Mexidol

Mexidol is a medication that affects the functioning of the nervous system.

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Indications Mexidol

It is used for the following disorders:

• acute forms of intracerebral blood flow disorders;
• TBI and its consequences;
• brain DEP;
• NCD;
• mild cognitive disorders of atherosclerotic origin;
• anxiety disorders observed against the background of neurosis-like or neurotic disorders;
• myocardial infarction in the acute stage (from the 1st day), in combination treatment;
• primary form of open-angle glaucoma at different stages (combined treatment);
• stopping the development of alcohol withdrawal (in the case of alcoholism, in which vegetative-vascular and neurosis-like disorders predominate);
• acute antipsychotic poisoning;
• acute stages of peritoneal lesions of a purulent-inflammatory nature (peritonitis or acute form of necrotic pancreatitis) – for combined treatment.

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Release form

The pharmaceutical element is released in the form of a liquid for intramuscular and intravenous injections, in ampoules with a capacity of 2 or 5 ml. The box contains 5 such ampoules.

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Pharmacodynamics

Mexidol is a drug that slows down the activity of free radicals, and in addition, it is a membrane protector and has nootropic, antihypoxic, anticonvulsant, stress-protective and anxiolytic properties.

The drug increases the body's resistance to the influence of various damaging factors and oxygen-dependent disease-causing conditions (hypoxia, shock, alcohol poisoning or intoxication with antipsychotics (neuroleptics), ischemia and disorders of intracerebral blood flow).

The drug improves cerebral metabolism and blood supply, and at the same time improves microcirculation processes and rheological parameters of blood; also reduces platelet aggregation. During hemolysis, the substance stabilizes the structure of blood cell walls (platelets with erythrocytes). Demonstrates hypolipidemic activity and reduces the values of total cholesterol, as well as LDL. Reduces enzymatic toxemia and endogenous poisoning associated with the acute stage of pancreatitis.

The principle of Mexidol's influence is related to its membrane-protective and antioxidant properties. It slows down lipid peroxidation, increases the activity of superoxide dismutase and the proportion of lipids with proteins, and also reduces membrane viscosity, increasing its fluidity.

Modulates the activity of membrane-bound enzymes (calcium-independent PDE, as well as AC and AChE) and terminal complexes (GABA, benzodiazepine, and acetylcholine), thereby potentiating their ability to synthesize with ligands. At the same time, the drug helps maintain the function and structure of biomembranes, promotes the movement of neurotransmitters, and improves synaptic reactions.

Mexidol increases the dopamine index inside the brain. It leads to potentiation of the compensatory activity of aerobic glycolysis and decrease in the intensity of oxidation suppression developing inside the Krebs cycle during hypoxia, accompanied by an increase in the level of ATP and phosphocreatine; in addition, it activates the energy-binding action of mitochondria and normalizes cell walls.

The drug stabilizes metabolic processes inside the ischemic myocardium, reduces the area of necrosis, improves and restores electrical activity with myocardial contractility, and at the same time potentiates coronary circulation in the ischemic area and reduces the consequences of reperfusion syndrome arising in connection with the acute stage of coronary insufficiency. Increases the antianginal effect of nitro drugs.

Mexidol helps to preserve retinal ganglion cells and optic nerve fibers during progressive neuropathy, which results in hypoxia and chronic subtype ischemia. It helps to improve the functional activity of the optic nerve with the retina, increasing visual acuity.

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Pharmacokinetics

After administration, the drug is registered in the blood plasma after 4 hours from the moment of administration. To obtain the Cmax values, 0.45-0.5 hours are required, and they are (with the administration of a portion of 0.4-0.5 g) 3.5-4 mcg/ml.

The substance passes from the bloodstream into tissues and organs at high speed and is quickly excreted from the body. Excretion occurs with urine, mostly in a glucuronide-conjugated state, and only in small quantities - remaining unchanged.

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Dosing and administration

Mexidol is used intravenously (via a drip or jet) or intramuscularly; the portion sizes are selected individually.

In case of infusion, the medicine is dissolved in physiological fluid NaCl (0.2 l). Adults should first be administered 50-100 mg of the substance 1-3 times a day, gradually increasing the portion until the desired result is achieved. The drug is administered by jet at a low speed for 5-7 minutes, and through a dropper - at a speed of 40-60 drops/minute. A maximum of 0.8 g of the medicine is allowed to be administered per day.

During acute stages of intracerebral blood flow disorder, the drug is used in a combined scheme - during the first 2-4 days, 0.2-0.3 g of the drug is administered intravenously through a dropper once a day, and later, 0.1 g of the drug should be administered 3 times a day, intramuscularly. The duration of such a cycle is 10-14 days.

For the treatment of TBI and its consequences, the drug is administered intravenously through a drip for 10-15 days - in a dose of 0.2-0.5 g, 2-4 times a day.

