Is it possible to inject Piracetam and Mexidol at the same time and which one is better?

For patients who have problems with cerebral circulation, memory or other brain functions, doctors most often prescribe the drug Piracetam. However, not everyone has any idea what other medicinal properties this remedy has. If you get to know it better, you will find out that this nootropic drug can be taken for various brain disorders. It can help not only older people to prevent the development of such pathologies, but also children to improve memory and correct behavior, as well as alcoholics and drug addicts who suffer from withdrawal symptoms.

Piracetam is a relatively safe drug and rarely causes adverse reactions, even with a hangover. Despite this, it is not recommended to use it on your own. It must be remembered that it has certain contraindications and side effects. Therefore, it is necessary to start treatment with this drug only after consultation with a specialist. After all, it is possible that the patient made a mistake with his choice and he needs to take not Piracetam at all, but a completely different drug.

pharmachologic effect

Manufacturer: Farstandard, Atoll, Ozon, Grotex, Russia
Release form: tablets, capsules 200, 400 mg, ampoules 20%

Active ingredient: piracetam

Synonyms: Lucetam, Nootropil

The nootropic drug Piracetam has the following pharmacological effects:

• memory improvement;
• increasing learning ability;
• increasing the resistance of nerve tissues and cells to the adverse effects of the environment, especially hypoxia and intoxication;
• increased attention;
• activation of blood microcirculation in the brain;
• increasing the speed of transmission of nerve impulses;
• inhibition of platelet aggregation;
• increased ATP levels in brain cells;
• activation of glucose utilization;
• increased production of RNA, phospholipids;
• improvement of metabolism in nerve tissues.

Piracetam does not have toxic properties or dangerous side effects. Sedative, psychostimulating and vasodilating effects are also not typical.

The principle of action of both drugs

The mechanism of action of drugs on the centers of the nervous system is different. Medicines have general principles of influence on brain cells:

• influence the rheological composition of the blood, which improves blood supply to the cerebral arteries;

• 
  change the speed of distribution of excitation in the cerebral cortex;

• improve all metabolic processes in the organ;
• restore erythrocyte membranes and suppress platelet aggregation;
• restore the functionality of brain vessels and cells during intoxication and oxygen deficiency;
• increase the synthesis of protein and protein compounds at the intracellular level.

Medicines also have individual therapeutic effects:

• Mexidol improves metabolism in cardiomyocytes during myocardial infarction, prevents necrosis from spreading throughout the organ, restores electrical conductivity in the heart and its contractile properties;
• Mexidol improves the functionality of the retina and optic nerve, and also increases the concentration of dopamine in brain cells;
• Mexidol inhibits the oxidation of lipid molecules, which helps maintain lipid balance and reduce the cholesterol index;
• Piracetam reduces the duration of nystagmus of vestibular etiology, which is effective in monotherapy for cortical myoclonus.

Indications for use of Piracetam

In the instructions for use of Piracetam, the main indications for its use in adults are:

• deterioration of memory, speech and other cognitive functions;
• cortical myoclonus;
• acute and chronic slowing of blood flow in the brain in hypertension, parkinsonism, atherosclerosis and other diseases;
• Alzheimer's disease;
• epilepsy;
• disturbances of mental processes;
• withdrawal syndrome in drug addiction and alcoholism;
• intolerance to neuroleptic, antidepressant and psychotropic drugs.

In pediatrics, Piracetam is indicated for the following diseases:

• attention deficit disorder;
• delayed speech development;
• mental retardation;
• cerebral palsy;
• consequences of damage to the central nervous system during fetal development or during childbirth.

Piracetam and its analogues are used in children over 8 years of age, in younger children - only if there are strict indications.

May reduce dementia and symptoms of Alzheimer's disease

Dementia describes a group of symptoms that affect your memory, ability to perform tasks and communicate.

Alzheimer's disease is the most common cause of dementia.

Research suggests that damage caused by the accumulation of amyloid beta peptides may play a role in its development. These peptides tend to clump between nerve cells and impair their function (,).

Test-tube studies suggest that piracetam may protect against dementia and Alzheimer's disease by preventing damage caused by the buildup of beta-amyloid (, , ).

Human studies also suggest that piracetam may help improve mental performance in older adults with dementia, Alzheimer's disease, or common brain disorders.

For example, an analysis of 19 studies involving approximately 1,500 adults with dementia or brain damage found that 61% of people taking piracetam showed improved mental performance, compared with only 33% when treated with placebo ().

Additionally, a study conducted on 104 people with Alzheimer's disease found that taking 4.8 grams of piracetam daily for 4 weeks, followed by 2.4 grams for 2 weeks improved memory, reaction speed, concentration and other indicators of brain health ().

However, other studies have found no effect ().

