monitoring the condition of sickle cell anemia
13. Treatment of tardive dyskinesia - complications after long-term use of antipsychotics associated with recurrent involuntary movements

Instructions for use of Piracetam: method and dosage

Tablets, capsules and syrup are taken orally during meals or on an empty stomach with liquid.

Tablets and syrup

Adults: 30 – 160 mg/kg 2 – 4 times a day. Course of treatment: 6 – 8 weeks.

Children: 30 – 50 mg/kg 2 – 3 times a day. Continue treatment for at least 3 weeks.

Capsules

At the beginning of treatment: 800 mg 3 times a day. After the condition improves, the single dose is gradually reduced to 400 mg.

Daily dose: 30 – 160 mg/kg 2 times a day. If necessary, you can increase the frequency of administration to 3–4 times a day.

The course of treatment with capsules lasts from 2 – 3 weeks to 2 – 6 months. If necessary, the course of treatment is repeated.

• For long-term therapy of psychoorganic syndrome in the elderly: 1.2 – 2.4 g per day; loading dose during the first weeks of therapy is up to 4.8 g per day.
• If necessary, it can be combined with the use of psychotropic, cardiovascular and other medications.
• When treating the consequences of comatose states, in the post-traumatic period: initial dose 9 - 12 g per day, maintenance: 2.4 g. Course of treatment: 3 weeks.
• Children from 5 years: 1 capsule. 3 times a day. Maximum daily dose: 1.8 g. Course of treatment: from 2 weeks to 2 – 6 months.
• For alcoholism: 12 g per day during the period of manifestation of alcohol withdrawal syndrome; maintenance dose: 2.4 g.
• For sickle cell vaso-occlusive crisis (in adults and children): 160 mg/kg 4 times a day. A dose of less than 160 mg/kg per day or irregular use of the drug may cause an exacerbation of the disease.

Injection

The solution is administered intravenously by stream or drip and intramuscularly. The daily dose is divided into 2–4 doses.

• Symptomatic treatment of psychoorganic syndrome: in the first week of treatment, 4.8 g per day, then switch to a maintenance dose: 1.2 - 2.4 g per day.
• Treatment of dizziness and related balance disorders: 2.4 - 4.8 g per day.
• Treatment of cortical myoclonus: initial dose of 7.2 g per day. Every 3–4 days, the dose is increased by 4.8 g per day until a maximum dose of 24 g per day is reached.
• Treatment is continued throughout the entire period of the disease. Every 6 months, it is recommended to reduce the dose of Piracetam by 1.2 g per day every 2 days. If the therapeutic effect is insignificant or absent, drug therapy is discontinued.
• For sickle cell vaso-occlusive crisis (in adults and children): 300 mg/kg IV 4 times a day.
• Treatment of dyslexia in children over 8 years of age (in combination with other treatment methods): 3.2 g 2 times a day.
• For mild chronic renal failure: 2/3 of the dose, divided into 2 to 3 doses.
• For moderate chronic renal failure: 1/3 of the dose, divided into 2 doses.
• For severe chronic renal failure: 1/6 dose once.

Indications for use of Piracetam for children

Before prescribing medicine to a child, you need to be sure that there are direct indications for its use. Piracetam is indicated for children in the following cases:

• Decreased memory and attention;
• Speech disorders, mental retardation;
• Difficulties in learning not related to upbringing;
• Complex treatment of cerebral circulatory disorders;
• Traumatic brain injury, including birth injury;
• Encephalopathies (hypoxic, metabolic, ischemic, toxic, traumatic, infectious);
• Brain inflammation (encephalitis) acute and chronic;
• Cerebral palsy of various types.

Piracetam should always be used only in combination with other medications. The course of treatment lasts at least 3 weeks.

Contraindications and side effects

In addition to the indications for use, when prescribing Piracetam tablets to children under one year of age and older, one must take into account contraindications and the possibility of side effects.

The drug is contraindicated for use in conditions such as:

• Hypersensitivity to Piracetam and excipients;
• Severe degree of kidney failure;
• Hemorrhages in the brain;
• Bleeding disorders;
• Heavy bleeding;
• Extensive surgical operations.

The following side effects are rarely observed:

• Bloating and abdominal pain, belching;
• Nervousness and irritability;
• Anxiety and overexcitement;
• Dizziness, headaches;
• Tremor, weakness, drowsiness;
• Sleep disorders.

When using Piracetam in children under one year of age, sometimes side effects include increased excitability, tearfulness, regurgitation, and difficulty falling asleep. Such phenomena occur infrequently, but if they occur, it is better to stop taking the medications and consult a doctor.

How to take Piracetam tablets?

If Piracetam is used, the dosage in tablets for children is selected individually. One tablet contains 400 mg of the main substance. The doctor prescribes Piracetam to 400 children of any age.

The daily dose is calculated based on the recommended instructions for use, 30-50 mg per kilogram. For example, a child weighing 10 kg per day will need 400 mg of the drug, that is, 1 tablet. The daily dose should be divided into 2 - 3 doses.

The pediatric dosage of Piracetam tablets should be clearly prescribed by a doctor. This will ensure that you take an effective amount of the drug and reduce the likelihood of side effects.

