Cavinton

Cavinton is a representative of a group of drugs whose main therapeutic effect is considered to be the effect on the nervous system. The main active component of the drug is vinpocetine.

According to the ATC code, Cavinton is a psychostimulant that affects the cognitive functions of the brain. In addition, the drug is considered a nootropic drug, which is why it is widely used for mental disorders, decreased attention and memory, and hyperactivity.

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

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Indications Cavinton

The drug has proven its effectiveness 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 areas of the brain that do not receive sufficient oxygen and nutrients as a result of a stroke.

Indications for the use of Cavinton include dementia of vascular genesis, vertebrobasilar insufficiency, atherosclerotic plaque damage to cerebral vessels, and encephalopathy, the development of which is based on persistent high blood pressure or trauma.

With the help of Cavinton, a decrease in the intensity of neurological and mental symptoms caused by vascular pathology of the brain is observed.

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

In ENT practice, the drug is used with therapeutic necessity in perceptual hearing loss of age-related genesis to restore local blood circulation. In addition, Cavinton successfully eliminates clinical manifestations of Meniere's disease, as well as tinnitus.

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Release form

The dosage form of Cavinton is a tablet form and a solution for infusions. The main physical and chemical characteristics of the drug are white (almost white) color and a flat round shape 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. The tablets are packaged in blisters, 25 pieces in each. One package of the drug 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 are considered to be a colorless liquid, sometimes with a greenish tint, and the absence of suspension, which ensures the transparency of the concentrate.

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

After the acute phase, it is recommended to use the tablet form of the drug, which is more convenient for taking at home.

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Pharmacodynamics

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

Pharmacodynamics Cavinton performs a protective function for nerve tissues, reducing the negative impact of cytotoxic processes caused by stimulation with amino acids.

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

Vinpocetine stimulates metabolic processes in brain cells by activating the capture and delivery of glucose and oxygen. The drug increases tissue resistance to insufficient oxygen supply, accelerates the transport of glucose, which is one of the important energy processes.

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

Pharmacodynamics Cavinton ensures activation of the microcirculatory bed by blocking the "sticking" of platelets, reducing blood viscosity, increasing the ability of red blood cells to change shape and inhibiting the capture of adenosine. In addition, accelerated oxygen circulation in brain cells is observed.

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

Vinpocetine provides activation of cerebral circulation without "robbing" other tissues and organs. On the contrary, what is characteristic, the drug increases blood supply in those areas where there is insufficient supply of oxygen and nutrients.

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Pharmacokinetics

The drug is absorbed quite quickly through the mucous membrane of the gastrointestinal tract after oral use. After 1 hour, the maximum concentration of the main active component - vinpocetine in the blood is noted. The same time is required for accumulation in the blood for the drug when taking Cavinton intravenously. As the drug passes through the intestinal wall, there are no metabolic processes involving it.

Pharmacokinetics Cavinton within 2-4 hours causes the greatest accumulation of the drug in the liver. However, it is worth noting that the volume of vinpocetine in brain tissue is significantly lower than its concentration in the blood.

Only 66% of the drug circulates in the blood in a protein-bound state. Due to its pronounced tissue tropism, vinpocetine provides maximum therapeutic effect in those areas where it is most important.

The half-life is between 3.5 hours and 6 hours, based on the dose taken. Vinpocetine is eliminated by the intestines (40%) and kidneys (60%), with only 3-5% excreted unchanged, the remaining 97% being metabolized.

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

The pharmacodynamic and pharmacokinetic properties of the drug do not differ when used in old age or in the presence of concomitant diseases.

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Dosing and administration

Based on the severity of the pathology, the patient's age and concomitant pathology, the method of administration and dosage of Cavinton are 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 should be carried out slowly, so that the number of drops does not exceed 80 per minute.

It is prohibited to administer vinpocetine intramuscularly or intravenously without first diluting the concentrate. The initial dosage is usually 20 mg of the drug diluted in 500 ml of solution. This dosage can be increased by up to 1 mg/kg/day for 2-3 days, taking into account the drug's tolerability.

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

To dilute the vinpocetine concentrate, use a physiological solution or a solution with glucose. It is worth noting that when diluting the drug, it should be used within 3 hours.

The method of administration and doses 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 a period of several weeks to months. In old age, as well as in the presence of liver and kidney dysfunction, vinpocetine does not require correction.

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

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Use Cavinton during pregnancy

Before using any medication, it is necessary to make sure that a person has no contraindications for taking it.

Such a contraindication is the use of Cavinton during pregnancy. At the time when the fetus is intensively growing and developing, no negative factor should act on the part of the pregnant woman or the external environment. It can become decisive in the formation of pathology in the fetus, which later manifests itself as insufficient functionality of any organ or system.

The ban on the use of vinpocetine is due to its ability to penetrate the fetal bloodstream, bypassing the placental barrier. The volume of the drug entering the fetal bloodstream is significantly less than in the pregnant woman's bloodstream, but even a small concentration can provoke the development of adverse reactions from the fetus.

Teratogenic and toxic effects of vinpocetine have not been proven, but despite this, the use of Cavinton during pregnancy is prohibited. Thanks to animal studies, it was found that when using high doses of the drug, it provoked the development of placental bleeding followed by abortion. The cause of adverse reactions is excessive increase in local blood circulation.

