In this article you can read the instructions for use of the drug Cavinton. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Cavinton in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Cavinton in the presence of existing structural analogues. Use for the treatment of strokes, encephalopathies and other vascular disorders in adults, children, as well as during pregnancy and lactation.
What kind of medicine is this
Cavinton is an effective medicine that improves metabolism and metabolic processes of the brain, and is effective for diseases of the nervous system, hearing and eyeballs. Cavinton has pronounced antioxidant and cerebroprotective effects. The drug qualitatively improves blood supply to brain tissue, supplies the brain with oxygen, and utilizes excess glucose. The drug dilates blood vessels and relaxes smooth muscles. Cavinton perfectly improves the plasticity of red blood cells and easily reduces blood viscosity.
Drug group
International nonproprietary name or INN of the drug: "Vinpocetine".
Trade name of the medicine: "Cavinton"
Name in Latin: "Vinpocetine".
Compound
The calculation for 1 ml of the drug is as follows:
- vinpocetine 5 mg;
- sodium disulfite, water for injection, ascorbic acid, sorbitol, tartaric acid - excipients.
Mechanism of action and properties
The main characteristic of the drug is described as a remedy that perfectly improves blood flow in the structures of the brain.
The pharmacology of the drug is:
- increasing the resistance of neurons to hypoxia;
- increasing the concentration of ATP in tissues;
- improving brain metabolism;
- stimulation of the ascending branch;
- increased oxygen and glucose consumption;
- decreased blood viscosity;
- increasing oxygen delivery;
- increased norepinephrine metabolism;
- decreased platelet aggregation;
- increased cerebral blood flow;
- increased blood supply to ischemic areas of the brain;
- antioxidant effect.
How long does it take for Cavinton to start working?
The effectiveness of the drug is expressed in the cumulative effect. The first effect occurs after a few hours. A pronounced effect is observed from the second dose of the medicine.
The pharmacokinetics of the drug is as follows:
- The therapeutic type plasma concentration is 20 ng/ml.
- How is the drug removed? - through the gastrointestinal tract and kidneys in a concentration of 3:2.
- The volume of distribution for parenteral administration is 5.3 l/kg.
- Easy penetration through histohematic barriers.
- The half-life is 4.74-5 hours.
The effect on the liver, as well as the effect on the kidneys, is negligible. No dose adjustment is required for diseases of these organs.
Indications
What does this drug treat and why is Cavinton needed?
It is used for diseases and symptoms such as:
- cerebral circulatory failure;
- consequences of a stroke;
- perceptual hearing loss;
- vascular dementia;
- hemorrhagic stroke at the recovery stage;
- retinal vein occlusion;
- ischemic stroke;
- vertebrobasilar insufficiency;
- thrombosis of the central retinal artery;
- idiopathic tinnitus;
- hypertensive encephalopathy;
- vascular atherosclerosis;
- post-traumatic encephalopathy;
- transient ischemic attack;
- diseases of the choroid;
- Meniere's disease.
Having learned information about what the medicine helps with, you need to understand the reason why this particular drug is used in specific cases. The benefits of the medicine for these ailments are irreplaceable with other drugs. Why is this particular medicine prescribed? The reason for this is the small number of analogues, including only Vinpocetine, Neurovin and Oxopocin.
Release forms
The medicinal forms of the drug are quite limited, since the medicine is produced exclusively in the form of a special concentrate for the preparation of an effective solution for infusion and tablets (regular and Forte form). In this case, you should not think about what is better - tablets or capsules of the drug.
The concentrate is contained in sterile ampoules in the following dosage:
- 2 ml - 10 ampoules per package;
- 5 ml - 10 ampoules in blister packaging;
- 10 ml - 5 ampoules per package.
The ampoules are packed in a reliable plastic tray and are also made of durable brown glass. You can open the ampoule using the white break point.
Tablets are produced in 50 pieces per package at the rate of 5 mg/10 mg of medication per tablet.
Instructions for use
The administration note provides detailed information on how to take or inject the medicine. The product is intended exclusively for intravenous drip infusion. The drug must not be administered intravenously, as well as intramuscularly, without diluting the concentrate. The infusion should be carried out at a rate of 80 drops per minute. To create an infusion and dilute the concentrate, the following solutions are used:
- Reomacrodex;
- Ringer;
- Salsol;
- Rindex.
The prepared solution for creating an infusion with Cavinton should be used no more than three hours after preparation.
The initial dosage for adults is 20 mg per half liter of prepared solution, which is equal to two ampoules.
The maximum daily dose of the drug is no more than 30 mg at initial doses. Next, the dose is calculated depending on the patient’s weight:
- with positive tolerance, the dose is increased at the rate of 1 mg per kg of weight.
- per 70 kg, 50 mg of the drug, which is equal to five ampoules per 500 ml of solution.
The dosage for children is not calculated, since the drug is contraindicated in therapy for patients under 18 years of age.
For kidney or liver diseases, dose adjustments of the drug are not provided. At the end of the prescribed course, which, as a rule, does not last more than two weeks, therapy with Cavinton tablets is prescribed - 2 tablets three times a day.
Side effect
While taking the drug, side effects are extremely rare. In some cases, the following reactions may occur:
- skin redness;
- ECG changes;
- allergic reactions;
- phlebitis;
- drowsiness;
- tachycardia;
- general weakness;
- extrasystole;
- changes in blood pressure;
- dizziness;
- nausea;
- insomnia;
- dry mouth;
- increased drowsiness;
- heartburn;
- increased sweating.
