Cerenin Tablet
Vinpocetine
Indications
Acute Cerebro-Vascular Accidents (Strokes): Ischaemic strokes due to cerebral thrombosis, cerebral embolism, acute circulatory disorder, hypertensive crisis; the acute cardiovascular disorders, ischaemic neurological defcit, complete stroke (CS), multiinfarct dementia, cerebral arteriosclerosis, hypertensive encephalopathy, post-apoplectic conditions with the background of haemorrhagic strokes etc.
Senile Disorder: For relief of psychosomatic symptoms in the elderly due to cerebral insufciency eg. forgetfulness, memory disturbances, slow thinking, lack of concentration, dizziness, mood instability, aphasia, sleep disturbances, vasovegetative symptoms of menopausal syndrome etc.
Visual Disorder: Vascular disorders of the choroid and retina due to arteriosclerosis. Vasospasm, macula degenerations, arterial or venous thrombosis or embolism and glaucoma secondary to the above mentioned disorders.
Hearing Disorder: For the treatment of impaired hearing of vascular or toxic (iatrogenic) origin presbyacusis, meniere’s disease, cochleovestibular neuritis, tinnitus and dizziness of labirynth origin.
Pharmacology
Vinpocetine increases cerebral metabolism; it increases glucose and O2 consumption; improves cerebral hypoxia tolerance; shifts glucose metabolism to the energetically more favourable aerobic pathway, but it increases the anaerobic pathway as well; it elevates the ATP concentration and the ATP/AMP ratio in the brain, and elevates the cerebral norepinephrine, dopamine and serotonin levels.
Vinpocetine considerably improves cerebral microcirculation by inhibiting platelet aggregation, reducing the pathologically increased blood viscosity, and increases erythrocyte deformability. It also promotes O2 transport into the tissues by reducing the O2 affinity of erythrocytes.
It selectively and intensely increases cerebral blood flow and the share of the brain in cardiac output, it reduces cerebral vascular resistance without affecting systemic circulation (blood pressure, heart rate, cardiac output, total peripheral resistance). It does not elicit steal phenomenon; on the contrary, it primarily improves the blood supply of the injured and ischaemic area while it remains unchanged in the intact areas (inverse steal effect). It further increases blood flow which is already increased as a result of hypoxia.
Dosage & Administration
Tablet: 1-2 tablets thrice daily, the maintenance dose is 1 tablet thrice daily.
IM Injection: Daily dose of 20-40 mg are to be given until improvement of symptoms is reached (for not longer than 10 days) then oral treatment should be applied. If this regimen fails, infusion treatment should be started.
IV Infusion: The daily starting dose is 20 mg in slow drip infusion (2 ampoules in 500-1000 ml infusion solution). This dose can be increased to 1 mg/kg body weight during 3 to 4 days. Treatment should be continued for 10-14 days depending on the tolerance of the patients and the dose should be gradually reduced before discontinuation of treatment.
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Interaction
The injection is chemically incompatible with heparin, therefore, it should not be injected in the same syringe.
Contraindications
Parenteral treatment- Severe ischaemic heart disease, severe rhythm disorders and pregnancy.
Side Effects
Transient hypotension, tachycardia may occur.
Pregnancy & Lactation
In Pregnancy and Lactation the drug is contraindicated.
Precautions & Warnings
In the acute stage until the improvement of symptoms parenteral treatment is recommended followed by oral treatment. In chronic cases oral therapy should be applied.
Therapeutic Class
Cerebral vasodilator & Neurosensory oxygenator drugs
Storage Conditions
Store in a cool and dry place, protected from light and moisture.
