Pharmacodynamics. The mechanism of action is due to the direct effect of hopantenic acid on the gamma-receptor-channel complex. the preparation has a nootropic and anticonvulsant effect, increases the resistance of the brain to hypoxia and to the action of toxic substances, stimulates the processes of anabolism in neurons, combines a moderate sedative effect with a mild stimulating effect, and reduces motor excitability. increases mental and physical performance. contributes to the normalization of gamma in chronic alcohol intoxication and further abolition of ethanol. prolongs the action of procaine and sulfonamides by inhibiting their acetylation reactions. causes inhibition of the pathologically increased gallbladder reflex and detrusor tone.
Pharmacokinetics. Cognum is rapidly absorbed into the gastrointestinal tract, penetrates the BBB; high concentrations are formed in the liver, kidneys and skin. The time to reach Cmax is 1 hour. The preparation is not metabolized and is excreted unchanged within 48 hours: 67.5% of the dose taken - with urine, 28.5% - with feces.
As part of complex therapy:
Cognum should be used as part of complex therapy. tablets are taken 15-30 minutes after meals.
A single dose for children aged 12 years and older - 250-1000 mg, for children aged 3 to 12 years - 250-500 mg.
The daily dose for children aged 12 years and adults is 1500-3000 mg, for children aged 3-12 years - 750-3000 mg.
The course of treatment is from 1 to 4 months, in some cases - up to 6 months. After 3–6 months, a second course of treatment is possible.
With the consequences of neuroinfections and traumatic brain injuries: children aged 3 years and older - 250 mg 3-4 times a day.
With cerebrovascular insufficiency: adults - 250 mg 3-4 times a day.
For the treatment of extrapyramidal disorders caused by the use of neuroleptics: children aged 12 years and adults - 500-1000 mg 3 times a day, children aged 3 to 12 years - 250-500 mg 3-4 times a day. The course of treatment is 1-3 months.
For epilepsy in combination with anticonvulsants: children aged 3 to 12 years - 250-500 mg 3-4 times a day, children aged 12 years and adults - 500-1000 mg 3-4 times a day daily for a long time (up to 6 months).
With psycho-emotional overload, decreased mental and physical performance: children aged 3 years and older - 250 mg 3 times a day.
For urinary disorders: children aged 12 years and older - 500-1000 mg 2-3 times a day, children aged 3-12 years - 250-500 mg (daily dose - 25-50 mg / kg body) 2-3 times a day. The course of treatment is from 1 to 3 months.
Children aged 3 to 12 years with perinatal encephalopathy, mental retardation, developmental delay, cerebral palsy Cognum is prescribed 500 mg 4-6 times a day daily for 3 months, with delayed speech development - 500 mg 3-4 times per day for 2-3 months.
For hyperkinetic disorders, tics, stuttering, neurosis-like conditions, the preparation is prescribed to children aged 3 to 12 years, 250-500 mg 3-6 times a day daily for 1-4 months, children aged 12 years and older - by 1500-3000 mg / day daily for 1-5 months.
Tactics for prescribing the preparation: increasing the dose for 7-12 days, taking the maximum dose for 15-40 days and gradually reducing the dose until Cognum is canceled within 7-8 days. The break between courses of therapy is from 1 to 3 months.
Hypersensitivity to the components of the preparation; acute severe kidney disease.
Allergic reactions are possible, including rhinitis, conjunctivitis, and skin rashes. if allergic reactions occur, the preparation should be canceled.
During the use of the preparation, the following are possible: urticaria, itching, flushing of the skin, flushing of the face, peeling of the skin. In this case, you should reduce the dose or discontinue the preparation. Neurological disorders are possible, including sleep disturbances or drowsiness, noise in the head, which are usually short-lived and do not require discontinuation of the preparation.
During the period of long-term treatment, the simultaneous administration of other nootropic and stimulating agents is not recommended. taking into account the nootropic action of the preparation, it is taken mainly in the morning and afternoon hours.
Use during pregnancy and lactation. Cognum is contraindicated during pregnancy and lactation.
Children. For use in children aged 3 years and older.
The ability to influence the reaction rate when driving or working with other mechanisms. During preparation treatment, care should be taken when driving or operating other mechanisms.
In conditions of long-term treatment, the simultaneous use of cognum with other nootropic and stimulating agents is not recommended.
The preparation prolongs the effect of barbiturates, enhances the effect of anticonvulsant preparations and preparations that stimulate the central nervous system, prevents the side effects of phenobarbital, carbamazepine, antipsychotics (neuroleptics), enhances the effect of local anesthetics (procaine).
The preparation is capable of inhibiting acetylation reactions, which are components of the mechanisms of inactivation of procaine and sulfonamides, due to which a prolonged action of the latter is achieved.
The effect of Cognum is enhanced in combination with glycine, etidronic acid, xydiphon.
Strengthening the severity of adverse reactions.
Treatment: activated carbon, gastric lavage, symptomatic therapy.
At a temperature not higher than 25 ° C.
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