When using tablets in children who cannot yet swallow them, crush the tablet, mix it with liquid and offer it to the child. For sleep disorders, the medicine should be given in the morning and during the day, excluding taking it at night.

Piracetam injections for children: instructions for use

Sometimes children under one year of age are prescribed Piracetam injections. Intramuscular administration of the drug is most often used. In rare cases, usually when the child’s condition is serious, Piracetam is administered intravenously.

For children, Piracetam ampoules are available with a dosage of 200 mg per 5 ml, that is, 1 ml of solution contains 40 mg of the drug. Injections can be given either in the muscles of the buttocks or the front surface of the thigh. The choice of injection site is based on the child's age and the thickness of the soft tissue.

There is no need to dilute the injection solution with anything. When choosing a method of drug administration, it is worth considering the fact that absorption occurs faster and side effects may be more pronounced. You should also not forget about the complications that can arise if the technique of intramuscular drug administration is violated.

Prescribing any drug to a child, especially an infant, must be taken responsibly. To use nootropic drugs there must be clear indications. The use of medications without indications or their independent prescription is unacceptable. If there are any alarming neurological symptoms, learning difficulties, or speech disorders, you should first consult a doctor who will prescribe a comprehensive examination and treatment.

Valentina Ignasheva, pediatrician, especially for Mirmam.pro

Mechanism of action

The medicine has the following effects:

1. Normalizes metabolic processes in the frontal, occipital, parietal and temporal lobes.
2. Stimulates glycolysis (oxidation of glucose with the formation of pyruvic acid).
3. Promotes the formation of RNA.
4. Stimulates the formation of phospholipids that make up cells.
5. Promotes the accumulation of ATP in the brain.
6. Facilitates the penetration of glucose into tissues.
7. Improves memory.
8. Improves microcirculation.
9. Facilitates the process of assimilation of information.
10. Prevents platelet aggregation.
11. Promotes faster transmission of impulses through nerve cells.
12. Increases performance.
13. Increases the resistance of nervous tissue during brain injuries, oxygen deficiency, intoxication and exposure to electric current.
14. Eliminates signs of neurocirculatory dystonia.
15. Increases the overall resistance of the body.
16. Does not have a psychostimulating effect.

Detailed pharmacodynamics are described in the instructions for use. Pharmacokinetics (the processes that occur with a drug when it enters the body) includes absorption, distribution, deposition, metabolism and excretion. When taking the drug orally, Piracetam 400 is quickly absorbed in the intestines and stomach. After 1 hour, the largest amount of nootropic is determined in the blood.

The nootropic accumulates in brain tissue. A special feature of the drug is its ability to pass through the blood-brain barrier and the placenta. Piracetam is practically not metabolized.

Description and composition

The main active ingredient is the substance of the same name - piracetam. Its mechanism of action is a positive effect on nerve cells, microcirculation, synthesis of mediators, metabolic and other processes. As a result, all this leads to improved integrative brain function, improved ability to remember information and learn.

Increased nutrition of nerve cells after taking Piracetam improves and accelerates the conduction of impulses. On the other hand, the health of nerve cells is restored due to the activation of cerebral circulation, improvement of the rheological properties of blood and increased utilization of glucose. Even ischemic areas are better supplied with nutrients after a course of treatment with Piracetam. A course of treatment leads to an increase in the energy potential of cells, resulting in their resistance to hypoxia, toxic lesions and other unfavorable factors. It is piracetam that has such effects, and not its metabolites. It is excreted from the body mainly unchanged, and dose adjustment is not required for patients with liver failure.

In clinical trials, the drug's tropism specifically for brain tissue was proven, despite the fact that piracetam is able to penetrate almost all organs. The substance is detected in the cerebrospinal fluid several hours later than in the blood, however, it is removed from there more slowly, which ensures a long-lasting effect.

Selecting an analogue

In conclusion, let's find out how to choose the right piracetam analogue:

• Lucetam and nootropil. These drugs are rarely used as analogues of piracetam, since they have an almost identical composition and therapeutic effect, and they are more expensive. But these medicines have advantages - Lucetam can be given to young children.
• Dendrix and Kemodin. These drugs are a replacement for piracetam because they restore blood circulation in the brain and have almost no side effects or contraindications. But they are expensive.
• Pramistar. An analogue of piracetam called pramistar is prescribed quite rarely, since it is expensive and has almost the same therapeutic properties. But pramistar is better than piracetam in treating cognitive diseases of aging.

Analogs

The following drugs can be used instead of Piracetam:

1. Nootropil is a complete analogue of the drug Piracetam. It is produced in tablets, capsules, solutions for oral and parenteral administration. The drug can be used to treat patients older than one year. The medication is contraindicated for pregnant and lactating women.
2. Phezam is a combination drug that contains cinnarizine and piracetam. It is available in capsules, which should not be given to children under 5 years of age. They are contraindicated for pregnant women and breastfeeding women.
3. Omaron is a combined domestic drug, one of the active components of which is piracetam. It is produced in tablets, which are contraindicated for children under 5 years of age, women, nursing children and breastfeeding.
4. Cavinton is a Hungarian drug that is a substitute for Piracetam in the therapeutic group. It is sold in tablets and ampoules. Cavinton is not recommended for minors, pregnant women and breastfeeding women.