Moreover, most human studies of piracetam are short, meaning its long-term effects in people with Alzheimer's disease and dementia remain unknown ().

Conclusion:

Piracetam may improve mental performance in people with dementia, Alzheimer's disease, and brain disorders. However, its long-term effects on mental performance in these groups are still poorly understood.

Piracetam - instructions for use

Piracetam ampoules

Piracetam solutions are administered only to adults in the form of intravenous infusions or injections. The daily dose is 4.8 g of the drug, divided into 2 injections. As the condition improves, the dose is reduced to 1200 mg/day slowly. Further therapy continues with capsules or tablets.

Piracetam tablets/capsules

Take orally with about 50 ml of water. The daily dose for children is 30–50 mg per kilogram of weight, divided into 2–3 doses. For adults, the average daily dose is 1.2–4.8 g, divided into 2 or 3 doses.

Analogues of Piracetam

Analogues of the drug Piracetam in terms of the active substance are all medicines in ampoules or tablets, capsules, solutions, syrups, granules for children containing piracetam. The following substitutes from different manufacturers are available on the market:

• Lutsetam;
• Nootropil;
• Nootobril;
• Noocetam;
• Pirabene;
• Pyramem;
• Stamin;
• Cerebril.

Foreign and domestic analogues of Piracetam are drugs with nootropic effects, differing in the composition of active substances:

• Preparations based on neuropeptides - Actovegin, Cerebrolysin, Cortexin.
• Products that contain vinpocetine - Cavinton, Bravinton.
• Analogs based on cinnarizine - Stugeron, Cyrizin, Cinnarizine, Vertizin, Disiron.
• Medicines that contain hopantenic acid - Pantocalcin, Pantogam, Cognum.
• A preparation based on gamma-aminobutyric acid - Aminalon.
• Medicines with gamma-butyric acid - Phenibut, Noofen, Bifren.
• Glycine and its derivatives - Glycine, Noopept.
• Mildronate is an analogue of Piracetam based on meldonium, which activates blood flow in the brain.
• Combined products with piracetam and cinnarizine or aminobutyric acid - Phezam, Omaron, Neuro-Norm, Cinatropil, Olatropil.
• Medicines with the active substance betahistine - Betaserc, Vestibo, Betahistine.
• Medicines - citicolines, modern imported analogues of Piracetam - Ceraxon, Neuroxon, Kvanil, Somazina.
• Products containing pramiracetam - Pramistar.
• Medicines that contain thiotriazolin - Thiocetam, Thiotriazolin.
• A new generation analogue of Piracetam based on pramiracetam - Entrop.
• A product containing fonturacetam - Phenotropil.
• Medicines with choline - Cereton, Gliatilin, Cerepro.
• An analogue with the active substance pyritinol - Encephabol.
• Combined products - Cytoflavin, Vasavital, Gamalate, Cognifen, Ceregin.
• Medicines with ginkgo biloba - Bilobil, Ginkoum, Giloba, Tanakan, Memoplant.

All analogues of Piracetam are approved for use as prescribed by a doctor; the price of these products differs depending on the country of origin and dosage.

List of Piracetam analogues with prices.

Piracetam

Active substance:

Piracetam*

Pharmgroup:

Nootropics

Average price in pharmacies

Piracetam or Nootropil - which is better for adults, what is the difference, reviews from doctors

Manufacturer: OSB Pharma, Belgium
Release form: ampoules, tablets, solution

Active ingredient: piracetam

Synonyms: Lucetam

Nootropil is an absolute analogue of Piracetam. Both products have the same composition and effects. The difference between analogues is in the manufacturers. Nootropil has some differences in release forms.

The drug is produced in the form of an oral solution, which makes it convenient to dose and use the medicine in children.

Reviews from neurologists indicate the high safety of Nootropil. For many patients, treatment begins with the use of Nootropil or another analogue of Piracetam in injections, and after improvement of the condition, therapy with tablets is continued. Treatment regimens and doses are the same as for Piracetam.

Analysis of pros and cons

When choosing Piracetam as an effective means for increasing brain performance and mental activity, one must not forget that this drug:

• valued for normalizing connections between both hemispheres of the brain;
• helps improve synaptic conductivity of neocortical structures;
• tones cerebral blood flow;
• restores the natural functionality of the brain;
• promotes protective normalization in the event of hypoxia and identified intoxication;
• significantly reduces the rate of chemical reactions if platelet aggregation occurs.

By preventing cells from sticking together in the initial stage of blood clot formation, the drug helps to improve the health of the body and maintain a high level of human performance.

