Cavinton

Cavinton is the representative of a group of drugs, the main therapeutic effect of which is considered to affect the nervous system. The main active ingredient of the drug is vinpocetine.

According to the code of automatic telephone exchange Cavinton refers to psychostimulants, which exert their influence on cognitive functions of the brain. In addition, the drug is considered a nootropic drug, as a result of which it is widely used for violations in the work of the mental sphere, reducing attention and memory, as well as in the presence of hyperactivity.

Due to the specific structure of the drug, blood circulation is activated in the ischemic areas of the brain, as a result of which their functionality is normalized. In addition, sufficient blood supply is restored, which contributes to the improvement of general condition and stimulation of cognitive functions.

[1], [2]

Indications Cavinton

The drug has proven effective in various pathological conditions in ophthalmology, neurology, neurosurgery and many other medical fields. Cerebrovascular pathology is considered the main indication for treatment in neurology.

Cavinton is used to restore blood supply to all parts of the brain that do not receive enough oxygen and nutrients as a result of a stroke.

Indications for use Cavinton include dementia of vascular genesis, vertebrobasilar insufficiency, damage to atherosclerotic plaques of cerebral vessels and encephalopathy, the development of which is based on persistent increase in pressure or injury.

With the help of Cavinton, there is a decrease in the intensity of neurological and psychiatric symptoms, the cause of which is the cerebral vascular pathology.

Disorders of blood supply to vascular genesis in the retina and choroid - indications for use Cavinton in ophthalmology.

In ENT-practice, a medicinal product is used with medical necessity for the hearing loss of the perceptive form of the age genesis for restoring the local circulation. In addition, Cavinton successfully removes the clinical manifestations of Meniere's disease, as well as tinnitus.

[3], [4]

Release form

Dosage form Cavinton is a tablet form and solution for infusion. The main physico-chemical characteristics of the drug is white (almost white) color and flat round form of the tablet. Its diameter is about 9 mm. On the surface on one side there is an inscription "CAVINTON".

Cavinton contains 5 mg of vinpocetine, which is considered the main active component of the drug. Tablets are packaged in blisters, 25 pieces each. One medicine package contains 2 blisters.

The next form of release is a solution for intravenous use. 1 ml of Cavinton concentrate contains 5 mg of vinpocetine. Important physical and chemical characteristics of the drug is a colorless liquid, sometimes with a greenish tint, and the absence of a suspension, which ensures the transparency of the concentrate.

This form of release of the drug is stored in ampoules of 2 ml. Each carton contains 10 ampoules. Cavinton in the form of a solution is used in the acute period of a pathological condition, since it has quick access to the bloodstream of the body.

At the end of the acute phase, it is recommended to use a tablet preparation, which is more convenient for reception at home.

[5], [6], [7]

Pharmacodynamics

Due to the basic characteristics of vinpocetine, Cavinton has a complex mechanism of action. It consists in influencing metabolic processes in the brain and activating the local circulation, improving the rheological parameters of the blood.

Pharmacodynamics Cavinton performs a protective function for nerve tissue, reducing the negative impact of cytotoxic processes due to stimulation with amino acids.

The drug blocks receptors and potential-dependent channels for calcium and sodium. In addition, the drug stimulates the protective effect on adenosine neurons.

Vinpocetine stimulates metabolic processes in the brain cells with the help of activated capture and delivery of glucose and oxygen. The drug increases the resistance of tissues to insufficient oxygen intake, speeds up the transportation of glucose, which is one of the important energy processes.

Cavinton increases the amount of ATP, activates the circulation of norepinephrine and serotonin in the brain cells, and also stimulates the upward pathways of the noradrenaline system, which provides a cerebroprotective effect.

Pharmacodynamics Cavinton provides activation of the microcirculatory bed by blocking the "gluing" of platelets, reducing the viscosity of the blood, increasing the ability of erythrocytes to alter the shape and inhibition of adenosine capture. In addition, there is an accelerated circulation of oxygen in the brain cells.

The drug selectively stimulates blood circulation in the tissues, increasing the cerebral systolic volume of the heart and reducing peripheral vascular resistance, without affecting the parameters of the general circulation.

Vinpocetine provides activation of cerebral circulation, not "robbing" other tissues and organs. On the contrary, as is typical, the drug increases blood supply in those areas where there is insufficient supply of oxygen and nutrients.

[8], [9]

Pharmacokinetics

The drug is quickly absorbed through the mucosa of the digestive tract after oral administration. After 1 hour, the maximum concentration of the main active ingredient, vinpocetine in the blood, is noted. The same time for accumulation in the blood is required for the drug with intravenous administration of Cavinton. As the drug passes through the wall of the intestine, metabolic processes with its participation are absent.

Pharmacokinetics Cavinton for 2-4 hours determines the greatest accumulation of the drug in the liver. However, it is worth noting that the volume of vinpocetine in the brain tissues is much lower than its concentration in the blood.

