Kokarnit - instructions for use, reviews, analogs and forms of release (injections in ampoules for injections 2.0, tablets) drugs for the treatment of diabetic polyneuropathy in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Cockarnite. Presented are reviews of visitors to the site - consumers of this medication, as well as opinions of doctors of specialists on the use of Cockarnit in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Cochranite in the presence of existing structural analogues. Use for the treatment of diabetic polyneuropathy in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Cockarnite - is a rationally selected complex of metabolic substances and vitamins.

Trifosadenin is a derivative of adenosine, it stimulates metabolic processes. Has a vasodilating effect, incl. on the coronary and cerebral arteries. Improves metabolism and energy supply of tissues. Has antihypertensive and antiarrhythmic action. Under the influence of ATP there is a decrease in blood pressure, relaxation of smooth muscles, improving the conduct of nerve impulses.

Kokarboksilaza - coenzyme, formed in the body from the external thiamine (vitamin B1). It is part of the enzyme carboxylase, which catalyzes the carboxylation and decarboxylation of keto acids. Mediates the synthesis of nucleic acids, proteins and lipids indirectly. Reduces the concentration of lactic and pyruvic acids in the body, promotes the absorption of glucose. Improves the trophism of nervous tissue.

Cyanocobalamin (vitamin B12) in the body is converted to methylcobalamin and 5-deoxyadenosyl cobalamin. Methylcobalamin is involved in the reaction of homocysteine ​​to methionine and S-adenosylmethionine - the key reactions of the metabolism of pyrimidine and purine bases (and, consequently, DNA and RNA).If the vitamin is deficient in this reaction, it can be replaced by methyltetrahydrofolic acid, with folic acid reactions of metabolism being disturbed.

5-deoxyadenosylcobalamin serves as a cofactor in the isomerization of L-methylmalonyl-CoA in succinyl-CoA, an important carbohydrate and lipid metabolism reaction. Deficiency of vitamin B12 leads to a violation of the proliferation of rapidly dividing cells of hematopoietic tissue and epithelium, as well as to the violation of the formation of the myelin sheath of neurons.

Nicotinamide is one of the forms of vitamin PP, it participates in oxidation-reduction processes in the cell, improves carbohydrate and Nitrogen metabolism, regulates tissue respiration.

Composition

Trifosadenina disodium trihydrate + cocarboxylase + cyanocobalamin + nicotinamide + auxiliary substances.

Pharmacokinetics

Trifosadenin

After parenteral administration, it penetrates into the cells of the organs, where it is split into adenosine and inorganic phosphate with the release of energy. Subsequently, decay products are included in the resynthesis of ATP.

Cocarboxylase

Quickly absorbed after intramuscular injection. Penetrates into most body tissues. It is subject to metabolic decomposition.Metabolism products are excreted mainly by the kidneys.

Cyanocobalamin

In the blood, cyanocobalamin binds to transcobalamins 1 and 2, which transport it to tissues. It is deposited mainly in the liver. Relationship with plasma proteins 0.9%. Quickly and completely absorbed after intramuscular and subcutaneous injection. From the liver is excreted bile in the intestine and again absorbed into the blood. It is excreted at normal kidney function - 7-10% by kidneys, about 50% - by the intestine. With reduced renal function - 0-7% kidney, 70-100% - intestine. Penetrates through the placental barrier, into breast milk.

Nicotinamide

Quickly distributed into all tissues. Penetrates through the placental barrier and into breast milk. Metabolized in the liver with the formation of nicotinamide-N-methyl nicotinamide. It is excreted by the kidneys.

Indications

• symptomatic treatment of diabetic polyneuropathy.

Forms of release

Lyophilizate for solution for intramuscular injection 2.0 (injections in ampoules for injection).

Other dosage forms, be it tablets or capsules, do not exist.

Instructions for use and dosing regimen

The drug is injected deeply intramuscularly (in the gluteus muscle).In cases of severe pain, it is advisable to start treatment with the introduction of 1 ampoule (2 ml) per day before the removal of acute symptoms. Duration of application - 9 days.

After improvement of symptoms or in cases of moderate symptoms of polyneuropathy: 1 ampoule 2-3 times a week for 2-3 weeks. The recommended course of treatment is 3-9 injections, depending on the severity of the disease. The duration of treatment and the holding of repeated courses is determined by the doctor depending on the nature and severity of the disease.

