Cerebrolysin

The drug for intramuscular and/or intravenous injections Cerebrolysin (cerebrolysin) by its pharmaceutical classification belongs to psychostimulant and nootropic drugs.

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Indications Cerebrolysin

The drug is intended for the treatment of dementia of various genesis, acute cerebrovascular accident of the ischemic type, chronic disorder of cerebral hemodynamics, traumatic brain injury, spinal injuries, endogenous manic-depressive state (psychosis) (included in the treatment regimen), inflammation of the membranes of the brain, cerebrovascular encephalopathy, cognitive retardation in children. Cerebrolysin can also be prescribed at the rehabilitation stage after acute cerebrovascular accident of the hemorrhagic type, brain surgery and ADHD.

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Release form

Liquid for intravenous and/or intramuscular administration, amber-colored, water-based, in dark glass ampoules.

One milliliter of the drug contains 215.2 mg of hydrolyzed peptide fraction made from pig brain.

Additional components: Natrii hydroxidum, aqua pro injectioni.

The pharmaceutical industry produces cerebrolysin:

• in dark glass ampoules of 1 ml, 2 ml, 10 pieces each, packed in plastic honeycomb inserts of factory cardboard boxes;
• in dark glass ampoules of 5 ml, 10 ml, 20 ml, 5 pieces in a cardboard package with plastic honeycomb inserts;
• in dark glass bottles of 30 ml, 50 ml, closed with a special stopper with an aluminum lock, packed in original cardboard boxes.

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Pharmacodynamics

Low molecular weight biologically active neuropeptides contained in Cerebrolysin overcome the BBB (blood-brain barrier) and enter the nervous tissue, exerting a stimulating and activating effect on functionality and trophism.

Under the influence of the drug, protein synthesis inside the cell accelerates due to improved productivity of energy metabolism of brain tissue.

The neuroprotective effect on the cells of the central nervous system consists in protecting neurons from the harmful effects of free radicals and toxins, which significantly increases the survival of cells under conditions of ischemic or hypoxic factors. Cerebrolysin has the ability to prevent excessive swelling in the lesion of the brain. Normalizes microcirculation in tissues. Due to its neurotrophic activity, which has a similar effect to the natural neuronal growth factor (NGF), Cerebrolysin slows down the development of degenerative processes in the nervous tissue. The effect of the drug on immunity, the formation of glycoproteins has not been established. It does not have stimulating properties of H1-histamine receptors and, accordingly, does not affect erythrocyte agglutination.

Positive dynamics with the use of Cerebrolysin for a month was obtained in the complex treatment of dementia and Alzheimer's disease. In all patients with vascular dementia, the results of electroencephalography showed a significant dose-dependent increase in neuronal activity (amplitude increase in the height of the alpha rhythm and beta rhythm), a positive cognitive response to therapy was observed (self-care skills, memory and intellectual abilities significantly improved). Positive dynamics began to manifest themselves after a two-week course and progressed during further treatment. The positive effect was observed regardless of the cause of dementia. This is relevant for long-term normalization of the ability to perform daily activities. The need for constant care and monitoring of patients is reduced.

After a single application, the specific neurostimulating effect appears for about 8 hours (EEG results).

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Pharmacokinetics

The biochemical composition of Cerebrolysin does not allow us to study the route of movement of the active components of the drug in the human body. The complex of low-molecular peptides contains protein compounds identical to those produced in the human brain. It is not possible to measure pharmacokinetic values. The neurotrophic activity of the drug is detected within 24 hours after a single use.

Dosing and administration

Only transparent solutions without color change and containing no sediment are allowed for use.

Concentrated cerebrolysin is approved for use in dosages from 1 ml to 10 ml for intramuscular or intravenous jet injection. Starting with a volume of more than 10 ml and up to 50 ml (maximum dosage), the drug is used for slow drip infusions. Before the procedure, the total volume of the drug is brought to 100 ml. Infusion solutions (isotonic NaCl solution) are used for dilution. The duration of drip infusion lasts from 15 minutes to 1 hour.

