Винпотропил Таблетки, 60 шт, 10 + 800 мг + мг, для приема внутрь

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Клиренс 66,7 л/ч превышает плазменный объем печени (50 л/ч), что свидетельствует о внепеченочном метаболизме. Главным метаболитом является аповинкаминовая кислота, которая обладает некоторой фармакологической активностью. Другие неактивные метаболиты – гидрокси-винпоцетин, гидрокси-аповинкаминовая кислота, гидрокси-винпоцетин-глицинат. При повторных приемах кинетика носит линейный характер. Период полувыведения (T1/2) у человека – 4,83±1,29 ч. Выводится почками и через кишечник в соотношении 3:2."}},{"type":"paragraph","data":{"text":"Пирацетам после приема внутрь хорошо всасывается и проникает в различные органы и ткани. Биодоступность составляет около 100 %. После однократного приема внутрь в дозе 3,2 г максимальная концентрация – 84 мкг/мл, после многократного (3,2 г 3 раза в сутки) – 115 мкг/мл. Время достижения максимальной концентрации в плазме 1 час, спинномозговой жидкости – 5 часов."}},{"type":"paragraph","data":{"text":"Объем распределения – около 0,6 л/кг. Проникает через гематоэнцефалический и плацентарный барьеры, избирательно накапливается в тканях коры головного мозга. Практически не подвергается биотрансформации и выводится почками в неизмененном виде путем клубочковой фильтрации. Общий клиренс 80-90 мл/мин. T1/2 из плазмы крови – 4-5 часов, из спинномозговой жидкости – 8,5 часов."}}]},{"id":7,"name":"Показания к применению","slug":"indications","body":[{"type":"list","data":{"style":"ordered","items":["Недостаточность мозгового кровообращения (восстановительный период ишемического и геморрагического инсульта);","хроническая недостаточность мозгового кровообращения гипертонического и посттравматического генеза, паркинсонизм сосудистого генеза, интоксикации;","психоорганический синдром с преобладанием признаков астении и адинамии;","симптоматическое лечение головокружений;","профилактика мигрени и кинетозов."]}}]},{"id":8,"name":"Противопоказания","slug":"contraindications","body":[{"type":"list","data":{"style":"ordered","items":["Повышенная чувствительность к компонентам препарата,","беременность,","период лактации,","выраженные нарушения ритма сердца,","ишемическая болезнь сердца (тяжелое течение),","геморрагический инсульт,","тяжелая ХПН (клиренс креатинина (КК) менее 20 мл/мин),","печеночная недостаточность,","возраст пациента до 18 лет."]}},{"type":"paragraph","data":{"text":"С осторожностью:"}},{"type":"paragraph","data":{"text":"Нарушение гемостаза, обширные хирургические вмешательства, тяжелое кровотечение, ХПН (КК 20-80 мл/мин)."}}]},{"id":10,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Препарат противопоказан при беременности и в период лактации."}}]},{"id":11,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Курс лечения и дозировка определяется лечащим врачом."}},{"type":"paragraph","data":{"text":"Для пациентов от 18 лет и старше: внутрь, независимо от приема пищи по 1 таблетке 2 - 3 раза в день, запивая достаточным количеством воды. Последний прием – за 4 часа до сна. Длительность курса лечения составляет от 2-3 недель до 2-6 месяцев."}},{"type":"paragraph","data":{"text":"Перед отменой препарата дозу рекомендуется постепенно уменьшать (возможно применение препарата Винпотропил® в другой лекарственной форме: капсулы, содержащие 5 мг винпоцетина и 400 мг пирацетама)."