Contraindications
The drug has some important contraindications for use. In particular, treatment with Cavinton is not recommended for:
- severe form of ischemic heart disease;
- lactation;
- hemorrhagic stroke;
- childhood;
- severe arrhythmia;
- pregnancy;
- hypersensitivity to components.
Use in children
The medicine is contraindicated for use in the treatment of children under 18 years of age. This is due to insufficient data on the effect of the drug at this age.
Use during pregnancy and breastfeeding
The product is prohibited and dangerous during pregnancy and lactation. The drug penetrates deeply into the placenta and can cause placental bleeding and miscarriage.
Also, the components of the drug can pass into breast milk. Studies have revealed that the concentration of vinpocetine in milk is several times higher than in the mother’s body.
Use in the elderly
Approved for use by pensioners, but only after consulting a specialist and prescribing a special treatment regimen. It is recommended to begin therapy with the use of tablets, gradually switching to concentrate.
Driving a car and other mechanisms
There is no data on Cavinton’s influence on operating machinery and driving. It is worth considering possible effects:
- drowsiness;
- dizziness;
- vertigo.
Do I need a prescription?
The drug is dispensed at the pharmacy only by prescription.
Compatibility with other drugs
Drug interactions between the drug and heparin are not allowed. Medicines must not be administered in the same syringe. Such combination therapy with the use of anticoagulants is possible only if necessary and prescribed by a specialist.
No drug interactions were found with drugs such as:
- Pindolol;
- Glibenclamide;
- Cloranolol;
- Digoxin;
- Clopamid;
- Hydrochlorothiazide;
- Acenocoumarol.
An additional effect is observed when interacting with alpha-methyldopa. In this case, you need to carefully monitor your blood pressure.
Alcohol compatibility
The compatibility of the drug with alcohol is undesirable. Serious effects on the cardiac and nervous systems are possible.
Cavinton - injections that help combat pathological changes associated with disruptions in cerebral blood circulation. Having a positive effect on blood vessels, it improves the structure of the brain and metabolism in it.
The drug is available without a prescription. However, for this reason you should not prescribe it to yourself. Since the severity of the structures affected by it, the active substances and the presence of contraindications require medical supervision over the practical use and administration of the drug.
Description of Cavinton and release form
The prescription for the use of Cavinton indicates that it is produced on the basis of vinpocetine, the main ingredient, which is a colorless liquid intended for injection into a vein. Among its additional components are tartaric and ascorbic acids, benzyl alcohol, sodium disulfide, sorbitol and special injection water. Cavinton-Forte is also produced in increased concentration, a tablet form of the drug with a dosage of 5 and 10 mg.
Active, additional components of the drug prevent the formation of blood clots, due to their ability to thin the blood. In addition, the medicine provides vasodilation, has a sedative effect, and lowers blood pressure. If we compare the main active component of Cavinton - vinpocetine, then it has an effect in terms of normalizing cerebral circulation among substances of a similar direction.
In what cases does it help?
To have a complete understanding of this drug, you need to know how Cavinton works and what it is used for. This remedy activates the blood supply to the brain without affecting the important functions of the heart and blood vessels associated with heart rate and blood pressure levels.
Vinpocetine, once in the blood, is quickly absorbed and distributed evenly throughout all tissues. It is excreted by the kidneys and partially through the intestines. The half-life (half of it is consumed) is about 4-5 hours.
The components of this medicine differ in that they contribute to:
- acceleration of the recovery process - the main component is quickly absorbed, penetrating into the brain cells, blood vessels, and heart muscles, which allows them to regenerate almost immediately;
- a significant supply of glucose - this restores neurons and axons, which has a positive effect on mental activity, activating it;
- preventing oxygen starvation of the brain - which usually happens when there is a disruption in blood circulation;
- a decrease in platelet aggregation - their gluing and fixation on the walls of injured vessels does not occur, and, consequently, the formation of blood clots;
- normalizing blood viscosity - by increasing the plastic abilities of red blood cells and reducing the amount of absorbed adenosine;
- improving the metabolic reactions of norepinephrine in brain tissue.
This prevents the death of brain cells and structures during a stroke or heart attack. In addition, accumulating and concentrating mainly in the blood plasma, the main active ingredient of Cavinton partially blocks free calcium elements, stabilizing blood pressure.
Subtleties of application
The instructions for this drug emphasize that Cavinton in ampoules involves its use for dripping into a vein. It is administered slowly, with a speed not exceeding 70-80 drops per minute.
Each ampoule contains a strict amount of medication for a single dose. According to indications, this dosage can be increased to 3 ampoules per day, but when the patient’s condition improves, they switch back to a one-time administration.
The medicine is prescribed with caution to seriously ill patients. The reason is Cavinton’s ability to increase the volume of lost blood. Therefore, in people with bleeding problems, the drug can cause harm, even death.
Injection treatment is required only in hospital settings. After all, only in this way will it be possible to constantly and competently monitor important biometric parameters of brain activity, as well as the cardiovascular system.
Indications for injections
Cavinton injections provide many positive therapeutic effects. But treating them requires a competent approach.
