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    3. Actovegin 200mg 50 tablets — Made in Ukraine — Free Delivery

    Actovegin 200mg 50 tablets — Made in Ukraine — Free Delivery


    Brand: Kusum Healthcare
    Product Code: Actovegin
    Availability: In Stock
    $93.68
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    Pharmacological properties

    Pharmacodynamics. The preparation actovegin is a deproteinized hemoderivative from the blood of calves, containing only physiological substances with a molecular weight of 5000 da.
    The preparation Actovegin is characterized by three main effects: metabolic, neuroprotective and microcirculatory. Inositol phosphate oligosaccharides (IPO), which are part of Actovegin, are responsible for improving the utilization and absorption of oxygen, as well as for improving energy metabolism and glucose uptake. This action has the potential to be beneficial after injury or damage to tissues and organs, in particular the brain, and to reduce the formation of lactate.
    Several pathways have been identified by which the neuroprotective mechanism of action of the preparation  Actovegin is carried out, due to the effect on the structure of beta-amyloid peptides (Aß25–35) that induce apoptosis. Beta-amyloid peptides act as triggers in a number of molecular and cellular processes, including oxidative stress and inflammation, resulting in neuronal death, which in turn leads to impaired memory and cognitive functions.
    Nuclear factor kappa B (NF-kB) performs numerous functions in the processes of both the central and peripheral nervous systems. It regulates the process of inflammation, which worsens the course of degenerative and vascular disorders, and is a factor involved in the formation of pain, learning, memory and neuroprotection.
    Actovegin activates the NF-kB expression reporter gene in a dose-dependent manner, and this transient activation may at least partially explain the neuroprotective properties of Actovegin.
    Another important mechanism of action of actovegin is associated with the nuclear enzyme poly- (ADP-ribose) -polymerase (PARP). PARP plays an important role in detecting single-stranded DNA breaks and in the repair process, however, excessive activation of this enzyme can trigger processes in the cell that lead to the completion of oxidative metabolism. These processes can ultimately lead to cell death due to depletion of energy reserves. It was revealed that Actovegin reduces the activity of PARP, which improves the functioning and optimizes the morphological structure of the central and peripheral nervous system.
    The positive effect of the preparation Actovegin on microcirculation is due to its effects such as an increase in the blood flow rate in the capillaries, a decrease in the pericapillary zone and a decrease in the smooth muscle tone of the precapillary arterioles and capillary sphincters, a decrease in arterio-venular shunting of blood with an increase in blood flow in the capillary bed and an increase in the function of the endothelial endothelialis. channel.
    Clinical efficacy and safety
    Disorders of cerebral circulation, including post-stroke cognitive impairment and dementia. Actovegin has been shown to be beneficial in the symptomatic treatment of dementia and dementia-related conditions in over 450 patients in several small randomized clinical trials. It was shown to be effective compared to placebo on endpoints related to cognitive function, daily activity and overall clinical response, while no statistically significant improvement in the speed of cognitive processes was found.
    In a 12-month, randomized, double-blind, placebo-controlled study evaluating the safety and efficacy of Actovegin in patients with post-stroke cognitive impairment was compared with placebo. 503 patients (250 patients received Actovegin) were randomized from the 5th to the 7th day after the onset of ischemic stroke. The 6-month treatment period consisted of ≤20 infusions (2000 mg daily), followed by taking the preparation in the form of tablets (2 tablets 200 mg 3 times a day), after which a 6-month observation treatment was carried out, during which the patients were kept in accordance with with standard clinical practice. At 6 and 12 months, patients treated with Actovegin showed statistically significant changes in the number of points on the extended cognitive subscale of the Alzheimer's disease assessment scale (ADAS-cog +) and on the Montreal Cognitive Assessment Scale (MoCA) compared with patients who received a placebo. At the 3rd, 6th and 12th months, most of the patients in the group receiving Actovegin showed a response to treatment according to the ADAS-cog + scale. The incidence of serious adverse events and deaths was similar in both treatment groups.
    The overall incidence of recurrent ischemic stroke during the study was within the limits assumed for this patient population, but the incidence was slightly higher in the Actovegin group compared with the placebo group.
    Peripheral blood flow disorders and their consequences. Approximately 190 patients with peripheral arterial disease were treated with Actovegin for a period of 10 to 42 days in several small, comparative randomized trials, which showed a short-term advantage of Actovegin infusions over placebo. An improvement in the form of an increase in walking distance of 35–42% was demonstrated in the Actovegin group compared with the placebo group.
    In an open, randomized study, 60 patients with large trophic ulcers of the lower extremities with venous insufficiency received a standard therapy regimen with or without the addition of Actovegin. The preparation Actovegin was administered in the form of daily intravenous infusions of 250 ml of 10% solution for 4 weeks. The average ulcer healing time was 31 days (in the group receiving Actovegin) and 42 days (in the group not receiving Actovegin). An improvement in the number of points on the pain intensity scale compared with the baseline level was observed in both groups, in particular, in the group receiving the preparation Actovegin, there was a decrease in the number of points from 4.47 to 1.77, and in the other study group - from 4.13 up to 2.07.
    Diabetic polyneuropathy. In a study involving 70 patients with diabetic polyneuropathy, statistically significant changes in walking distance, nerve impulse conduction velocity and pain sensitivity were demonstrated in patients treated with Actovegin compared with placebo. The difference in the placebo therapeutic effect was about 6.5 m in walking distance, 0.9 m / s in nerve impulse conduction velocity, and 6.8 points on the pain sensitivity scale (on a 100-point scale).
    As part of a 6-month, double-blind, randomized, placebo-controlled study evaluating the safety and efficacy of 567 patients with type II diabetes mellitus and symptomatic diabetic distal polyneuropathy received 20 intravenous infusions of Actovegin (2000 mg / day) (n = 281) or placebo (n = 286) once a day for 20–36 days, after which they received 3 tablets of Actovegin (1800 mg / day) or placebo 3 times a day for 140 days. When using the preparation Actovegin, there was a better effect compared to placebo according to the endpoint assessment on the overall symptom score (TSS), including positive neuropathic pain symptoms, burning, paresthesias and numbness of the feet or legs, decreased vibration sensitivity and improved the quality of life of patients. There were no significant differences in the distribution of adverse events between the treatment group and the control group.
    Pharmacokinetics. Using pharmacokinetic methods, it is impossible to study the pharmacokinetic characteristics of the preparation Actovegin (absorption, distribution and elimination of active ingredients), since it contains only physiological components that are usually present in the body.
    The results obtained in studies on animals and in the framework of clinical studies have shown that the effect of the preparation begins no later than 30 minutes after its administration. The maximum effect is achieved 3 hours after parenteral administration or oral administration of the preparation (2-6 hours).