The listed advantages of Piracetam do not exclude its disadvantages, among which it is particularly worth highlighting:

• has certain contraindications for use, which can be individually determined by the attending neurologist;
• capable of provoking and causing undesirable manifestations of central nervous system failures;
• promotes the development of hypertension;
• causes an exciting side effect;
• if the functions of the nervous system are impaired, not only drowsiness and nervousness may be observed, but also depression, apathy, and bad mood may appear;
• when taking tablets systemically, severe headache, dizziness, insomnia, anxiety are often observed, and hallucinations are possible;
• the digestive system often reacts to nootropic drugs with sudden nausea or vomiting, severe abdominal pain;
• patients prone to allergies sometimes notice a rash, swelling, itching and even hives.
• in certain situations, when metabolic processes are disrupted, the immune system is malfunctioning, a sharp increase in body weight may be observed, which is observed when taking nootropic tablets.

Piracetam is prescribed by a neurologist and prescribes this effective remedy for his patients to improve cerebral circulation.

For adults and children, regardless of age, this medication is prescribed:

• after suffering traumatic brain injuries;
• for hyperactivity and anxiety in children;
• if there is a lack of attention, general concentration is impaired;
• as a means of improving memory and mental performance;
• recommended for children - to improve speech, improve learning ability at school or other educational institutions.

It is not always possible to find this popular drug in pharmacies and, knowing its analogues, as well as the compatibility of Piracetam with other medications, you can more effectively influence the activity of the brain and the entire nervous system, and many people are pushed to look for substitutes by the desire to try something new, better and more efficient.

Piracetam or Actovegin - which is better?

Manufacturer: Takeda, Austria
Release form: tablets, ampoules

Active ingredient: neuropeptides obtained from calf blood hemoderivat

Synonyms: Cortexin, Cerebrolysin

Actovegin is a substitute for Piracetam with a different composition and mechanisms of action on the bloodstream. Indications for the use of Actovegin differ. Unlike Piracetam, diabetic neuropathy, post-stroke complications, venous trophic ulcers and congestion are added. The drug is well tolerated and has rapid effects, according to patient reviews.

Dosing of Actovegin in tablets and injections: 1-3 tablets or intravenous infusion of a solution of 1500-2000 mg. The dosage and duration of treatment are determined by the doctor.

Piracetam or Vinpocetine - which is better?

Manufacturer: Gedeon Richter, Hungary
Release form: tablets, ampoules

Active ingredient: vinpocetine

Synonyms: Cavinton

Vinpocetine is a nootropic drug and an analogue of Piracetam in action. The pharmacological effects and indications are similar, and both drugs are inexpensive. It also has a more expanded list of effects, in particular improving blood flow in peripheral tissues.

Reviews from doctors indicate that if treatment with Piracetam is intolerant or impossible, therapy can be replaced with an effective and safe analogue, Vinpocetine.

Dosage: 5-10 mg 3 times a day for two months. When administered intravenously, the average daily dose is 50 mg of Vinpocetine.

Piracetam or Mexidol - which is better for blood vessels

Manufacturer: Pharmasoft, Russia
Release form: tablets, ampoules

Active ingredient: hydroxypyridine succinate

Synonyms: Armadin, Elflunat, Dinar, Mexicor

Mexidol is a medicine with a wider spectrum of action, the list of indications is much wider. Positively affects blood circulation, slows down platelet aggregation, improves the supply of oxygen and ATP energy to brain cells. Unlike Piracetam, the analogue has an effect on the blood supply and functioning of the myocardium. Therefore, Mexidol is a substitute for some effects. This indicates that the medicine is better than Piracetam not only for dizziness, but also for disorders of blood flow in the lower parts - the heart, spinal cord due to osteochondrosis and other pathologies. Doctors and patients have many positive reviews from treatment with Mexidol.

Dosage of the drug: intravenously or intramuscularly, 50–100 mg 2–3 times a day. Orally - 300–600 mg per day. Prescription and replacement are made only by a doctor.

