Combitropil, capsules, 30 pcs.

Combitropil is a combined medicine with pronounced antihypoxic, nootropic and vasodilator effect.

The two components mutually potentiate their own antihypoxic effect and have a vasodilator effect. The combination drug also contributes to a significant increase in blood flow in the brain. The toxicity of the combination does not exceed the toxicity of the individual components of the drug.

Piracetam is a nootropic drug. It has a positive effect on metabolic processes in the brain: it increases the concentration of ATP in the brain tissue, increases the synthesis of RNA and phospholipids, stimulates glycolytic processes and increases the utilization of glucose.
Improves integrative activity of the brain, promotes memory consolidation, facilitates learning.
It changes the speed of excitation in the brain, improves microcirculation, without a vasodilator effect, inhibits the aggregation of activated thrombocytes. It has a protective effect in brain injuries caused by hypoxia, intoxication and electroshock; it increases alpha and beta activity, decreases delta activity on EEG, reduces severity of vestibular nystagmus.

It improves inter-neuronal transmission and synaptic conduction in the neocortical structures, increases mental performance, improves cerebral blood flow. The effect develops gradually.

It has practically no sedative and psychostimulant effect.

Cinnarizine is a selective blocker of slow calcium channels, reduces the entry of Ca2+ into cells and reduces its content in the plasma membrane depot, reduces the tone of the arteriolar smooth muscle, reduces their response to biogenic vasoconstrictors (epinephrine, norepinephrine, dopamine, angiotensin, vasopressin, serotonin).

It has a vasodilator effect (especially on brain vessels, increasing the antihypoxic effect of piracetam) without having a significant effect on blood pressure. It has moderate antihistamine activity, reduces the excitability of the vestibular apparatus, reduces the tone of the sympathetic nervous system. In patients with impaired peripheral circulation improves blood supply to organs and tissues (including myocardium), increases postischemic vasodilation. Increases the elasticity of red blood cell membranes, their ability to deform, reduces blood viscosity.

Pharmacokinetics

The combined drug is quickly and completely absorbed in the gastrointestinal tract. Bioavailability of piracetam is 95%. Therapeutic effect is manifested in 1-6 hours. Maximal level of cinnarizine in plasma is observed after 1-4 hours, piracetam – after 2-6 hours.

The metabolism of cinnarizine occurs entirely in the liver (by dealkylation). 60% of cinnarizine in unchanged form is excreted with feces, the rest is excreted with urine as metabolites in about 5 hours. Maximal level of cinnarizine in 1-4 hours is observed not only in blood, but also in liver, kidneys, heart, lungs, spleen and brain. It is 91% bound to plasma proteins.

Piracetam penetrates through the blood-brain barrier and accumulates in the brain tissue 1-4 hours after oral administration. Excretion from cerebrospinal fluid is significantly slower than from other tissues. It is practically not metabolized. Elimination half-life is 4.5 hours (7.7 hours – from brain). Excreted by the kidneys – 2/3 unchanged within 30 hours.

Indications

Active ingredient

Composition

acting ingredients:

cinnarizine – 25 mg,

piracetam – 400 mg.

Auxiliary substances:

microcrystalline cellulose,

lactose (milk sugar),

magnesium stearate,

talc.

composition of the gelatin capsule:

titanium dioxide, methyl parahydroxybenzoate, propyl parahydroxybenzoate, acetic acid, gelatin.

How to take, the dosage

Inside, adults – 1-2 capsules 3 times a day, for 1-3 months, depending on the severity of the disease, children from 5 years – 1-2 capsules 1-2 times a day, for 1-3 months. The course of treatment 2-3 times a year.

In chronic renal insufficiency (CKD less than 60 ml/min) it is necessary to decrease the dose or to increase interval between the doses of the preparation.

Interaction

Combitropil enhances the effects of drugs that depress the central nervous system, ethanol, as well as nootropic and hypotensive drugs.

It improves the tolerability of antipsychotic drugs (neuroleptics) and tricyclic antidepressants.
Vasodilating drugs increase the effect of Combitropil.

Special Instructions

Hypatic function should be monitored during treatment.

At the beginning of treatment the patient should refrain from taking alcohol.

Due to the content of cinnarizine the drug may cause a positive reaction in athletes during a doping test.

The drug should be prescribed with caution in case of increased intraocular pressure.

During treatment, caution should be exercised while driving and engaging in activities requiring increased concentration and quick psychomotor reactions.

Contraindications

With caution:
Parkinson’s disease; renal and/or hepatic failure.

Side effects

Similarities