    Indications

    Treatment of cerebral diseases of vascular origin, including post-stroke cognitive impairment and dementia. treatment of peripheral (arterial, venous) blood circulation disorders and their complications (arterial angiopathy, venous trophic ulcer). treatment of diabetic polyneuropathy.

    Application

    Actovegin, film-coated tablets, should be taken before meals, swallowed whole with a small amount of liquid.
    Dosage: 1-2 tablets 3 times a day.
    Duration of treatment: the preparation should be used for 4-6 weeks. Depending on the severity of the clinical course, treatment can be started with injections or infusions.
    With diabetic polyneuropathy. The initial dose is 50 ml (2000 mg) per day in the form of intravenous infusion for 3 weeks, followed by switching to tablets - 2-3 tablets 3 times a day (up to 1800 mg) for at least 4-5 months.

    Contraindications

    Hypersensitivity to the components of the preparation or preparations of a similar composition.

    Side effects

    The following are the side reactions that may occur in patients as a result of the use of the preparation Actovegin. development of anaphylactoid (allergic) reactions is possible, which can manifest itself:
    from the immune system and skin: hypersensitivity reactions are possible, including allergic reactions, anaphylactic and anaphylactoid reactions up to the development of anaphylactic shock, fever, chills, angioedema, skin flushing, skin rashes, itching, urticaria, increased sweating, skin edema and / or mucous membranes, hot flashes;
    from the digestive tract: dyspeptic symptoms, including pain in the epigastric region, nausea, vomiting, diarrhea;
    on the part of the cardiovascular system: pain in the region of the heart, tachycardia, shortness of breath, acrocyanosis, pallor of the skin, arterial hypotension or hypertension;
    from the respiratory system: increased breathing rate, a feeling of compression in the chest, difficulty swallowing and / or breathing, sore throat, choking attack;
    from the nervous system: headache, general weakness, dizziness, loss of consciousness, agitation, tremor, paresthesia;
    from the musculoskeletal system: muscle and / or joint pain, back pain.
    In such cases, treatment with Actovegin should be discontinued and symptomatic therapy should be applied.

    Special instructions

    Patients with rare hereditary fructose intolerance, malabsorption of glucose-galactose or sucrase-isomaltase should not take the preparation, since it contains sucrose.
    During pregnancy and lactation, the preparation is used only when the expected benefit to the mother outweighs the possible risk to the fetus or child. During the period of application of the preparation Actovegin with placental insufficiency, although rarely, there were cases of death, which could be a consequence of the underlying disease. The use of the preparation Actovegin during lactation was not accompanied by negative effects for either the mother or the child.
    Children. There are currently no data on the use of the preparation in children, so the preparation is not recommended for use in this category of patients.
    The ability to influence the reaction rate when driving vehicles or other mechanisms. Actovegin does not have or has very little effect on the ability to drive vehicles or other mechanisms. However, one should take into account the possible manifestations of side effects from the nervous system (see SIDE EFFECTS).

    Interactions

    There are no data on the interaction of Actovegin with other preparations.

    Overdose

    Overdose cases of Actovegin are unknown.

    Storage conditions

    Store at a temperature not exceeding 25 ° C in its original packaging.

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