Only 66% of the drug circulates in the blood with a bound state with proteins. Due to the pronounced tropism to the tissues, vinpocetine provides the maximum therapeutic effect in those areas where this is most important.

The half-life is between 3.5 hours and 6 hours, based on the dosage taken. Excretion of vinpocetine is carried out by the intestine (40%) and kidneys (60%), with only 3-5% excreted unchanged, the remaining 97% are metabolized.

Pharmacokinetics Cavinton provides the preparation of apovincaminic acid from vinpocetine, which is its main metabolite. An important feature of the drug is the lack of requirements for the selection of individual dosages for people with kidney and liver pathology.

Pharmacodynamic and pharmacokinetic properties of the drug do not differ when it is used in old age or in the presence of concomitant diseases.

[10], [11], [12], [13], [14]

Dosing and administration

Based on the severity of the pathology, the age of the patient and the concomitant pathology, the method of administration and dose of Cavinton is selected.

In the acute period of the disease, it is recommended to use the drug in the form of solutions for intravenous infusions. The introduction must be carried out slowly, so that the number of drops does not exceed 80 per minute.

It is forbidden to administer vinpocetine intramuscularly, and also intravenously without preliminary dilution of the concentrate. The initial dosage is usually 20 mg of the drug, diluted in 500 ml of the solution. This dose can be increased up to 1 mg / kg / day for 2-3 days, taking into account the tolerability of the drug.

The average therapeutic course is up to 2 weeks. At a mass of 70 kg, the usual dose is 50 mg / day, diluted in 500 ml of the solution.

To dilute the concentrate vinpocetine used physiological saline or solution with glucose. It should be noted that when the drug is diluted it should be used within 3 hours.

The method of administration and dose after the end of the acute period of the pathological condition are selected individually, but in most cases Cavinton is used in tablet form.

Cavinton with a dosage of 5 mg can be taken 1 tablet three times a day for several weeks to months. In old age, as well as in the presence of dysfunction of the liver and kidneys, vinpocetine does not require correction.

The drug can be used for monotherapy or for complex treatment to restore cerebral circulation and normalize cognitive functions.

[18], [19], [20]

Use Cavinton during pregnancy

Before using any medication, you need to make sure that a person does not have contraindications to receive it.

Such a contraindication is the use of Cavinton during pregnancy. At a time when the fetus is intensively growing and developing, there should not be any negative factor from the pregnant or external environment. It can become decisive in the formation of pathology in the fetus, which further manifests itself as insufficient functionality of any organ or system.

The prohibition on the use of vinpocetine is due to its ability to penetrate the bloodstream of the fetus, bypassing the placental barrier. The amount of medicinal product entering the blood of the fetus is much less than in the pregnant system, but even a small concentration may provoke the development of adverse reactions from the fetus.

Teratogenic and toxic effects of vinpocetine are not proven, but despite this, the use of Cavinton during pregnancy is prohibited. Due to animal studies, it was found that with the application of high doses of the drug, the development of placental bleeding followed with abortion. The cause of the emergence of adverse reactions is an excessive increase in local blood circulation.

In addition, you must stop using Cavinton during breastfeeding. Vinpocetine has a high ability to penetrate into breast milk, exceeding the concentration in the blood of a woman more than 10 times.

With breast milk within a hour can stand out to a quarter of the entire dose of the drug. As a consequence, the baby can receive a large dose of vinpocetine, which threatens his health and possibly even life.

Contraindications

In order to avoid the negative effect of the drug on the body, it is necessary to familiarize yourself in advance with possible contraindications to its use. This will provide the desired therapeutic effect without adverse reactions.

Contraindications to the use of Cavinton include an acute phase of hemorrhagic stroke, severe heart damage due to insufficient intake of oxygen and nutrients to the myocardium (ischemia), as well as severe disturbances in the rhythm of the heart.

In addition, it should be remembered that the drug is prohibited for use by pregnant women and those women who are breastfed. During pregnancy, when taking the drug, there is a high risk of bleeding and abortion.

Contraindications to the use of Cavinton also prohibit its use at the age of up to 18 years, as there is no reliable information about the absence of side effects at this age.

The drug is not recommended if a person has an individual intolerance to the main active component or ancillary components. In addition, one should carefully use vinpocetine in the presence of allergic reactions to drugs from the group that Cavinton belongs to.

Particular attention should be paid to taking vinpocetine together with drugs that can extend the QT segment to the ECG, which can disrupt the work of the heart. Also among the contraindications, lactose intolerance is highlighted, since in the presence of this syndrome Cavinton's use is limited in view of the drug's 83 mg lactose monohydrate.

[15]

Side effects Cavinton

Most often the drug is well tolerated by a person, but despite this, it is still recommended to know about possible negative actions that can develop after using vinpocetine.

Their appearance is due to the individual characteristics of the body and its response to certain components of the drug.

