Citoflavin injection 10ml amp 10 pcs dark glass

Description

Composition
Active substance:
1 liter of solution contains: succinic acid – 100 g Nicotinamide – 10 g, Riboxin (inosine) – 20 g, riboflavin sodium phosphate (riboflavin) – 2 g ;.
Excipients:
N-methylglucamine (meglumine) – 165 g Sodium hydroxide – 34 g Water for injection – up to 1.0 liters.
Description:
Transparent yellow liquid.
Product form:
Solution for intravenous administration in ampoules of 5 or 10 ml of the colorless or brown glass. 5 ampoules in blisters, open, or heat-sealed with a cover film or aluminum foil; 1 or 2 blisters together with instructions for use in a cardboard package.
Contraindications
Hypersensitivity of formulation components, pregnancy, breast-feeding.
Not assigned patients (except for the neonatal period), are in a critical state, to stabilize the central hemodynamics and / or reducing oxygen partial pressure in arterial blood is below 60 mm Hg. Art.
Carefully
When nephrolithiasis, gout, hyperuricemia. If you have one of these diseases, before taking cytoflavin medication should consult a physician.
Indications
In adults, in the treatment of: – cerebral infarction; – effects of cerebrovascular disease (cerebral infarction, cerebral atherosclerosis); – toxic and hypoxic encephalopathy in acute and chronic poisoning, endotoxemia, postanesthetic oppression of consciousness, as well as for the prevention and treatment of hypoxic encephalopathy during cardiac surgery with cardiopulmonary bypass.
In children (including preterm gestation 28-36 weeks) in combination therapy in the neonatal period: – in cerebral ischemia.
Interaction with other drugs
Succinic acid, inosine, nicotinamide compatible with other drugs.
Riboflavin reduces the activity of doxycycline, tetracycline, oxytetracycline, erythromycin and lincomycin. Incompatible with streptomycin. Chlorpromazine, imipramine, amitriptyline due to blockade flavinokinazy violate the inclusion of riboflavin and flavin adenine dinucleotide flavinadeninmononukleotid and increase its excretion in the urine.
Thyroid hormones speed up the metabolism of riboflavin.
Reduces and prevents side effects chloramphenicol (impaired hematopoiesis, optic neuritis). Compatible with drugs that stimulate hematopoiesis, antigipoksantami, anabolic steroids.
Overdose
Cases of overdose were observed. In overdose symptomatic therapy.
pharmachologic effect
Pharmacological group:
Metabolic means.
Pharmacodynamics:
Pharmacological effects are due to the combined action of a part of the drug cytoflavin components.
Citoflavin intensifies the aerobic glycolysis, leading to the activation of glucose utilization and fatty acid beta-oxidation, and also stimulates the synthesis of GABA in the neurons.
Citoflavin increases resistance membranes of nerve and glial cells to ischemia, resulting in a decrease in the concentration neurospecific proteins, characterizing the level of degradation of the main structural components of the nervous tissue.
Cytoflavin improves coronary and cerebral blood flow, activates metabolic processes in the central nervous system, restores impaired consciousness, promotes regression of neurological symptoms and improved cognitive brain functions. It has a rapid awakening effect in postanesthetic oppression of consciousness.
In applying the drug Citoflavin in the first 12 hours after the onset of stroke observed beneficial for ischemic and necrotic processes in the affected area (decrease the hearth), the recovery of neurologic status and a decrease in the level of disability in the remote period.
Pharmacokinetics:
With intravenous infusion at a rate of about 2 ml / min (in terms of undiluted Citoflavin) succinic acid and inosine are utilized almost instantly and are not detected in the blood plasma.
Succinic acid: peak concentration is determined within the first minute after administration to a further rapid decrease without accumulation and return it to the level of background values ​​as a result of enzymatic breakdown to water and carbon dioxide. Inosine is metabolized in the liver to form inosine monophosphate, followed by its oxidation to uric acid. In the small amount excreted by the kidneys.
Nicotinamide is rapidly distributed in all tissues permeates through the placenta and into breast milk, is metabolized in the liver to form the N-methylnicotinamide, kidneys displayed. Plasma half-life is approximately 1.3 hours, the equilibrium distribution volume – 60 liters, total clearance – about 0.6 L / min.
Riboflavin is distributed unevenly largest amount in the myocardium, liver and kidneys. Plasma half-life is about 2 hours and the equilibrium distribution of volume – about 40 liters, total clearance – about 0.3 L / min. It crosses the placenta and breast milk. Relationship to plasma proteins – 60%. Excreted by the kidneys partially in the form of a metabolite; in higher doses – preferably in an unmodified form.
Conditions of supply of pharmacies
On prescription.
side effects
According to the World Health Organization, undesirable effects are classified according to their rate of development as follows: – Very frequent (> 1/10); – Frequent (> 1/100 –
special instructions
The introduction of newborn drug (premature) children to carry out under the supervision of acid-base balance of capillary blood at least 2 times a day (both before and during therapy). If possible indicators of serum lactate and glucose should be monitored.
The introduction rate of the solution containing Citoflavin, reduce or interrupt the infusion newborn (preterm) children – are on mechanical ventilation, when the signs of the mixed (respiratory metabolic) alkalosis threatening development of cerebral circulatory disorders; – if a stored spontaneous breathing and respiratory support by continuous positive airway pressure (CPAP) or receiving an air-oxygen mixture through a mask when a laboratory signs of metabolic alkalosis, or threatening appearance quickening apnea episodes.
Patients treated diabetes be under the control of blood glucose index.
Perhaps the intense staining of urine yellow.
Effect on the ability to drive, TSITOFLAVIN® mechanisms do not affect the ability to drive.
Storage conditions
In a place protected from light at a temperature not higher than 25 C. Keep out of reach of children.
Dosing and Administration
adults
Citoflavin used only intravenously at a dilution of 100-200 ml 5-10% dextrose or 0.9% sodium chloride solution. The administration rate of 3-4 ml / min. 1. In myocardial brain preparation is administered as early as possible from the onset of the disease in a volume of 10 ml for administration at intervals of 8-12 hours for 10 days.
In severe form of the disease single dose increased to 20 ml. 2. If the consequences of cerebrovascular diseases (cerebral infarction, cerebral atherosclerosis) preparation is administered in a volume of 10 ml for administration once a day for 10 days. 3. toxic and hypoxic encephalopathy, drug is administered in a volume of 10 ml for administration twice a day every 8-12 hours for 5 days. In comatose – 20 ml in volume on introduction to the dilution to 200 ml dextrose. When postanesthetic oppression of consciousness – once in the same doses. In the treatment of hypoxic encephalopathy with cardiac surgery with cardiopulmonary bypass is introduced 20 ml of the drug dilutions to 200 ml of 5% dextrose solution for 3 days prior to surgery, on the day of surgery, for 3 days after surgery.
In children (including preterm) in the neonatal period with cerebral ischemia Citoflavin daily dose of the drug was 2 ml / kg. The calculated daily dose administered intravenously (slowly) after dilution in 5% or 10% dextrose solution (in a ratio of at least 1: 5). Introducing the first – the first 12 hours after birth; the optimal time to begin therapy are the first 2 hours of life. Recommended prepared solution administered using an infusion pump at a rate of 1 to 4 ml / hr, ensuring uniform delivery of the drug into the blood stream throughout the day, depending on the calculation of the daily volume of solutions for the basic therapy, the patient’s hemodynamic status indicators and acid-base status. The course of treatment an average of 5 days.
Information
Appearance may differ from that depicted in the picture. There are contraindications. You need to read the manual or consult with a specialist