Cytoflavin tablets p / o, No. 100

As part of complex therapy in adults:

• consequences of cerebral infarction;

• cerebrovascular diseases (cerebral atherosclerosis, hypertensive encephalopathy);

• neurasthenia (increased irritability, fatigue, loss of ability for prolonged mental and physical stress).

The drug is taken orally in 2 tabs. 2 times / day with an interval of 8-10 hours. It is recommended to take CytoflavinЃ in the morning and afternoon, no later than 18 hours.

The tablets should be taken at least 30 minutes before meals, without chewing, with water (100 ml).

The duration of the course of treatment is 25 days. The appointment of a repeated course is possible with an interval of at least 1 month.

• children and adolescents up to 18 years of age (due to insufficient data on efficacy and safety);

• hypersensitivity to the components of the drug.

The drug should be prescribed with caution to patients with diseases of the digestive system (erosion, stomach and / or duodenal ulcers, gastritis, duodenitis) in the acute phase, with arterial hypotension, with nerfrolithiasis, concomitant gout, hyperuricemia.

Clinical and pharmacological group: A drug that improves brain metabolism

Pharmaco-therapeutic group: Metabolic agent

pharmachologic effect

Pharmacological effects are due to the complex action of the components that make up the preparation CytoflavinЃ.

Succinic acid is an endogenous intracellular metabolite of the Krebs cycle, which performs a universal energy-synthesizing function in the cells of the body. With the participation of the coenzyme flavin adenine dinucleotide (FAD), succinic acid is rapidly transformed by the mitochondrial enzyme succinate dehydrogenase into fumaric acid and then into other metabolites of the tricarboxylic acid cycle. Stimulates aerobic glycolysis and ATP synthesis in cells. The end product of the metabolism of succinic acid in the Krebs cycle is carbon dioxide and water. Succinic acid improves tissue respiration by activating the transport of electrons in mitochondria.

Inosine is a purine derivative, a precursor of ATP. Has the ability to activate a number of enzymes of the Krebs cycle, stimulating the synthesis of key enzymes-nucleotides - FAD and NAD.

Nicotinamide (vitamin PP), niacin amide. Nicotinamide in cells, through a cascade of biochemical reactions, is transformed into the form of nicotinamide adenine nucleotide (NAD) and its phosphate (NADP), activating nicotinamide-dependent enzymes of the Krebs cycle, which are necessary for cellular respiration and stimulation of ATP synthesis.

Riboflavin (vitamin B2) is a flavin coenzyme (FAD) that activates succinate dehydrogenase and other redox reactions of the Krebs cycle.

Thus, all components of CytoflavinЃ are natural metabolites of the body and stimulate tissue respiration. Metabolic energy correction, antihypoxic and antioxidant activity of the drug, which determine the pharmacological properties and therapeutic efficacy of the components, is due to the complementary action of succinic acid, inosine, nicotinamide and riboflavin.

Pharmacokinetics

CytoflavinЃ is highly bioavailable.

Succinic acid, when taken orally, is absorbed from the gastrointestinal tract, enters the blood and tissues, participating in the reactions of energy metabolism, and completely decomposes to the final metabolic products (carbon dioxide and water) after 30 minutes.

Inosine is well absorbed from the gastrointestinal tract. Tmax in blood is 5 hours, average retention time in blood is 5.5 hours, Vd in equilibrium is about 20 liters. Inosine is metabolized in the liver to form inosine monophosphate, followed by its oxidation to uric acid. It is excreted in small quantities by the kidneys.

Nicotinamide is rapidly distributed in all tissues (Vd in an equilibrium state is about 500 liters). Tmax in the blood is 2 hours, the average retention time in the blood is 4.5 hours. It is metabolized in the liver to form N-methylnicotinamide. It is excreted by the kidneys. Nicotinamide crosses the placental barrier, excreted in breast milk.

Riboflavin is rapidly absorbed from the gastrointestinal tract, unevenly distributed (the largest amount in the myocardium, liver, kidneys), is transformed into flavin adenine mononucleotide (FMN) and FAD in mitochondria. It is excreted by the kidneys, mainly in the form of metabolites. Penetrates through the placental barrier, excreted in breast milk.

Indications

As part of complex therapy in adults:

• consequences of cerebral infarction;

• cerebrovascular diseases (cerebral atherosclerosis, hypertensive encephalopathy);

• neurasthenia (increased irritability, fatigue, loss of ability for prolonged mental and physical stress).

Dosage regimen

The drug is taken orally in 2 tabs. 2 times / day with an interval of 8-10 hours. It is recommended to take CytoflavinЃ in the morning and afternoon, no later than 18 hours.

The tablets should be taken at least 30 minutes before meals, without chewing, with water (100 ml).

The duration of the course of treatment is 25 days. The appointment of a repeated course is possible with an interval of at least 1 month.

Side effect

According to the WHO, side effects are classified according to their frequency of development as follows: very often (? 1/10); often (? 1 / 100- <1/10); infrequently (? 1 / 1000- <1/100); rarely (? 1 / 10000- <1/1000); very rare (<1/10000); the frequency is unknown (the frequency cannot be determined from the available data).

From the nervous system: very rarely - headache.

From the side of the cardiovascular system: very rarely - hyperemia.

From the digestive system: very rarely - pain in the epigastric region, discomfort in the epigastric region, nausea.

From the side of metabolism: very rarely - transient hypoglycemia, hyperuricemia, exacerbation of concomitant gout.

Skin and subcutaneous tissue disorders: very rarely - itching, urticaria.

If any of the side effects indicated in the instructions are aggravated or any other side effects not indicated in the instructions are noted, the patient should be informed about this by the doctor.

Contraindications for use

• children and adolescents up to 18 years of age (due to insufficient data on efficacy and safety);

• hypersensitivity to the components of the drug.

The drug should be prescribed with caution to patients with diseases of the digestive system (erosion, stomach and / or duodenal ulcers, gastritis, duodenitis) in the acute phase, with arterial hypotension, with nerfrolithiasis, concomitant gout, hyperuricemia.

Application during pregnancy and lactation

It is not recommended to use CytoflavinЃ during pregnancy and lactation due to the lack of clinical data on the efficacy and safety of the drug in this category of patients.

Application for impaired renal function

The drug should be used with caution in nephrolithiasis.

Application in children

Contraindicated in children and adolescents under 18 years of age.

special instructions

With arterial hypertension, dose adjustment of antihypertensive drugs may be required.

In patients with diabetes mellitus, treatment should be carried out under the control of the concentration of glucose in the blood.

During the treatment period, intense yellow urine staining is possible.

Influence on the ability to drive vehicles and mechanisms

CytoflavinЃ does not affect the ability to drive vehicles and mechanisms.

Overdose

To date, no cases of overdose of CytoflavinЃ have been established.

Drug interactions

Succinic acid, inosine and nicotinamide are compatible with other drugs.

Riboflavin reduces the activity of some antibiotics (tetracyclines, erythromycin, lincomycin), is incompatible with streptomycin. Ethanol, tricyclic antidepressants, tubular secretion blockers reduce the absorption of riboflavin, and thyroid hormones accelerate its metabolism.

Storage conditions

The drug should be stored out of the reach of children, protected from light at a temperature not exceeding 25 ? C.

Shelf life

Shelf life is 3 years. Do not use after the expiration date printed on the package.

Terms of sale

The drug is available with a prescription.