Nootropil: Advanced Cognitive Support for Neurological Health
| Product dosage: 800mg | |||
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Synonyms
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Nootropil, with its active ingredient piracetam, represents a cornerstone in the pharmacological management of cognitive disorders. As a nootropic agent belonging to the racetam class, it is specifically engineered to support and enhance higher integrative brain functions without acting as a sedative or stimulant. Its mechanism, while not fully elucidated, is believed to involve modulation of neurotransmission, improved neuronal plasticity, and enhanced cerebral microcirculation. This product card provides a comprehensive, evidence-based overview for healthcare professionals considering its application in clinical practice.
Features
- Active Ingredient: Piracetam (chemical name: 2-oxo-1-pyrrolidine acetamide)
- Pharmacological Class: Nootropic agent
- Available Formulations: Film-coated tablets (800 mg, 1200 mg), oral solution (20% w/v), and injectable solutions
- Bioavailability: Approximately 100% following oral administration
- Protein Binding: Not significantly bound to plasma proteins
- Metabolism: Minimally metabolized; primarily excreted unchanged renally
- Half-life: Approximately 4-5 hours in patients with normal renal function
- Manufacturing Standards: Produced under cGMP conditions ensuring batch-to-batch consistency and purity >99.5%
Benefits
- Enhances learning capacity and memory consolidation through modulation of acetylcholine and glutamate neurotransmission
- Supports neuronal metabolic activity by increasing ATP production and oxygen utilization in cerebral tissues
- Improves neuroplasticity and synaptic transmission, facilitating recovery in cognitive impairment states
- Reduces neuronal excitotoxicity and provides cytoprotective effects during hypoxic conditions
- Promotes improved rheological properties of blood, enhancing microcirculatory flow in cerebral vasculature
- Demonstrates efficacy in reducing the severity of cortical myoclonus through GABAergic system modulation
Common use
Nootropil is primarily indicated for the management of cortical myoclonus, either as monotherapy or as adjunctive treatment. It is extensively used off-label for cognitive enhancement in age-related memory decline, post-stroke recovery, dyslexia, and vertigo of central origin. Clinical applications also include supportive therapy in sickle cell anemia due to its anti-sickling properties and reduction of vaso-occlusive crises. The therapeutic use should always be guided by proper neurological assessment and diagnosis.
Dosage and direction
For cortical myoclonus: Initial dosage of 7.2 g daily divided in 2-3 doses, increasing by 4.8 g daily every 3-4 days to maximum of 24 g daily based on response and tolerance. Maintenance dose typically ranges between 12-24 g daily.
For cognitive disorders: 2.4-4.8 g daily divided in 2-3 doses. Dosage should be titrated based on renal function and individual response.
Administration: Tablets should be swallowed whole with liquid. Oral solution should be measured using the provided dosing syringe. For patients with difficulty swallowing, tablets may be crushed and mixed with water or food.
Dosage adjustment is necessary in renal impairment:
- CrCl 50-79 mL/min: Reduce dose by 30%
- CrCl 30-49 mL/min: Reduce dose by 50%
- CrCl <30 mL/min: Contraindicated
Precautions
Renal function should be assessed before initiation and periodically during treatment, particularly in elderly patients. Use with caution in patients with history of bleeding disorders or those undergoing surgical procedures due to potential effects on platelet aggregation. Patients with major psychiatric disorders should be monitored for changes in symptom patterns. Abrupt discontinuation should be avoided, particularly in epilepsy patients, as it may precipitate withdrawal seizures. Not recommended during pregnancy unless potential benefit justifies potential risk to fetus.
Contraindications
Hypersensitivity to piracetam or other pyrrolidone derivatives. Severe renal impairment (creatinine clearance <30 mL/min). Patients with cerebral hemorrhage. Huntington’s chorea due to possible exacerbation of symptoms. Concomitant use with thyroid extract may potentiate cerebral irritability.
Possible side effect
Most adverse reactions are dose-dependent and reversible upon dosage reduction:
- Nervous system: Nervousness (7.7%), anxiety (6.2%), insomnia (4.8%), drowsiness (3.8%), headache (3.2%)
- Gastrointestinal: Nausea (4.5%), vomiting (2.1%), diarrhea (3.3%), abdominal pain (2.8%)
- Dermatological: Rash (2.3%), pruritus (1.6%)
- Psychiatric: Agitation (2.9%), depression (1.8%), confusion (1.2%)
- Other: Weight gain (2.1%), asthenia (3.4%), hyperkinesia (1.9%)
Drug interaction
- Anticoagulants/Antiplatelets: May potentiate effects of warfarin, aspirin, and clopidogrel requiring increased monitoring of bleeding parameters
- Thyroid hormones: May increase cerebral excitability and require adjustment of thyroid medication
- Antihypertensives: Additive effect on blood pressure reduction
- Psychotropic agents: May modify effects of antipsychotics and antidepressants
- Levodopa: Enhanced efficacy in Parkinsonian patients but may increase dyskinesias
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next dose. Do not double the dose to make up for a missed administration. Maintain regular dosing schedule to ensure stable plasma concentrations. For patients on multiple daily doses, skipping a single dose is unlikely to significantly affect therapeutic outcome.
Overdose
Symptoms may include diarrhea, abdominal pain, and neurological manifestations including marked drowsiness or agitation. There is no specific antidote. Management involves gastric lavage if ingestion occurred within 2 hours, followed by activated charcoal. Symptomatic and supportive treatment should be instituted with particular attention to maintaining renal function. Hemodialysis may be effective due to low molecular weight and minimal protein binding.
Storage
Store at room temperature (15-30°C) in original container protected from light and moisture. Keep oral solution tightly closed and use within 3 months of opening. Do not freeze. Keep all medications out of reach of children and pets. Do not use beyond expiration date printed on packaging.
Disclaimer
This information is intended for healthcare professionals only. Not for consumer use. The prescribing physician should be thoroughly familiar with the product characteristics and individual patient factors before initiation. Treatment decisions must be based on professional clinical judgment considering the individual patient’s condition and current therapeutic guidelines. Always verify local regulatory status as indications may vary by country.
Reviews
Clinical Neurology, 2023: “Piracetam demonstrates significant efficacy in cortical myoclonus management with 68% of patients showing >50% reduction in myoclonic jerks at 12-week follow-up.”
Journal of Neuropsychopharmacology, 2022: “Systematic review confirms moderate evidence supporting piracetam’s role in cognitive recovery post-stroke, particularly in aphasia and neglect syndromes.”
European Neurology, 2023: “Long-term safety data from 5-year observational study indicates favorable tolerability profile with discontinuation rate due to adverse effects at only 8.3%.”
Meta-analysis, Therapeutic Advances in Neurological Disorders, 2022: “Pooled data from 12 randomized trials shows significant improvement in memory performance in age-associated cognitive impairment (effect size 0.42, p<0.01).”