Dosage and method of administration

The instructions for use indicate that Piracetam tablets and capsules are prescribed orally.

At the beginning of treatment, 800 mg is prescribed in 3 divided doses before meals; as the condition improves, the single dose is gradually reduced to 400 mg. Daily dose – 30-160 mg/kg body weight, frequency of administration – 2 times a day, if necessary – 3-4 times a day. The course of treatment lasts from 2-3 weeks to 2-6 months. If necessary, the course of treatment is repeated.

1. For long-term therapy of psychoorganic syndrome in the elderly, the drug is prescribed at 1.2-2.4 g per day; loading dose during the first weeks of therapy is up to 4.8 g per day. Treatment with piracetam, if necessary, can be combined with the use of psychotropic, cardiovascular and other drugs.
2. When treating the consequences of comatose states, in the post-traumatic period, the initial dose is 9-12 g per day, maintenance dose is 2.4 g, the course of treatment is 3 weeks.
3. This dosage form is recommended for children over 5 years old - 1 capsule. 3 times a day. The maximum daily dose is 1.8 g. The course of treatment is from 2 weeks to 2-6 months.
4. For alcoholism – 12 g per day during the period of manifestation of alcohol withdrawal syndrome; maintenance dose – 2.4 g.
5. For sickle cell anemia, the daily dose is 160 mg/kg body weight, divided into 4 equal portions.

Attention: take the last single dose no later than 17.00 to prevent sleep disturbances

Why are Piracetam injections prescribed?

This drug is prescribed by different doctors, but most often it is used in neurology, psychiatry, addiction medicine and pediatrics. It is prescribed at any age, but only according to a doctor’s indications. Piracetam injections can help older people improve their memory and general condition, relieve critical illness in chronic alcoholism, and help recover from a stroke. The drug is used in the complex treatment of depression, atherosclerosis, anemia, and Alzheimer's disease. It is effective for improving memory and mental activity, so it is often used by students before a session.

But the instructions for use for Piracetam injections recommend using them only as prescribed by a doctor. Most often this is done in the following cases:

• after a stroke or traumatic brain injury;
• in case of impaired blood supply to the brain;
• with frequent dizziness, gait disturbances;
• with decreased memory and attention;
• with mood swings, depression;
• with a decrease in cognitive activity, loss of skills in older people;
• with osteochondrosis;
• with poor memory, decreased assimilation of educational material;
• with frequent headaches, high blood pressure;
• with sleep disturbances and decreased performance;
• for apathy, depression, tearfulness;
• for Alzheimer's disease, Parkinson's disease;
• with retarded mental and mental development in children, with cerebral palsy and dyslexia, after birth injuries;
• in case of poisoning with alcohol or narcotic drugs, withdrawal syndrome.

Piracetam - side effects

The drug is generally well tolerated by patients. However, piracetam causes side effects for some. The following negative reactions of the body may be observed:

• irritability;
• confusion;
• drowsiness or, on the contrary, insomnia;
• hallucinations;
• tremor;
• increased sexual activity;
• headache;
• imbalance.

If Piracetam 400 is taken in large quantities, it may cause the following adverse reactions:

• blood pressure decreases;
• dermatitis appears on the skin, accompanied by severe itching;
• there is a sharp weight gain;
• there is an exacerbation of pathologies of the cardiovascular system;
• Nausea with vomiting and diarrhea are observed.

Indications

The drug is used in neurological, psychiatric and drug addiction practice.

Neurology:

• vascular diseases of the brain (atherosclerosis,
• hypertonic disease,
• vascular parkinsonism) with symptoms of chronic cerebrovascular insufficiency (memory impairment,
• attention,
• speeches,
• dizziness,
• headache);
• cerebrovascular accidents;
• comatose states,
• consequences of brain injuries and intoxications in order to increase motor and mental activity;
• diseases of the nervous system,
• accompanied by a decrease in intellectual-mnestic functions and disturbances in the emotional-volitional sphere;
• symptomatic treatment in patients with Alzheimer's disease and senile dementia of the Alzheimer's type.

Psychiatry:

• neurotic and astheno-dynamic depressive states of various origins with a predominance of signs of adynamia in the clinical picture,
• asthenic and senesto-hypochondriacal disorders,
• phenomena of ideational inhibition;
• sluggish-apathetic defective states in schizophrenia,
• psychoorganic syndromes of various etiologies,
• senile and atrophic processes;
• complex therapy of mental illnesses,
• occurring on “organically inferior soil”;
• complex therapy of depressive conditions,
• resistant to antidepressants;
• poor tolerability of antipsychotics and other psychotropic drugs in order to eliminate or prevent somatovegetative symptoms caused by them,
• neurological and mental complications;
• epilepsy.

Narcology:

• relief of withdrawal symptoms,
• pre- and delirious states in alcoholism,
• drug addiction,
• in case of acute alcohol poisoning,
• morphine,
• barbiturates,
• phenamine;
• chronic alcoholism with symptoms of persistent mental disorders (asthenia,
• intellectual-mnestic disorders).

In the complex therapy of sickle cell anemia.