There are four main areas of use of the healing abilities of this drug:
- neurology - ischemic heart attack or stroke, acute, chronic disruptions of blood circulation in the brain, deposition of cholesterol on the walls of veins, which contributes to their thickening, intracranial hypertension;
- ophthalmology – myopia and hypermetropia, lens opacity, increased intraocular pressure, vascular lesions of the visual organs of various etiologies;
- otorhinolaryngology – idiopathic tinnitus, damage to the inner ear caused by the accumulation of internal fluid in it, perceptual deafness;
- obstetrics - during gestation to prevent hypoxia of the fetus in the womb and the immediate process of childbirth.
However, pregnant women need to know that they are not allowed to self-treat with such a drug, as it can cause a miscarriage or dangerous uterine bleeding. Cavinton has a good effect on patients with low levels of adenosine monophosphate, the deficiency of which provokes the development of convulsive conditions.
Directions for use and dosage
Cavinton is prescribed dropwise in a daily dosage of 20 mg ((4 ml) per 500 ml of mixture for infusion. If the drug is well tolerated, it is increased, but in an amount not exceeding 1 mg per kilogram of the patient’s weight. The dose is valid throughout the day. On average this effect can last about two weeks.
For patients with kidney and liver pathologies, the norms of these injections are not adjusted. Infusions are prepared on the basis of saline solution or similar liquids containing dextrose - Salsol, Ringer, Rindeks, Reomacrodex. This mixture is indicated for use within three hours after preparation.
At the end of the drip course, therapy continues. The tablet form is prescribed: Cavinton-forte - one, Cavinton - two tablets three times a day.
Cavinton for intravenous administration also corresponds to the disposable standard. In severe cases, up to 3 injections per day are indicated. When the condition returns to normal, you should return to the initial dosage. When preparing to give an injection, shake the ampoule well, its contents are diluted with saline or, in certain cases, combined with 5% glucose.
Without dilution, intravenous and intramuscular administration of this medicine is not permitted! Cavinton administered intramuscularly in its pure form is destroyed in soft tissues and has no therapeutic effect.
The dosage of Cavinton is directly intertwined with the type of pathology, its symptoms, and its dosage form:
- in case of sudden disruptions in cerebral blood circulation - 1 ampoule no more than 3 times a day (diluted in a 9% sodium chloride solution);
- in the post-stroke recovery period - 5-10 mg three times a day for 1.5-2 months;
- for atherosclerosis - 5 mg 3 times a day for three weeks, after a month's pause the treatment is repeated;
- for third stage hypertension, including complications of encephalopathy - 5 mg twice a day for a month. Then a week-long break, then, if necessary, therapy is continued only with an increased dose - 10 mg 2 times a day.
In ophthalmological practice, Cavinton therapy is indicated at a dose of 10 mg twice a day for 30 days or, if necessary, more.
Contraindications
The main limitation of the use of this medicine is the hemorrhagic type of stroke, including the effusion of blood into the space surrounding the brain, the complete rupture of a cerebral aneurysm. The drug should not be taken if you are hypersensitive to its components.
Other factors limiting the use of Cavinton for therapeutic purposes include:
- complicated ischemia;
- complicated forms of arrhythmia;
- gestation and lactation period;
- children under 18 years of age;
- intolerance to fructose and milk sugar.
Side effects from injections
Exposures due to the use of infusion or injection forms usually occur from rapid administration of the medication. Although there are also other reasons. Be that as it may, if it has a negative effect, you need to immediately inform your doctor about it.
If the rules are not violated and the dosage is not exceeded, then the negatives make themselves felt infrequently, but you should be aware of them. Mainly, violations manifest themselves:
- from the heart and blood vessels - changes in electrocardiographic readings, premature contraction of the heart, an increase or decrease in the frequency of its contracting rhythm, cardiac and venous insufficiency, decreased blood pressure, red rashes on the skin;
- from the central nervous system - painful lack of sleep or, conversely, a constant desire to sleep, vertigo, headache, impotence, trembling, pre-syncope, fainting;
- from the gastrointestinal tract - dry mouth, vomiting, burning sensation.
Side effects may also manifest themselves as irritating skin rashes and increased sweating.
In some patients, after administration of the drug, visual acuity may decrease, aniseikonia may occur (a condition in which each eye sees the same object in different sizes), hyphema (bleeding in the front of the eye), double vision, redness of the mucous membrane of the eyeball, deterioration hearing, ringing in the ears.
Interaction with other drugs
In medical practice, only competent combinations of medications are allowed. This is allowed to be done by specialists who understand such subtleties. Otherwise, violating these rules can cause serious complications and your health may worsen instead of improving.
This is based on the fact that not all healing substances can be combined. For example, Cavinton injections, if mixed with a heparin-containing medicine, can cause bleeding. But if you do not mix, then taking such treatment at the same time is permissible.
Cavinton should be used with caution by hypertensive patients who are constantly taking medication to lower blood pressure. It does not differ in particular contact with beta-blockers (Propranolol, Pindolol), Clopamide, Glibenclamide, Digoxin, Acenocoumarol or Hydrochlorothiazide.
Cavinton for droppers does not accept mixtures in which it is diluted, if it contains amino acids. Therapy with this medicine, which has a positive effect on cerebral blood circulation and related problems, provides for a taboo on the consumption of alcoholic beverages.
