Expiration date: 03/2025

Release form and composition: 

Gelatine capsule, size No. 0, white contents of capsules - powder white, or almost white.

1 capsule contains:

piracetam 400 mg

Cinnarizine 25 mg

Excipients: cellulose microcrystalline, lactose (milk sugar), magnesium stearate, talc.

The composition of the gelatin capsules: titanium dioxide, methyl parahydroxybenzoate, parahydroxybenzoate, acetic acid, gelatin.

10 PCs. - packaging sells contoured (3) - packs cardboard.

10 PCs. - packaging sells contoured (6) - packs cardboard.

60 PCs banks polymer (1) - packs of cardboard.

Pharmacological action:

Combined preparation, improves circulation and metabolism of the brain. Has a pronounced antihypoxic (mutually potentiated components), a nootropic and vasodilator effect. Contributes to a significant increase blood flow in the brain.

Piracetam is nootropic agent. Has a positive effect on brain metabolism: it increases the concentration of ATP in the brain tissue, enhances the synthesis of RNA and phospholipids, stimulates glycolytic processes, enhances glucose utilization.

Improves integrative brain activity, promotes memory consolidation, eases the process of learning.

Changes the velocity of propagation of excitation in the brain, improves microcirculation, without vasodilating action, inhibits the aggregation of activated platelets.

Has a protective effect in brain damage caused by hypoxia, intoxication, an electric shock increases apha - and beta-activity, reduces deta-activity on EEG, reduces the severity of vestibular nystagmus.

Improves mineralnue transmission and synaptic conduction in neokorticalnah structures, improves mental performance, improves cerebral blood flow.

The effect develops gradually. Virtually no sedative and psychoactive effect.

The therapeutic effect of piracetam is manifested through 1-6 h

Cinnarizine - a selective blocker of the slow calcium channels, reduces the flow into cells calcium ions and reduces its maintenance depot plasmolemma reduces the tone of smooth muscles of arterioles and reduces their reaction to biogenic vasoconstrictors (i.e. epinephrine, norepinephrine, dopamine, angiotensin, vasopressin, serotonin).

Has vasodilator effect (particularly in respect of brain vessels, increasing antihypoxia action piracetam) without having a significant impact on AD.

Exhibits moderate antihistaminic activity, reduces the excitability of the vestibular apparatus, lowers the tone of the sympathetic nervous system.

In patients with impaired peripheral circulation improves blood flow to organs and tissues (including myocardium), enhances postischemic vasodilation.

Increases the elasticity of erythrocyte membranes, their deformation ability, reduces blood viscosity.

Toxicity of the combination does not exceed the toxicity of the individual components of the drug.

Pharmacokinetics:

The drug is rapidly and completely absorbed from the gastrointestinal tract.

Piracetam

Suction

The bioavailability of piracetam - 95%. Cmax piracetam is achieved through 2-6 hours

Distribution

Piracetam is not associated with blood plasma proteins. Penetrates the GEB, the placental barrier. Accumulates in brain tissue through 1-4 h after intake. Of spinal fluid is much slower than from other tissues.

Metabolism and excretion

Piracetam is practically not metabolized. T1/2 piracetam from blood plasma is 4.5 h, T1/2 of the brain - an average of 7.7 hours report mostly kidneys (more than 95% of the dose in 30 hours).

Cinnarizine

Suction

Cinnarizine Cmax achieved through 1-4 hours

Distribution

Cmax Cinnarizine through 1-4 h celebrated not only in blood but also in liver, kidney, heart, lung, spleen and brain. Linking blood plasma proteins is 91%.

Metabolism and excretion

Cinnarizine is completely metabolised in the liver (by dezalkilirovania). T1/2 Cinnarizine is 4 hours Excreted as metabolites (1/3 - kidney with urine, 2/3 - through the intestine with faeces).

Indications:

• cerebrovascular disease (including atherosclerosis of cerebral vessels, ischemic stroke, treatment after hemorrhagic stroke, after head injuries)
  
• encephalopathy of various Genesis
  
• comatose and subcomittee condition after intoxication and brain injuries
  
• diseases of the Central nervous system, accompanied by a decline in intellectual-mnestic functions
  
• labirintovaya of various origins (accompanied by dizziness, tinnitus, nystagmus, nausea and vomiting), Meniere's syndrome
  
• depression
  
• psycho-organic syndrome with predominance of symptoms of fatigue and weakness
  
• asthenia psychogenic origin
  
• prevention of migraine and kinetosis
  
• impaired memory, mental function and concentration
  
• the lag of intellectual development in children.
  

Dosing regimen:

The drug should be taken orally.

Adult for the 1-2 caps. 3 times/day for 1-3 months depending on the severity of the disease.

Children under the age of 5 years, 1-2 capsules. 1-2 times/day for 1-3 months.

Treatments 2-3 times per year.

In chronic renal failure (KKt60 ml/min) to reduce the dose or increase the interval between doses of the drug.

Side effects:

CNS and peripheral nervous system: irritability, sleep disturbance, headache, tremor of extremities.

From the digestive system: dyspepsia, epigastric pain, dry mouth.

Allergic reactions: skin rash.

Contraindications:

• hepatic insufficiency, severe
  
• renal failure severe
  
• parkinsonism
  
• pregnancy
  
• lactation
  
• children's age (up to 5 years)
  
• hypersensitivity.
  

With caution should use the drug in Parkinson's disease, kidney and/or liver failure.

Pregnancy and lactation:

The drug is contraindicated during pregnancy and breastfeeding.

Special instructions:

During treatment should monitor liver function.

At the beginning of treatment the patient should refrain from receiving alcohol.

Due to the content Cinnarizine drug may cause a positive reaction from the athletes during the doping test.

The drug should be used with caution with increased intraocular pressure.

Effects on ability to drive vehicles and management mechanisms

During treatment use caution when driving and doing activities that require high concentration and psychomotor speed reactions.

Overdose:

Data on overdose of the drug is not provided.

Drug interactions:

Combitropil® enhances the effects of drugs, CNS depressants, ethanol, and nootropic and hypotensive drugs.

Improves tolerability of antipsychotic drugs (neuroleptics) and tricyclic antidepressants.

Vasodilating drugs increase action Combitropil®.

Terms and conditions of storage:

List B. the Drug should be stored out of reach of children, dry, protected from light place at temperature not exceeding 25°C. shelf Life - 2 years.