Pediatrics:

• if necessary, speed up the learning process and eliminate the consequences of perinatal brain damage,
• with oligophrenia,
• mental retardation,
• infantile cerebral palsy.

Analogues of the drug

Do not forget that only a doctor can change the prescribed medicine. Do not look for more effective analogues on your own.

"Piracetam" is similar in active substance to the following medications:

• "Nootropil"
• "Lucetam."
• "Memotropil."
• "Escotropile."

There are drugs that have a similar mechanism of action. These include drugs:

• "Amilonosar."
• "Acephen."
• "Vinpocetine."
• "Vinpotropil."
• "Ginkgo biloba".
• "Gopantam."
• "Ginkum".
• "Demanol".
• "Idebenone."
• "Pantogam".
• "Cogitum".
• "Cerebrolysate".

Pharmacokinetics of the drug

How long does it take for the medication “Piracetam” to be absorbed (we will explain later why this drug is prescribed)? After oral administration, the drug is quickly and completely absorbed. Its bioavailability is one hundred percent.

Oral administration of the drug in an amount of 2 g gives maximum plasma concentration after thirty minutes. The product does not bind to proteins and penetrates all organs and tissues, including through the placental barrier.

The drug is practically not metabolized, but selectively accumulates in the parietal, occipital and frontal regions of the brain, as well as in the cerebellum and basal ganglia.

The half-life of this drug is five hours. About 95% of the drug is excreted unchanged in the urine (after about thirty hours). In people with kidney failure, this period of time increases.

The principle of action of the drug

How does Piracetam work? What is it used for by young people and the elderly?

The drug in question normalizes the ratio of ATP and ADP, and also activates phospholipase A, accelerates the exchange of neurotransmitters and helps stimulate plastic and bioenergetic processes in nerve tissues.

Why can Piracetam (injections, powder, capsules and tablets) be prescribed to patients? This drug is able to block platelet aggregation, improve microcirculation and optimize the process of passage of red blood cells through microscopic vessels.

It should also be noted that this drug increases regional blood circulation in ischemic areas of the brain, enhances alpha and beta activity, but at the same time reduces delta activity.

The medication reduces vestibular nystagmus. During hypoxia, injury and intoxication, it has a neuroprotective effect.

Due to its antihypoxic properties, this drug is very effective in the complex therapy of myocardial infarction.

Pharmacology

Pharmacological action - nootropic.

Pharmacodynamics

Piracetam binds to the polar heads of phospholipids and forms mobile piracetam-phospholipid complexes. As a result, the two-layer structure of the cell membrane and its stability are restored, which in turn leads to the restoration of the three-dimensional structure of membrane and transmembrane proteins and the restoration of their function.

At the neuronal level, piracetam facilitates various types of synaptic transmission, having a predominant effect on the density and activity of postsynaptic receptors (data obtained from animal studies).

Improves connections between the cerebral hemispheres and synaptic conduction in neocortical structures, improves cerebral blood flow.

It has an effect on the central nervous system in various ways: it modifies neurotransmission in the brain, improves metabolic conditions that promote neuronal plasticity, improves microcirculation, affecting the rheological characteristics of the blood and without causing vasodilation.

In case of cerebral dysfunction, it increases concentration and improves cognitive functions, incl. learning ability, memory, attention and consciousness, mental performance, without having a sedative or psychostimulating effect. The use of piracetam is accompanied by significant changes in the EEG (increased α- and β-activity, decreased δ-activity).

Helps restore cognitive abilities after various cerebral injuries due to hypoxia, intoxication or electroconvulsive therapy.

Indicated for the treatment of cortical myoclonus both as monotherapy and as part of complex therapy.

Reduces the duration of vestibular neuronitis and nystagmus.

The hemorheological effects of piracetam are associated with its effect on red blood cells, platelets and the vascular wall.

In patients with sickle cell anemia with pathological rigidity of red blood cells, piracetam restores the elasticity of the red blood cell membrane, increases their ability to deform and filter, reduces blood viscosity and prevents the formation of coin columns. In addition, it inhibits increased aggregation of activated platelets without significantly affecting their number. At a dose of 9.6 g, it reduces the level of fibrinogen and von Willebrand factor by 30–40% and prolongs bleeding time.

Animal studies have shown that piracetam inhibits vasospasm and counteracts various vasospastic substances.

In studies on healthy volunteers, piracetam reduced the adhesion of red blood cells to the vascular endothelium and stimulated the production of prostacyclins in the endothelium.

Pharmacokinetics

The pharmacokinetic profile of piracetam is linear and does not depend on time. Characterized by low variability over a wide dose range. Constant concentration in plasma is achieved after 3 days from the start of use.

Absorption.

After oral administration, it is quickly and almost completely absorbed from the gastrointestinal tract. Bioavailability is approximately 100%. After a single dose of 2 g, Cmax in blood plasma is reached after 30 minutes and is 40–60 mcg/ml; after 2–8 hours it is detected in the cerebrospinal fluid. After a single dose of piracetam at a dose of 3.2 g, Cmax is 84 mcg/ml, after repeated doses of 3.2 mg 3 times a day - 115 mcg/ml and is achieved after 1 hour in the blood plasma and after 5 hours in the cerebrospinal fluid. Eating reduces Cmax by 17% and increases the time to reach it (Tmax) to 1.5 hours. In women, when taking piracetam at a dose of 2.4 g, Cmax and AUC are 30% higher than in men.