Terms and conditions of storage
The prescription for this medicine emphasizes that the medicine must be kept where it cannot be reached by children. It should be dark and with an optimal temperature range from 15 to 30°C.
Cavinton remains suitable for 5 years. And the solution prepared on its basis is indicated for use, as noted above, for 3 hours.
Analogues
Like most drugs, Cavinton has analogues. However, when choosing such a remedy, you should take into account that each of these drugs has its own composition and area of action. For this reason, it is advisable to buy the medicine prescribed by the doctor. After all, an analogue can manifest itself a little differently.
Among the popular analogues of Cavinton are:
- Cavinton-forte,
- Vinpocetine,
- Vinpotropil,
- Winpoton,
- Bravinton,
- Telektol.
The most expensive from this list can be called Cavinton-Forte, which is an exact copy of the original, only in a more concentrated composition. Their prices are almost the same. Other analogues are several times cheaper. But that doesn't mean anything yet. The main thing when choosing a medicine is to study its instructions, which are always included, paying attention to all contraindications and side effects. The main thing is to understand that you cannot prescribe such serious medications to yourself. We recommend that you familiarize yourself with the action of Panavir.
Instructions for medical use
medicine
Cavinton®
Tradename
Cavinton®
International nonproprietary name
Vinpocetine
Dosage form
Solution for injection 10 mg/2 ml
Compound
2 ml of solution contains
active substance- vinpocetine 10 mg,
Excipients: ascorbic acid, sodium metabisulfite, tartaric acid, benzyl alcohol, sorbitol, water for injection.
Description
Colorless or slightly greenish transparent solution
Pharmacotherapeutic group
Psychoanaleptics. Psychostimulants and nootropics. Other psychostimulants and nootropics. Vinpocetine
ATX code N06BX18
Pharmacological properties
Pharmacokinetics
When administered intravenously, during first pass metabolism through the liver, 25-30% of vinpocetine is converted to apo-vincamic acid (VCA). Liver and kidney diseases do not affect the metabolism of vinpocetine. Blood protein binding is 66%. The volume of distribution is 246.7 ± 88.5 l, indicating good tissue distribution. The clearance value of vinpocetine (66.7 l/h) exceeds the values in plasma and liver (50 l/h), which indicates extrahepatic metabolism of the compound.
Penetrates well into various tissues and body fluids, including cerebrospinal fluid. The half-life is 4.83±1.29 hours. It is excreted by the kidneys and through the gastrointestinal tract. Removal of apovincamic acid is carried out by glomerular filtration. The half-life depends on the dose of vinpocetine and the dosage regimen.
Elderly age: there are no significant differences in the kinetics of the drug in elderly and young patients, the drug does not accumulate. For patients with chronic liver and kidney diseases, the drug is prescribed in the usual dose; the lack of accumulation allows for long courses of treatment.
Pharmacodynamics
Vinpocetine is a compound with a complex mechanism of action that has a beneficial effect on brain metabolism and improves its blood supply, as well as improves the rheological properties of the blood.
The neuroprotective effect of vinpocetine is associated with the blockade of voltage-dependent Na + and Ca 2+ channels and the protection of neurons from the inadequate influx of Na + under hypoxia conditions and the resulting excess entry of Ca 2+ into the cell. The interaction of vinpocetine with glutamate receptors protects nerve cells from the cytotoxic effects of glutamate and N-methyl-D-aspartate, as well as alpha-amino-3-hydroxy-5-methyl-4-isoxazole-propionic acid.
Vinpocetine enhances the neuroprotective effect of adenosine by blocking its utilization. It has a direct antioxidant effect, preventing the formation of reactive substances.
Vinpocetine stimulates cerebral metabolism: The drug increases the uptake of glucose and oxygen, increasing the consumption of these substances by brain tissue. The drug increases the brain's resistance to hypoxia; increases the transport of glucose - an exclusive source of energy for the brain - across the blood-brain barrier; shifts glucose metabolism towards the energetically more favorable aerobic pathway; selectively inhibits Ca 2+ -calmodulin-dependent enzyme cGMP phosphodiesterase (PDE); increases the level of cAMP and cGMP in the brain. The drug increases the concentration of ATP and the ATP/AMP ratio; increases the turnover of norepinephrine and serotonin in the brain; stimulates the ascending noradrenergic system; has antioxidant activity; As a result of all of the above effects, vinpocetine has a cerebroprotective effect.
Vinpocetine improves microcirculation in the brain: the drug inhibits platelet aggregation; reduces pathologically increased blood viscosity; increases the deformability of erythrocytes and inhibits the uptake of adenosine; improves O 2 transport in tissues by reducing the affinity of O 2 for red blood cells.
Vinpocetine selectively increases blood flow in the brain: the drug increases cerebral cardiac output fraction; reduces vascular resistance in the brain without affecting the parameters of systemic circulation (blood pressure, cardiac output, pulse rate, total peripheral resistance); the drug does not cause a “stealing effect”. Moreover, the drug improves blood flow to damaged (but not yet necrotic) ischemic areas with low perfusion (“reverse steal effect”).
As a result of such a complex mechanism of action, Vinpocetine accelerates the regression of general cerebral and focal symptoms, improves memory, attention, and intellectual productivity.
