Cytoflavin, 10 ml 5 pcs

CITOFLAVIN® promotes the activation of aerobic cell metabolism, which leads to an increase in glucose utilization, promotes increased levels 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 the level of disability in the long-term period are observed.

Indications

In adults in the complex therapy:
1. acute cerebrovascular disorders.
2. consequences of cerebrovascular diseases (consequences of brain infarction, cerebral atherosclerosis).
3. Toxic and hypoxic encephalopathy in acute and chronic poisonings, endotoxicosis, post-arrest depression of consciousness as well as for prevention and treatment of hypoxic encephalopathy during cardiac surgery using artificial circulation.

In children (including prematurely born with gestation period of 28-36 weeks) during the period of neonatal:
1. In cerebral ischemia.

Active ingredient

Composition

1 ml of the solution contains:

the active ingredients:

succinic acid – 100 mg,

nicotinamide – 10 mg,

riboxin (inosine) – 20 mg,

riboflavin mononucleotide (riboflavin) – 2 mg;

excipients:

N-methylglucamine (meglumine) 165 mg;

sodium hydroxide 34 mg;

water for injection

How to take, the dosage

In adults:
CYTOFLAVIN® is administered only by intravenous drip in dilution of 100-200 ml of 5-10 % dextrose solution or 0.9 % sodium chloride solution.

1. In acute impairment of cerebral circulation the drug is administered as soon as possible after the disease onset in the volume of 10 ml per injection with 8-12 hour intervals for 10 days. In case of severe disease the single dose is increased up to 20 ml.

2. In case of consequences of cerebrovascular diseases (consequences of cerebral infarction, cerebral atherosclerosis) the drug is injected in the volume of 10 ml per injection once a day during 10 days.

In toxic and hypoxic encephalopathy the drug is administered in the volume of 10 ml by injection twice a day in 8-12 hours during 5 days. In comatose state in the volume of 20 ml per injection diluted in 200 ml of dextrose solution. In postnarcotic depression, once in the same dosage. In therapy of hypoxic encephalopathy during cardiac surgery with application of artificial circulation 20 ml of the preparation are administered diluted in 200 ml of 5% dextrose solution 3 days before the surgery, on the day of the surgery and 3 days after the surgery.

In children (including prematurely born) in neonatal period with cerebral ischemia daily dose of the preparation CITOFLAVINE® is 2 ml/kg/day. The calculated daily dose of the drug is administered intravenously by drop-flow (slowly) after dilution in 5% or 10% dextrose solution (ratio of not less than 1:5). The time of first administration is the first 12 hours after birth; the optimal time to start therapy is the first 2 hours of life. It is recommended to administer the prepared solution using infusion pump at a rate of 1 to 4 ml/hour, ensuring equal inflow of the drug into the bloodstream during a day, depending on the calculated daily volume of solutions for basic therapy, hemodynamic state of the patient and indicators of acid-base status. The average course of treatment is 5 days.

Interaction

Amber acid, inosine, nicotinamide, compatible with other drugs.
Thyroid hormones accelerate the metabolism of riboflavin.

Reduces and prevents the side effects of chloramphenicol (hematopoiesis disorders, optic neuritis).
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, disrupts riboflavin incorporation into flavinadeninmononucleotide and flavinadenindinucleotide and increases its excretion with urine.

Compatible with drugs that stimulate hematopoiesis, antihypoxant, 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 neonates (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 an 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

When rapidly administered by drip, there may be adverse reactions not requiring withdrawal of the drug: skin hyperemia of varying degrees of severity, fever, bitterness and dryness in the mouth, throat fart.

Rare adverse reactions include: epigastric and chest pain and discomfort for a short time, difficulty in breathing, nausea, headache, dizziness, “tingling” in the nose, dysosmia, pale skin of varying severity.

Allergic reactions in the form of skin itching, transient hypoglycemia, hyperuricemia, worsening of gout are also possible.
In children (including prematurely born) during the newborn period it is possible to 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 pregnancy and lactation, due to the lack of clinical data on the effectiveness and safety of the drug during this period