Actovegin and antibiotics compatibility. Actovegin: instructions for the use of injections and what they are for, price, reviews, analogues

This tool contains as active substance deproteinized hemoderivate from calf blood .

The injection also contains sodium chloride and water as additional substances. OKPD code 24.42.13.815.

Release form

There are the following forms of the drug:

• Solution for injection 2 ml, 5.0 No. 5, 10 ml No. 10. It is contained in colorless glass ampoules that have a breaking point. Packed in a blister pack of 5 pieces.
• The solution for infusion (Actovegin intravenously) is placed in 250 ml bottles, which are corked and placed in a cardboard box.
• Actovegin tablets have a round biconvex shape, covered with a yellow-green shell. Packed in dark glass bottles of 50 pieces.
• Cream Actovegin is packaged in tubes of 20 g.
• Gel Actovegin 20% is packaged in tubes of 5 g.
• Actovegin eye gel 20% is packaged in tubes of 5 g.
• Ointment 5% is packaged in tubes of 20 g.

pharmachologic effect

Wikipedia indicates that this medicine activates metabolic processes in body tissues, activates regeneration processes and improves trophism. Active substance gemoderivate obtained by dialysis and ultrafiltration.

Under the influence of the drug, the resistance of tissues to hypoxia increases, since this drug stimulates the process of utilization and consumption of oxygen. It also activates energy metabolism and glucose uptake. As a result, the energy resource of the cell increases.

Due to the increase in oxygen consumption, the plasma membranes of cells in people suffering from ischemia and the formation of lactates is also reduced.

Under influence Actovegina not only increases the glucose content in the cell, but also stimulates oxidative metabolism. All this contributes to the activation of the energy supply of the cell. This confirms the increase in the concentration of free energy carriers: ADP, ATP, amino acids, phosphocreatine.

Actovegin has a similar effect also in the manifestation of peripheral circulatory disorders and with the consequences that are manifested as a result of these violations. It is effective in accelerating the wound healing process.

In people with trophic disorders , , ulcers of various etiologies under the influence of Actovegin, both morphological and biochemical parameters of granulation are improved.

Since Actovegin affects the absorption and utilization of oxygen in the body and exhibits insulin-like activity, stimulating transport and oxidation glucose , then its influence is significant in the course of therapy diabetic polyneuropathy .

In people suffering diabetes , in the process of treatment, disturbed sensitivity is restored, the severity of symptoms associated with mental disorders decreases.

Pharmacokinetics and pharmacodynamics

The abstract indicates that the pharmacokinetic characteristics of the drug cannot be studied, since it contains only physiological components that are present in the body. Therefore there is no description.

After parenteral administration Actovegina the effect is noted after about 30 minutes or earlier, its maximum is noted after 3 hours on average.

There was no decrease in the pharmacological efficacy of gemoderivatives in people who suffer from renal and hepatic insufficiency, as well as in the elderly, newborns, etc.

Indications for use Actovegin

The use of the drug is carried out according to the doctor's prescription for a number of diseases and disorders.

Indications for use Actovegin tablets

• complex treatment of vascular and metabolic brain disorders (ischemic , , insufficiency of blood flow in the brain TBI );
• diabetic ;
• arterial and venous vascular disorders, as well as the consequences associated with such disorders ( trophic ulcers , angiopathy ).

A dropper and injections of Actovegin are prescribed for similar diseases and conditions of the body.

Ointment Actovegin, indications for use

• inflammatory processes of the skin and mucous membranes, wounds (with burns , abrasions , cuts , cracks and etc.);
• weeping ulcers, varicose origin, etc.;
• to activate tissue regeneration after burns;
• for the treatment and prevention bedsores ;
• in order to prevent manifestations on the skin associated with the influence of radiation.

With the same diseases, Actovegin cream is used.

Indications for use Gel Actovegin similar, but the preparation is also used for the purpose of surface treatment skin before starting the skin grafting process in the treatment of burn disease.

The use of medication in different forms for pregnant It is carried out with similar indications, but only after the appointment of a doctor and under his control.

Actovegin for athletes is sometimes used to improve their performance.

From what ointment Actovegin , as well as other forms of drugs are still used, and why this or that form helps, the attending physician will advise.

Contraindications

Contraindications for use are defined as follows:

• oliguria ;
• pulmonary edema;
• fluid retention;
• anuria ;
• if a dropper is used - decompensated heart failure;

Side effects of Actovegin

Side effects of injections and other forms of the drug are rare, as in most cases it is well tolerated.

When using the drug, the following side effects may occur:

• : in rare cases, it is possible to develop , , heavy sweating, fever, hot flashes;
• gastrointestinal function : vomiting, nausea, dyspepsia, pain in the epigastric region ;
• the cardiovascular system : , pain in the region of the heart, pale skin, shortness of breath, arterial hypertension or hypotension;
• functions nervous system : weakness, , , agitation, loss of consciousness, tremor, paresthesia;
• functions respiratory system : feeling of constriction in the area chest, rapid breathing, difficulty swallowing, sore throat, feeling of choking;
• musculoskeletal system : back pain, feeling of pain in the joints and bones.

If there are indications for the use of the drug, but these side effects are noted, you need to stop taking the medication and apply symptomatic therapy.

Application instruction of Actovegin (Method and dosage)

The medicine is prescribed in the form that will be most effective for a particular disease.

Actovegin injections, instructions for use

The drug in the form of a solution for injection can be administered intravenously, intra-arterially or intramuscularly.