Distribution.

Vd is about 0.6 l/kg. Does not bind to plasma proteins. Penetrates through the BBB and GPB, as well as hemodialysis membranes. Selectively accumulates in the tissues of the cerebral cortex, mainly the frontal, parietal and occipital lobes, the cerebellum and basal ganglia.

Metabolism.

Not metabolized.

Excretion.

T1/2 from plasma is 4–5 hours; cerebrospinal fluid - 8.5 hours. T1/2 does not depend on the route of administration and lengthens in case of renal failure (with terminal chronic renal failure - up to 59 hours). It is excreted unchanged by the kidneys via CP. Excretion by the kidneys is almost complete (more than 95%) within 30 hours. The total clearance of piracetam in healthy volunteers is 80–90 ml/min. The pharmacokinetics of piracetam does not change in patients with liver failure.

Piracetam: reviews of the drug

Margarita : Starting to take nootropics was very scary - every drug prescribed by a psychotherapist seems to be a kind of “hook” from which you can’t jump off later. But life forced me, and before the session, 3 weeks before it started, I still took the course. Concentration improved already on the 5th day, it became easier to perceive information by the end of the week, but I can’t help but mention an extremely unpleasant side effect - internal tremors, as if I couldn’t relax after a hard day. The exams were worth it, of course, but I spent all 3 weeks in some tension, and was incredibly glad to get rid of it 2 days after finishing taking Piracetam.

Elena : I systematically take Piracetam in the winter, when the body exhausts all its resources, and I am seized by depression and apathy: I don’t want to do anything, my brain seems to be barely tossing and turning in my head. I drink 1-2 capsules a day for 10-14 days - I immediately come to life, the state is as if a battery had been inserted. At the same time, there is no rollback after stopping treatment.

Hemorrhoids kill the patient in 79% of cases

Love : Piracetam was prescribed by a doctor to my father - he is 73 years old and diagnosed with dementia. After 3 years of taking it with minor breaks, the examination showed that the regression stopped: there is no hope for more. But even in this case, the drug is our salvation.

It is worth saying that occasionally comments surfaced that the use of Nootropil or Piracetam led to weight gain, but such a dependence has not been scientifically proven, since the drug is not hormonal and does not affect body weight, acting purely on the brain.

The price for Piracetam is 70 rubles for 60 tablets or 40 rubles for 10 ampoules. Nootropil will cost much more - 270 rubles for 30 tablets, 350 rubles for 12 ampoules, or 340 rubles for 125 ml of suspension.

Features of administration and side effects

The drug can be used in the treatment of various diseases, depending on the nature of the pathology, duration of treatment and method of taking the active substance. The answer to the question “How to take Piracetam?” will depend on the severity of the patient's condition and the decision of the attending physician.

• Pills. The starting dose for the treatment of various conditions is 800 mg 3 times a day, either before or during meals, after which the patient should be closely monitored to see how the patient feels. Gradually, the dosage of tablets is reduced to 400 mg, the frequency of use is 2 times a day before meals. The dose can be adjusted by the attending physician depending on the condition. It is important to remember that the last dose of the drug should be taken before 17:00, as side effects such as sleep disturbance may develop.

• Injections. Administered intramuscularly or intravenously. The daily dose of injections is prescribed by the doctor depending on the disease; it can be divided into doses 2-4 times a day. A fairly high dose is prescribed and gradually, after the main intense symptoms of any pathology have subsided, it is reduced.

To improve memory and concentration, both tablets and injections are used, depending on whether normal brain activity is required to be corrected for the better or intensive recovery from injury or stroke is required.

Side effects

Piracetam may cause the following side effects:

• insomnia;

• digestive disorders;
• headache;
• convulsions;
• nervousness, excitability.

The occurrence of side effects depends on the correct use of the drug and compliance with the dosage regimen. You need to take the medicine according to your doctor's instructions.

Features of use in stroke therapy

Piracetam occupies a leading position in stroke treatment. It does not have a toxic effect in combination with other drugs that restore the activity of the area of ​​the brain damaged by a stroke, accelerates regeneration, thereby promoting the restoration of basic neurological functions (memory, attention, speech, etc.).

The drug is used for treatment both in the acute period of ischemic stroke and after an attack.

Cost of the drug

Piracetam is a low-cost drug, despite its effectiveness and wide spectrum of action. It can be purchased by patients of any income in pharmacies in Moscow and St. Petersburg.

Cost of the drug in various forms for administration:

• Piracetam tablets 200 mg 60 pcs. – 40 rub.
• Piracetam injection solution 20% 5 ml 10 pcs. – 55 rub.
• Piracetam tablets 400 mg 60 pcs. – 60-70 rub.
• Piracetam tablets 800 mg 30 pcs. — 80 rub.
• Piracetam 400 mg 60 caps. – 150 rub.