Indications for use
Transient cerebral ischemia
Cerebral ischemic stroke
Conditions after cerebral stroke
Dementia due to multiple brain lesions
Atherosclerosis of cerebral vessels
Post-traumatic and hypertensive encephalopathy
Vertebrobasilar insufficiency
Mental and neurological disorders caused by cerebrovascular insufficiency
Ophthalmological diseases of the retina and choroid (caused by atherosclerosis, arterial or venous thrombosis and embolism, vasospasm)
Diseases of the inner ear (hearing loss due to vascular diseases or toxic effects (including iatrogenic), Meniere's disease, tinnitus
Directions for use and doses
Intended for intravenous infusion, administered slowly (infusion rate should not exceed 80 drops/min!).
It is prohibited to administer intramuscularly or in concentrated form intravenously.!
To prepare the infusion, you can use saline solution or infusion solutions containing glucose (Salsol, Ringer, Rindex, Reomacrodex). Infusion solution with Cavinton® should be used within the first 3 hours after preparation.
Initial daily dose: 20 mg (2 amps) in 500 ml of infusion solution for intravenous administration. Depending on the patient’s tolerance, the dose can be increased over 2-3 days, but not more than 1 mg/kg body weight. The average course of treatment is 10-14 days, the average daily dose is 50 mg for a body weight of 70 kg (5 amps in 500 ml of infusion solution).
Patients with liver and kidney diseases can be prescribed in the same doses.
Side effects
Infrequently ( > 1/1000 <1/100)
Feeling hot
Lower blood pressure
Euphoria
Rarely ( > 1/10000 <1/1000)
Headache, dizziness, drowsiness, anxiety, hemiparesis
Hearing impairment, hyperacusis, hypoacusia
Myocardial ischemia/infarction, angina pectoris, arrhythmia, bradycardia, tachycardia, extrasystole, palpitations
Hemorrhage in the anterior chamber of the eye, hypermetropia, decreased visual acuity, myopia
Increased blood pressure, prolongation of the QT interval, ST segment depression on the ECG
Hot flashes, asthenia, chest discomfort, thrombosis at the injection site
Nausea, dry mouth, abdominal discomfort
Erythema, hyperhidrosis, urticaria
Thrombocytopenia, red blood cell agglutination
Hypercholesterolemia, diabetes mellitus
Increased urea concentration in the blood
Very rarely (<1/10000)
Depression, tremor, loss of consciousness, lightheadedness
Anorexia, vomiting, hypersecretion of saliva
Heart failure, atrial fibrillation, prolonged PR interval on ECG
Thrombophlebitis
Conjunctival hyperemia, papilledema, diplopia
Noise in ears
Skin itching, dermatitis
Increased lactate dehydrogenase activity
Contraindications
Hypersensitivity to any component of the drug
Acute stage of cerebral hemorrhage
Severe coronary heart disease
Severe heart rhythm disturbances
Pregnancy and lactation
Children and teenagers up to 18 years of age
Persons with hereditary fructose intolerance
Drug interactions
Cavinton® solution is chemically incompatible with heparin, so administering them in the same syringe is prohibited.
Cavinton® solution is chemically incompatible with infusion solutions containing amino acids, therefore they cannot be used to dilute the injection form of Cavinton®.
The simultaneous use of vinpocetine and alpha-methyldopa may increase the hypotensive effect, so regular monitoring of blood pressure is required when using them together.
Despite the lack of clinical trial data confirming the possibility of interaction, caution is recommended when vinpocetine is co-administered with drugs acting on the central nervous system, antiarrhythmics and anticoagulants. However, if necessary, the simultaneous use of anticoagulants and Cavinton® is permissible.
special instructions
In case of increased intracranial pressure, taking antiarrhythmic drugs, cardiac arrhythmias or prolongation of the QT interval, Cavinton® is prescribed after a careful assessment of the expected benefit and potential risk to the patient.
The presence of long QT syndrome and concomitant use of drugs that cause QT prolongation require periodic monitoring of the electrocardiogram.
Cavinton® injection solution contains sorbitol (160 mg/2 ml), therefore, if a patient has diabetes mellitus, it is necessary to control blood sugar levels.
In case of fructose intolerance or fructose 1,6-biphosphatase deficiency, the use of the drug should be avoided.
Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms
There is no data confirming the adverse effect of vinpocetine on the ability to drive a car or use potentially dangerous mechanisms, but given the possibility of developing side effects such as dizziness and drowsiness, caution should be exercised.
Overdose
Contains active substance vinpocetine 5 mg each. In addition, it contains additional substances.
- In tablets: talc, silicon dioxide, magnesium stearate, lactose monohydrate and corn starch.
- In the concentrate for infusion: tartaric acid, sodium disulfite, water for injection, benzyl alcohol, ascorbic acid and sorbitol.
Release form
- Tablets in blister packs with engraving Cavinton white.
- Solution concentrate for injection (Cavinton IV). Basically colorless liquid.
The recipe in Latin is Cavintonum.
pharmachologic effect
Cavinton tablets - what are they for? The main active ingredient is . Belongs to group cerebrovasodilating agents. LS improves brain metabolism , cerebral circulation , rheological properties of blood. Cavinton has a cerebroprotective effect, significantly reduces the severity of the damaging effect, inhibits the activity of transmembrane calcium and sodium channels, receptors AMRA , NMDA . The drug Cavinton has a potentiating effect on the neuroprotective effect. Vinpocetine increases absorption, improves absorption, metabolism of oxygen and glucose in the brain. The drug is able to shift glucose metabolism to a more beneficial energetic aerobic direction. Stimulates cerebral metabolism and norepinephrine , renders antioxidant , stimulating impact on the noradrenergic system.
