Nicergoline - Instructions For Use, Price, Reviews, Analogues

Nicergoline

Nicergoline: instructions for use and reviews

1. 1. Release form and composition
2. 2. Pharmacological properties
3. 3. Indications for use
4. 4. Contraindications
5. 5. Method of application and dosage
6. 6. Side effects
7. 7. Overdose
8. 8. Special instructions
9. 9. Application during pregnancy and lactation

1. 10. In case of impaired renal function
2. 11. Use in the elderly
3. 12. Drug interactions
4. 13. Analogs
5. 14. Terms and conditions of storage
6. 15. Terms of dispensing from pharmacies
7. 16. Reviews
8. 17. Price in pharmacies

Latin name:

ATX code: С04АЕ02

Active ingredient: nicergoline (nicergoline)

Manufacturer: JSC "Sintez" (Russia), JSC "Moskhimfarmpreparaty" them. N. A. Semashko "(Russia), NPO FSUE" Microgen "(Russia), JSC" AVVA RUS "(Russia), CJSC" Obolensk pharmaceutical company "(Russia)

Description and photo update: 2019-14-08

Prices in pharmacies: from 356 rubles.

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Nicergoline is a drug with a vasodilating effect.

Release form and composition

• Lyophilisate for preparation of solution for injection: white porous mass or powder, odorless (in glass ampoules of 4 mg, 5 ampoules in a blister, (complete with solvent in ampoules of 5 ml, 5 ampoules in a blister), in a cardboard box 1 package);
• Film-coated tablets: white, round, biconvex, two layers are visible in the cross section.

The composition of 1 ampoule includes:

• Active ingredient: nicergoline - 4 mg;
• Auxiliary components: tartaric acid - 1.04 mg, lactose monohydrate (milk sugar) - 30 mg.

Solvent: 0.9% sodium chloride solution.

The composition of 1 tablet includes:

• Active ingredient: nicergoline - 10 mg;
• Auxiliary components: lactose monohydrate - 70 mg, potato starch - 26.9 mg, colloidal silicon dioxide (aerosil) - 2 mg, magnesium stearate - 1.1 mg;
• Sheath: sugar (sucrose) - 65.3 mg, povidone - 1.967 mg, magnesium hydroxycarbonate pentahydrate - 2.1 mg, colloidal silicon dioxide (aerosil) - 0.13 mg, talc - 0.016 mg, titanium dioxide - 0.37 mg, beeswax - 0.117 mg.

Pharmacological properties

Pharmacodynamics

Nicergoline is an alpha-adrenergic blocker - a derivative of synthetic ergot alkaloids, into which a bromine-substituted nicotinic acid residue is incorporated. It activates blood flow in the vessels of the lower and upper extremities, especially in case of circulatory disorders. This compound reduces platelet aggregation and normalizes hemorheological parameters.

Nicergoline is characterized by an α1-adrenergic blocking action, which leads to an improvement in blood flow and directly stimulates the cerebral neurotransmitter systems - acetylcholinergic, dopaminergic and noradrenergic. This ensures the optimization of cognitive processes.

Pharmacokinetics

Nicergoline is rapidly and almost 100% absorbed after oral administration. Food intake does not significantly change the degree and rate of absorption. The bioavailability of the compound reaches approximately 60%. The maximum concentration of the drug in the blood is detected 1–1.5 hours after oral administration.

In the liver, 90% of the administered dose of nicergoline is metabolized. In this case, two main metabolites are formed: 6-methyl-8β-hydroxymethyl-1α-methoxyergoline (MDL, which is a product of demethylation under the action of the isoenzyme CYP2D6) and 1,6-dimethyl-8β-hydroxymethyl-1α-methoxyergoline (MMDL, is a hydrolysis product) … The ratio of the area under the concentration-time curve (AUC) for MDL and MMDL after oral administration of the drug proves that nicergoline has a “first pass” effect, during which it actively participates in metabolic processes. After oral administration of 30 mg nicergoline, the maximum concentrations of MDL (41 ± 14 mg / ml) and MMDL (21 ± 14 mg / ml) in blood plasma were determined after about 1 and 4 hours, respectively. Thereafter, the MDL level decreased, and the half-life was 13–20 hours. Experiments prove the absence of accumulation of other metabolites in the blood.

The degree of binding of nicergoline to plasma proteins exceeds 90%, which indicates the activity of this process. In this case, the degree of affinity of the substance for acidic α1-glycoprotein is greater than for albumin contained in serum.

When nicergoline was taken orally at doses of 30–60 mg, it was found that the pharmacokinetics of the compound is linear and does not depend on the patient's age.

Approximately 80% of nicergoline and its metabolites are excreted in the urine within 70-100 hours after taking the drug, and 20% are excreted in the feces. The half-life of nicergoline is 2.5 hours, and the half-lives of MDL and MMDL are 13–20 hours and 2–4 hours, respectively.

In patients with severe renal insufficiency, the degree of excretion of nicergoline metabolism products is significantly less than in patients with normally functioning kidneys.

Indications for use

• Cerebral circulation disorders (cerebral ischemia, cerebral atherosclerosis, thromboembolism and thrombosis of cerebral arteries, psychoorganic syndrome, post-traumatic encephalopathy);
• Vertigo;
• Vascular disorders of the peripheral circulatory system (functional and organic);
• Migraine;
• Obliterating endarteritis;
• Arteriopathy of the extremities;
• Raynaud's disease;
• Ischemic neuropathy of the optic nerve;
• Dystrophic diseases of the cornea;
• Diabetic angiopathy and retinopathy.

