Pharmacodynamics. Citicoline stimulates the biosynthesis of structural phospholipids of neuronal membranes, which is confirmed by the data of magnetic resonance spectroscopy. Citicoline improves the functioning of membrane mechanisms such as ion pumps and receptors, without the regulation of which it is impossible for the normal conduction of nerve impulses. due to the stabilizing effect on the membrane of neurons, citicoline exhibits decongestant properties that contribute to the reabsorption of cerebral edema.
Clinical studies have shown that citicoline inhibits the activation of certain phospholipases (A1, A2, C and D), decreasing the formation of free radicals, preventing the destruction of membrane systems, and preserving antioxidant defense systems such as glutathione.
Citicoline preserves neuronal energy stores, inhibits apoptosis, which improves cholinergic transmission.
It has been experimentally proven that citicoline also has a prophylactic neuroprotective effect in focal cerebral ischemia.
Clinical studies have shown that citicoline significantly increases the indicators of functional recovery in patients with acute cerebrovascular accident, which coincides with a slowdown in the growth of ischemic brain damage according to neuroimaging data. In patients with traumatic brain injury, citicoline accelerates recovery and reduces the duration and intensity of post-traumatic stress disorder.
Citicoline increases the level of attention and consciousness, helps to reduce the manifestations of amnesia, cognitive and other neurological disorders associated with cerebral ischemia.
Pharmacokinetics. Citicoline is well absorbed after oral, intramuscular and intravenous administration. Plasma choline levels rise significantly after administration by the aforementioned routes. Absorption after oral administration is almost complete, and the bioavailability is practically the same as with intravenous administration.
Depending on the route of administration, the preparation is metabolized in the intestine, liver to choline and cytidine. After administration, citicoline is widely distributed in the structures of the brain with the rapid incorporation of the choline fraction into structural phospholipids and cytidine fractions into cytidine nucleotides and nucleic acids. Having reached the brain, citicoline is incorporated into the cellular, cytoplasmic and mitochondrial membranes, participating in the construction of the phospholipid fraction.
Only a small amount of the dose is excreted in urine and feces (less than 3%). Approximately 12% of the dose is excreted in expired CO2. In the excretion of the preparation in the urine, two phases are distinguished: the first phase - about 36 hours, in which the rate of excretion decreases rapidly, and the second phase, in which the rate of excretion decreases much more slowly. The same phasicity is observed during excretion with CO2: the rate of excretion of exhaled CO2 decreases rapidly after about 15 hours, then it decreases much more slowly.
Stroke, acute phase of cerebrovascular accidents and treatment of complications and consequences of cerebrovascular accidents; traumatic brain injury and its neurological consequences; cognitive and behavioral impairments due to chronic vascular and degenerative cerebral disorders.
Inside. the recommended dose for adults is from 500 mg (5 ml) to 2000 mg (20 ml) per day, which are divided into 2-3 doses. taken regardless of food intake.
The required amount of solution is collected in a syringe-dispenser and mixed with a small amount of water, taken with a syringe-dispenser. It is necessary to rinse the syringe dispenser with water after each use.
Doses of the preparation and the duration of treatment depend on the severity of the brain damage and are set by the doctor individually. The minimum recommended treatment period is 45 days.
Elderly patients do not require dose adjustment.
Hypersensitivity to any of the components of the preparation, increased tone of the parasympathetic nervous system.
Adverse reactions occur very rarely (1/10 000), including isolated cases.
Mental disorders: hallucinations.
From the nervous system: severe headache, vertigo.
From the side of the cardiovascular system: hypertension, arterial hypotension, tachycardia.
From the respiratory system: shortness of breath.
From the digestive system: nausea, vomiting, diarrhea.
General disorders: chills, edema, allergic reactions, including: rash, purpura, itching, angioedema, anaphylactic shock.
The preparation contains the dye ponso 4r, which can cause allergic reactions, asthmatic attack, especially in patients with hypersensitivity to acetylsalicylic acid. patients with hereditary disorders of fructose tolerance should not take lyre, solution for oral administration, since the preparation contains sorbitol. methyl parahydroxybenzoate and propyl parahydroxybenzoate contained in the preparation can cause allergic reactions (usually of a delayed type).
This medicinal product contains 1.2 mmol sodium per 5 ml of the preparation. Use with caution in patients on a sodium-controlled diet.
Use during pregnancy and lactation. There is insufficient data on the use of Lyra in pregnant women.
There are no data on the excretion of citicoline in breast milk and its effect on the fetus. During pregnancy and lactation, the preparation is prescribed only when the expected benefit to the mother outweighs the potential risk to the fetus.
Children. The experience of using the preparation in children is limited.
The ability to influence the reaction rate when driving or working with other mechanisms. In some cases, some side reactions from the central nervous system can affect the ability to drive vehicles or work with complex mechanisms.
Do not use the preparation simultaneously with preparations containing meclofenoxate. enhances the effect of levodopa.
Overdose cases are not described.
In its original packaging at a temperature not exceeding 25 ° c. do not freeze or refrigerate.
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