Piracetam and piracetam-like drugs: the view of a clinical pharmacologist

Currently, there are more than 10 “piracetam-like” drugs, including piracetam itself, which are used in various countries around the world or are at one or another stage of clinical trials. These include: • piracetam, levetiracetam, seletracetam and brivaracetam (developed by UCB Pharma, Belgium); • oxiracetam (developed by ISF, Italy); • aniracetam (developed by Roche Pharmaceuticals, Switzerland); • pramiracetam (developed by Warner-Lambert, USA) [6]; • phenylpiracetam (developed at the Institute of Medical and Biological Problems of the Russian Academy of Medical Sciences, produced by Valenta Pharmaceuticals, Russia). All of these drugs have a chemical structure similar to piracetam, the main component of which is the pyrrolidone ring, and therefore this group is called “racetams” (Fig. 1). Despite the structural similarity, the clinical effects observed with the use of racetams are quite diverse and allow us to divide them into 3 subgroups: 1. Drugs primarily used to treat cognitive impairment. This subgroup includes piracetam, pramiracetam, phenylpiracetam, oxiracetam and aniracetam (the latter two drugs are no longer used in clinical practice). It should be noted that drugs in this group can also be used for balance disorders, cortical myoclonus and dyslexia. 2. Drugs for the treatment of epilepsy. This subgroup includes levetiracetam, brivaracetam and seletracetam. The effect of these drugs on cognitive function is unclear. 3. The third subgroup includes drugs whose clinical effectiveness is unknown. These drugs include nefiracetam (which has not been shown to improve cognitive function in stroke patients) and rolipram (currently being studied as an antidepressant). This subgroup also includes a number of other drugs that are at the stage of clinical trials. Thus, we can say that piracetam and piracetam-like drugs (drugs) (let’s call them piracetam analogues) have found their use in a fairly wide range of neurological diseases [1], which is based on the results of clinical studies with different designs (both open uncontrolled and double-blind, placebo-controlled). These drugs have been actively studied over the past three decades, resulting in a significant number of publications. Of more than 10 new piracetam-like drugs, 8 have undergone clinical trials for various CNS indications in recent years. When searching the Internet using the US National Library of Medicine PubMed database [2] using the keywords “clinical trial” and “international nonproprietary name of the drug” (piracetam or the international nonproprietary name of the “piracetam-like” drug), more than 300 publications were found. Table 1 shows the dynamics of publications on clinical trials of piracetam and piracetam-like drugs over four time periods: 2007–2010, 2004–2006, 1999–2003. and until 1999. Two articles are meta-analyses: one is the clinical effectiveness of piracetam in cognitive disorders [3], the other is a meta-analysis of the effectiveness of piracetam and piracetam-like drugs in experimental strokes in animals [4]. This review analyzes the results of experimental and clinical studies of piracetam and piracetam-like drugs belonging to the first subgroup of drugs that studied the effectiveness of piracetam in the treatment of cognitive impairment. Mechanisms of action of piracetam It should be noted that the pharmacology of piracetam-like drugs is much less studied than their clinical use [5]. These compounds modulate the processes of excitation and/or inhibition of neurotransmitters, neurohormones and/or postsynaptic signals. These effects of piracetam and piracetam-like drugs can manifest themselves in the form of an effect on cognitive and mnestic functions [5]. Based on the results of several experimental studies, it has been suggested that piracetam plays an important role in energy metabolism, including increasing brain oxygenation and the permeability of cellular and mitochondrial membranes to Krebs cycle mediators [7,8], increasing the synthesis of cytochrome b5 [9 ]. The similarity of the chemical structure of piracetam to GABA suggests that piracetam is likely to have GABAergic effects [10]. Other researchers suggest that piracetam “works” as an antioxidant/neurotonic [11,12] and increases acetylcholine receptor density [13]. The number of such hypotheses, each of which quite convincingly describes one or another aspect of the mechanism of action of piracetam, is quite large; however, in order to form a unified concept, additional research on the drug is required. Due to the differences between piracetam and piracetam-like drugs, it is unlikely that all of these drugs will act in the same way, affecting the same target molecules. A number of hypotheses focus on the modulation by piracetam of the function of ion channels (sodium, potassium, calcium) in the neuronal membranes of neurons or neuromuscular synapses. Thus, it has been established that piracetam, oxiracetam and aniracetam activate the AMPA type of glutamate receptors (the endogenous ligand is amino-3-hydroxy-5-methylisoxazole-4-propionate), but do not affect the NMDA receptors of neurons. This leads to an increase in the release of calcium from the cell [14], resulting in a decrease in the concentration of intracellular calcium. Pramiracetam increases the rate of sodium-dependent choline uptake in the hippocampus in rats. Its effect on cognitive function may occur through acceleration of the flow of impulses from cholinergic neurons in the hippocampal septum [15]. The experiment established that phenylpiracetam has an affinity for H-cholinergic receptors, but not for NMDA-type glutamate receptors. However, injections of this drug (100 mg/kg, intraperitoneal) increase the number of both H-cholinergic and NMDA receptors in rats, but reduce the number of serotonin and dopamine receptors in brain tissue [16]. Unlike other piracetam-like drugs, levetiracetam has pronounced anticonvulsant activity, and therefore is used to treat patients suffering from epilepsy. Its mechanism of