For the treatment of DCE in the decompensation stage, the drug is used by jet method or through a dropper intravenously - in a dosage of 0.1 g 2-3 times a day for a 2-week cycle. Later, the drug is used intramuscularly, 0.1 g per day for 14 days.

During the prophylactic course of DCE, the medication is administered intramuscularly, at a dosage of 0.1 g, 2 times a day over a 10-14-day cycle.

In case of mild forms of cognitive disorders in the elderly or in anxiety states, Mexidol is used intramuscularly in a dose of 0.1-0.3 g per day, over a period of 0.5-1 month.

In case of acute myocardial infarction, in combination therapy, the drug is used intramuscularly or intravenously during a 2-week cycle, together with a standard course of therapy - ACE inhibitors, nitrates, thrombolytics with β-blockers, antiplatelet drugs, anticoagulants and substances as indicated.

For the first 5 days, to achieve maximum effect, the drug should be administered intravenously, and for the next 9 days it can be administered intramuscularly. The drug is administered through a dropper, by infusion, at a low speed (to avoid negative symptoms) (in this case, 0.9% NaCl or 5% glucose liquid should be used in a 0.1-0.15 l portion), over 0.5-1.5 hours. If necessary, a 5-minute jet injection of the drug at a slow speed can be performed.

The substance is administered (i/m or i/v) 3 times a day, with 8-hour time intervals. During the day, 6-9 mg/kg of the drug is administered in this way, and 2-3 mg/kg per injection. A maximum of 0.8 g of the drug is allowed per day, and 0.25 g per injection.

During open-angle glaucoma, occurring in different phases, in combination treatment the drug is used intramuscularly at a dosage of 0.1-0.3 g per day, with 1-3-fold use over a 2-week course.

In case of alcohol withdrawal, the medication is used in a dose of 0.1-0.2 g 2-3 times a day or through an intravenous drip 1-2 times a day for a 5-7 day period.

In case of acute poisoning with antipsychotics, the medication is administered intravenously in a dose of 0.05-0.3 g per day for a 1-2 week period.

In the treatment of acute peritoneal lesions of a purulent-inflammatory nature (peritonitis or acute stage of necrotic pancreatitis), Mexidol is administered on the first day of the preoperative and postoperative period. The doses are selected taking into account the intensity of the disease and its form, the prevalence of the lesion and the clinical course options. The drug should be discontinued gradually, only after achieving a stable positive clinical and laboratory result.

During the acute stage of edematous pancreatitis, 0.1 g of the drug should be administered 3 times a day, through a dropper, intravenously (using isotonic NaCl liquid) or intramuscularly.

For necrotic pancreatitis in the mild stage: 0.1-0.2 g of the drug 3 times a day, intravenously through a dropper (isotonic NaCl liquid is used), or intramuscularly.

At a moderate stage: 0.2 g 3 times a day, through a drip intravenously (isotonic NaCl liquid).

In severe cases: for a pulse dose of 0.8 g per day, taken twice a day, and later – 0.3 g twice a day with a gradual reduction in the daily dosage.

In extremely severe cases: first, 0.8 g is used per day until the symptoms of pancreatogenic shock are stably eliminated, and after the condition has stabilized - 0.3-0.4 g of the drug 2 times per day, through a dropper, intravenously (isotonic NaCl liquid), with a further gradual reduction in the daily portion.

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Use Mexidol during pregnancy

There have been no adequate clinical tests to check the safety of using the drug during lactation or pregnancy, which is why it is not prescribed during these periods.

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Contraindications

Among the contraindications:

• acute renal or hepatic failure;
• severe intolerance associated with the elements of the drug.

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Side effects Mexidol

Occasionally, the use of drugs leads to dryness of the oral mucosa or nausea, and in addition to this, to a feeling of drowsiness or anxiety, sleep disorder and emotional reactivity. In addition, the appearance of allergy symptoms, headaches, coordination disorders and distal hyperhidrosis is possible, and along with this, an increase or decrease in blood pressure.

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Overdose

Drug poisoning leads to the development of a feeling of drowsiness.

In such cases, detoxification procedures are carried out.

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Interactions with other drugs

Mexidol potentiates the effect of benzodiazepine anxiolytics, antiparkinsonian drugs (levodopa) and anticonvulsants (carbamazepine).

Reduces the toxic activity of ethanol.

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Storage conditions

Mexidol should be stored in a dark and dry place, out of the reach of small children. Temperature indicators - maximum 25°C.

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Shelf life

Mexidol can be used within a 3-year period from the date of release of the pharmaceutical product.

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Application for children

There is no information regarding whether Mexidol is safe for children, which is why it is not used in pediatrics.

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Analogues

Analogues of the drug are Neurox, Emoksibel, Cerecard, Riluzole with Hypoxen and Vitagamma.

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