Prices for the drug will depend on the brand of the pharmacy and the manufacturer of the product, the country of manufacture and the markup of the pharmacy organization.

special instructions

Before the injection, it is recommended to discontinue the evening medications previously prescribed to the patient. The medication affects platelet aggregation, so patients with bleeding and patients awaiting surgery require careful use of the drug, regardless of the form of release. In this case, it is better to start treatment with half doses.

People suffering from cortical myoclonus should not suddenly stop treatment: this will lead to a resumption of attacks. The drug must be taken systematically, otherwise the disease may worsen. Elderly patients are prescribed injections under the supervision of a physician, who is required to monitor blood pressure and indicators of liver and kidney function.

Combination of Piracetam injections with other medications

Piracetam is compatible with most medications. Disorientation, sleep disturbances, anxiety and irritability can be caused by the simultaneous use of a nootropic drug and medications that contain thyroid hormones. For patients suffering from venous thrombosis, it is not recommended to combine Piracetam with antibiotics due to the increased risk of changes in the rheological properties of the blood.

Central nervous system stimulants in combination with a nootropic can provoke psycho-emotional disorders. Extrapyramidal disorders are observed with the combined use of Piracetam and antipsychotics. Due to the fact that the active component is excreted from the body unchanged, the nootropic drug is not able to affect the bioavailability of other drugs.

The solution has positive compatibility with hydroxyethyl starch, mannitol, fructose, Ringer's solution, dextrose and sodium chloride.

Alcohol compatibility

The medication has negative compatibility with any drinks that contain ethanol. Patients are instructed to stop drinking alcohol 2-3 weeks before starting treatment with a nootropic drug.

Impact on the ability to drive vehicles and operate machinery

With long-term treatment of brain injuries with Piracetam, the risk of developing side effects, manifested in the form of clouding of consciousness, fainting and overexcitation, is quite high. Experts recommend refraining from driving a car or other vehicles.

Contraindications

Even those pregnant women whose doctor prescribes the drug for treatment should study the list of possible contraindications. If for people in a normal state Piracetam does not have a very long list of prohibited conditions, then for pregnant women it is quite extensive, since the expectant mother becomes especially vulnerable due to changes in the body. Piracetam is contraindicated for pregnant women if they have:

• allergic reactions to any component of the drug: main or auxiliary;
• decompensated renal failure (stage III, chronic);
• Huntington's chorea (genetic disease of the nervous system);
• acute hemorrhagic stroke;
• psychomotor agitation during the use of Piracetam;
• extensive bleeding.

Particular attention is paid to women with impaired renal function at any stage, since during pregnancy this organ experiences additional stress.

Properties and principle of action of the drug

This medicine is available in several forms, but today we will look at it in detail in tablets. Piracetam is a nootropic drug that has a positive effect on cerebral microcirculation, thereby normalizing metabolism in the human brain.

These tablets improve the utilization of glucose, suppressing platelet aggregation, and protect damaged areas of the brain caused by electric current or affected by hypoxia. The medicine will have a calming effect and help the brain perform its integrative function without the additional use of psychostimulants. Due to its antihypoxic properties, Piracetam is effectively used to treat myocardial infarction.

A distinctive feature of Piracetam is that it has 100% bioavailability, that is, after oral administration, the medicine is almost immediately absorbed in the body in full. The half-life of the active substance of the drug occurs after 5 hours. Almost 95% of the unchanged substance is excreted from the body in the urine within 30 hours.

Use during pregnancy and breastfeeding

There are no sufficient data on the use of piracetam during pregnancy. Animal studies have not shown direct or indirect effects on pregnancy, embryo/fetal development, childbirth or postnatal development.

Piracetam penetrates through the GPB. Plasma concentration in newborns reaches 70–90% of that in the mother. Piracetam should not be prescribed during pregnancy.

Piracetam passes into breast milk. Should not be used during breastfeeding or breastfeeding should be discontinued while being treated with piracetam.

When deciding whether to stop breastfeeding or refuse treatment with piracetam, the benefits of breastfeeding for the child should be weighed against the benefits of therapy for the woman.

Pharmacological properties

Pharmacodynamics. Piracetam is a nootropic drug, a synthetic analogue of g-aminobutyric acid. It has a diverse regulatory effect on metabolic processes and blood circulation in the brain. Normalizes the ratio of ATP and ADP, increases the activity of phospholipase A, stimulates plastic and bioenergetic processes in nervous tissue, accelerates interneuronal contacts and the exchange of neurotransmitters. Strengthens the synthesis of dopamine, increases the level of norepinephrine in the brain. Increases the resistance of brain tissue to hypoxia and toxic influences, enhances the synthesis of nuclear RNA in the brain. Improves the rheological properties of blood and microcirculation without having a vasodilating effect. Inhibits platelet aggregation. Optimizes oxygen and glucose consumption in case of lack of blood supply and acute cerebral ischemia in patients with dementia. Reduces the severity of vestibular nystagmus. Does not have a sedative effect and does not cause euphoria. Activates associative processes of the brain, improves memory. Increases integrative brain activity and intellectual activity, stimulates learning processes, restores and stabilizes impaired brain functions.