Pharmacodynamics and pharmacokinetics
Cavinton selectively improves cerebral circulation: increases the cerebral fraction of minute blood volume, reduces the resistance of the blood vessels of the brain, without affecting general blood circulation ( Heart rate , minute volume , HELL , OPSS ). The drug does not cause steal syndrome. Improves blood circulation ischemic , but a viable area of the brain, causing the phenomenon of “reverse steal”. Increases the resistance of brain cells to hypoxia , improves microcirculation , reduces platelet aggregation, resists pathologically high blood viscosity, increases the deformability of erythrocytes, has a blocking effect on the absorption of adenosine red blood cells .
The tablets are absorbed within an hour. It is not metabolized in the intestine. It is excreted in feces and urine in a ratio of 2 to 3.
The concentration of the solution for infusion is therapeutic in plasma in the range of 10-20 ng/ml. It is excreted via the gastrointestinal tract and kidneys in a ratio of 2 to 3.
Indications for use
What is the medicine Cavinton for? The purpose of the drug is extensive. Indications for the use of Cavinton in injections (droppers) and in tablets are general.
Neurology
Otorhinolaryngology
Hearing loss of age-related, toxic and vascular origin, cochleovestibular neuritis, dizziness, tinnitus, vasovegetative manifestations in the menopause.
Contraindications
Contraindications are severe forms of arrhythmia, severe ischemic heart disease, lactation (due to the lack of safety data).
Side effect
Side effects are as follows:
The cardiovascular system
Intensification of an existing arrhythmia, possible tachycardia, drop in blood pressure.
Gastrointestinal tract
Dyspeptic disorders, dry mouth,.
central nervous system
Weakness, sleep disturbance, dizziness,. .
Instructions for use of Cavinton (Method and dosage)
Cavinton tablets, instructions for use
The course of drug treatment is on average 3 months (acceptable from 1 to 8). Cavinton is taken after meals, 1 tablet three times a day. When discontinuing the drug, the dose must be reduced gradually over 3 days.
Instructions for using Cavinton in ampoules
Cavinton's solution is administered intravenously via a drip at a dose of 20 mg per 500 ml of saline. solution per day. Intramuscular injections are prohibited. The infusion solution must be used within 3 hours of preparation. The maximum dripping speed is 80 drops per minute.
Overdose
At this time, information about overdose is limited. It is recommended to lavage the stomach, use activated charcoal and use symptomatic therapy.
Interaction
The use of the drug Cavinton against the background heparin therapy increases the risk of developing various hemorrhagic complications. Drug solution for injection is incompatible with.
Terms of sale
Requires a prescription.
Storage conditions
Avoid exposure to sunlight. The temperature should be between 15-30 degrees Celsius. The drug should be stored in a place out of the reach of children.
Best before date
No more than 5 years.
special instructions
Cavinton does not have nephro- and hepatotoxic effects. In patients with lactose intolerance, it is necessary to take into account that 1 tablet contains 83 mg of lactose. In patients with diabetes mellitus When administering the drug parenterally, blood glucose control is necessary (the solution contains sorbitol , when administered intravenously, increases the risk of developing arrhythmia, ventricular fibrillation). In case of cerebral hemorrhagic stroke, the drug can be administered parenterally only after the acute effects have subsided (after 5-7 days). The drug is not recommended for use in pediatrics.
There is no article on the drug in Wikipedia.
Cavinton's analogues
Level 4 ATX code matches:Similar drugs are: Vicebrol , Neurovin , Oxopotin . The price of Cavinton's analogues is often less. For example, a medicine whose name comes from the main active ingredient is significantly cheaper.
Which is better Cavinton or Vinpocetine?
The drugs are absolutely identical. However, Cavinton is considered to be safer than Vinpocetine due to better alkaloid clearance.
Which is better Cavinton or Piracetam?
It has a slightly different purpose and is often used in combination with Cavinton to treat problems associated with circulatory and metabolic disorders.
Cavinton for newborns
Alcohol compatibility
The drug is definitely incompatible with alcohol, as it dilates blood vessels, as a result of which alcohol is better absorbed, which is very detrimental to the body.
Reviews about Cavinton
Reviews from patients
In general, opinions were divided. Those who have taken the drug say that it helps, but there are statements that no effect was noticed. The advantage is the low price. Side effects have been observed.
Reviews of Cavinton for children
It is important to remember that the drug is contraindicated for children. However, doctors still run the risk of prescribing this medicine. Reviews from parents indicate that when children use the medication, side effects occur, such as irritability and insomnia.
Cavinton price, where to buy
The price of Cavinton in 5 mg tablets is 230 rubles per pack of 50 pieces.
The price of Cavinton ampoules is 240 rubles for 10 pieces of 10 mg/2 ml, and 330 rubles for 10 pieces of 25 mg/5 ml.
