Napilept
Napilept: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. Use in the elderly
- 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: Neipilept
ATX code: N06BX06
Active ingredient: citicoline (citicoline)
Producer: CJSC PharmFirma SOTEX (Russia)
Description and photo update: 2018-21-11
Prices in pharmacies: from 235 rubles.
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Napilept is a nootropic agent.
Release form and composition
Dosage forms of Napilept:
- solution for intravenous and intramuscular administration: colorless transparent liquid (4 ml each in transparent glass ampoules with a colored dot and a notch or a colored break ring - 3 ampoules each in blisters, in a cardboard box 1 pack; 5 ampoules in blisters, in a cardboard box 1 or 2 packages);
- oral solution: colorless or slightly yellowish transparent liquid with a characteristic strawberry aroma (30, 50 and 100 ml in brown glass bottles, in a cardboard box 1 bottle complete with a measuring cup and / or dosing pipette).
Composition of 1 ampoule of solution for injection:
- active substance: citicoline sodium - 500 or 1000 mg (in terms of citicoline);
- auxiliary components: 1 M sodium hydroxide solution water for injection or 1 M hydrochloric acid solution.
Composition of 1 ml of oral solution:
- active substance: citicoline sodium - 100 mg (in terms of citicoline);
- auxiliary components: methyl parahydroxybenzoate, sodium citrate (sodium citrate dihydrate), potassium sorbate, propyl parahydroxybenzoate, citric acid monohydrate, glycerol, sorbitol, sodium saccharinate, purified water, strawberry flavor.
Pharmacological properties
Pharmacodynamics
Citicoline - the active substance of Napilept - is a natural endogenous compound that is an intermediate metabolite in the synthesis of one of the main structural components of the cell membrane (phosphatidylcholine).
The drug has a wide spectrum of action: by acting on the mechanisms of apoptosis, it prevents cell death, and also prevents the excessive formation of free radicals, inhibits the action of phospholipases, and promotes the restoration of damaged cell membranes.
In traumatic brain injury, Neipilept helps to reduce the duration of the recovery period, reducing the severity of neurological symptoms and the duration of post-traumatic coma.
In the acute period of stroke, the drug reduces the amount of damage to the brain tissue and improves cholinergic transmission.
In chronic hypoxia of the brain, citicoline effectively eliminates cognitive disorders such as lack of initiative, memory impairment, and various difficulties in self-care and daily activities. Reduces the manifestation of amnesia. Increases the level of attention and consciousness.
Neipilept is effective in sensory and motor neurological disorders of vascular and degenerative etiology.
Pharmacokinetics
When administered intravenously, citicoline is rapidly hydrolyzed into cytidine and choline and enters various tissues of the body.
Citicoline is well and almost completely absorbed after oral administration. Bioavailability is approximately the same as after intravenous administration of the drug. It is metabolized in the intestine and liver, as a result of which the metabolites choline and cytidine are formed, which significantly increases the concentration of choline in the blood plasma.
It is distributed in the structures of the brain, where choline fractions are quickly incorporated into structural phospholicides, cytidine fractions - into nucleic acids and cytidine nucleotides. Reaching the brain, the drug participates in the construction of the phospholipid fraction, is embedded in the cytoplasmic, mitochondrial and cell membranes.
It is excreted from the body in a small amount (about 15% of the dose): by the kidneys and through the intestines - less than 3%, with exhaled carbon dioxide - about 12%. The drug is excreted by the kidneys in two phases: the first, lasting about 36 hours, with a rapid decrease in the rate of excretion, the second, with a slow decrease in the rate of excretion. A similar phasicity is observed during excretion with carbon dioxide, the rate of excretion of which rapidly decreases after about 15 hours, after which it slows down much.
Indications for use
- behavioral and cognitive disorders in vascular and degenerative diseases of the brain;
- traumatic brain injury (TBI), acute (as part of complex therapy) and recovery period;
- acute period of ischemic stroke (as part of complex therapy);
- the recovery period of hemorrhagic and ischemic strokes.
Contraindications
- severe vagotonia (high tone of the parasympathetic part of the autonomic nervous system);
- age up to 18 years;
- lactation period;
- hypersensitivity to any component of Napilept.
Instructions for the use of Napilept: method and dosage
Solution for injection Neipilept is administered intramuscularly, intravenously in a stream (for 3-5 minutes) or drip (at a rate of 40-60 drops per minute). Intravenous administration is more preferred. It is recommended to alternate the injection sites. The drug should be administered immediately after opening the ampoule. The solution is compatible with all types of dextrose solutions and isotonic solutions.