action has not been fully studied, but we can say that the drug does not directly affect such “classical” processes/targets for antiepileptic drugs as GABAergic transmission and sodium channels. The most likely site of application of levetiracetam is the SV2A protein. It is assumed that this protein is involved in the processes of exocytosis and, due to its structural similarity to membrane transporters, may play a role in maintaining synaptic homeostasis, in particular, components such as ATP and calcium. The effect on calcium homeostasis is confirmed by the data that SV2A interacts with synaptotagmin, which is a kind of calcium sensor of the cell, as well as by the inhibition under the influence of levetiracetam of calcium release by PC-12 cells, which contain SV2A, and the absence of such an effect in 3T3 fibroblasts, where no SV2A [52]. There is also evidence that, in a therapeutic dose range, levetiracetam reduces ion fluxes into neurons induced by activation of AMPA receptors [19]. This may be due to inhibition of calcium channels [17–19]. Levetiracetam and nefiracetam activate NMDA receptors. In cultured rat cortical neurons, this effect was mediated through activation of protein kinase C and phosphorylation of one of the NMDA receptor subunits. This, in turn, increases the binding of glycine to the NMDA receptor [20]. Fasoracetam modulates glutamate receptors, which leads to activation of adenylate cyclase and increased formation of cyclic adenosine monophosphate (cAMP), which is involved in various “signaling” processes, incl. such as learning and memory. The mechanism of action of colurocetam has been described in different ways. Most authors indicate that colurocetam affects choline transport [21], which leads to increased choline uptake in hippocampal synaptosomes [22]. It should be noted that the relationships between these various complex processes are very difficult to analyze. Clinical use of piracetam Piracetam was first registered in Europe in the early 1970s. It does not belong to potent drugs and drugs with a narrow therapeutic index, therefore, in experiments it is characterized by low toxicity, and in clinical settings by low frequency and mild severity of adverse reactions, such as anxiety, insomnia or drowsiness and agitation [3,5, 23]. Treatment of Cognitive Impairment Although the first reported effect of piracetam on the central nervous system was the suppression of nystagmus in the rabbit, further findings over the past 25 years have shown that the main effect of piracetam is to improve cognitive function. The earliest studies focused on pharmacological modulation of cerebral shock-induced amnesia. Giurgea and Mouravieff Lesuisse demonstrated that piracetam reduced the effect of electric shock on disorientation in rats in a water maze. Similar effects of piracetam and drugs similar to it in chemical structure have been described by many other authors. Studies of piracetam and aniracetam by Cumin et al., studies of piracetam and oxiracetam by Mondadori et al., and studies of etiracetam by Sara et al. showed significant protective effects against electrical shock. Buler et al. also described the antiamnestic effects of a whole series of piracetam analogues, including pramiracetam. The direct positive effect of nootropics on learning and memory has been repeatedly described [29]. Over the past 10 years, more than 20 review articles have been published with the results of clinical studies of piracetam confirming its clinical effectiveness (Table 2). In a study involving 162 patients who were diagnosed with age-related memory impairment, three groups of patients were formed. Patients of the first group received piracetam at a dose of 2.4 g/day, the second - 4.8 g/day, patients of the third group received placebo. The duration of the study was three months. All patients included in the study participated in a memory training program. The best results in tests for immediate (p<0.0004), general (p<0.002) and delayed (p<0.04) recall were achieved in the group of patients who took piracetam at a dose of 4.8 g/day. In the group of patients taking piracetam at a dose of 2.4 mg/day, a significant improvement compared with placebo was observed in immediate recall tests (p < 0.03) [30]. The therapeutic effect of piracetam in dementia is limited by the pathology underlying the disease. However, a number of studies have shown that piracetam can slightly improve the cognitive status of such patients [32]. A study of 130 patients diagnosed with mild to moderate dementia compared the effect of piracetam at a dose of 4.8 g/day with placebo. At the end of the 12-week treatment period, the piracetam group showed a significant improvement compared with the placebo group (p<0.001). Long-term treatment with piracetam may also slow the development of cognitive impairment. Thus, according to the results of a one-year double-blind study on patients diagnosed with probable Alzheimer's disease, in the group of patients taking piracetam, deterioration in cognitive function was observed in only one of the 14 scales used. At the same time, in the group of patients taking placebo, deterioration of cognitive functions was observed on 9 scales [33]. Of course, the number of patients participating in the studies described above is too small to draw valid conclusions about the effectiveness of piracetam, so two meta-analyses were conducted that examined the effectiveness of piracetam in elderly patients with age-related cognitive decline. Both meta-analyses used clinical global impression (CGI) scores from different studies. PCS is an important measurement tool that helps determine the clinical significance of any reported improvement. In addition, this scale is recommended for use as part of any clinical trial in patients with Alzheimer's disease. This scale is not sensitive to small changes in the patient's condition, which may not be clinically significant. Any change recorded using this scale is, by definition, clinically significant [32]. A smaller meta-analysis examined data from 6 randomized placebo-controlled