Instructions for Vinpotropil (Piracetam, Vinpocetine)
Active substances
Vinpotropil is a nootropic drug Vinpotropil that improves cerebral circulation. Release Form and Composition Vinpotropil Dosage Forms: Film coated tablets: oval, light brown with a greyish tint, with a risk, on a cross section - almost white color (10 pieces in contour pockets, in a cardboard pack 3 or 6 packages);
Capsules: size №0, yellow with red lid; contents - white powder, possible presence of separate lumps and crystals (10 pcs each in contour pockets, in cardboard pack 2, 3, 5 or 10 packages; 15 pieces each in contour box packages, in cardboard pack 2, 4 or 6 packages; 15 or 50 pcs. in plastic bottles, in a cardboard pack 1 bottle); Infusion solution concentrate: transparent, colorless or lightly coloured (5 ml each in dark glass ampoules: 5 ampoules in a cardboard pack; 5 ampoules in a contour bin package, in a cardboard pack 2 packages; 10 ampoules in a contour bin package, in a cardboard pack 1 or 2 packages). Active substances in 1 tablet: Vinpocetine - 10 mg; Piracetam - 800 mg. Active substances in 1 capsule: Vinpocetine - 5 mg; Piracetam - 400 mg. Active substances in 1 ml of concentrate: Vinpocetine - 1 mg; Piracetam - 80 mg
The auxiliary substances of tablets: sodium croscarmellose, calcium hydrophosphate dihydrate, povidone, magnesium stearate, cellulose microcrystalline, talc.
The composition of the shell of the tablets:
Opadray II is brown (lactose monohydrate, macrogol, hypromellose, titanium dioxide, iron oxide dyes red and iron oxide black). Capsule auxiliary substances: calcium stearate and lactose. Auxiliary substances of the concentrate: sodium disulphite (sodium metabisulphite), amber acid, ascorbic acid, water for injection.
Pharmacodynamics
Vinpotropil is a combined agent, the action of which determines the properties of its active components: cerebrovasodilating (vinpocetine) and nootropic (piracetam). Vinpocetine improves cerebral circulation, expands cerebral vessels, increases blood flow, improves brain glucose and oxygen supply. It facilitates the transport of oxygen and energy-supply substrates to tissues, which increases the resistance of brain cells to hypoxia. It increases the content of catecholamines in brain tissues, and contributes to the accumulation of cyclic adenosine monophosphate and adenosine triphosphate. The vasodilating effect of vinpocetine is associated with its direct relaxing effect on the smooth musculature of vessels, especially the brain. Vinpotropil enhances blood supply to the ischemized region of the brain, while not causing the phenomenon of theft and does not change the blood supply to the intact areas of the brain. It increases the elasticity of red blood cells, reduces platelet aggregation and reduces blood viscosity, thus improving microcirculation in the brain. Piracetam is a cyclic derivative of gamma-aminobutyric acid and has a nootropic effect. This substance has a direct effect on the brain, thereby improving productivity and cognitive processes such as attention, memory and learning ability. The central nervous system is affected in various ways: It affects the rheological characteristics of the blood, improves microcirculation, changes the rate of excitation in the brain, improves metabolic processes in nerve cells. It has no vasodilating effect.
Pharmacokinetics
Pharmacokinetic characteristics of active components of Vinpotropil: vinpocetine: after taking the drug Vinpotropil, it is quickly absorbed into the gastrointestinal tract, mainly in its proximal sections. When passing through the wall of the intestine is not metabolized. Maximum plasma concentration is achieved within 1 hour. Therapeutic concentrations of vinpocetine in plasma after oral and parenteral use are 10-20 ng/ml. Bioavailability of the drug - 50-70%, connection with proteins - 66%. Clearance is - 66.7 l/h, this figure exceeds the plasma volume of the liver (50 l/h), which indicates the extraphenogenic metabolism of the drug Vinpotropil. The main metabolite of vinpocetine is apovincamic acid, which has a minor pharmacological activity. Other inactive metabolites are hydroxyapovincamic acid, hydroxyvinpocetine, and hydroxyvinpocetinaglycinate. Pharmacokinetics in repeated applications is linear. It is excreted by the kidneys and through the intestines in a ratio of 3:2. The spinal fluid is removed much more slowly than other tissues. The half-life is on average 4.8 h (3.54-6.12). Easily penetrates the histohematic barriers (including the blood-brain barrier), the placental barrier and breast milk;
pirates: it penetrates well into various tissues and organs. In animal experiments, it was found that the substance selectively accumulates in the tissues of the cerebral cortex, mainly in the occipital, parietal and frontal lobes, basal nuclei and cerebellum. Characterized by very high bioavailability - about 100%. After a single dose of 3.2 g, the maximum concentration is 84 ug/ml, after repeated use (3.2 g thrice daily) - 115 ug/ml. Maximum plasma concentration is reached within 1 hour, in cerebrospinal fluid - within 5 hours. The distribution volume is about 0.6 l/kg. Total clearance 80-90 ml/min. Penetrates through blood-brain and placental barriers. It does not bind to plasma proteins. It is virtually non-metabolized. It is excreted unchanged by the kidneys through a 30-hour flowering process. The half-life from the blood plasma is 4-5 h, from the brain - 7.7 h, from spinal fluid - 8.5 h. In chronic renal failure, the half-life is extended (up to 59 h at the terminal stage). Piracetam is removed in hemodialysis.
Indications for Use
For all Vinpotropil dosage forms: Parkinsonism of vascular genesis; Cerebral circulation failure (recovery period after haemorrhagic and ischemic stroke); Psychoorganic syndrome with the predominance of signs of adinamia and asthma; Intoxication. Extra for tablets: Symptomatic treatment of vertigo; Chronic cerebral circulatory failure of post-traumatic and hypertensive genesis; Prevention of kinetosis and migraine. In addition for capsules and a concentrate for preparing infusions: Labyrinthopathy; Asthenic syndrome; Brain injuries and other diseases of the central nervous system, accompanied by a decline in intellectual mnestic functions; Ménière syndrome; Encephalopathy of various origins, including alcoholism. In addition, Vinpotropil in capsules is prescribed for the prophylaxis of kinetoses and migraines.
Overdose In the case of a significant excess of the dose of Vinpotropil, it is possible to increase the severity of dose-dependent side effects, the occurrence of abdominal pain and diarrhea with a blood mixture. In the case of oral administration, gastric flushing and activated carbon are recommended. Piracetam is 50-60% excreted from the body using hemodialysis. There is no specific antidote. Further treatment is symptomatic.
Nosology (ICD codes)
F07
Personality and behavioural disorders caused by disease, damage or brain dysfunction
F48.0
Neurasthenia
G20
Parkinson's disease
G21
Secondary parkinsonism
G43
Migraine
G93.4
Encephalopathy unrefined
H81
Vestibular function disorders
H81.0
Ménière's disease
H93.0
Degenerative and vascular ear disease
I61
Intracerebral hemorrhage (haemorrhagic type disorder)
I63
Brain infarction
I69
Effects of cerebrovascular disease