Injections, depending on the severity of the disease, are carried out at a dose of 10-20 ml intravenously, after which a slow introduction of 5 ml of the solution intravenously is practiced. The drug in ampoules should be administered every day or several times a week.

Ampoules are prescribed for disorders of metabolism and blood supply and brain . Initially, 10 ml of the drug is administered intravenously for two weeks. Further, within four weeks, 5-10 ml are administered several times a week.

Sick with ischemic stroke intravenously drive 20-50 ml of Actovegin, previously diluted in 200-300 ml of infusion solution. For two to three weeks, the drug is administered every day or several times a week. Similarly, treatment is carried out for people suffering from arterial angiopathy .

Patients with trophic ulcers or other sluggish ulcers or burns prescribe the introduction of 10 ml intravenously or 5 ml intramuscularly. This dose, depending on the severity of the lesion, is administered once or several times a day. Additionally carried out local therapy means.

For prevention or treatment radiation damage to the skin applied every day 5 ml of the drug intravenously, during the intervals between exposure to radiation.

Solution for infusion, instructions for use

Infusions are carried out intravenously or intraarterially. The dose depends on the diagnosis and condition of the patient. As a rule, 250 ml is prescribed per day. Sometimes the initial dose of a 10% solution is increased to 500 ml. The course of treatment can be from 10 to 20 infusions.

Before infusion, you need to make sure that the vial has not been damaged. The flow rate should be approximately 2 ml per minute. It is important that the solution does not get into extravascular tissues when injected.

Instructions for use Actovegin tablets

It is necessary to take the tablets before meals, they do not need to be chewed, they should be washed down with a small amount of water. In most cases, 1-2 tablets are prescribed three times a day. Therapy usually lasts 4 to 6 weeks.

People suffering diabetic polyneuropathy , the drug is initially administered intravenously at 2 g per day for three weeks, after which tablets are prescribed - 2-3 pcs. per day for 4-5 months.

Gel Actovegin, instructions for use

The gel is applied topically to cleanse wounds and ulcers, as well as their subsequent treatment. If there is a burn or radiation injury on the skin, the product should be applied in a thin layer. In the presence of an ulcer, the gel is applied in a thick layer and covered with a compress on top, which is saturated with Actovegin ointment.

The bandage should be changed once a day, but if the ulcer gets very wet, then this should be done more often. For patients with radiation injuries, the gel is applied in the form of applications. For the purpose of treatment and prevention of bedsores, dressings should be changed 3-4 times a day.

Cream Actovegin, instructions for use

It is used to activate the healing process of wounds, weeping ulcers. After the end of treatment with Actovegin gel, it is used to prevent the development of bedsores. For the treatment and prevention of radiation injuries, the use of the cream 2-3 times a day is indicated.

Ointment Actovegin, instructions for use

The ointment is indicated for long-term therapy of ulcers and wounds, it is used after the completion of treatment with gel and cream. The ointment is applied to skin lesions in the form of bandages that need to be changed up to 4 times a day. If the ointment is used to prevent bedsores or radiation injuries, the bandage should be changed 2-3 times.

Actovegin ointment for burns should be applied very carefully so as not to damage the skin, for which it is best to initially apply the ointment to the bandage.

Overdose

If the use of the drug was carried out in too large doses, then the development of negative effects from the gastrointestinal tract is possible. In this case, symptomatic treatment is practiced.

In order to avoid overdose, it is important to take into account the indications for the use of the drug, to know how to inject Actovegin intramuscularly, intravenously, in what doses, and also how any other form of drug release is correctly applied.

Interaction

There are no data on the interaction of Actovegin and other drugs. But, since the possibility of pharmaceutical incompatibility still exists, the Actovegin dropper should not be mixed with other drugs.

Terms of sale

In pharmacies, all forms of the drug are sold by prescription, the doctor writes out a prescription in Latin.

Storage conditions

The medicine should be stored in a dark place, the temperature should not exceed 25 degrees Celsius.

Best before date

All forms of the drug can be stored for 5 years, a solution for infusion 10% can be stored for 3 years. After the vial has been opened and Actovegin has been injected intravenously, the remnants of the drug should not be stored. Ampoules of Actovegin also need to be used completely and do not store leftovers.

special instructions

Actovegin should be administered parenterally very carefully, as there is a possibility of anaphylactic reactions. Before starting treatment, a test injection should be performed.

If develop allergic reactions , it is better to use a drug substitute. If necessary, allergic reactions are stopped by the use of antihistamines or corticosteroids.

When determining whether it is possible to inject intramuscularly or inject a drug solution intravenously, it should be taken into account that the solution may have a slight yellowish tint. In this case, the intensity of the shade may be different, depending on the production batch.

As evidenced by the reference book of Vidal preparations, when the drug is administered parenterally repeatedly, it is necessary to clearly control the water balance, as well as the electrolyte composition of the serum.

Actovegin in gynecology applied on the recommendation of the attending physician. In particular, its ability to improve blood circulation and metabolism plays an important role in IVF.

In sports, the drug is used to improve the performance of athletes, but doctors do not recommend uncontrolled use of the drug. Injections in bodybuilding can lead to the manifestation side effects.

For the eyes, only a special gel contained in tubes of 5 g can be used.

Dragee contains sucrose, this should be taken into account for people with fructose intolerance, malabsorption of sucrase-isomaltase or glucose-galactose.

There is no data on how the use of the drug affects the ability to concentrate and drive.

Actovegin's analogues

On sale there are both more expensive and cheaper analogues of this drug, which can replace injections and tablets. Analogues of Actovegin are drugs , Vero-Trimetazidine , , , .