trials involving 477 patients with vascular dementia, unclassified dementia, Alzheimer's disease, or cognitive impairment not meeting criteria for dementia. The ratio of patients who improved to those who did not was 3.47 (95% confidence interval) or 3.55, depending on whether a fixed- or random-effects model was used [34]. The second meta-analysis examined the effectiveness of piracetam for PCS in a larger number of studies and in a larger number of patients. It included both published and unpublished studies on piracetam. The number of studies was 19, the number of patients included was 1500. All studies were double-blind, parallel groups, placebo-controlled. They were carried out from 1972 to 1993. The studies involved patients 50 years of age and older with diagnoses of age-related cognitive impairment and degenerative dementia. The duration of the studies ranged from 6 to 52 weeks, piracetam was prescribed in doses from 2.4 to 8 g/day. This meta-analysis showed that improvement in the PCS was observed in more than 60% of patients taking piracetam, and only 30% of those taking placebo. The consequence of this is that the ratio of patients who showed improvement to those who did not show a change was favorable for piracetam, which was 2.45 (95% confidence interval) or 3.35 (95% confidence interval) depending on the statistical method used [3]. The meta-analysis data is consistent with the data obtained by Flicker and Grimley Evans, but is more accurate because smaller confidence intervals are used). Use of piracetam-like drugs in the Oxiracetam clinic. Due to the hydroxyl groups in the oxypyrrolidone core, oxiracetam has a favorable pharmacokinetic profile - high oral bioavailability [37]. In a prospective, double-blind study in 12 healthy volunteers, oxypiracetam attenuated the decline in neuropsychological performance (eg, semantic memory, reading) induced by scopolamine [38]. There is evidence that the use of oxiracetam for 2–6 months in people over the age of 65 years improves some cognitive impairment of non-specific etiology [39]. However, oxiracetam failed to benefit patients with Alzheimer's disease (albeit, the duration of treatment was only 1 month) [40]. The recommendations of the International Anti-Aging Systems (UK) indicate that oxiracetam can be used for “memory disorders caused by cerebrovascular insufficiency, mental impairment in old age,” but there is no such information from the manufacturer yet [5]. Pramiracetam. Replacing the amide group in the structure of piracetam with dipropane-2-ulaminoethyl also allows pramiracetam to have high bioavailability [41,42]. However, it is more active than piracetam and is therefore used in lower doses compared to piracetam [43]. Italian researchers demonstrated a reduction in the scopolamine-induced amnesic effect in healthy volunteers when treated with pramiracetam, that is, two out of five cognitive measures (including immediate and delayed verbal tests) were approximately 50% better than those receiving placebo [44]. . Two small studies were conducted in Ukraine: one in patients with cerebrovascular disease [45] and the other in patients with concussion [46]. The first study showed that visual and verbal memory improved modestly with pramiracetam in younger patients with chronic cerebrovascular and post-stroke cognitive symptoms and to a lesser extent in older patients. Aniracetam. Due to changes in the N-side chain derivative, aniracetam has low bioavailability and is rapidly eliminated [47]. In another small study in elderly patients with cerebrovascular disease, aniracetam was effective [48]. However, animations are not effective in patients with memory impairment, cognitive functions associated with chronic toxic effects of organic solvents [49]. Phenylpiracetam. Like piracetams, this drug has high bioavailability, however, data on pharmacokinetics were obtained on laboratory animals [50.51], the pharmacokinetic parameters in humans are not published. Phenylpiracetams reduces the severity of headache and general fatigue after 14 days of therapy in patients with cognitive disorders and/or depression after the CMT, with encephalopathies of various etiology [53, 54]. It has a favorable effect in patients with CVB [55], reduces the manifestations of asthenia and depression in patients with RS [56], chronic fatigue syndrome [57], in adolescents with asthenic syndrome [58]. Adding to anticonvulsants reduces the amount and frequency of seizures, slightly improves cognitive functions [59, 60]. Perhaps the drug reduces the titer of antibodies to myelin in cerebral stroke [61], but this is not confirmed in all studies [62]. In 80% of patients with an open -angle form of glaucoma after normalizing eye pressure, the drug contributed to the stabilization of the disease [63]. It is also recommended to astronauts to increase physical and mental performance, stimulate cognitive functions [6]. Nevertheless, to draw conclusions about the effectiveness of phenylpiracetam prematurely, since there are no large prospective placebo -controlled studies. The conclusion of the results of experimental and clinical studies accumulated to date allow us to say that it is necessary to deeply study the effectiveness and safety of piracetam and piracetam -like drugs. It seems that the effectiveness of these drugs according to most indications seems promising. Therefore, there is a need for better, large controlled clinical studies. It should also be noted that the neuroprotective effects of piracetam and piracetam -like drugs are practically not studied. Unlike most GABA --ergic preparations (for example, barbiturates, carbamazepine), which can cause pronounced NPR, including amnesia, piracetam and piracetam -like drugs are relatively safe. However, we can say that delayed effects of these drugs and potential risks associated with their use have not yet been identified. The mechanisms of action of piracetam and piracetam -like drugs are also not studied and require further clarifications. But the prospects of the use of piracetam in clinical practice are not in doubt.

