Cocarnit, lyophilizate 187.125 mg+2 ml p-val 2 ml 3 pcs

Pharmacodynamics

The drug is a rationally selected complex of metabolic substances and vitamins. Triphosadenine is a derivative of adenosine and stimulates metabolic processes. It has a vasodilatory effect, including on coronary and cerebral arteries.

It improves metabolism and energy supply of tissues. It has hypotensive and antiarrhythmic action. Under the influence of ATP the blood pressure decreases, smooth muscles relax, and the conduction of nerve impulses improves. Cocarboxylase is a coenzyme formed in the body from ingested thiamine (vitamin B1).

It is part of the enzyme carboxylase, which catalyzes the carboxylation and decarboxylation of α-keto acids. Indirectly promotes the synthesis of nucleic acids, proteins and lipids. Reduces the concentration of lactic and pyruvic acids in the body, promotes glucose absorption. Improves the trophism of nervous tissue.

The body converts cyanocobalamin (vitamin B12) into methylcobalamin and 5-deoxyadenosylcobalamin. Methylcobalamin is involved in the conversion of homocysteine to methionine and S-adenosylmethionine, key reactions in the metabolism of pyrimidine and purine bases (and therefore of DNA and RNA). If the vitamin is deficient in this reaction, it can be replaced by methyltetrahydrofolic acid, with impaired folic metabolic reactions.

5-deoxyadenosylcobalamin serves as a cofactor in the isomerization of L-methylmalonyl-CoA into succinyl-CoA, an important reaction in carbohydrate and lipid metabolism. Vitamin B12 deficiency leads to impaired proliferation of rapidly dividing cells of hematopoietic tissue and epithelium, as well as to impaired formation of the myelin sheath of neurons. Nicotinamide, a form of vitamin PP, is involved in redox processes in the cell, improves carbohydrate and nitrogen metabolism, regulates tissue respiration.

Pharmacokinetics

Trifosadenin After parenteral administration penetrates the cells of organs where it splits into adenosine and inorganic phosphate with release of energy. Subsequently, the breakdown products are included in ATP resynthesis. Cocarboxylase Quickly absorbed after intramuscular administration. It penetrates into most body tissues. It undergoes metabolic degradation. Products of metabolism are excreted mainly by the kidneys.

Cyanocobalamin

In the blood cyanocobalamin binds to transcobalamin I and II, which transport it to the tissues. It is deposited mainly in the liver. The binding to plasma proteins is 0 90%. It is quickly and completely absorbed after intramuscular and subcutaneous administration. Maximum concentration after intramuscular administration is reached after 1 hour. It is excreted from the liver by bile into the intestine and is absorbed back into the blood. Period of semiejection is 500 days. Withdrawal in normal renal function is 7-10% by the kidneys and about 50% by the intestines. With reduced renal function 0-7% by kidneys and 70-100% by intestines. Passes through the placental barrier, in breast milk.4

Nicotinamide

Fastly distributed to all tissues. Passes through the placental barrier and into breast milk. It is metabolized in the liver to form nicotinamide-N-methylnicotinamide. It is excreted by the kidneys. The plasma elimination half-life is about 1.3 h, steady-state volume of distribution is about 60 liters, total clearance is about 0.6 l/min.

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Form of release

lyophilisate for preparing a solution for intramuscular administration Kokarnit