The prepared solution for infusion must be used immediately, since sunlight has a detrimental effect on the active components of Cerebrolysin, reducing their effectiveness.

With the standard regimen of Cerebrolysin injections, the duration of therapy is 10-20 days of daily administration of the drug.

A therapy option with a single drip administration of the drug in a dosage of 50 ml is possible, but cyclic treatment with smaller volumes is preferable and more effective.

Recommended daily doses for various conditions:

• For organic destructive changes in the brain, neurodegenerative disorders – 5 ml – 30 ml per day.
• Conditions after a hemorrhagic stroke, acute cerebrovascular accident of the ischemic type (acute period), transient ischemic attack, use 10 ml - 50 ml per day.
• TBI – 10 ml – 50 ml per day.
• For children over six months of age, the recommended dosage is 0.1 ml per kilogram of body weight, but not more than two ml per day.
• For acute childhood neurological disorders, the standard dose is 1-2 ml of the drug.

Cerebrolysin therapy brings maximum benefit in case of cyclic use. The drug is taken until positive dynamics are noted. After the first cycle of therapy, the frequency of Cerebrolysin administration can be reduced to a maintenance dose with a frequency of two or three times over seven days. Between treatment cycles, it is necessary to take a break equal in duration to the course of treatment.

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Use Cerebrolysin during pregnancy

Caution should be exercised when prescribing Cerebrolysin in the first trimester of pregnancy.

Experimental studies have not revealed any negative effects of the drug on the fetus. No clinical studies have been conducted.

Prescription during the gestational and lactation periods is justified only when the benefit to the mother outweighs the possible negative consequences for the fetus or newborn.

Contraindications

Contraindications to the use of Cerebrolysin are:

• individual intolerance to the components of the drug;
• allergic conditions;
• severe kidney damage with impaired filtration function;
• pregnancy;
• convulsive readiness.

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Side effects Cerebrolysin

Side effects from the administration of Cerebrolysin are practically not observed, but the following features may occur:

• With rapid intravenous or intramuscular administration of the drug, pain in the injection area, a feeling of heat throughout the body, dizziness, sweating, tachyarrhythmia are sometimes observed. Inject the drug slowly and smoothly!
• digestive system - anorexia, nausea, vomiting, manifestation of dyspeptic symptoms (flatulence, constipation, diarrhea).
• CNS - psychomotor agitation manifested in aggressive behavior, confusion, insomnia, hand tremors, dizziness, lethargy, apathy, depression, isolated cases of epilepsy during treatment.
• local reactions - itching, redness and pain at the injection site.
• immune system - increased sensitivity, allergic reactions such as headache, paresthesia of the cervical spine or limbs, back pain, spasm of superficial (cutaneous) blood vessels, shortness of breath.
• general manifestations of blood pressure (hypo- or hypertension).

But it is necessary to take into account that cases of undesirable effects, manifested in the form of instability of blood pressure, lethargy, weakness, nausea, vomiting, apathetic-depressive states, etc. were identified both in the group of patients injected with Cerebrolysin and in the placebo group.

Cerebrolysin does not affect the ability to drive a vehicle or operate complex mechanisms that require concentration.

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Overdose

There have been no reported cases of adverse health effects from taking large amounts of Cerebrolysin.

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Interactions with other drugs

It is necessary to take into account that in therapy with the combined use of MAO (monoamine oxidase) inhibitors or antidepressants, the use of Cerebrolysin can cause additive synergism. In this combination, the dosage of antidepressants is reduced.

It is not allowed to mix Cerebrolysin solution and amino acids in one bottle.

It is possible to simultaneously use the drug with vitamin complexes and cardiovascular drugs.

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Storage conditions

Cerebrolysin is stored in the original factory packaging, in a dry, dark place, inaccessible to children. The room temperature should not exceed 25 ° C. Do not freeze. The expiration date of the permitted use is present on the factory-made cardboard packaging, the label of each ampoule and bottle.

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Shelf life

Cerebrolysin in ampoules is stored for 5 years, and in vials - 4 years. It is not recommended to use the drug after the expiration date.

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