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Piracetam or Cinnarizine - which is better for dizziness?

Manufacturer: Sopharma, Bulgaria
Release form: tablets

Active ingredient: cinnarizine

Synonyms: Stugeron

The substitute Cinnarizine, in addition to improving cerebral blood flow, has a positive effect on microcirculation in peripheral areas, for example, in the extremities. This effective and cheap analogue of Piracetam is well tolerated and has almost no side effects.

To eliminate dizziness and other disorders caused by blood circulation disorders, take the medicine one tablet three times a day. Prescribed for adults, as well as children over 12 years of age.

Piracetam or Picamilon - which is better for blood vessels

Manufacturer: Pharmstandard, Russia
Release form: tablets

Active ingredient: gamma-aminobutyric acid

Synonyms: Aminalon, Phenibut

Picamilon is an analogue of Piracetam in action. Medicines with different compositions, but common effects - improve blood circulation in the brain, activate the supply of oxygen and energy to neurons, and have antioxidant properties.

Picamilon additionally has a vasodilating effect, which, according to patients, is more effective for various diseases. The list of indications is supplemented by use in ophthalmology for glaucoma, in urology for urinary disorders, as well as for migraines and neuroinfections.

Standard dosage: orally from 20 to 200 mg per day, depending on the disease, as directed by the doctor.

Piracetam or Lucetam - which is better, what is the difference

Manufacturer: Egis, Hungary
Release form: tablets, ampoules

Active ingredient: piracetam

Synonyms: Nootropil

Lucetam is an equivalent foreign analogue of Piracetam with the same composition and effectiveness. Differences in manufacturers are explained by different quality of raw materials, as well as the composition of auxiliary components.

Lucetam is a high-quality medicine with a pronounced nootropic effect on the brain.

Dosing is the same as for the Piracetam substitute: orally - 1.2–4.8 g per day, ampoules - 4.8 g per day. The entire dose prescribed by the doctor is divided into 2-3 doses or administrations.

Side effects from taking the drug

In some cases, Piracetam can cause severe complications. First of all, those at risk are children, elderly people, as well as patients who take the drug in violation of the dosage - more than 5 g per day. Keeping in mind that Piracetam is prescribed for a long course, in some cases it is difficult to understand that the negative reactions that arise in the body are associated specifically with its use. Most often, patients who have been prescribed this drug experience the following side effects:

• Increased body weight;
• Skin itching, as well as acute pain at the injection site;
• Deterioration of the condition in patients with angina pectoris;
• Headaches and dizziness;
• Nausea and vomiting, stool upset, abdominal pain, loss of appetite;
• Weakness and cramps, anxiety, insomnia;
• fussiness, imbalance, irritability, mental agitation.

In some patients, Piracetam may cause a decrease in concentration, as a result of which they need to stop driving during treatment with this drug. Many people are interested in whether it is possible to drink alcohol during treatment. It is not advisable to take Piracetam and alcohol at the same time, since such a combination can reduce the therapeutic effect of the drug.

However, eliminating the symptoms described above is quite simple - you just need to reduce the dose , after which the patient’s well-being is usually restored. Only in rare cases do you have to agree to completely stop the drug.

Piracetam or Cavinton - which is better for blood vessels

Manufacturer: Gedeon Richter, Hungary
Release form: ampoules, tablets

Active ingredient: vinpocetine

Synonyms: Vinpocetine, Barviton

Cavinton is a high-quality medicine with a complex effect on blood circulation. Unlike Piracetam, it is able to improve blood circulation not only in the brain, but also in nerve tissues throughout the body. Can be taken orally or administered intravenously. When taken orally, this Piracetam analogue is well tolerated. With parenteral administration, according to doctors, there may be a decrease in blood pressure, nausea or dizziness.

Doses of Cavinton orally are 5–10 mg 3 times a day, injections are 50 mg/day.

Reviews about the drug

Although many new nootropic drugs have recently appeared in pharmacies, most specialists still remain faithful to Piracetam, which they prescribe to their patients. This remedy can quickly help patients who suffer from frequent headaches, dizziness, memory loss and bad mood after a hangover. Elderly people also call this medicine effective , explaining this by the calming effect of the drug, improving memory and coordination of movement.

He also performed well in drug treatment. It is often recommended for patients with alcohol intoxication and drug addiction. But if you are unsure whether you can take Piracetam, we advise you to consult your doctor.

Piracetam or Noopept - which is better and more effective for adults

Manufacturer: OTS-pharm, Russia
Release form: tablets

Active ingredient: glycine derivatives

Synonyms: Glycine

Noopept is an analogue of Piracetam based on glycine derivatives, which have nootropic and neuroprotective properties. The products are identical in their effects.