In Kharkov you can buy tablets for 160-200 UAH. Ampoules 10 mg/2 ml No. 10 for 230 UAH
- Online pharmacies in Russia Russia
- Online pharmacies in Ukraine Ukraine
- Online pharmacies in Kazakhstan Kazakhstan
ZdravCity
Cavinton tab. 5mg No. 50Gedeon Richter-RUS ZAO
Cavinton conc.d/inf. 5mg/ml 2ml n10 JSC Gedeon Rikhp
Cavinton forte tab. 10mg No. 30Gedeon Richter-RUS ZAO
Cavinton conc.d/inf. 5mg/ml 5ml n10 JSC Gedeon Rikhp
Cavinton conc.d/inf. 5mg/ml 10ml n5 JSC Gedeon Rikhp
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Cavinton (amp. 2ml No. 10)
Cavinton (amp. 5ml No. 10)
Cavinton Comforte (tablet dispenser 10mg No. 30)
Cavinton Comforte (tablet dispenser 10mg No. 90)
Cavinton Forte (10 mg tablet No. 30)
Excipients: colloidal silicon dioxide, magnesium stearate, talc, corn starch, lactose monohydrate.
25 pcs. - blisters (2) - cardboard packs.
pharmachologic effect
The mechanism of action of vinpocetine consists of several elements: it improves cerebral blood flow and brain metabolism, and has a beneficial effect on the rheological properties of blood.
The neuroprotective effect is realized by reducing the adverse cytotoxic effect of excitatory amino acids. Blocks voltage-dependent Na + and Ca 2+ channels and NMDA and AMPA receptors. Increases the neuroprotective effect of adenosine. Vinpocetine stimulates brain metabolism: increases the uptake and consumption of oxygen. Increases tolerance to hypoxia; increases the transport of glucose, the only source of energy for brain tissue, across the BBB; shifts glucose metabolism towards the energetically more favorable aerobic pathway. Selectively inhibits Ca 2+ -calmodulin-dependent cGMP phosphodiesterase; increases the content of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) in the brain, ATP concentration and the ATP/AMP ratio in brain tissue; enhances the metabolism of norepinephrine in the brain, stimulates the noradrenergic neurotransmitter system, and also has an antioxidant effect; As a result of all these effects, vinpocetine has a cerebroprotective effect.
Improves microcirculation in the brain by inhibiting platelet aggregation, reducing pathologically increased blood viscosity, increasing the ability of red blood cells to deform and inhibiting adenosine uptake; promotes the transition of oxygen into cells by reducing the affinity of red blood cells for it. Selectively increases cerebral blood flow by increasing cerebral ejection fraction, reducing cerebral vascular resistance without significantly affecting systemic circulatory parameters (BP, cardiac output, heart rate, peripheral vascular resistance); does not have the effect of "stealing". With the use of vinpocetine, the blood supply to damaged (but not yet necrotic) ischemic areas with low perfusion improves (the “reverse steal effect”).
Pharmacokinetics
Suction
Vinpocetine is rapidly absorbed after oral administration and reaches Cmax in the blood within 1 hour. Absorption occurs mainly in the proximal intestine. It is not metabolized when passing through the intestinal wall. Bioavailability when taken orally - 7%.
Distribution
In preclinical studies of oral administration of radioactively labeled vinpocetine, it was detected in the highest concentrations in the liver and gastrointestinal tract. Cmax in tissues is observed 2-4 hours after oral administration. The amount of radioactive isotope in the brain did not exceed that in the blood. Protein binding in the human body is 66%. Vd is 246.7±88.5 l, which indicates significant distribution in tissues. Clearance is 66.7%, which exceeds the plasma volume of the liver (50 l/h), metabolism is predominantly extrahepatic.
With repeated doses of 5 and 10 mg, the kinetics of vinpocetine is linear. C ss were 1.2±0.27 ng/ml and 2.1±0.33 ng/ml, respectively.
Metabolism
The main metabolite of vinpocetine is apovincamic acid (AVA), the proportion of which in humans is 25-30%. After taking vinpocetine orally, the AUC of VKA is 2 times greater than that after intravenous administration. This indicates that VKA is formed during the “first pass” metabolism of vinpocetine. Other known metabolites are hydroxyvinpocetine, hydroxy-AVA, dihydroxy-AVA-glycinate, and their conjugates with glucuronides and/or sulfates.
Removal
T1/2 in humans - 4.83±1.29 hours. In studies with a radioactive label, the drug was excreted by the kidneys and through the intestines in a ratio of 60:40. In preclinical studies, a significant portion of the radioactivity was detected in bile, but significant enterohepatic circulation was not found. Preclinical studies revealed that vinpocetine is excreted unchanged in small quantities. Apovinamic acid is excreted by the kidneys by simple glomerular filtration, T 1/2 depends on the dose taken and the route of administration of vinpocetine.
Pharmacokinetics in selected patient groups
It was revealed that the pharmacokinetics of vinpocetine in elderly patients does not differ significantly from that in young patients; there is no accumulation of the drug. Therefore, vinpocetine can be prescribed to patients with impaired liver and kidney function for a long time and in normal doses.
Indications
Neurology:
- reducing the severity of neurological and mental disorders in various forms of cerebral circulatory failure (symptomatic treatment of the consequences of ischemic stroke, vertebrobasilar insufficiency, vascular dementia, cerebral atherosclerosis, post-traumatic and hypertensive encephalopathy);
Ophthalmology:
— chronic vascular diseases of the retina and choroid;
Otorhinolaryngology:
- for the treatment of perceptual hearing loss, Meniere's disease, tinnitus.