However, when discussing analogues of Actovegin in ampoules, it should be noted that a similar active substance is only in the composition of the drug. Solcoseryl . All other drugs listed above have only similar indications for use. The price of analogues depends on the manufacturer.

Which is better - Actovegin or Solcoseryl?

As part of the medicine Solcoseryl - the same active ingredient that is made from the blood of calves. But Actovegina longer shelf life as it contains preservative. However, some experts note that the preservative can adversely affect the human liver.

Cortexin or Actovegin - which is better?

Cortexin is also a drug of animal origin. But it is obtained from the cerebral cortex of piglets or calves. Which drug is appropriate to prescribe in a particular case, only a specialist should determine.

Which is better - Cerebrolysin or Actovegin?

Cerebrolysin in the composition contains a hydrolyzate of the brain substance freed from protein. Which of the drugs to prefer, only the doctor determines, depending on the indications. In some cases, these funds are prescribed simultaneously.

children

For children, the drug is prescribed for diseases of a neurological nature, which were the result of complications of pregnancy or problems during childbirth. The drug in the form of injections can be prescribed to children up to a year old, but during treatment it is necessary to adhere to the prescribed scheme very precisely.

With mild lesions, a pill is prescribed - 1 tablet per day. If Actovegin injections are prescribed intramuscularly, the dosage depends on the condition of the baby.

Actovegin for newborns

For newborns, as a rule, the drug is prescribed at a dose of 0.4-0.5 ml / kg once a day, administered either intravenously or intramuscularly.

With alcohol

Drug compatibility with alcohol is not described in the instructions. But, despite the absence of explicit prohibitions on alcohol intake during treatment with Actovegin, doctors do not recommend drinking alcohol, since alcohol almost completely neutralizes the effect of treatment.

Actovegin during pregnancy

Actovegin is not contraindicated for pregnant women. Why pregnant women are prescribed this drug depends on the state of health of the woman during the period of bearing the child. Mainly during Actovegin is used to prevent fetal developmental disorders in placental insufficiency .

Also, the drug is sometimes prescribed when planning a pregnancy. For expectant mothers, a dropper, injections or tablets during pregnancy are prescribed in order to activate the uteroplacental circulation, normalize the metabolic functions of the placenta, and gas exchange.

Since the drug consists of natural ingredients, it does not have a negative effect on the fetus, as evidenced by reviews during pregnancy.

During pregnancy, a dose of Actovegin solution is administered intravenously from 5 to 20 ml, intravenous administration is practiced every day or every other day. Intramuscularly, the agent is prescribed in an individual dosage, depending on what this medicine is prescribed for during pregnancy. Treatment usually lasts 4 to 6 weeks.

Actovegin belongs to the group of antihypoxants, i.e. drugs that help the cells of the body store oxygen and reduce the need for it. The pharmaceutical raw material for the production of Actovegin is an extract of calf blood serum. By activating the cellular metabolism of oxygen and glucose and optimizing their consumption, the drug significantly increases the energy capacity of cells and their resistance to oxygen starvation. When using actovegin, the synthesis of ATP - the main energy "fuel" of the body - increases 18 times. Thus, there is an intensification of all energy-consuming processes in cells (regeneration). At the same time, actovegin increases the concentration of the "building materials" of the body - amino acids aspartate, glutamate, gamma-aminobutyric acid, which contributes, for example, to the speedy healing of wounds and other skin lesions.

The method of application of actovegin is determined by its form of release. Tablets are taken three times a day before meals, along with a small amount of water, 1-2 pieces. The duration of treatment is 1-1.5 months. Actovegin solution is injected into a vein, muscle or artery. The initial dose is 10-20 ml per day, then the dose is reduced to 5-10 ml. The duration of treatment depends on the specific disease, for example, in violation of cerebral circulation and metabolism, it is at least a month, with ischemic stroke - 3 weeks, with poorly healing ulcers and burns, they are guided mainly by the speed of the healing process.

As for the external forms of release of actovegin - cream, gel and ointment - in this case, the drug is used externally: it is applied twice a day (this is the minimum, it can be more often) for at least 12 days. For ulcers, wounds and inflammatory diseases skin treatment starts with 20% gel and 5% cream, then proceeds to 5% ointment (the so-called three-step treatment). In order to prevent bedsores, the external forms of actovegin are rubbed into the skin in the most unfavorable places in this regard.

When using actovegin in the form of an injection solution, a number of important circumstances should be known. Yes, at intramuscular way the use of the drug is allowed to enter no more than 5 ml of the solution. To prevent allergies, it is recommended to do a test injection (2 ml of solution intramuscularly). In the production of injectable Actovegin, no preservatives are used, so injections must be carried out with strict observance of all asepsis conditions. And most importantly: the opened drug is not stored, and if not all the solution was used from the open ampoule, then the remains of the drug must be disposed of.

Pharmacology

Antihypoxant. Actovegin ® is a hemoderivate, which is obtained by dialysis and ultrafiltration (compounds with a molecular weight of less than 5000 daltons pass). It has a positive effect on the transport and utilization of glucose, stimulates oxygen consumption (which leads to stabilization of the plasma membranes of cells during ischemia and a decrease in the formation of lactates), thus having an antihypoxic effect, which begins to manifest itself no later than 30 minutes after parenteral administration and reaches a maximum on average after 3 hours (2-6 hours).

Actovegin ® increases the concentration of adenosine triphosphate, adenosine diphosphate, phosphocreatine, as well as amino acids - glutamate, aspartate and gamma-aminobutyric acid.

