Cocarnit
Kokarnit: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Instructions for use: method and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. For violations of liver function
- 12. Drug interactions
- 13. Analogs
- 14. Terms and conditions of storage
- 15. Terms of dispensing from pharmacies
- 16. Reviews
- 17. Price in pharmacies
Latin name: Cocarnit
ATX code: A11DA
Active ingredient: cocarboxylase (cocarboxylase), nicotinamide (nicotinamide), cyanocobalamin (cyanocobalamin), adenosine triphosphate (adenosintriphosphate)
Manufacturer: EIPICo (Egypt)
Description and photo update: 2018-24-10
Cocarnit is a drug for improving metabolism and regeneration of nerve fibers of the peripheral nervous system.
Release form and composition
Cocarnit is produced in the form of a lyophilisate for the preparation of a solution for intramuscular (i / m) administration: a pink lyophilized mass, after reconstitution - a transparent pink solution (187.125 mg each in a dark glass ampoule, 3 ampoules with lyophilisate and 3 ampoules in a blister strip packaging) 2 ml with solvent, in a cardboard box 1 package).
1 ampoule contains:
- active ingredients: cocarboxylase - 50 mg, cyanocobalamin - 0.5 mg, triphosadenine disodium trihydrate - 10 mg, nicotinamide - 20 mg;
- auxiliary components: propyl parahydroxybenzoate, glycine, methyl parahydroxybenzoate.
Solvent - lidocaine hydrochloride, water for injection.
Pharmacological properties
Pharmacodynamics
The action of Cocarnit is due to the properties of a rationally selected complex of active substances.
Cocarboxylase is a coenzyme formed from thiamine (vitamin B 1) entering the body. It is an integral element of the enzyme carboxylase, which catalyzes the carboxylation and decarboxylation of alpha-keto acids. Indirectly affects the synthesis of nucleic acids, lipids and proteins. Promotes the assimilation of glucose, lowering the content of lactic and pyruvic acids in the body, improving the trophism of the nervous tissue.
Triphosadenine - adenosine derivative, has metabolic, antiarrhythmic, hypotensive, vasodilating effects. Under the influence of ATP (adenosine triphosphoric acid), smooth muscles relax, blood pressure (BP) decreases, and nerve impulse conduction is improved. Promotes an increase in metabolism and energy supply to tissues. The vasodilating effect is manifested, among other things, on the coronary and cerebral arteries.
Cyanocobalamin is a vitamin B 12 that, after entering the body, turns into two coenzyme forms: 5-deoxyadenosylcobalamin and methylcobalamin. Methylcobalamin plays an important role in key reactions in the metabolism of purine and pyrimidine bases, for example, in the conversion of homocysteine to methionine and S-adenosylmethionine. The lack of vitamin in this reaction can be compensated for by methyltetrahydrofolic acid, as a result of this, a violation of folate-demanding metabolic reactions occurs. 5-deoxyadenosylcobalamin is involved in the metabolism of carbohydrates and lipids, being a cofactor in the isomerization of L-methylmalonyl coenzyme A to succinyl coenzyme A. Lack of vitamin B 12 in the body causes a violation of the formation of the myelin sheath of neurons, the proliferation of rapidly dividing epithelial cells and hematopoietic tissue.
Nicotinamide - a form of vitamin PP, takes part in redox processes in the cell. Regulates tissue respiration, improves carbohydrate and nitrogen metabolism.
Pharmacokinetics
After parenteral administration, triphosadenine enters the cells of the organs. There it is broken down into adenosine and inorganic phosphate, releasing energy. The decomposition products are subsequently included in the ATP resynthesis.
The absorption of cocarboxylase with intramuscular injection occurs in the body quickly with penetration into most tissues. Excretion of metabolic degradation products mainly occurs through the kidneys.