}}]},{"id":12,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Со стороны сердечно-сосудистой системы: изменения на ЭКГ (депрессия сегмента ST, удлинение Q-T интервала), тахикардия, экстрасистолия, лабильность артериального давления (АД) (чаще снижение). Со стороны центральной нервной системы (ЦНС): двигательная расторможенность, раздражительность, депрессия, астения, головокружение, головная боль, нарушение сна (бессонница, повышенная сонливость), психическое возбуждение, нарушение равновесия, обострение течения эпилепсии, тревога, галлюцинации, спутанность сознания, экстрапирамидные нарушения, снижение способности к концентрации внимания. Со стороны пищеварительной системы: тошнота, рвота, изжога, диарея, абдоминальная боль, снижение аппетита, гастралгии, запор. Со стороны обмена веществ: повышение массы тела, повышенное потоотделение. Со стороны органов чувств: вертиго. Со стороны кожных покровов: дерматит, зуд, крапивница, гиперемия кожи. Аллергические реакции: гиперчувствительность, анафилактические реакции, ангионевротический отек. Местные реакции: боль в месте введения, тромбофлебит. Прочие: лихорадка, общая слабость (могут быть проявлением основного заболевания), повышение сексуальной активности."}}]},{"id":13,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: абдоминальная боль, диарея с примесью крови."}},{"type":"paragraph","data":{"text":"Лечение: симптоматическая терапия, гемодиализ (эффективность 50-60%)."}}]},{"id":14,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Повышает: риск геморрагического осложнения на фоне гепаринотерапии, эффекты гормонов щитовидной железы, антипсихотических средств (нейролептиков), психостимуляторов, непрямых антикоагулянтов, в том числе аценокумарола (более выраженное снижение агрегации тромбоцитов, содержания фибриногена, фактора Виллебранда, вязкости плазмы и крови)."}},{"type":"paragraph","data":{"text":"Возможно некоторое усиление гипотензивного эффекта при одновременном применении с метилдопой (необходим контроль артериального давления)."}},{"type":"paragraph","data":{"text":"Ослабляет: эффект противосудорожных препаратов (снижает судорожный порог)."}},{"type":"paragraph","data":{"text":"Несмотря на отсутствие данных, подтверждающих возможность взаимодействия, рекомендуется проявлять осторожность при одновременном назначении с препаратами центрального, противоаритмического действия."}}]},{"id":15,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Наличие синдрома пролонгированного интервала QT и прием препаратов, вызывающих удлинения интервала QT, требует периодического контроля ЭКГ."}},{"type":"paragraph","data":{"text":"В связи с влиянием пирацетама на агрегацию тромбоцитов рекомендована осторожность при назначении препарата больным с нарушением гемостаза, во время больших хирургических операций или больным с симптомами тяжелого кровотечения."}},{"type":"paragraph","data":{"text":"В период лечения следует соблюдать осторожность при вождении автотранспорта и выполнении работы с механизмами."}}]},{"id":17,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки, покрытые пленочной оболочкой."}}]},{"id":18,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В сухом, защищенном от света месте при температуре не выше 25 °С."}}]},{"id":19,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"2 года."}}]},{"id":20,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту."}}]},{"id":21,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"\u003ca href=\"https://www.eapteka.ru/goods/manufacturer/kanonfarma/\"\u003eКанонфарма продакшн ЗАО, Россия\u003c/a\u003e"}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"Винпотропил – комбинированный препарат. Обладает свойствами, характерными для средства, улучшающего мозговой кровоток (винпоцетин), и для ноотропного средства (пирацетам). Как средство, улучшающее мозговой кровоток. Улучшает метаболизм головного мозга, увеличивая потребление глюкозы и кислорода тканью головного мозга. Повышает устойчивость нейронов к гипоксии, усиливает транспорт глюкозы к головному мозгу через гематоэнцефалический барьер; переводит процесс распада глюкозы на энергетически более экономный, аэробный путь; селективно блокирует Са2+-зависимую фосфодиэстеразу; повышает уровни аденозинмонофосфата (АМФ), циклического гуанозинмонофосфата (цГМФ) и аденозинтрифосфата (АТФ) головного мозга. Усиливает обмен норадреналина и серотонина головного мозга; оказывает антиоксидантное действие. Снижает агрегацию тромбоцитов и повышенную вязкость крови; увеличивает эластичность эритроцитов