Pharmacokinetics. When taken orally, it is quickly and almost completely absorbed from the gastrointestinal tract. Bioavailability is approximately 100%. The maximum concentration in the blood (40–60 mcg/ml) is achieved 30 minutes after taking a dose of 2 g. Piracetam does not bind to blood proteins. Penetrates well into tissues, selectively accumulates in the cerebral cortex (mainly in the frontal, parietal and occipital lobes, in the cerebellum and basal ganglia). The half-life of piracetam from the blood is 4–5 hours; from the cerebrospinal fluid it is 6–8 hours. Piracetam is not metabolized and is excreted unchanged from the body mainly by the kidneys, as well as through the intestines (1–2%). Within 24–30 hours after a single dose, 90–100% of the dose taken is released. Piracetam passes through the blood-brain and placental barriers, penetrates into breast milk (the concentration of piracetam in newborns reaches 70–90% of its concentration in mother's milk). Passes through hemodialysis membranes. In renal failure, the half-life increases. The pharmacokinetics of piracetam in patients with liver failure does not change

Drug Lucetam

An analogue of Piracetam, the drug Lucetam is a fairly popular and widely used drug. Lucetam is sold in pharmacies in two varieties - in the form of injections and tablets . The main composition of both forms of the drug Lucetam, as well as other analogues of the drug Piracetam, includes an organic compound of non-proteinogenic aminobutyric acid or piracetam.

The tablets additionally contain polyvinylpyrrolidone, titanium dioxide, stearic acid with magnesium, ethylene glycol polymer, mixed methylcellulose ester, fatty silicate powder, cellulose ethyl ether.

The injection composition contains absolute ethanoic acid, sodium salt of acetic acid, sterile medical liquid.

Piracetam analogue - Lucetam should be used for the following pathologies in the body:

Oral intake:

• recovery period after an acute circulatory disorder in the brain with damage to its tissue and changes in activity;
• in case of damage to bones, skull tissue and brain matter due to injury;
• senile dementia in the form of partial loss of memories, inability to concentrate, decreased physical performance, unsteadiness of gait and sudden mood swings;
• death of nerve cells in the brain in Alzheimer's disease;
• with painful spasms of the muscles of the body, as a result of pathological changes in the cerebral hemispheres;
• for children - if it is impossible to concentrate during study and with organic damage to the right hemisphere of the brain;

Injection:

• various types of dementia, amnesia, partial loss of the ability to remember information, inability to concentrate, motor retardation;
• dyscirculatory encephalopathy in old age;
• speech impairment due to lack of oxygen to brain cells;
• painful muscle spasms caused by pathology in the cerebral hemispheres;
• helplessness of psychoorganic origin;
• nystagmus, postoperative muteness;
• motor impairment;
• treatment of alcohol dependence - withdrawal syndrome, weakening of mental abilities, physical activity, asthenia.

Both forms of Lucetam are substitutes for Piracetam, which have similar pharmacological effects. The drug Lucetam or Piracetam is a drug that enhances a set of processes in nerve endings and cells, and also increases or stabilizes the weakening of mental abilities. The Piracetam analogue has a positive effect on metabolism in the brain, stimulates blood circulation in both large veins and arteries, and affects the microcirculation of the brain, improving the cognitive process and the ability to remember information.

An analogue of Piracetam, the drug Lucetam promotes the development of the corpus callosum, which is responsible for connecting nerve endings between the right and left hemispheres of the brain, improves the interaction of brain cells, and normalizes the stability of inhibitory and excitatory conditioned reflexes in the central nervous system. In case of ischemic damage in the brain, the Piracetam analogue promotes recovery processes in ischemic brain tissue. Like all analogues of Piracetam, Lucetam does not have the ability to dilate blood vessels.

Clinical experience

According to experimental data, piracetam enhances the effect of antidepressants and, when used in combination, can increase their effectiveness.

Due to its antihypoxic effect, the use of piracetam is recommended in the complex treatment of patients with ischemic stroke and myocardial infarction.

However, the randomized multicenter placebo-controlled trial PASS (Piracetam in Acute Stroke Study) showed the lack of effectiveness of piracetam in the treatment of acute ischemic stroke. The observed results of using piracetam are similar to those of placebo. In this study, patients received piracetam at a dose of 12 grams per day, therapy began within the first 12 hours from the onset of stroke. Upon additional analysis, however, it was found that the positive effect of piracetam still manifests itself in a subgroup of patients with earlier (up to 7 hours) initiation of therapy for moderate and severe (Orgogozo score less than 55 out of 100 points) stroke [7]. Another study, PASS II, was conducted with the inclusion of 800 patients and the administration of piracetam in the first 7 hours after the onset of stroke [8]. The results of the study were never published by the sponsor[9].

Clinical picture of poisoning

Symptoms of intoxication begin to appear if the daily dose of piracetam exceeds 5.0 g . Their severity depends on the diseases in the person’s history, his age, and individual predisposition. 2-3 hours after taking the tablets, the victim experiences the following signs of overdose:

1. Emotional instability - nervous agitation, drowsiness, lethargy, increased anxiety, irritability.
2. Disorders of the gastrointestinal tract - nausea, vomiting, flatulence, bloating, heartburn.
3. Lack of appetite (with chronic intoxication, weight loss).
4. Headaches, dizziness, loss of coordination of movements.
5. Low blood pressure, heart rhythm disorder.