Pharmacokinetics

Using pharmacokinetic methods, it is impossible to study the pharmacokinetic parameters of the drug Actovegin ®, since it consists only of physiological components that are usually present in the body.

To date, no decrease in the pharmacological effect of hemoderivates has been found in patients with altered pharmacokinetics (for example, hepatic or kidney failure, metabolic changes associated with old age, as well as features of metabolism in newborns).

Release form

Solution for infusion (in dextrose solution) is clear, colorless to slightly yellow.

Excipients: dextrose - 7.75 g, sodium chloride - 0.67 g, water for injection - up to 250 ml.

250 ml - colorless glass bottles (1) - packs of cardboard.

Dosage

In / in drip or in / a jet. 250-500 ml per day. The infusion rate should be about 2 ml/min. The duration of the course of treatment is 10-20 infusions. Due to the potential for anaphylactic reactions, it is recommended that a test be performed prior to infusion.

Metabolic and vascular disorders of the brain: at the beginning - 250-500 ml / day / in for 2 weeks, then - 250 ml / in several times a week.

Peripheral vascular disorders and their consequences: 250 ml intravenously or intravenously, daily or several times a week.

Wound healing: 250 ml IV, daily or several times a week, depending on the rate of healing. It is possible to use together with Actovegin ® in the form of medicines for topical use.

Prevention and treatment of radiation injuries of the skin and mucous membranes: an average of 250 ml / in the day before and daily during radiotherapy and also within 2 weeks after its completion.

Interaction

Currently unknown.

However, in order to avoid possible pharmaceutical incompatibility, it is not recommended to add other drugs to Actovegin ® infusion solution.

Side effects

Allergic reactions (skin rash, skin flushing, hyperthermia) up to anaphylactic shock.

Indications

• metabolic and vascular disorders of the brain (including ischemic stroke, traumatic brain injury);
• peripheral (arterial and venous) vascular disorders and their consequences (arterial angiopathy, trophic ulcers);
• wound healing (ulcers of various etiologies, burns, trophic disorders (pressure sores), impaired wound healing processes);
• prevention and treatment of radiation damage to the skin and mucous membranes during radiation therapy.

Contraindications

• hypersensitivity to the drug Actovegin ® or similar drugs;
• decompensated heart failure;
• pulmonary edema;
• oliguria, anuria;
• fluid retention in the body.

With caution: hyperchloremia, hypernatremia, diabetes mellitus (1 vial contains 7.75 g of dextrose).

Application features

Use during pregnancy and lactation

The use of the drug in pregnant women did not cause negative effects on the mother or fetus. However, when used in pregnant women, the potential risk to the fetus must be considered.

Application for violations of kidney function

special instructions

With repeated injections, the water-electrolyte balance of the blood plasma should be monitored.

The infusion solution has a slightly yellowish tint. The color intensity may vary from one batch to another depending on the characteristics of the starting materials used, but this does not adversely affect the activity of the drug or its tolerability.

Do not use a solution that is opaque or contains particles. After opening the vial, the solution can not be stored.

The drug Actovegin is used to improve metabolic processes in tissues due to improved blood supply. In addition, Actovegin is an active antihypoxant and antioxidant.

Description

The drug has earned the trust of doctors and patients as a reliable remedy. It is well tolerated by both adults and children. And even the relatively high price of the drug is not a hindrance to this. For example, the average price for a pack of 50 tablets is approximately 1,500 rubles. Such a high price is due to both the complexity of the technology for obtaining the drug, and the fact that it is manufactured by a foreign manufacturer - an Austrian pharmaceutical company. And at the same time, the drug is in demand, which means that Actovegin is an effective remedy.

What does the drug help? The main purpose of the drug is the treatment of diseases associated with blood circulation. Ointments are widely used to treat bruises, abrasions and bedsores. Also, the drug is used to treat diseases associated with circulatory disorders.

The main component of the drug is hemoderivat (hemodialysate). It consists of a complex of nucleotides, amino acids, glycoproteins and other low molecular weight substances. This extract is obtained by hemodialysis of the blood of dairy calves. Hemoderivat is devoid of proper proteins, which significantly reduces its ability to cause allergic reactions.

At the biological level, the effect of the drug is explained by the stimulation of cellular oxygen metabolism, improved glucose transport, an increase in the concentration of nucleotides and amino acids involved in energy metabolism in cells, and stabilization of cell membranes. The action of the drug begins half an hour after ingestion and reaches a maximum after 2-6 hours.

Since the drug is made from natural biological components, so far it has not been possible to trace their pharmacokinetics. It can only be noted that pharmacological effect the funds do not decrease due to impaired renal and liver functions and in old age - that is, in such cases when such an effect would be expected.

Indications for use

Tablets and solutions:

• Cerebral circulatory disorders
• Diabetic polyneuropathy
• Trophic ulcers
• Angiopathy
• Encephalopathy
• Traumatic brain injury
• Circulatory disorders caused by diabetes

Ointment, cream and gel:

• Inflammatory processes of the skin, mucous membranes and eyes
• Wounds, abrasions
• Tissue regeneration after burns
• Treatment and prevention of bedsores
• Treatment of radiation skin lesions

Can Actovegin be used during pregnancy? At the moment, there is no data on the harm caused by the drug to the health of the mother and child. However, no serious studies have been conducted on this subject. Thus, the drug can also be used in case of pregnancy, but only as prescribed by a doctor and under his supervision, and if the risk to the health of the mother outweighs that potential harm, which can be inflicted on her unborn child.