Oral solution Neipilept is taken orally, during meals or between meals, dissolved immediately before use in a small amount of water (approximately 100-120 ml).
The specific doses and duration of treatment in each case are determined individually, depending on the indication and the severity of symptoms.
General recommendations for the Neipilept dosage regimen:
- acute period of TBI and ischemic stroke: 1000 mg every 12 hours from the first day after diagnosis for at least 6 weeks;
- behavioral and cognitive disorders in vascular and degenerative diseases of the brain, the recovery period of hemorrhagic and ischemic strokes: 500-2000 mg per day.
Side effects
Napilept is generally well tolerated. In very rare cases (<1/10000), the following side effects are noted: decreased appetite, diarrhea, nausea, vomiting, changes in the activity of liver enzymes, fever, insomnia, headache, hallucinations, dizziness, agitation, tremor, shortness of breath, swelling, allergic reactions (rash, itchy skin, anaphylactic shock), numbness in paralyzed limbs.
In some cases, during drug therapy, stimulation of the parasympathetic system is noted, as well as a short-term change in blood pressure.
Overdose
Neipilept is characterized by low toxicity, therefore, even when the recommended doses are exceeded, cases of overdose have not occurred so far.
special instructions
When treating patients with persistent intracranial hemorrhage, a dose of 1000 mg per day should not be exceeded. The drug is recommended to be injected intravenously at a rate of 30 drops per minute.
In a solution for oral administration in the cold, a small amount of crystals may form, due to the temporary partial crystallization of the preservative. Further, with proper storage, the crystals dissolve within several months. This phenomenon does not affect the effectiveness and performance of Napilept.
Influence on the ability to drive vehicles and complex mechanisms
During the period of therapy, patients need to be careful while driving and engaging in potentially hazardous activities, which require quick reactions and / or increased concentration of attention.
Application during pregnancy and lactation
There are no data on the safety of the use of citicoline during pregnancy, therefore, Neipilept can be prescribed only in cases where the expected benefit from the forthcoming therapy is definitely higher than the potential risks.
Lactating women, if treatment is necessary, should decide with a doctor about stopping breastfeeding, since there is no information on the excretion of citicoline in breast milk.
Pediatric use
There are no sufficient clinical data on the efficacy and safety of the drug in pediatrics; therefore, Neipilept is not prescribed for the treatment of children and adolescents under the age of 18.
Use in the elderly
Elderly patients do not need dose adjustment of Neipilept.
Drug interactions
According to the instructions, Neipilept should not be used simultaneously with drugs that contain meclofenoxate.
Citicoline, when combined, enhances the effect of levodopa.
Analogs
The analogues of Napilept are Quinel, Neurocholine, Proneiro, Cerakson, Ceresil Canon.
Terms and conditions of storage
Shelf life is 2 years.
Store at temperatures up to 25 ° C out of the reach of children.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Napilept
Reviews about Napilept are mostly positive. The drug is well tolerated, practically has no contraindications, significantly improves the condition, including after stroke and traumatic brain injury: reduces the severity of neurological symptoms, eliminates cognitive disorders.
The disadvantages include only the relatively high price.
The price of Napilept in pharmacies
Approximate prices for Napilept:
- solution for intravenous and intramuscular administration, 5 ampoules of 125 mg / ml - 466–493 rubles;
- solution for intravenous and intramuscular administration, 5 ampoules of 250 mg / ml - 855-927 rubles;
- oral solution, bottle 100 ml - 393 rubles.
Napilept: prices in online pharmacies
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Drug name Price Pharmacy |
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Neipilept 125 mg / ml solution for intravenous and intramuscular administration 4 ml 5 pcs. 235 RUB Buy |
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Neipilept 100 mg / ml oral solution 30 ml 1 pc. 349 r Buy |
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Napilept solution for internal approx. 100mg / ml 30ml 375 RUB Buy |
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Neipilept 250 mg / ml solution for intravenous and intramuscular administration 4 ml 5 pcs. 419 RUB Buy |
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Neipilept solution for intravenous and intramuscular injection. 125mg / ml 4ml 5 pcs. 459 r Buy |
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Neipilept 100 mg / ml oral solution 100 ml 1 pc. 941 RUB Buy |
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Napilept solution for internal approx. 100mg / ml 100ml 1141 RUB Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, 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!