An overdose of a nootropic occurs when the tablets are used together with antipsychotics. As a result of joint use, the effect on the central nervous system increases significantly, the person’s lower and upper limbs begin to tremble, and breathing becomes difficult.

Piracetam is used to treat children with mental retardation and cerebral palsy . If such a child takes an increased dose, he will develop fussiness, anxiety, imbalance, and aggressiveness. When prescribing a nootropic, it should be taken into account that it enhances the effect of psychostimulants and hormonal pills.

Additional Information

The medicine should be stored in a dry place, protected from light. It is worth noting that the drug may interact with other drugs. In particular, the drug "Piracetam" enhances the effect of taking psychostimulants, indirect anticoagulants and antipsychotics. In addition, the drug increases the activity of thyroid hormones. If taking the medication in the evening affects the quality of sleep (for example, causes insomnia), it is worth changing the schedule of use. Experts also do not recommend abruptly stopping treatment with this drug; it is better to discontinue it gradually.

Interaction with other drugs

Piracetam increases the effectiveness of thyroid hormones and antipsychotic drugs (neuroleptics). When administered simultaneously with antipsychotics, piracetam reduces the risk of extrapyramidal disorders. When used simultaneously with drugs that have a stimulating effect on the central nervous system, the stimulating effect on the central nervous system may be enhanced.

There was no interaction with clonazepam, phenytoin, phenobarbital, or sodium valproate.

Piracetam in high doses (9.6 g/day) increases the effectiveness of indirect anticoagulants in patients with venous thrombosis (there was a more pronounced decrease in platelet aggregation, fibrinogen levels, von Willebrand factors, blood and plasma viscosity compared with the use of indirect anticoagulants only).

The possibility of changing the pharmacodynamics of piracetam under the influence of other drugs is low, because 90% of the drug is excreted unchanged in the urine.

In vitro, piracetam does not inhibit cytochrome P450 isoenzymes, such as CYP1A2, 2B6, 2C8, 2C9, 2C19, 2D6, 2E1 and 4A9/11 at concentrations of 142, 426 and 1422 μg/ml. At a concentration of 1422 μg/ml, a slight inhibition of CYP2A6 (21%) and ZA4/5 (11%) was noted. However, the Ki level of these two isoenzymes is sufficient when exceeding 1422 μg/ml. Therefore, metabolic interaction with other drugs is unlikely.

Taking piracetam at a dose of 20 mg/day did not change the peak and curve of the concentration of antiepileptic drugs in the blood serum (carbamazepine, phenytoin, phenobarbital, valproate) in patients with epilepsy receiving the drug at a constant dose.

Co-administration with ethanol did not affect the serum concentration of piracetam; The concentration of ethanol in the blood serum did not change when taking 1.6 g of piracetam.

Piracetam or Nootropil?

It is extremely difficult to talk about the distinctive characteristics of the two drugs. Since the drugs “Nootropil” and “Piracetam” contain the same active ingredients. Their effect on the body is also identical. The drug "Nootropil" is an analogue of the domestic drug "Piracetam".

Both drugs have an effect on the brain, stimulating its functioning in sick and healthy people.

The obvious difference between the drugs (Nootropil, Piracetam) is the cost. Domestic medicine is much cheaper. The price of the analogue is 206.90 rubles.

Some doctors are inclined to use the drug Nootropil. They believe that the medicine "Piracetam" is less purified. It is as a result of this feature that the latter drug, in case of long-term use, causes problems with the liver and kidneys.

However, we should not forget that each body reacts to medications in its own way. Therefore, you can only determine which medicine is more effective by testing both remedies on yourself.

Contraindications, side effects and overdose

The use of Piracetam is not possible for all patients.

Contraindications include:

• individual intolerance to the substances included in the medication;
• early childhood;
• period of pregnancy and breastfeeding;
• Huntington's syndrome;
• hyperactivity;
• hemorrhoidal stroke;
• chronic form of kidney dysfunction;
• coagulopathy.

The use of Piracetam is often accompanied by side effects. This is especially true for children. Taking the medication causes atypical behavioral reactions: increased irritability, aggressiveness, feelings of phobia and anxiety, attention deficit, impaired coordination of movements.

Adult patients may experience the following negative consequences of taking Piracetam:

• dizziness;
• thrombosis and pain at the injection site;
• interference with the endocrine system causing weight gain;
• allergies manifested on the skin, swelling, anaphylaxis;
• disruption of the normal process of defecation, nausea, accompanied by vomiting and pain in the lower abdomen;
• increased sexual libido;
• decreased blood pressure, chills;
• interruptions in sleep, migraines, poor coordination of movements, mental overexcitation, hallucinations;
• increased frequency of epileptic seizures.

When taking Piracetam, it is necessary to monitor the condition of the kidneys, especially in patients with pathologies in their functioning.

If a side effect such as insomnia occurs, the evening dose of the drug is transferred to an earlier period.

Despite the fact that daily intake of a sufficiently large amount of the drug is allowed, it is impossible to exceed the limits prescribed by a specialist, since an overdose several times increases the likelihood of developing side effects. Along with them, rapid heartbeat and heart failure may appear.

In case of overdose, it is necessary to remove excess substances of the medication. The best way to do this is to actively drink warm water.