Actovegin injections for children

When treating children, injections are not recommended due to the high risk of allergic reactions. If there is a need to use Actovegin for the treatment of children, then it is preferable to use other dosage forms. However, in some cases, the doctor may prescribe Actovegin injections to the child. The basis for the appointment of injections may be regurgitation or vomiting.

Side effects and contraindications

The medicine is made from natural ingredients, so the likelihood that any side effects will occur is extremely small. However, in some cases there are:

• soreness at the injection site
• skin hyperemia
• hyperthermia
• hives
• edema
• fever
• anaphylactic shock
• headache
• dizziness
• weakness
• nausea
• vomit
• diarrhea
• pain in the stomach
• tachycardia
• hypertension or hypotension
• increased sweating
• heartache

When applying ointments and creams to treat wounds, soreness can often be observed in the place where the drug touches the skin. Such pains usually disappear within 15-30 minutes and do not indicate intolerance to the remedy.

At the moment, there is no data on the interaction of Actovegin with other drugs. It is not recommended to add foreign substances to the solution for infusion.

Actovegin has few contraindications. These include:

• Oliguria or anuria
• Pulmonary edema
• Decompensated heart failure
• Component intolerance

Dosage forms and their composition

The drug is available in various dosage forms ah - tablets, ointment, cream, gel, solutions for infusions and injections. The price of dosage forms is not the same. The most expensive are tablets; creams and ointments are much cheaper.

Actovegin ointment

Used to treat wounds, abrasions, ulcers, burns, various inflammatory processes on the skin and mucous membranes. The basis of the ointment is fatty substances. The ointment softens the skin; active ingredients better absorbed into the skin from the ointment than from other dosage forms.

Actovegin gel

It is used for the same purposes as the ointment. The gel is water based. It does not clog skin pores, spreads faster over the surface of the skin and begins to act compared to ointment.

Tablets Actovegin

Tablets are prescribed for circulatory disorders, treatment trophic ulcers, encephalopathies, consequences of craniocerebral injuries. Taking tablets is more convenient and has a lower risk of side effects than parenteral administration of the drug.

Actovegin, instructions for use and dosage

The optimal way to take Actovegin tablets according to the instructions is 1-2 tablets 2 times a day. It is recommended to take the drug before meals. The course of treatment usually lasts 2-4 weeks.

Used in the treatment of diabetic polyneuropathy intravenous administration. The dose is 2 g / day, and the course of treatment is 3 weeks. After that, therapy is carried out with the help of tablets - 2-3 pcs. in a day. Reception is carried out within 4-5 months.

Instructions for use, ointment, gel and cream

The ointment is used for wounds, ulcers, burns. The bandage with ointment must be changed 4 times a day, with bedsores and radiation burns - 2-3 times a day.

The gel has a less oily base than the ointment. Actovegin gel, as the instructions say, is used to treat wounds, ulcers, bedsores, burns, including radiation. For burns, Actovegin gel is applied in a thin layer, for ulcers - thick, and closed with a bandage. The bandage should be changed once a day, with bedsores - 3-4 times a day.

The cream is used to treat wounds, weeping ulcers, prevent bedsores (after using the gel).

Injections

Injections can be carried out in two ways: intravenously and intramuscularly. Since injections increase the risk of allergic reactions, it is recommended to pre-test for hypersensitivity.

In ischemic stroke and angiopathy, 20-50 ml of Actovegin, previously diluted in 200-300 ml of solution, is injected. The course of treatment is 2-3 weeks. Injections are given every day or several times a week.

With metabolic and vascular disorders of the brain, it is necessary to inject 5-25 ml daily for two weeks. After this, the course of treatment must be continued with tablets.

For ulcers and burns, 10 ml intravenously or 5 ml intramuscularly are prescribed. Injections must be done one or more times a day. In addition, therapy is carried out with the help of an ointment, gel or cream.

Doses for children are calculated based on their weight and age:

• 0-3 years - 0.4-0.5 ml / kg 1 time per day
• 3-6 years - 0.25-0.4 ml / kg 1 time per day
• 6-12 years - 5-10 ml per day
• over 12 years - 10-15 ml per day

Drug analogues

An analogue of the drug Actovegin is Solcoseryl, which also contains a blood derivative. Actovegin differs from Solcoseryl in that it has no preservatives. This, on the one hand, increases the shelf life of the product, but on the other hand, it can cause a negative effect on the liver. The price of Solcoseryl is slightly higher.

Actovegin is a drug that activates tissue metabolism, improves trophism and stimulates the regeneration process.

Release form and composition

Actovegin is produced in the following dosage forms:

• solution for infusion 4 mg / ml in dextrose solution: clear, colorless or pale yellow (250 ml in clear glass bottles, 1 bottle in a carton box);
• solution for infusion 4 or 8 mg / ml in 0.9% sodium chloride solution: clear, colorless or pale yellow (250 ml in clear glass bottles, 1 bottle in a carton box);
• solution for injection: transparent, yellowish (2, 5 or 10 ml in colorless glass ampoules with a break point, 5 ampoules in a plastic blister pack, 1, 2 or 5 packs in a carton box);
• film-coated tablets: biconvex, round, shiny, greenish-yellow (10, 30 or 50 pieces in dark glass bottles, 1 bottle in a carton box);
• cream for external use: homogeneous, white (20, 30, 50 or 100 g in aluminum tubes, 1 tube in a cardboard box);
• ointment for external use: homogeneous, white (20, 30, 50 or 100 g in aluminum tubes, 1 tube in a cardboard box);
• gel for external use: homogeneous, colorless or pale yellow, transparent (20, 30, 50 or 100 g in aluminum tubes, 1 tube in a cardboard box).

