As indicated by the instructions for use, "Cerecard" refers to medicines, which include substances that inhibit oxidation (antioxidants) and to drugs that help restore and improve the functions of the nervous system (neuroprotectors).
Let's consider this drug in more detail.
Composition and form of release
According to the instructions, “Cerecard” is produced in the form of glass ampoules of 2 and 5 ml each, containing a light yellow or colorless solution for intravenous and intramuscular injections, the active substance of which is ethyl methylhydroxypyridine succinate (50 mg in 1 ml of solution). It also contains an auxiliary substance - sodium metabisulfite (special water for injections). There are tablets "Cerecard". Instructions for use and reviews confirm this.
Pharmacological properties
“Cerecard” refers to pyridine derivatives (a class of 3-hydroxypyridines) that behave like typical phenols. The drug slows down free radical reactions, i.e. It is a membrane protector, and also has a stress-protective, antihypoxic, antiepileptic, anxiolytic and nootropic effect. Increases stress resistance of the body. Not applicable in medical practice in Western countries.
Active substance
According to the instructions, the active substance "Cerecade" is a pyridine derivative - ethylmethylhydroxypyridine succinate from the class of 3-hydroxypyridines. The substance suppresses biochemical processes taking place with the participation of free radicals, performs a protective function, protecting the membrane membranes of cells from various injuries, and also has a nootropic, antiepileptic, anxiolytic and stress-protective effect. What else does the instructions for use for Cerecard in injections say?
Mechanism of action
The mechanism of action of the drug is determined by its antioxidant and membrane-protective qualities, with the help of which the process of lipid peroxidation (lipid peroxidation ) is suppressed, the activity of superoxide oxidases increases, the ratio of lipid proteins increases, the structure and functions of the cell membrane are normalized. The drug imitates the activity of membrane-bound (vector) enzymes, such as calcium phosphodiesterosis, acetylcholinesterosis and adenylate cyclosis, as well as receptor aggregates: benzodiazepine, acetylcholine, y-aminobutyric acid. Thus, it promotes their binding to agonist ligands. In addition, the drug improves the functional features and structure of the membranes, the translation of neuromoderators and the optimization of neurotransmission. This is confirmed by the instructions for the drug "Cerecard".
In systemic use, it:
- Increases the concentration of the brain neurotransmitter - dopamine.
- It improves the compensatory activation of glycolytic processes and reduces the degree of suppression of oxidative reactions in the tricarboxylic acid cycle (Krebs cycle) under conditions of low oxygen content with increased ATP, and also activates the restoration of the energy-synthesizing function of mitochondria.
- Increases the body's resistance to the effects of a variety of damaging and pathogenic factors (physical, biological and chemical) during hypoxia and ischemia, shock, deterioration of the blood circulation of the brain and other pathological processes.
- It improves blood supply and metabolism of the brain, and also normalizes blood viscosity and fluidity and its microcirculation, reduces the risk of platelets. Regulates the stabilization of the membrane membrane of red blood cells and platelets, while reducing platelet aggregation. This is indicated by the instructions for use with Cerecard.
- Reduces the concentration of LDL (low density lipoproteins) and total cholesterol.
- It improves the state of the heart muscle functions in myocardial infarction and ischemic myocardium, and also reduces the risk of diastolic and systolic disorders of the left ventricle.
- Helps maintain the structural and functional association of the membranes of cardiomyocytes. It activates membrane enzymes - phosphodiesterase, acetylcholinesterase, adenylate cyclase.
- It supports the activation of aerobic glycolysis, which develops in acute ischemia and the normalization of mitochondrial redox reactions under hypoxia. Increases ATP synthesis.
- Helps maintain the integrity of the morphological structures of the ischemic myocardium and its physiological functions.
- It improves the combination of manifestations of myocardial infarction, and also makes the therapy much more effective, providing restoration of the left ventricle. Reduces the incidence of cardiac arrhythmias and intracardiac conduction defects.
Pharmacokinetics
According to the instructions, “Cerecard”, when administered intramuscularly, is rapidly absorbed and detected in blood plasma within 4 hours after administration. The time it takes to reach the maximum concentration of the drug is 0.3-0.5 hours. In accordance with the instructions for use, Cerecard, when administered intramuscularly at a dose of 500 mg, provides a maximum concentration of the drug in the range of 2.5 to 4 μg / ml. Intramuscular injections should be done by a qualified specialist.
The drug instantly spreads in tissues and organs. With intramuscular injection, the average delay time of the drug in the body is 0.7-1.3 hours. By glucuronidation, it is metabolized in the liver.
Excreted very quickly in the urine. Mainly in the form of metabolites and in insignificant quantities in its unchanged form.
Indications for use
Assign with the complex treatment of the following diseases:
- functional disorders, which are based on violations of the vascular system of the body (vegetovascular dystonia);
- slowly developing damage to the vessels of the brain;
- anxiety conditions caused by neurotic and neurosis-like disorders;
- acute deterioration of cerebral circulation (cerebral infarction);
- intoxication of the body while taking antipsychotic drugs;
- acute cognitive impairment of vascular origin;
- acute damage to the heart muscle (myocardial infarction);
- mental and neurological disorders that occur with alcohol withdrawal syndrome, accompanied by vegetovascular and neurosis-like pathologies.