Contraindications

Injection solution

• Myocardial infarction;
• Severe atherosclerosis of peripheral vessels;
• Arterial hypotension;
• Organic heart damage;
• Exertional angina;
• Pregnancy and lactation;
• Hypersensitivity to drug components.

Pills

• Violation of orthostatic regulation;
• Recently suffered myocardial infarction;
• Severe bradycardia;
• Acute bleeding;
• Glucose-galactose malabsorption, isomaltase / sucrase deficiency, lactase deficiency, fructose and lactose intolerance;
• Age under 18;
• Hypersensitivity to drug components.

According to the instructions, Nicergoline in the form of tablets should be used with caution in case of hyperuricemia or a history of gout and / or simultaneously with drugs that interfere with the excretion or metabolism of uric acid.

Instructions for the use of Nicergoline: method and dosage

Injection solution

Assign intramuscularly, intravenously and intraarterially 2 times a day, 2-4 mg after preliminary dissolution in the attached 0.9% sodium chloride solution.

Intra-arterially, 4 mg in 10 ml of saline sodium chloride solution is used (the drug is administered for 2 minutes).

Intravenous drip of Nicergoline is administered at 4-8 mg per 100 ml of physiological sodium chloride solution (if necessary, the administration of the solution can be repeated several times a day).

The duration of the course is at least 2 months (the therapeutic effect of Nicergoline develops gradually).

Pills

Nicergoline tablets are taken orally.

The dose and duration of the course are determined by the nature, severity of the disease and the effectiveness of the therapy. Sometimes it is preferable to start treatment with parenteral administration, after which, for maintenance treatment, you should switch to taking Nicergoline orally.

The average single dose is 10 mg, the frequency of administration is 3 times a day, observing the same intervals between doses. Usually therapy is long-term (up to several months).

In the treatment of vascular dementia, 30 mg is usually prescribed 2 times a day, while it is recommended to consult a doctor once every 6 months to confirm the advisability of continuing therapy.

In case of functional impairment of the kidneys (with serum creatinine ≥ 2 mg / dL), the therapeutic dose of Nicergoline is recommended to be reduced.

Side effects

During the use of Nicergoline, side effects can develop such as: dyspepsia (in the form of nausea, vomiting, diarrhea, abdominal pain), a feeling of heat, flushing of the skin of the face and upper half of the body, sleep disturbances, angina pectoris, lowering blood pressure, dizziness, headache, symptoms of ergotism (pain in the limbs, coldness of the limbs), allergic reactions, itching.

The concentration of uric acid in the blood may also increase, while this effect does not depend on the dose and duration of use of Nicergoline. As a rule, this disorder is moderate or mild.

In case of aggravation of the described side effects, or in cases of the development of any other disorders, you should consult a doctor.

Overdose

The main symptom of an overdose of Nicergoline is a significant decrease in blood pressure. In this case, the patient should be given a horizontal position. In exceptional cases, if necessary, sympathomimetics are prescribed, but regular monitoring of blood pressure is required.

special instructions

To prevent the development of orthostatic hypotension after intravenous administration of Nicergoline, the patient needs to be in a horizontal position for 10-15 minutes.

Drinking alcohol during treatment is not recommended.

The therapeutic doses of Nicergoline usually have no effect on blood pressure, however, with arterial hypertension, a gradual decrease is possible.

Given the nature of the underlying disease, during therapy, it is recommended to be careful when driving and performing work requiring increased attention.

Application during pregnancy and lactation

It is contraindicated to take Nicergoline during pregnancy and during breastfeeding.

With impaired renal function

Patients with impaired renal function (serum creatinine level more than 2 mg / ml) should be adjusted to the dosage regimen (reduce the daily dose by 25-50%).

Use in the elderly

When used in elderly patients in whom the concentration of serum creatinine exceeds 2 mg / dL, the dosage regimen should be adjusted.

Drug interactions

Nicergoline enhances the effects of antipsychotic, anxiolytic and antihypertensive drugs.

The absorption of the drug is slowed down by cholestyramine and antacids.

Analogs

Nicergoline analogs are: Nilogrin, Nicergoline-Ferein, Sermion.

Terms and conditions of storage

Store in a dark, dry place out of reach of children at a temperature: lyophilisate for preparation of solution for injection - up to 10 ° C, tablets - up to 25 ° C.

The shelf life is 3 years.

Terms of dispensing from pharmacies

Dispensed by prescription.

Reviews about Nicergoline

Many patients leave negative reviews about Nicergoline, since it is characterized by many side effects, and the state of health during the course of treatment does not significantly improve.

Price for Nicergoline in pharmacies

The approximate price for Nicergoline tablets is 359-417 rubles (the package includes 30 pcs.). You can buy a lyophilisate for the preparation of a solution for injection for about 708 - 805 rubles (the package includes 5 ampoules).

Nicergoline: prices in online pharmacies

Drug name Price Pharmacy

Nicergoline 10 mg film-coated tablets 30 pcs. 356 r Buy

Nicergoline 5 mg film-coated tablets 30 pcs. 365 RUB Buy

Nicergoline pills 10mg 30 pcs. 383 r Buy

Nicergoline 10 mg film-coated tablets 30 pcs. 383 r Buy

Nicergoline tablets p.p. 10mg 30 pcs. RUB 400 Buy

Nicergoline 4 mg lyophilisate for preparation of solution for injection 5 ml 5 pcs. RUB 615 Buy

Nicergoline 4 mg lyophilisate for preparation of solution for injection 5 ml 5 pcs. 733 r Buy

Nicergoline 4 mg lyophilisate for the preparation of a solution for intramuscular administration 5 ml 5 pcs. RUB 907 Buy

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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!