After i / m administration, cyanocobalamin is rapidly and completely absorbed. Its delivery to tissues is carried out by transcobalamins I and II, with which it binds in the blood. 0.9% of the administered dose binds to plasma proteins. After i / m administration, the maximum concentration in the blood is reached after 1 hour. It accumulates mainly in the liver. It is excreted by bile from the liver into the intestines, where it is again absorbed into the blood. The half-life is 500 days. With normal renal function, 7-10% is excreted through the kidneys and about 50% through the intestines. In case of impaired renal function 0-7% is excreted by the kidneys, 70-100% - by the intestines. Cyanocobalamin crosses the placental barrier and into breast milk.
The distribution of nicotinamide in all tissues occurs quickly, the substance has the ability to overcome the placental barrier and penetrate into breast milk. As a result of metabolism in the liver, nicotinamide-N-methylnicotinamide is formed. The excretion of the substance occurs through the kidneys. The half-life is approximately 1.3 hours.
The volume of distribution is approximately 60 liters, the total clearance of blood plasma is approximately 0.6 liters / min.
Indications for use
According to the instructions, Cocarnit is indicated for the symptomatic treatment of diabetic polyneuropathy.
Contraindications
- acute stage of gastric ulcer or duodenal ulcer;
- acute myocardial infarction;
- acute stage of heart failure;
- arterial hypotension;
- arterial hypertension in an uncontrolled form;
- bradyarrhythmia - severe;
- atrioventricular (AV) block II – III degree;
- shock, including cardiogenic;
- III – IV stage of chronic heart failure according to NYHA (New York Heart Association);
- QT prolongation syndrome;
- hemorrhagic stroke;
- thromboembolism;
- bronchial asthma;
- inflammatory pathologies of the lungs;
- chronic obstructive pulmonary disease (COPD);
- erythremia, hypercoagulability (including acute thrombosis), erythrocytosis;
- gout;
- cirrhosis of the liver;
- hepatitis;
- period of pregnancy;
- breast-feeding;
- age up to 18 years;
- individual intolerance to the components of the drug or solvent.
Care should be taken when prescribing Cocarnit to patients with angina pectoris.
Instructions for the use of Cocarnit: method and dosage
The ready-made solution of the drug is intended for intramuscular injection (deep into the gluteus muscle).
After mixing the lyophilisate with the solvent, the resulting solution should have a pink color. If the color of the solution does not match, it cannot be used.
The solution is prepared before the direct administration of the drug.
Do not store the prepared solution of the drug!
The doctor prescribes the duration of treatment and the frequency of administration of Cocarnit, taking into account the nature and severity of the disease.
Recommended dosage:
- severe pain syndrome of polyneuropathy: 1 ampoule 1 time per day, duration of use to relieve acute symptoms - 9 days;
- moderately pronounced symptoms of polyneuropathy: 1 ampoule 1 time in 2-3 days. The course of treatment depends on the severity of the disease and can range from 3 to 9 injections within 14–21 days.
The need for repeated courses is determined by the doctor.
Side effects
- on the part of the cardiovascular system: very rarely - tachycardia; isolated cases - arrhythmia, bradycardia; frequency not established - pain in the heart area, hot flashes, redness, tingling and burning sensation of the skin on the face and upper body;
- from the nervous system: very rarely - headache, agitation, dizziness, confusion;
- from the musculoskeletal and connective tissue: very rarely - convulsions;
- from the gastrointestinal tract: very rarely - diarrhea, vomiting;
- allergic reactions: shortness of breath, skin rash, Quincke's edema, anaphylactic shock;
- dermatological reactions: very rarely - acne, increased sweating, urticaria, itching;
- local reactions: very rarely - pain and burning at the injection site, irritation;
- others: very rarely - weakness.