Contraindications
As the instruction indicates to the Cerecard tablets, they have, like injections, a number of the following contraindications:
- individual intolerance to the active substance of the drug;
- period of breastfeeding;
- pregnancy;
- minor age;
- acute violations of the functional activity of the liver and / or kidneys.
"Cerecard" should be used with caution in the presence of a history of allergies.
Instructions for use
“Cerecard” is injected directly into the muscle either by intravenous drip (at a rate of 60 drops / min) or by the jet method (the duration of infusion is 5-7 minutes). With this method, a 0.9% sodium chloride solution is used. The initial dose of "Cerecard" should be in the range of 50-100 mg 1-3 times a day. The maximum daily dosage of this drug should not exceed 800 mg.
The following dosage of Cerecard is recommended:
- In case of dyscirculatory encephalopathy in the decompensation phase, “Cerecard” is administered iv in a drip or in a jet of 100 mg three times a day, the course duration is two weeks, and then i / m also 100 mg for another 14 days.
- In case of acute circulatory disturbance of the brain, “Cerecard” is administered iv in a drip method of 200 mg once a day for the first three days, and then IM 100 mg three times a day.
- For the course of prophylaxis of discirculatory encephalopathy - intramuscular injections (instructions for use for "Cerecard") at one hundred mg twice a day for two weeks.
- In case of dystonia of vegetovascular, neurotic and neurosis-like conditions, “Cerecard” is administered IM four hundred mg once a day, course duration 14 days.
- In case of intoxication with antipsychotics, “Cerecard” is administered iv 100-300 mg once a day, the course is 7-14 days.
- In case of withdrawal alcohol syndrome (withdrawal syndrome), “Cerecard” is administered IM 100-200 mg three times a day, or IV drip two hundred mg twice a day for a week.
- With a decrease in mental performance, “Cerecard” is administered in the m / m at three hundred mg once a day, the course lasts from two weeks to a month.
- In case of acute myocardial infarction, “Cerecard” is administered intravenously infusion over an hour and a half (it is necessary to dilute it in one hundred ml of 0.9% sodium chloride solution), or intravenously (duration of the procedure is 5 minutes) for 5 days. In the next 9 days, the drug is administered intramuscularly three times a day with an interval of 8 hours. The recommended average single dose is 2 mg / kg, daily - 7-9 mg / kg. According to the instructions for use with Cerecard tablets, the maximum permitted daily dose of the drug is 800 mg.
Side effects
During the injection, due to the high injection rate, a feeling of shortage of air (short-term nature), a metallic taste and dry mouth, a feeling of heat spreading over the body, an unpleasant odor, allergic reactions, discomfort in the chest area may appear. The above phenomena often occur with the introduction of drugs in / in the jet method.
When taking Cerecard, nausea, sleep disturbance and flatulence are possible for a long time.
Overdose
In case of an overdose of Cerecard, sleep disturbances (drowsiness or insomnia) can sometimes be observed. During intravenous administration of the drug, blood pressure may slightly and briefly increase.
Usually, the symptoms of an overdose of “Cerecard” disappear within a day and do not require additional treatment. With obvious high blood pressure, medications that reduce it should be used.
If insomnia appeared on the background of taking Cerecard, it is recommended to prescribe sleeping pills: Diazepam, Oxazepam, Nitrazepam.
special instructions
When treating with “Cerecard”, care must be taken when managing complex mechanisms and vehicles.
The drug is contraindicated during pregnancy and during lactation.
"Cerecard" is prohibited for the treatment of children under the age of 18 years.
Also, this drug can not be used for acute violations of the kidneys and liver.
Drug interaction
The instructions for use with "Cerecard" indicate that the drug increases the effect of antiepileptic (carbamazepine) and antiparkinsonian (levodopa) drugs, as well as anxiolytics.
Analogs
To understand what drugs you can replace this drug, you need to find out what substance in it is an active, basic. To do this, it is useful to study the instructions for use. Analogues of Cerecard are the following drugs: Mexidol, Astrox, Mexiprim, Mexidant, Metostabil, Mexicor, Neurox, Mexifin.
Storage conditions
"Cerecard" is stored in a dark place inaccessible to children at room temperature up to + 25 ° C. The shelf life of the drug is 3 years.
It is released according to the prescription of the attending physician.
Price in pharmacies
The price of "Cerecard" on average is:
- Ampoules of 5 ml volume (10 pcs per pack) - 350-500 rubles.
- Ampoules of 5 ml volume (5 pcs per pack) - 150 - 300 rubles.
- Ampules volume of 2 ml (10 pcs per pack) - 250 - 400 rubles.
- Ampoules volume of 2 ml (5 pcs per pack) 200 - 250 rubles.
The cost of the drug in the form of tablets is about 250 rubles. It often depends on the region and the pharmacy chain.
Reviews about the drug
In reviews of Cerecard, many consumers emphasize the fact that it is a generic of the more expensive Mexidol. Its action is similar. However, Mexidol acts gently, and Cerecard is, in fact, intended for emergency care. Cons: side effects, the presence of a list of contraindications, leave only on prescription. “However, at the same time, it has such advantages as an affordable price and high efficiency,” consumers emphasize in their reviews of Cerecard.
The instruction for the drug is not just a piece of paper. You need to read it not after any side effects from the medication have occurred, but before taking it. In addition, the prescribed dosage must be strictly observed.