Contraindications
- galactose intolerance, lactase deficiency, glucose-galactose malabsorption;
- pregnancy;
- period of breastfeeding;
— age under 18 years (due to insufficient data);
- hypersensitivity to vinpocetine or other components of the drug.
Carefully: long QT syndrome, taking drugs that cause prolongation of the QT interval.
Dosage
Take orally after meals.
Typically the daily dose is 15-30 mg (5-10 mg 3 times a day).
The initial daily dose is 15 mg. The maximum daily dose is 30 mg.
At kidney and liver diseases the drug is prescribed in the usual dose; the lack of accumulation allows for long courses of treatment.
Side effects
During clinical trials, the most common adverse reactions occurred in the following systemic organ classes (according to the MedDRA classification), which are listed according to the frequency of occurrence: uncommon (from ≥1/1000 to<1/100), редко (от ≥1/10 000 до <1/1000); очень редко (<1/10 000).
From the hematopoietic system: rarely - leukopenia, thrombocytopenia; very rarely - anemia, red blood cell agglutination.
From the immune system: very rarely - hypersensitivity reactions.
Metabolism and nutrition: infrequently - hypercholesterolemia; rarely - loss of appetite, anorexia, diabetes mellitus.
Mental disorders: rarely - insomnia, sleep disturbance, anxiety; very rarely - euphoria, depression.
From the nervous system: infrequently - ; rarely - dizziness, taste disturbance, stupor, unilateral paresis, drowsiness, amnesia; very rarely - tremors, spasms.
From the side of the organ of vision: rarely - swelling of the optic nerve nipple; very rarely - conjunctival hyperemia.
Hearing and labyrinth disorders: infrequently - vertigo; rarely - hyperacusis, hypoacusia, tinnitus.
From the cardiovascular system: infrequently - decreased blood pressure; rarely - myocardial ischemia/infarction, angina pectoris, bradycardia, tachycardia, extrasystole, palpitations, increased blood pressure, hot flashes, thrombophlebitis; very rarely - blood pressure lability, arrhythmia, atrial fibrillation.
From the digestive system: uncommon - abdominal discomfort, dry mouth, nausea; rarely - epigastric pain, constipation, diarrhea, dyspepsia, vomiting; very rarely - dysphagia, stomatitis.
For the skin and subcutaneous tissues: rarely - erythema, hyperhidrosis, itching, urticaria, rash; very rarely - dermatitis.
General disorders and disorders at the injection site: rarely - asthenia, malaise, feeling hot; very rarely - chest discomfort, hypothermia.
Laboratory and instrumental data: rarely - hypertriglyceridemia, depression of the ST segment on the ECG, decrease/increase in the number of eosinophils, increased activity of liver enzymes; very rarely - decrease/increase in the number of leukocytes, erythropenia, decrease in thrombin time, increase in body weight.
Overdose
There are no data on overdose with vinpocetine. A single dose of 360 mg of vinpocetine did not cause clinically significant reactions, incl. from the cardiovascular system.
Treatment: gastric lavage, taking activated carbon, symptomatic therapy.
Drug interactions
Interaction is not observed when used simultaneously with (chloranolol, pindolol), clopamide, glibenclamide, digoxin, acenocoumarol, hydrochlorothiazide and imipramine.
The simultaneous use of vinpocetine and alpha-methyldopa sometimes caused a slight increase in the hypotensive effect, so regular monitoring of blood pressure is required with this treatment.
Despite the lack of data confirming the possibility of interaction, caution is recommended when co-administering with drugs that act on the central nervous system and with drugs with antiarrhythmic and anticoagulant effects.
special instructions
The presence of long QT syndrome and the use of drugs that prolong the QT interval require periodic ECG monitoring.
1 tablet of the drug contains 140 mg of lactose monohydrate. Patients with rare hereditary diseases such as galactose intolerance, lactase deficiency or glucose-galactose malabsorption should not take this drug.
Impact on the ability to drive vehicles and machinery
There are no data on the effect of vinpocetine on the ability to drive vehicles and operate machinery.
Pregnancy and lactation
Pregnancy
Vinpocetine crosses the placental barrier and is therefore contraindicated during pregnancy. Moreover, its concentration in the placenta and in the blood of the fetus is lower than in the blood of a pregnant woman. No teratogenic or embryotoxic effects were detected. In animal studies, placental hemorrhage and spontaneous abortion occurred when large doses were administered, probably as a result of increased placental blood flow.
Breastfeeding period
Vinpocetine passes into breast milk. In studies using labeled vinpocetine, the radioactivity of breast milk was ten times higher than that in the mother's blood. Within 1 hour, 0.25% of the administered dose of the drug passes into breast milk. Since vinpocetine passes into breast milk, and there is no data on the effect of vinpocetine on infants, the use of the drug during breastfeeding is contraindicated.
Use in childhood
Use is contraindicated in people under 18 years of age (due to insufficient data).
For impaired renal function
At kidney diseases
For liver dysfunction
At liver diseases the drug is prescribed in the usual dose.
Conditions for dispensing from pharmacies
The drug is available with a prescription.
Storage conditions and periods
The drug should be stored in its original packaging to protect from light, out of the reach of children at a temperature not exceeding 30°C. Shelf life - 5 years. Do not use after the expiration date stated on the package.