Overdose
Symptoms characteristic of an overdose of certain substances that make up Cocarnit:
- triphosadenine: with a daily dose of more than 600 mg - dizziness, lowering blood pressure, asystole, ventricular disturbances, arrhythmia, AV block II or III degree, tachycardia, sinus bradycardia, loss of consciousness, bronchospasm;
- cocarboxylase: with the introduction of a dose exceeding more than 100 times the recommended one - spasm and / or muscle weakness, headache, arrhythmia, paralysis;
- cyanocobalamin: eczematous skin disorders, benign acne, impaired purine metabolism, development of hypercoagulability;
- nicotinamide: weakness, hyperpigmentation, amblyopia, jaundice, exacerbation of gastric ulcer and duodenal ulcer. Against the background of a long period of therapy - steatohepatosis, impaired glucose tolerance, an increase in the concentration of uric acid in the blood.
Treatment: immediate cancellation of Cocarnit. Appointment of symptomatic or desensitizing therapy.
special instructions
If any adverse reactions occur, you should consult a doctor.
With a pronounced nature of side effects, Cocarnit should be canceled.
If after 9 days of using the drug there is no therapeutic effect or an aggravation of the symptoms of the disease is observed, it is necessary to consider the issue of correcting the course of treatment.
During the period of use of Cocarnit, for adequate control of the course of diabetes mellitus, it is necessary to adjust the dose of the hypoglycemic agent.
Influence on the ability to drive vehicles and complex mechanisms
During the period of treatment, care should be taken when performing potentially hazardous activities. Patients in whom the reception of Cocarnite causes the development of dizziness, confusion or other disorders of the nervous system, should not be involved in driving vehicles and mechanisms.
Application during pregnancy and lactation
It is not recommended to prescribe the drug Cocarnit during gestation and lactation.
If it is necessary to prescribe the drug, breastfeeding should be discontinued for the duration of treatment.
Pediatric use
The use of Kokarnit for the treatment of children under the age of 18 is contraindicated due to the lack of information on the effectiveness and safety of therapy.
For violations of liver function
The use of the drug is contraindicated in hepatitis, liver cirrhosis.
Drug interactions
With the simultaneous use of the drug Cocarnit:
- hypoglycemic agents containing metformin can affect the absorption of cyanocobalamin and cause a decrease in its concentration in the blood;
- riboflavin, ascorbic acid, thiamine bromide, thiamine, heavy metal salts, pyridoxine, folic acid, blood clotting agents, chloramphenicol - should not be used due to incompatibility with cyanocobalamin;
- aminoglycosides, antiepileptic drugs, salicylates, colchicine, potassium preparations reduce the absorption of cyanocobalamin;
- dipyridamole enhances its vasodilating effect and the effect of triphosadenine;
- caffeine, theophylline (purine derivatives) may cause some antagonism to the drug;
- cardiac glycosides in large doses can increase the risk of developing undesirable effects from the cardiovascular system;
- xanthinol nicotinate reduces the effect of the drug;
- antihypertensive and sedatives, tranquilizers under the influence of nicotinamide enhance their therapeutic effect.
Analogs
The analogues of Cocarnit are Thiamine Chloride and Cocarboxylase.
Terms and conditions of storage
Keep out of the reach of children.
Store at temperatures up to 15-25 ° C in a dark place.
Shelf life - 3 years, solvent - 4 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Kokarnite
Few reviews of Kokarnite indicate the effectiveness of the drug in the treatment of diabetic polyneuropathy. Patients with diabetes mellitus write about the rapid action of the drug, when pain in the legs and sciatica disappear after just a few injections. There are no complaints about poor tolerance and adverse events during the course of treatment.
Since the components of the drug have a wide therapeutic range, there are often positive reviews of patients using the drug for diseases such as osteochondrosis, cardiovascular pathologies, neuralgia of the lumbosacral spine. In addition to a significant analgesic effect, an improvement in general well-being and the functional state of the liver is noted. The drug lowers blood pressure and cholesterol levels, has antiarrhythmic and vasodilating effects.
Price for Cocarnit in pharmacies
The price of Cocarnit for 1 package can be from 689 rubles.
Anna Kozlova Medical journalist About the author
Education: Rostov State Medical University, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