Noopept is taken only orally after meals, 20–30 g/day, divided into 2–3 doses. There is no possibility of parenteral administration of the drug.

It is very well tolerated, allergic reactions occur extremely rarely. Not for use in children under 18 years of age, as well as pregnant and lactating women.

Piracetam or Phezam - which is better?

Manufacturer: Balkanfarma, Bulgaria
Release form: capsules

Active ingredient: cinnarizine, piracetam

Synonyms: Omaron, Neuro-Norm, Evrysam, Cinatropil

Phezam is a high-quality combination analogue drug that is widely used when therapy with single drugs based on piracetam or cinnarizine is insufficient. Includes a powerful complex of active substances that has a pronounced nootropic and neuroprotective effect on the brain.

Use only internally, 1-2 capsules 3 times a day. Treatment up to 3 months. Fezam is well tolerated if the dosages prescribed by the doctor are followed. Not prescribed for children.

Piracetam or Phenibut - which is better?

Manufacturer: Ozone, Russia
Release form: tablets

Active ingredient: gamma-aminobutyric acid

Synonyms: Picamilon, Aminalon

A domestic drug based on aminobutyric acid with nootropic, psychostimulating, mild sedative and neuroprotective effects. Used at 20–750 mg in adults and 20–250 mg in children over 6 years of age.

The Piracetam analog Phenibut can irritate the mucous membranes of the gastrointestinal tract, so it is not prescribed for ulcers. At the beginning of use, it may cause slight drowsiness and weakness. Side effects of this analogue often include headaches, anxiety, allergies and nausea. Phenibut is not used to treat pregnant and breastfeeding women.

Contraindications and side effects

Since piracetam is used in the treatment of various pathologies, the instructions focus on this, only a doctor should prescribe its use, based on the patient’s condition and the presence of contraindications. Do not use the drug if you are hypersensitive to the active substance or other components included in its composition. The medicine is not used to treat children under one year of age, as well as during pregnancy and lactation.

Piracetam tablets, the instructions indicate this, are not used in the presence of the following pathologies:

• Huntington's chorea, which is a genetic disease and is characterized at the initial stage of development by impaired coordination of movements.
• Chronic renal failure in severe form.
• Hemorrhagic stroke.
• Psychomotor agitation.

The decision to take piracetam should be made with extreme caution in case of hemostasis disorders, severe bleeding, or after major surgical operations.

Various side effects were observed when taking the drug. Patients most often experienced the following body reactions:

• Nausea and vomiting.
• Headache.
• Hives.
• Diarrhea.

As a rule, such side effects disappear on their own during therapy. More dangerous symptoms while taking the drug are decreased blood pressure, abdominal pain, depression, hallucinations, dermatitis, and confusion. Sometimes during treatment with the drug, motor disinhibition, increased libido, drowsiness or insomnia, and a constant feeling of internal anxiety occur. Overdose may increase side effects.

Piracetam or Pantogam - which is better for an adult?

Manufacturer: Pik-Pharma, Russia
Release form: tablets, syrup

Active ingredient: calcium hopantenate

Synonyms: Pantocalcin, Pantogam Active

The Pantogam analogue is characterized by nootropic and anticonvulsant effects. Unlike Piracetam, it is used for diseases accompanied by seizures.

The drug is taken orally in the morning or afternoon. For children under 3 years of age, it is recommended in the form of syrup, 1-30 ml/day. Adults and children over 3 years of age are recommended to take 1.5-3 g/day. Take for a long time, up to 6 months.

It is possible to develop adverse allergic reactions such as rash, conjunctivitis and rhinitis. Prohibited in the first trimester of pregnancy.

Answers on questions

Does Piracetam lower blood pressure or not?

The drug does not have a significant effect on blood pressure, a very slight decrease is possible.

Does Piracetam thin the blood or not?

The drug reduces platelet aggregation, thereby reducing the likelihood of thrombosis and improving blood flow.

Does Piracetam increase or decrease blood pressure?

The drug does not have a significant effect on pressure in blood vessels and has no effect on blood vessels.

Is Piracetam available with a prescription or not?

Piracetam and its analogues are prescription drugs.

Piracetam tablets or capsules - which is better?

The effectiveness of the medicine is the same in any form of release. It is assumed that the product in capsules has a faster effect.

Who can take Piracetam?

An absolute contraindication to the use of Piracetam is pregnancy and age under 1 year. However, in some cases, the doctor may ignore these instructions and prescribe the drug in question to patients. At the same time, there are a number of conditions for which it is prohibited to prescribe Piracetam for treatment:

• Lactation period;
• After extensive surgical interventions;
• Severe hypertension;
• Hemorrhagic stroke;
• Intolerance to certain foods;
• Diabetes mellitus, especially if children suffer from it;
• Acute renal failure.