Ceresil Canon, 250 mg/ml 4 ml 5 pcs

Pharmacodynamics

Cyticoline is a natural endogenous compound which is an intermediate metabolite in the synthesis of phosphatidylcholine, one of the main structural components of the cell membrane. Citicoline, being a precursor of key ultrastructural components of the cell membrane (mainly phospholipids), has a broad spectrum of action: it promotes the restoration of damaged cell membranes, inhibits the action of phospholipases, prevents the excessive formation of free radicals and also prevents cell death by acting on apoptosis mechanisms. In the acute period of stroke citicoline reduces the volume of brain tissue damage, improves cholinergic transmission. In craniocerebral trauma reduces the duration of post-traumatic coma and severity of neurological symptoms, in addition, contributes to reducing the duration of the recovery period. In chronic cerebral hypoxia citicoline is effective in treating cognitive disorders such as memory impairment, lack of initiative, difficulties in daily activities and self-care. It increases the level of attention and consciousness and reduces the manifestation of amnesia.

Cyticoline is effective in the treatment of sensory and motor neurological disorders of degenerative and vascular etiology.

Pharmacokinetics

absorption

Cyticoline is well absorbed when taken orally. Absorption after oral administration is almost complete and bioavailability is about the same as after intravenous administration.

Distribution

Cyticoline is largely distributed in brain structures, with rapid incorporation of choline fractions into structural phospholipids and citidine fractions into citidine nucleotides and nucleic acids.

Cyticolin penetrates the brain and is actively incorporated into cellular, cytoplasmic and mitochondrial membranes, forming part of the structural phospholipid fraction.

Metabolism

The drug is metabolized in the intestine and in the liver to form choline and cytidine. After intake, plasma concentrations of choline are significantly increased.

Evacuation

Only 15% of the administered dose of citicoline is excreted from the human body: less than 3% by the kidneys and through the intestines and about 12% with exhaled CO2.

Two phases can be distinguished in the urinary excretion of citicoline: a first phase lasting about 36 hours, during which the excretion rate decreases rapidly, and a second phase, during which the excretion rate decreases much more slowly. The same is observed in exhaled CC2 – the excretion rate decreases rapidly after about 15 hours and then decreases at a much slower rate.

.

Indications

Acute period of ischemic stroke (as part of complex therapy).
Recovery period of ischemic and hemorrhagic strokes.
Traumatic brain injury (TBI), acute (as part of complex therapy) and recovery period.
Cognitive and behavioral disorders in degenerative and vascular diseases of the brain.

Pharmacological effect

Pharmacodynamics

Citicoline is a natural endogenous compound that is an intermediate metabolite in the synthesis of phosphatidylcholine, one of the main structural components of the cell membrane. Citicoline,

being a precursor of the key ultrastructural components of the cell membrane (mainly phospholipids), it has a wide spectrum of action – it promotes the restoration of damaged cell membranes, inhibits the action of phospholipases, prevents the excessive formation of free radicals, and also prevents cell death by affecting the mechanisms of apoptosis. In the acute period of stroke, citicoline reduces the volume of brain tissue damage and improves cholinergic transmission. In case of traumatic brain injury, it reduces the duration of post-traumatic coma and the severity of neurological symptoms, in addition, it helps to reduce the duration of the recovery period. In chronic cerebral hypoxia, citicoline is effective in the treatment of cognitive disorders such as memory impairment, lack of initiative, and difficulties in performing daily activities and self-care. Increases the level of attention and consciousness, and also reduces the manifestation of amnesia.

Citicoline is effective in the treatment of sensory and motor neurological disorders of degenerative and vascular etiology.

Pharmacokinetics

Suction

Citicoline is well absorbed when taken orally. Absorption after oral administration is almost complete, and bioavailability is approximately the same as after intravenous administration.

Distribution

Citicoline is widely distributed in brain structures, with rapid incorporation of choline fractions into structural phospholipids and cytidine fractions into cytidine nucleotides and nucleic acids.

Citicoline penetrates the brain and is actively incorporated into cellular, cytoplasmic and mitochondrial membranes, forming part of the fraction of structural phospholipids.

Metabolism

The drug is metabolized in the intestines and liver with the formation of choline and cytidine. After administration, the concentration of choline in the blood plasma increases significantly.

Removal

Only 15% of the administered dose of citicoline is excreted from the human body: less than 3% by the kidneys and through the intestines and about 12% by exhaled CO2.

The excretion of citicoline in urine can be divided into 2 phases: a first phase, lasting about 36 hours, during which the rate of excretion decreases rapidly, and a second phase, during which the rate of excretion decreases much more slowly. The same is observed in exhaled CC2 – the rate of elimination decreases rapidly after about 15 hours and then decreases much more slowly.

Special instructions

In the cold, a small amount of crystals may form due to temporary partial crystallization of the preservative. With further storage under recommended conditions, the crystals dissolve within several months. The presence of crystals does not affect the quality of the drug.

Impact on the ability to drive vehicles and machinery

During the treatment period, care should be taken when performing potentially hazardous activities that require special attention and quick reactions (driving a car and other vehicles, working with moving mechanisms, working as a dispatcher and operator, etc.).

Active ingredient

Citicoline

Composition

1 ml of solution contains:
Active substances:
Citicoline sodium 104.5 mg, which corresponds to the content of citicoline 100 mg.
Excipients:
Banana flavor (essence “Banana”) – 0.4 mg;
Glycerin – 50 mg;
Potassium sorbate – 3 mg;
Methyl parahydroxybenzoate – 1.45 mg;
Sodium saccharinate – 0.2 mg;
Sodium citrate – 6 mg;
Propyl parahydroxybenzoate – 0.25 mg;
Sorbitol – 200 mg;
Citric acid solution 50% – to pH 5.9-6.1;
Purified water – up to 1 ml.

Contraindications

Hypersensitivity to any of the components of the drug;
Severe vagotonia (predominance of the tone of the parasympathetic part of the autonomic nervous system);
Due to the lack of sufficient clinical data, it is not recommended for use in children under 18 years of age.

Side Effects

From the central nervous system and peripheral nervous system: insomnia, headache, dizziness, agitation, tremor, numbness in paralyzed limbs.

From the digestive system: nausea, loss of appetite, changes in the activity of liver enzymes.

Allergic reactions: rash, itchy skin, anaphylactic shock.

Other: fever; in some cases – short-term hypotensive effect, stimulation of the parasympathetic nervous system.

Interaction

Citicoline enhances the effects of levodopa.

Should not be used concomitantly with medicinal products containing meclofenoxate.

Overdose

Given the low toxicity of the drug, cases of overdose have not been described, even if therapeutic doses are exceeded.

Storage conditions

At a temperature not exceeding 25°C in the manufacturer’s packaging.

Keep out of the reach of children.

Shelf life

2 years.

Manufacturer

Armavir biofactory FKP, Russia