Cytoflavin, 10 ml 10 pcs

Pharmacodynamics

Pharmacological effects are due to the complex action of the ingredients of the drug CITOFLAVIN®.

CITOFLAVIN® promotes activation of aerobic cell metabolism which results in increase of glucose utilization, promotes increased level of beta-oxidation of fatty acids and resynthesis of γ-aminobutyric acid in neurons.

CITOFLAVIN® increases resistance of nerve and glial cell membranes to ischemia, which is manifested by a decrease in the concentration of neuro-specific proteins characterizing the level of destruction of the main structural components of nervous tissue.

CITOFLAVIN® improves coronary and cerebral blood flow, activates metabolic processes in the central nervous system, restores disturbed consciousness, facilitates regress of neurological symptoms and improves cognitive functions of the brain. It has a fast awakening effect in post-arrest depression of consciousness.

When administering CITOFLAVIN® within the first 12 hours of the onset of stroke a favorable course of ischemic and necrotic processes in the affected area (decrease of the focus), recovery of neurological status and decrease of disability in the long-term period are observed.

Pharmacokinetics

In intravenous infusion at the rate of about 2 ml/min (in terms of undiluted CITOFLAVIN®) succinic acid and inosine are utilized almost immediately and are not determined in blood plasma.

Amber acid – the peak concentration is determined within the first minute after administration, with a further rapid decrease without cumulation and its level returns to the background values due to metabolism to water and carbon dioxide.

Inosine is metabolized in the liver to form inosinmonophosphate with subsequent oxidation to uric acid. A small amount is excreted by the kidneys.

Nicotinamide is rapidly distributed in all tissues, passes through the placenta and into the breast milk, is metabolized in the liver to form N-methylnicotinamide, and is excreted by the kidneys. The plasma elimination half-life is about 1.3 hours, the equilibrium volume of distribution is about 60 liters, total clearance is about 0.6 l/min.

Riboflavin is distributed unevenly: the greatest amount in the myocardium, liver, kidneys. The plasma elimination half-life is about 2 hours, the equilibrium volume of distribution is about 40 liters, total clearance is about 0.3 l/min. It penetrates through the placenta and into the breast milk. Binding with plasma proteins is 60%. It is excreted by the kidneys, partially as a metabolite; in high doses it is mainly unchanged.

Indications

Atherosclerosis, Headache, Consequences of stroke, Impaired cerebral circulation

In adults in the complex therapy:

1. acute impairment of cerebral circulation.
2. consequences of cerebrovascular diseases (consequences of cerebral infarction, cerebral atherosclerosis).
3. toxic and hypoxic encephalopathy in acute and chronic poisonings, endotoxemia, post-arrest depression of consciousness, as well as for prevention and treatment of hypoxic encephalopathy during cardiac surgery with artificial circulation.

In children (including prematurely born with gestation period of 28-36 weeks) during the period of newborn infancy:

1. In cerebral ischemia.

Active ingredient

Inosine, Nicotinamide, Riboflavin, Amber acid

Composition

1 ml of the solution contains:

active ingredients:

• succinic acid – 100 mg,
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• nicotinamide – 10 mg,

• riboxin (inosine) – 20 mg,

• riboflavin mononucleotide (riboflavin) – 2 mg;

accompanies:

• N-methylglucamine (meglumine) 165 mg;

• Sodium hydroxide 34 mg;

• water for injection

How to take, the dosage

In children (including prematurely born) in neonatal period with cerebral ischemia, the daily dose of CITOFLAVIN® is 2 ml/kg/day. The calculated daily dose of the drug is administered intravenously by drip (slowly) after dilution in 5% or 10% dextrose solution (ratio of at least 1:5).

Interaction

Amber acid, inosine, nicotinamide, compatible with other drugs.

Riboflavin: Reduces the activity of doxycycline, tetracycline, oxytetracycline, erythromycin and lincomycin.

It is not compatible with streptomycin.

Chlorpromazine, imipramine, amitriptyline due to blockade of flavinokinase, disrupt riboflavin incorporation into flavinadeninmononucleotide and flavinadenindinucleotide and increase its excretion with the urine.

The thyroid hormones accelerate the metabolism of riboflavin.

Mitigates and prevents the side effects of chloramphenicol (hematopoiesis disorders, optic neuritis).

Compatible with drugs that stimulate hematopoiesis, antihypoxant drugs, anabolic steroids.

Special Instructions

Injection of the drug in newborns (premature infants) should be carried out under control of capillary blood acid-base status indicators at least twice a day (both before and during therapy). If possible, serum lactate and glucose values should be monitored.

The rate of infusion of solution containing CITOFLAVIN® should be reduced or the infusion should be temporarily stopped in newborns (premature infants):

– being on artificial ventilation, with signs of mixed (respiratory-metabolic) alkalosis, threatened by the development of cerebral circulatory disorders;
– in patients with preserved spontaneous breathing and respiratory support by CPAP method or in those receiving air-oxygen mixture through a mask, with the appearance of laboratory signs of metabolic alkalosis, threatened by the appearance or increase in the frequency of apnea attacks.

In diabetic patients, treatment should be performed under control of the blood glucose index.

It may cause intense yellow staining of the urine.

CITOFLAVIN® has no effect on the ability to drive.

Contraindications

Hypersensitivity, patients undergoing ventilatory ventilation, when the partial pressure of oxygen in the arterial blood is less than 60 mm Hg, the period of breast-feeding.

With caution – nephrolithiasis, gout, hyperuricemia.

Side effects

Children (including prematurely born) in the period of newbornness may develop disorders of acid-base balance (alkalosis).

Overdose

To date, no cases of overdose with CITOFLAVIN have been established.

Pregnancy use

It is not recommended to take during lactation and pregnancy, due to the lack of clinical data on the safety and efficacy of the drug during this period.