Side effect

• allergic reactions (skin rash, shortness of breath, anaphylactic shock, Quincke's edema);
• dizziness;
• headache;
• excitation;
• confusion of consciousness;
• tachycardia;
• bradycardia;
• arrhythmia;
• pain in the heart;
• reddening of the skin of the face and upper half of the trunk with a sensation of tingling and burning;
• "tides";
• vomiting;
• diarrhea;
• increased sweating;
• acne;
• itching;
• hives;
• convulsions;
• may cause irritation, pain and burning at the injection site;
• weakness.

If any of these unwanted reactions are aggravated or any other undesirable reactions not indicated in the instructions appear,it is necessary to inform the doctor about it.

With the development of severe undesirable reactions, the drug is canceled.

Contraindications

• hypersensitivity to any component of the preparation or solvent;
• cardiovascular diseases: acute heart failure, acute myocardial infarction, uncontrolled arterial hypertension, arterial hypotension, severe forms of bradyarrhythmia, 2-3-degree AV blockade, chronic heart failure (3-4 NYHA), cardiogenic shock and other types shocks, QT prolongation syndrome, thromboembolism, hemorrhagic stroke;
• inflammatory lung diseases, COPD, bronchial asthma;
• pregnancy, the period of breastfeeding;
• children's age till 18 years;
• hypercoagulation (including acute thrombosis), erythremia, erythrocytosis;
• peptic ulcer of the stomach or duodenum in the stage of exacerbation;
• gout;
• hepatitis, cirrhosis.

Application in pregnancy and lactation

It is not recommended to use Cockarnit during pregnancy. It is recommended to stop breastfeeding for the duration of treatment with the drug.

Use in children

Contraindicated use of the drug in children and adolescents under the age of 18 years.

special instructions

With aggravation of the symptoms of the disease or lack of effect after 9 days, correction of the course of treatment is necessary.

When using the drug Cockarnit proper selection of a dose of hypoglycemic drug and adequate control of the course of diabetes.

The color of the prepared solution should be pink. Do not use the drug if the color of the solution has changed.

The solution must be used immediately after its preparation!

With caution should be used in patients with angina pectoris.

Influence on ability to drive vehicles, mechanisms

In the event of side effects from the central nervous system (dizziness, confusion), it is recommended to refrain from controlling vehicles and other mechanisms.

Drug Interactions

In patients who use hypoglycemic agents of the biguanide group (metformin), a decrease in the concentration of cyanocobalamin in the blood can be observed due to a violation of absorption of cyanocobalamin from the gastrointestinal tract. With other hypoglycemic agents, drug interactions are not described.

Cyanocobalamin is incompatible with ascorbic acid, heavy metal salts, thiamine, thiamine bromide, pyridoxine, riboflavin, folic acid. It is impossible to apply simultaneously cyanocobalamin with drugs that increase blood coagulability. In addition, simultaneous use of cyanocobalamin with chloramphenicol should be avoided. Aminoglycosides, salicylates, antiepileptic medicines, colchicine, potassium preparations reduce the absorption of cyanocobalamin. When the preparations containing trifosadenine are combined with dipyridamole, the action of Dipyridamole is enhanced, in particular the vasodilating effect. Dipyridamole enhances the effect of trifosadenin.

There is some antagonism in the joint use of the drug with derivatives of purine (caffeine, theophylline).

Do not administer simultaneously with cardiac glycosides in large doses, as the risk of developing adverse reactions from the cardiovascular system increases.

With simultaneous application of xanthinal nicotinate, the effect of the drug is reduced.

Nicotinamide potentiates the action of sedatives, tranquilizers, as well as hypotensive drugs.

Analogues of Cocarinate

Structural analogues for the active substance do not have a Cockarnitum. The drug is unique in the combination of active ingredients that make up the composition.

Analogues on the curative effect (agents for the treatment of diabetic polyneuropathy):

• Actovegin;
• Amitriptyline;
• Benfolipen;
• Berlition 300;
• Vitaxon;
• Gabagamma;
• Durogesic;
• Carbamazepine;
• Kombilipen;
• Liptiokson;
• Milgamma;
• Milgamma compositum;
• Neurolephone;
• Nitethyl;
• Octolipen;
• Simbalta;
• Tiogamma;
• Tioctacid;
• Thiolept;
• Trigamma;
• Finlepsin;
• Finlepsin retard;
• Espa Lipon.

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