Side effects Cavinton can manifest from any body system. Thus, due to prolonged use of the drug, changes in the circulatory system are possible. The picture of the blood in this case can reflect an insufficient number of white blood cells, platelets, red blood cells with their possible gluing.

The immune response to the use of vinpocetine is manifested by the reaction of hypersensitivity, and the metabolic disorders are manifested by increased cholesterol, the development of diabetes and a decrease in appetite.

Side effects of Cavinton from the side of the central nervous system are insomnia, tremor, headaches, cramps, dizziness, changes in skin sensitivity, amnesia, depressive or euphoric state.

In addition, in rare cases, edema of the papillae of the optic nerve, congestion of the eye conjunctiva, an increase in the auditory threshold and an increase in noise in the ears are possible. The use of the drug can cause fluctuations in blood pressure. In addition, due to myocardial ischemia, the risk of developing a heart attack increases.

On the part of the digestive tract after using Cavinton, there may be a discomfort in the abdomen, dryness in the oral cavity, bowel dysfunction, nausea, vomiting and ulcerative lesions of the oral mucosa.

It happens that the skin can be covered with a rash, itching, erythema, dermatitis and hyperhidrosis. The general condition of a person worsens due to weakness, a feeling of heat and discomfort in the chest.

In laboratory and instrumental examination, it is possible to detect some abnormalities. Among them, it is worth paying attention to the increase in the number of triglycerides, the increase / decrease of eosinophils, the activation of liver enzymes and ST depression on the ECG.

[16], [17]

Overdose

When using the Cavinton tablet form, an overdose is observed more rarely than with the use of vinpocetin concentrate.

A special feature of the solution is the mandatory slow introduction and observance of a certain speed. If the dose exceeds 1 mg / kg / day, the likelihood of an overdose increases.

As for the Cavinton tablets, they have a certain dosage, which, if observed in the frequency of administration, excludes the development of an overdose.

The maximum dose per day for tablets is 60 mg, which should not be exceeded. Usually prescribed 1-2 tablets with a dosage of 5 mg three times a day.

In addition, when taking 360 mg Cavinton, there were no side effects from the heart, vascular or digestive systems.

In case of excess dosage, it is necessary to perform gastric lavage in a hospital to prevent further absorption of the drug into the bloodstream. If vinpocetine was administered intravenously, then it is recommended to use solutions for detoxification and stimulate urination with the help of diuretics.

Throughout the reduction in concentration due to an overdose, the work of the heart and the respiratory system should be monitored.

[21], [22], [23], [24]

Interactions with other drugs

Vinpocetine is quite well used in parallel with other medicines. Cavinton does not react with them and does not work on them.

Despite this, it is still necessary to identify some groups of drugs with which vinpocetine should be used with caution. The interaction of Cavinton with other drugs of the antihypertensive group - beta-blockers does not cause any side effects. Among this group, cloranolol and pindololol were tested for interaction.

In addition, no adverse clinical manifestations have been detected with the parallel use of vinpocetine with clopamid, digoxin (cardiac glycosides), acenocoumarol, hydrochlorothiazide (diuretics) or glibenclamide (hypoglycemic agents).

It is necessary to control blood pressure, when Cavinton interacts with other drugs - alpha-methyldopa, when the probability of increasing the activity of the latter increases.

With caution should take Cavinton with drugs that affect the nervous system, antiarrhythmic drugs and anticoagulants.

[25], [26], [27]

Storage conditions

In order to prevent premature loss of the therapeutic properties of the drug, certain recommendations for its storage must be taken into account.

Cavinton's storage conditions assume the maintenance of the optimal temperature regime, humidity and the degree of illumination in the room where the drug will be located. So, for vinpocetine the maximum temperature level is 25 degrees, at excess of which the structure of the medicinal product may undergo changes.

The tablet preparation should be stored in blisters, and the concentrate in intact ampoules. In addition, the drug must be stored in a place where direct sunlight does not reach.

If vinpocetin is exposed to a negative factor for a long time, for example, sun or high temperature, the risk of changes in the pharmacokinetic and pharmacodynamic properties of the drug increases.

In addition, Cavinton's storage conditions imply that the kids do not have access to the medication. Children can be injured by an ampoule if the integrity of the ampoule is violated, and if the concentrate is taken orally, poisoning or the appearance of side reactions due to an overdose is possible.

Shelf life

Cavinton has a 5-year shelf life. However, it should be borne in mind that during this period of time the medicinal properties of the medicinal product can be preserved provided all the rules for its storage are observed.

The production date and the date of the last use must be indicated in the manufacture of the preparation. After the expiration date, Cavinton can not be used both in tablet form and in concentrate form.

The shelf life may prematurely end if the product is exposed to a negative factor in the form of sunlight or high temperature for a long period of time. In addition, it should be noted that when diluting vinpocetin concentrate with a solution it persists for up to 3 hours, after which the structure of the drug undergoes changes.