250 ml solution for infusion in dextrose solution contains:

• active substance: deproteinized calf blood hemoderivat - 25 ml (equivalent to 1000 mg of dry weight);

• additional components: dextrose, sodium chloride, water for injection.

250 ml solution for infusion in 0.9% sodium chloride solution contains:

• active substance: deproteinized calf blood hemoderivat - 25 and 50 ml (equivalent to 1000 and 2000 mg of dry weight at a dosage of 4 and 8 mg / ml, respectively);

• additional components: sodium chloride, water for injection.

1 ampoule of solution for injection (in a volume of 2, 5 and 10 ml) contains:

• active substance: Actovegin concentrate (in terms of dry deproteinized hemoderivat blood of calves) - 80, 200 or 400 mg respectively);

• additional component: water for injections.

1 tablet contains:

• active substance: deproteinized calf blood hemoderivat - 200 mg [in the form of Actovegin granulate in the amount of 345 mg (auxiliary ingredients: microcrystalline cellulose - 135 mg, povidone-K 90 - 10.0 mg)];
• additional components: magnesium stearate, talc;
• shell: hypromellose phthalate, macrogol-6000, acacia gum, mountain glycol wax, povidone-K 30, titanium dioxide, quinoline yellow dye aluminum lacquer, diethyl phthalate, sucrose, talc.

1000 mg of cream contains:

• additional components: glyceryl monostearate, macrogol 4000, benzalkonium chloride, macrogol 400, cetyl alcohol, purified water.

1000 mg of ointment contains:

• active substance: deproteinized hemoderivat from the blood of calves - 0.05 ml (equivalent to 2 mg of dry weight);
• additional components: methyl parahydroxybenzoate, white paraffin, propyl parahydroxybenzoate, cholesterol (cholesterol), cetyl alcohol, purified water.

1000 mg of gel contains:

• active substance: deproteinized hemoderivat from the blood of calves - 0.2 ml (equivalent to 8 mg of dry weight);
• additional components: propyl parahydroxybenzoate, carmellose sodium, methyl parahydroxybenzoate, calcium lactate, propylene glycol, purified water.

Indications for use

• brain dysfunction (metabolic, vascular) including ischemic stroke and traumatic brain injury;
• wound healing, including trophic disorders (pressure sores), burns, ulcers various genesis, violation of wound healing processes;
• diabetic polyneuropathy (for solution for injection and solution for infusion in 0.9% sodium chloride solution);
• radiation damage to the skin and mucous membranes due to radiation therapy (prevention / treatment).

Tablets

• peripheral vascular disorders (arterial and venous) and their consequences, such as arterial angiopathy and trophic ulcers;
• brain dysfunction (metabolic, vascular) including dementia, cerebrovascular insufficiency in various forms, traumatic brain injury (as part of combination therapy);
• diabetic polyneuropathy.

Ointment, cream, gel

• wounds and diseases of the inflammatory nature of the skin and mucous membranes, including burns, including sunburn (for ointment - chemical burns in acute stage), scratches, cracks, skin cuts, abrasions;
• conditions after burns, including after a burn with steam or boiling liquid (to improve and accelerate tissue regeneration);
• weeping ulcers, including ulcers of varicose origin (the gel is indicated as an initial therapy);
• wound surfaces (as pre-treatment) in the treatment of burn disease before skin transplantation - for the gel;
• bedsores (prevention / treatment) - for ointment and cream;
• mucosal and skin reactions caused by exposure to radiation (prevention/treatment).

Contraindications

The use of all forms of release of Actovegin is contraindicated in the presence of hypersensitivity to its components or to similar drugs.

Absolute contraindications to the use of solution for infusion and solution for injection:

• pulmonary edema;
• decompensated heart failure;
• fluid retention in the body;
• anuria;
• oliguria.

Solution for infusion and solution for injection is used with caution in the following conditions and / or diseases:

• pregnancy (after assessing the ratio of benefits and possible risks);
• hypernatremia;
• diabetes mellitus (for solution for infusion in dextrose solution);
• hyperchloremia.

Actovegin tablets should be used with caution in the following conditions and / or diseases:

• pulmonary edema;
• heart failure II and III degree;
• hyperhydration;
• anuria;
• oliguria;
• pregnancy and lactation period.

Method of application and dosage

Injection

Solution for injection is intended for intramuscular (in / m), intra-arterial (in / a) and intravenous (in / in) administration (including in the form of infusion).

• ischemic stroke: daily intravenous drip at a dose of 800-2000 mg, diluted in 200-300 ml of 5% dextrose solution or 0.9% sodium chloride solution for 7 days, then 400-800 mg in a course of 14 days, then the drug taken orally;
• brain disorders (vascular and metabolic): daily IV in a daily dose of 200-1000 mg for 14 days with a further transition to oral administration of the drug;
• peripheral vascular disorders (arterial and venous) and their consequences: daily intravenously or intravenously at a dose of 800-1000 mg, diluted in 5% dextrose solution or 0.9% sodium chloride solution in a volume of 200 ml; course - 28 days;
• diabetic polyneuropathy: intravenously at a daily dose of 2000 mg, the course is 21 days, then they switch to oral administration;
• radiation cystitis: daily transurethral at a dose of 400 mg in combination with the use of antibiotics;
• radiation damage to the mucous membranes and skin during radiation therapy (prevention/treatment): daily i.v. at an average dose of 200 mg in between exposures;
• wound healing: intravenously at a dose of 400 mg or intramuscularly at a dose of 200 mg, daily or 3-4 times a week, taking into account the healing process (as an addition to local therapy).