и блокирует утилизацию эритроцитами аденозина; способствует повышению отдачи эритроцитами кислорода. Увеличивает церебральный кровоток; снижает резистентность сосудов головного мозга без существенного изменения показателей системного кровообращения. Не оказывает эффекта «обкрадывания» и усиливает кровоснабжение, прежде всего, в ишемизированных участках мозга. Проникает через плацентарный барьер. Как ноотропное средство. Улучшает интегративную деятельность головного мозга, способствует консолидации памяти, облегчает процесс обучения; изменяет скорость распространения возбуждения в головном мозге, улучшает микроциркуляцию, не оказывая при этом сосудорасширяющего действия, подавляет агрегацию активированных тромбоцитов; оказывает защитное действие при повреждениях головного мозга, вызываемых гипоксией, интоксикациями, электрошоком; усиливает α- и β-активность, снижает δ-активность на электроэнцефалограмме, уменьшает выраженность вестибулярного нистагма; улучшает связи между полушариями головного мозга и синаптическую проводимость в неокортикальных структурах, повышает умственную активность, усиливает мозговой кровоток; не обладает седативным, психостимулирующим влиянием. Эффект развивается постепенно. Обладает выраженным эффектом в отношении симптомов начальных проявлений когнитивных нарушений церебрально-сосудистого генеза у больных пожилого и старческого возраста. Рекомендован в психогериатрической практике.ФармакокинетикаВинпоцетин быстро всасывается. Терапевтическая концентрация в плазме – 10-20 нг/мл. Время достижения максимальной концентрации в плазме крови – 1 ч. Всасывание происходит, главным образом, в проксимальных отделах желудочно-кишечного тракта. При прохождении через стенку кишечника не подвергается метаболизму. Максимальная концентрация в тканях отмечается через 2-4 ч после приема внутрь. Связь с белками – 66 %, биодоступность при приеме внутрь – 7 %. Клиренс 66,7 л/ч превышает плазменный объем печени (50 л/ч), что свидетельствует о внепеченочном метаболизме. Главным метаболитом является аповинкаминовая кислота, которая обладает некоторой фармакологической активностью. Другие неактивные метаболиты – гидрокси-винпоцетин, гидрокси-аповинкаминовая кислота, гидрокси-винпоцетин-глицинат. При повторных приемах кинетика носит линейный характер. Период полувыведения (T1/2) у человека – 4,83±1,29 ч. Выводится почками и через кишечник в соотношении 3:2. Пирацетам после приема внутрь хорошо всасывается и проникает в различные органы и ткани. Биодоступность составляет около 100 %. После однократного приема внутрь в дозе 3,2 г максимальная концентрация – 84 мкг/мл, после многократного (3,2 г 3 раза в сутки) – 115 мкг/мл. Время достижения максимальной концентрации в плазме 1 час, спинномозговой жидкости – 5 часов. Объем распределения – около 0,6 л/кг. Проникает через гематоэнцефалический и плацентарный барьеры, избирательно накапливается в тканях коры головного мозга. Практически не подвергается биотрансформации и выводится почками в неизмененном виде путем клубочковой фильтрации. Общий клиренс 80-90 мл/мин. T1/2 из плазмы крови – 4-5 часов, из спинномозговой жидкости – 8,5 часов.","substance":[{"id":115,"title":"Пирацетам","title_latin":"Piocetamum","slug":"piratsetam_115"},{"id":649,"title":"Винпоцетин","title_latin":"Vinpocetinum","slug":"vinpotsetin_649"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":false,"comments":null,"image_alt":"Винпотропил - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/5078/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/5078/share_default/"}},"diseases":[{"id":"470","title":"Расстройства личности и поведения, обусловленные болезнью, повреждением или дисфункцией головного мозга","slug":"470-rasstroystva_lichnosti_i_povedeniya_obuslovlennye_boleznyu_povrezhdeniem_ili_disfunktsiey_golovnogo_mozga"},{"id":"504","title":"Неврастения","slug":"504-nevrasteniya"},{"id":"539","title":"Болезнь 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