ZYNAPSE 1000 Citicoline 250mg / mL Solution for Injection 4mL 1's
Indications/Uses
The results of a recent phase 3 clinical trial among patients suffering from ischemic stroke demonstrated a statistically and clinically significant improvement in the neurological function of patients treated with optimal dose of citicoline 500 mg daily. The potential of citicoline as stroke therapy is underscored by other key attributes: Its oral dosage for a 24-hr window of therapeutic opportunity following stroke and an apparent absence of significant side effects. Preliminary evidence suggests that in a small subgroup of patients, citicoline may reduce the size of the impact caused by stroke.
Treatment of citicoline within the first 24 hrs after onset in patients with moderate to severe stroke increase the probability of complete recovery at 3 months.
Head Trauma of Varying Severity: In a clinical trial, citicoline accelerated the recovery from posttraumatic coma and the recuperation of walking ability, achieved a better final functional result and reduced hospital stay.
Cognitive Disorders of Diverse Etiology [eg, Senile Cognitive Impairment which is Secondary to Degenerative Diseases (eg, Alzheimer's disease) and to Chronic Cerebral Vascular Disease]: Citicoline improves scores on cognitive evaluation scales and slowed the progression of Alzheimer's disease.
Parkinson's Disease: Citicoline has also been shown to be effective as co-therapy for Parkinson's disease. Beneficial neuroendocrine, neuroimmunomodulatory and neurophysiological effects have been described. Considerable experimental evidence of effects of citicoline on CNS dopaminergic system has accumulated. After treatment with citicoline, regeneration of cells in rats with substantia nigra lesions has been demonstrated. Citicoline increases striatal dopamine and tyrosine hydroxylase synthesis.
Dosage/Direction for Use
Zynapse 1000: 1 injection daily.
Dosage may be adjusted based on the severity of the disease. It can be administered IM, IV (3-5 min) injection and in IV drop perfusion (dripping speed 40-60 drops/min). In case of persistent intracranial hemorrhage, a very slow administration (30 drops/min) is recommended. The administration of larger doses could provoke an increase in the cerebral blood flow.
Contraindications
Special Precautions
Adverse Reactions
Drug Interactions
Action
Citicoline activates the biosynthesis of structural phospholipids in the neuronal membrane, increases cerebral metabolism and the level of various neurotransmitters, including acetylcholine and dopamine. Citicoline has shown neuroprotective effects in situations of hypoxia and ischemia, as well as improved learning and memory performance in animal models of brain aging. Furthermore, it has been demonstrated that citicoline restores the activity of mitochondrial ATPase and of membranal Na+/K+ ATPase, inhibits the activation of phospholipase A2 and accelerates the reabsorption of cerebral edema in various experimental models.
Pharmacodynamics: When administered orally, it is absorbed almost completely and its bioavailability is approximately the same when administered IV.
Once absorbed, cytidine and choline disperse widely throughout the body, cross the blood-brain barrier and reach the central nervous system (CNS), where they are incorporated into the phospholipid fraction of the cellular membrane and microsomes.
The concept that administration of exogenous citicoline can augment the synthesis of neural membrane phospholipid is attractive, because accelerated replacement or repair plays a critical role in maintaining the healthy function of numerous physiological processes. It has shown therapeutic efficacy in a variety of diseases in which membrane disorder, dysfunction or degeneration result in cellular and tissue ischemia and necrosis.
MedsGo Class
Features
- Citicoline