In addition, it is necessary to stop using Cavinton during breastfeeding. Vinpocetine has a high ability to penetrate into breast milk, exceeding the concentration in the woman's blood by more than 10 times.

Up to a quarter of the entire dose of the drug may be excreted in breast milk within an hour. As a result, the baby may receive a large dose of vinpocetine, which threatens his health and possibly even his life.

Contraindications

To avoid the negative impact of the drug on the body, it is necessary to familiarize yourself with possible contraindications to its use in advance. This will allow you to get the desired therapeutic effect without side effects.

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

In addition, it should be remembered that the drug is prohibited for use by pregnant women and those women whose child is 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 under 18 years, since there is no reliable information about the absence of side effects at this age.

The drug is not recommended for use if a person has an individual intolerance to the main active component or auxiliary components. In addition, vinpocetine should be used with caution in the presence of allergic reactions to drugs from the group that includes Cavinton.

Particular attention should be paid to taking vinpocetine together with drugs that can prolong the QT segment on the ECG, which can disrupt the heart. Also, lactose intolerance stands out among the contraindications, since in the presence of this syndrome, the use of Cavinton is limited due to the fact that the drug contains 83 mg of lactose monohydrate.

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Side effects Cavinton

Most often, the drug is quite well tolerated by humans, but despite this, it is still recommended to be aware of the possible negative effects that may develop after using vinpocetine.

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

Side effects of Cavinton can manifest themselves from any system of the body. Thus, as a result of long-term use of the drug, changes in the circulatory system are possible. The blood picture in this case may display an insufficient number of leukocytes, platelets, erythrocytes with their possible adhesion.

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

Side effects of Cavinton from the central nervous system include insomnia, tremors, headaches, convulsions, dizziness, changes in skin sensitivity, amnesia, depressive or euphoric state.

In addition, in rare cases, swelling of the optic nerve papilla, hyperemia of the conjunctiva of the eyes, increased hearing threshold and increased tinnitus 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.

From the gastrointestinal tract, after using Cavinton, discomfort in the abdomen, dry mouth, intestinal dysfunction, nausea, vomiting and ulcerative lesions of the oral mucosa may appear.

It happens that the skin may become covered with a rash, itching, erythema, dermatitis and hyperhidrosis may appear. The general condition of a person may worsen due to weakness, a feeling of heat and discomfort in the chest area.

Laboratory and instrumental examination may reveal some abnormalities. Among them, it is worth paying attention to an increase in the amount of triglycerides, an increase/decrease in eosinophils, activation of liver enzymes and ST depression on the ECG.

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Overdose

When using the tablet form of Cavinton, overdose occurs much less frequently than when using vinpocetine concentrate.

The peculiarity of the solution is the mandatory slow introduction and adherence to a certain speed. If the dose exceeds 1 mg/kg/day, the probability of overdose increases.

As for Cavinton tablets, they have a certain dosage, which, if taken regularly, eliminates the possibility of an overdose.

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

In addition, when taking 360 mg of Cavinton, no side effects were observed on the heart, vascular or digestive systems.

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

Throughout the period of decreased concentration due to overdose, the work of the heart and respiratory system should be monitored.

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Interactions with other drugs

Vinpocetine is used quite well in parallel with other drugs. Cavinton does not react with them and does not affect them.

Despite this, it is still necessary to highlight 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 negative clinical manifestations were identified with the parallel use of vinpocetine with clopamide, digoxin (cardiac glycosides), acenocoumarol, hydrochlorothiazide (diuretics) or glibenclamide (hyperglycemic agents).

It is imperative to monitor blood pressure when interactions between Cavinton and other drugs are observed - alpha-methyldopa, when the likelihood of increased activity of the latter increases.

Cavinton should be taken with caution with medications that affect the nervous system, antiarrhythmic drugs and anticoagulants.

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Storage conditions

In order to prevent a drug from losing its therapeutic properties prematurely, it is necessary to take into account certain recommendations for its storage.

Storage conditions for Cavinton involve maintaining optimal temperature, humidity and lighting conditions in the room where the drug will be located. Thus, for vinpocetine, the maximum temperature level is 25 degrees, above which the structure of the drug may undergo changes.

The tablet preparation should be stored in blisters, and the concentrate in undamaged ampoules. In addition, the preparation should be stored in a place where there is no direct sunlight.

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

In addition, the storage conditions of Cavinton imply that children have no access to the medicine. Children can get hurt by the ampoule if its integrity is violated, and also when taking the concentrate orally, poisoning or side effects due to overdose are possible.

Shelf life

Cavinton has a 5-year shelf life. However, it is worth considering that during this period of time, the medicinal properties of the drug can be preserved, provided that all storage rules are followed.

When manufacturing the drug, the date of manufacture and the date of last use must be indicated. After the expiration date, Cavinton cannot be used either in tablet form or as a concentrate.

The expiration date may expire prematurely if the drug is exposed to negative factors such as sunlight or high temperatures for a long period of time. It should also be noted that when diluting vinpocetine concentrate with a solution, it is preserved for up to 3 hours, after which the structure of the drug undergoes changes.