The rate of administration is 2 ml per minute, the duration of treatment is set individually depending on the symptoms and severity of the disease.

Solution for infusion

The solution for infusion is administered intravenously by drip or intravenous jet at a dose of 250–500 ml per day. Infusion injections of Actovegin are carried out at a rate of about 2 ml per minute.

• brain disorders (including ischemic stroke): intravenously at a daily dose of 1000-2000 mg, course - 14 days, with further oral administration - for the drug in 0.9% sodium chloride solution, or with further intravenous administration of 1000 mg several times a week - for the drug in a dextrose solution;
• peripheral vascular disorders and their consequences: IV or IV 1000 mg daily or several times a week with a further transition to the oral form;
• wound healing: IV at a dose of 1000 mg daily or several times a week, a combination with topical formulations is possible;
• diabetic polyneuropathy (for solution for infusion in 0.9% sodium chloride solution): in / in a daily dose of 2000 mg (500 ml - at a dosage of 4 mg / ml or 250 ml - at a dosage of 8 mg / ml); course - 21 days, then oral administration is prescribed;
• radiation damage to the mucous membranes and skin: intravenously at an average dose of 1000 mg 1 day before the start and daily during the period of radiation therapy, as well as after its completion for 14 days, followed by oral administration.

The duration of therapy is set according to the severity of the disease and its symptoms. The course of treatment with a solution for infusion in a dextrose solution can vary from 10 to 20 infusions.

In connection with the potential threat of anaphylactic reactions with parenteral administration of the drug, it is recommended to test for the presence of hypersensitivity to Actovegin before the start of the course.

Tablets

Tablets are taken orally before meals, swallowed whole, without breaking or chewing, with a small amount of liquid. A single dose - 1-2 tablets, the frequency of administration - 3 times a day. The duration of treatment should be at least 4-6 weeks.

In the treatment of diabetic polyneuropathy after completion of a 21-day course of intravenous administration of the drug, it is recommended to take 2-3 tablets of Actovegin 3 times a day. The minimum duration of admission is 4-5 months.

Ointment, cream, gel

These forms of the drug are used only externally.

The gel is applied to the affected areas in a thin layer several times a day. In order to cleanse ulcerative surfaces, it is recommended to apply a thick layer of gel and cover with a gauze bandage soaked in ointment, or a compress with ointment. It is required to change the dressing once a day, and in the case of therapy of heavily weeping surfaces - several times a day.

For further treatment, use a cream or ointment. In the treatment of wounds, ulcers, inflammatory diseases of the skin and mucous membranes, the drug is recommended to be applied to problem areas in a thin layer: cream - after initial gel therapy, ointment - as the last link, as a rule, after treatment with gel and cream.

To prevent the appearance of bedsores in areas of increased risk of their formation, the drug should be rubbed into the skin.

In order to prevent the occurrence of radiation injuries, Actovegin should be applied in a thin layer in the intervals between radiation therapy sessions, as well as immediately after it.

Ointment and cream are used at least 2 times a day for 12 days or more, including the entire period of active regeneration.

In case of insufficiency or absence of the desired effect from the external use of the gel, cream or ointment, you should consult with your doctor.

Side effects

Solution for infusion, solution for injection

Against the background of parenteral administration of Actovegin, allergic reactions (hyperthermia, skin rashes, hyperemia of the skin) up to anaphylactic shock.

Tablets

During the treatment period, allergic reactions may occur, such as drug fever, edema, urticaria. In such conditions, it is required to stop the use of Actovegin. If necessary, prescribe standard therapy - taking antihistamines and/or corticosteroids.

Ointment, cream, gel

Actovegin externally is usually well tolerated.

In rare cases, with a history of hypersensitivity reactions, allergic reactions may occur.

At the beginning of the use of the gel, local pain may also occur against the background of local tissue edema. This effect does not apply to manifestations of drug intolerance. If pain persists during treatment, it is necessary to consult a specialist.

special instructions

When prescribing Actovegin, an intramuscular solution must be administered slowly, in a volume of not more than 5 ml. Due to the possibility of developing an anaphylactic reaction, a trial intramuscular injection of 2 ml of the drug should be carried out before starting therapy.

Actovegin solutions have a yellowish tint. Depending on the characteristics of the starting materials used, the color of the drug may vary from one batch to another, which does not adversely affect its efficacy and tolerability.

Patients with diabetes it should be borne in mind that in 1 vial (250 ml) of a solution for infusion in a dextrose solution, the dextrose content is 7.75 g.

It is forbidden to use a solution that has lost its transparency, or with the presence of visible particles.

With repeated parenteral administration of the drug, it is necessary to monitor the water and electrolyte balance of the blood plasma.

After opening the ampoule / vial, the solution cannot be stored.

drug interaction

Until now, the interaction of deproteinized calf blood hemoderivat with other medicinal substances / agents has not been established.

In order to prevent possible pharmaceutical incompatibility, add other drugs to Actovegin's infusion solution. medicinal products Not recommended.

Analogues

Actovegin's analogues are Solcoseryl and Solcoseryl dental adhesive paste.

Terms and conditions of storage

Keep out of the reach of children and protected from light, at a temperature not exceeding 25 °C.

Best before date:

• solution for infusion in dextrose solution, solution for injection, tablets, gel - 3 years;
• solution for infusion in 0.9% sodium chloride solution, ointment, cream - 5 years.

Terms of dispensing from pharmacies

Released:

• on prescription: injection solution, solution for infusion, tablets;
• without prescription: cream, ointment, gel.

1 ampoule (2 ml) contains actovegin concentrate as an active substance (in terms of dry deproteinized calf blood hemoderivat) - 80 mg, containing sodium chloride - 53.6 mg;

excipient: water for injection - up to 2 ml.

1 ampoule (5 ml) contains actovegin concentrate as an active substance (in terms of dry deproteinized calf blood hemoderivat) - 200 mg, containing sodium chloride - 134.0 mg;

excipient: water for injection - up to 5 ml.

1 ampoule (10 ml) contains actovegin concentrate as an active substance (in terms of dry deproteinized calf blood hemoderivat) - 400 mg, containing sodium chloride - 268.0 mg;

excipient: water for injection - up to 10 ml.

Description

Clear, yellowish solution, practically free of particles.

Pharmacotherapeutic group

Other hematological agents.

ATX code: B06AB.

Pharmacological properties"type="checkbox">

Pharmacological properties

Pharmacodynamics

Deproteinized calf blood hemoderivat causes an increase in the energy metabolism of cells, which is not organ-specific. This activity is confirmed by the results of measurements of increased accumulation and increased utilization of glucose and oxygen. The total effect of these processes leads to an increase in ATP metabolism and, accordingly, to an increase in the energy supply of the cell. In deficient conditions with impaired normal functioning of energy metabolism (hypoxia, substrate deficiency) and in conditions with increased energy needs (repair, regeneration), Actovegin® activates energy-dependent processes of functional metabolism and conservation metabolism. As a secondary effect, there is an increase in blood supply.

Pharmacokinetics

Using chemical-analytical methods, it is impossible to study the pharmacokinetic parameters of Actovegin®, such as absorption, distribution and excretion, since its active ingredients are physiological components that are normally present in the body.

The study of various parameters in animal experiments and in clinical research showed that the effect of the drug Actovegin® begins to appear no later than 30 minutes after application. The maximum effect after parenteral administration or oral administration is achieved after 3 hours (2-6 hours).

Indications for use

Metabolic and vascular disorders of the brain (including dementia);

Peripheral (arterial and venous) vascular disorders and their consequences (arterial angiopathy, venous ulcers lower extremities), including diabetic polyneuropathy.

Method of application and dosage

General dosing instructions

Break Point Ampoules (TP)

Instructions for use of TR ampoules:

Take the ampoule pointing the colored dot up! Allow the solution to drain from the top of the ampoule by lightly tapping the ampoule and shaking it.

Take the ampoule pointing the colored dot up! Break off the top of the ampoule as shown.

The solution for injection has a slightly yellowish color. The color intensity of the drug from different series may vary due to the raw materials used. Color does not affect the efficacy and tolerability of the drug.

Actovegin® solution for injection can be administered intravenously (IV), intramuscularly (IM) or intra-arterially (IV), and it can also be added to infusion solutions.

When administered as an infusion, 10-50 ml of the drug is added to 200-300 ml of the stock solution (isotonic sodium chloride solution or 5% glucose solution). Rate of infusion: approximately 2 ml/min. When administered as an infusion, general contraindications to infusion therapy should be taken into account, such as decompensated heart failure, pulmonary edema, oliguria, anuria, and hyperhydration.

Dosage depending on specific indications

Metabolic and vascular disorders of the brain: from 5 to 25 ml (200-1000 mg per day) intravenously daily for two weeks, followed by the transition to the tablet form.

Metabolic and vascular disorders of the brain, such as ischemic stroke: 20-50 ml (800-2000 mg) in 200-300 ml of 0.9% sodium chloride solution or 5% dextrose solution intravenously daily for 1 week, then 10-20 ml (400-800 mg) intravenously - 2 weeks, followed by the transition to the tablet form.

Peripheral (arterial and venous) vascular disorders and their consequences: 20-30 ml (800-1000 mg) of the drug in 200 ml of 0.9% sodium chloride solution or 5% dextrose solution intra-arterially or intravenously daily; the duration of treatment is 4 weeks.

Venous ulcers of the lower extremities: 10 ml (400 mg) intravenously or 5 ml intramuscularly daily or 3-4 times a week depending on the healing process.

Diabetic polyneuropathy:

50 ml (2000 mg) per day intravenously for 3 weeks, followed by the transition to the tablet form - 2-3 tablets 3 times a day for at least 4-5 months.

The duration of the course of treatment is determined individually according to the symptoms and severity of the disease.

Contraindications

The presence of an allergy to Actovegin® or similar drugs or excipients.

Precautionary measures

With parenteral administration of Actovegin®, sterility must be observed during manipulations. Actovegin® is intended for single use as it does not contain preservative additives. Opened ampoules and the prepared solution should be used immediately. Unused drug and used consumable must be disposed of in accordance with local regulations.

When mixing the contents of Actovegin® ampoules with other solutions for injection or infusion, physical and chemical incompatibility, as well as interaction between active substances, cannot be excluded, even if the solution remains clear. As a result, it is unacceptable to mix Actovegin® with other medicines, with the exception of those mentioned in the "General Dosing Instructions" section.

With the / m use of Actovegin® should be administered slowly, no more than 5 ml, since the solution is hypertonic.

Parenteral administration of Actovegin® should be carried out under medical supervision in the presence of appropriate means for the treatment of allergic reactions. Due to the possibility of anaphylactic reactions, a test infusion/injection (hypersensitivity test) is recommended before starting therapy.

Do not use a solution that is cloudy or with visible solid particles.

It is a source of sodium, which should be considered when prescribing to patients on a controlled sodium diet. In the presence of electrolyte disturbances (such as hyperchloremia and hypernatremia), they should be adequately corrected.