CYTOFLAVIN PILLS

Trade name: Cytoflavin (CYTOFLAVIN®).
Grouping name: Inosine + Nicotinamide + Riboflavin + Succinic Acid;
Dosage form: enteric-coated tablets.

The composition of 1 tablet:
active substances:
succinic acid - 0.300 g, inosine (Riboxin) - 0.050 g, nicotinamide - 0.025 g,
Riboflavin Sodium Phosphate (Riboflavin) - 0.005 g;
Excipients:
Povidone - 0.00810 g, Calcium stearate - 0.00390 g,
hypromellose - 0.00360 g, polysorbate-80 - 0.00040 g;
enteric coating: methacrylic acid and ethyl acrylate copolymer - 0.02902 g, propylene glycol - 0.00291 g, dye azorubine - 0.00004 g, tropeolin-O - 0.00003 g

Description: round biconvex pills coated with a red color. On the cross section, two layers are visible. The core of the pills is from yellow to yellow-orange.

Pharmacotherapeutic group: metabolic agent.

Pharmacological properties

Pharmacodynamics
Pharmacological effects are due to the complex effect of the components that make up the preparation of CYTOFLAVIN.
Succinic acid (UC) is an endogenous intracellular metabolite of the Krebs cycle, which performs a universal energy-synthesizing function in the cells of the body. With the participation of the coenzyme flavinadenedinucleotide (FAD), succinic acid, a mitochondrial enzyme succinate dehydrogenase, is rapidly transformed into fumaric acid and further into other metabolites of the tricarboxylic acid cycle.Stimulates aerobic glycolysis and ATP synthesis in cells.

The final product of the metabolism of succinic acid in the Krebs cycle is carbon dioxide and water. Succinic acid improves tissue respiration due to the activation of electron transport in mitochondria.

Riboflavin (vitamin B2) is a flavin coenzyme (FAD) that activates succinic dehydrogenase and other redox reactions of the Krebs cycle. Nicotinamide (vitamin PP), nicotinic acid amide. Nicotinamide in cells, through a cascade of biochemical reactions, is transformed into the form of nicotinamide adenine nucleotide (NAD) and its phosphate (NADP), activating the nicotinamide-dependent enzymes of the Krebs cycle, necessary for cellular respiration and stimulation of ATP synthesis.

Inosine is a derivative of purine, the precursor of ATP. It has the ability to activate a number of Krebs cycle enzymes, stimulating the synthesis of key nucleotide enzymes: flavin adenine dinucleotide (FAD) and nicotinamide adenine dinucleotide (NAD).

Thus, all components of Cytoflavin are natural metabolites of the body and stimulate tissue respiration. Metabolic energy correction, antihypoxic and antioxidant activity of the drug, determining the pharmacological properties and therapeutic effectiveness of the components, due to the complementary effect of succinic acid, inosine, nicotinamide and riboflavin.

Cytoflavin has a high bioavailability.
When taken orally, succinic acid from the gastrointestinal tract enters the blood and tissues, participating in energy metabolism reactions, and completely decomposes to the final metabolic products (carbon dioxide and water) after 30 minutes.

Inosine is well absorbed from the gastrointestinal tract. The time to reach the maximum concentration in the blood is 5 hours, the average retention time in the blood is 5.5 hours, the equilibrium volume of distribution is about 20 liters. Inosine is metabolized in the liver to form inosine monophosphate, followed by its oxidation to uric acid. In small quantities excreted by the kidneys.

Nicotinamide is rapidly distributed in all tissues (the equilibrium volume of distribution is about 500 liters). The time to reach the maximum concentration in the blood - 2 hours, the average retention time in the blood - 4.5 hours. Nicotinamide passes through the placenta and into breast milk; metabolized in the liver to form N-methylnicotinamide, excreted by the kidneys.

Riboflavin is rapidly absorbed from the gastrointestinal tract, is distributed unevenly (the largest number in the myocardium, liver, kidneys), is transformed into flavinadenin mononucleotide (FMN) and flavivinadenine nucleotide (FAD) in mitochondria. Penetrates through the placenta and into breast milk; excreted by the kidneys, mainly in the form of metabolites.

Indications

In adults in complex therapy:
- effects of cerebral infarction;
- other cerebrovascular diseases (cerebral atherosclerosis, hypertensive encephalopathy);
- neurasthenia (irritability, fatigue, loss of ability to prolonged mental and physical stress).

Contraindications

Individual intolerance to the components of the drug.
Not recommended for use in children under 18 years due to insufficient data on efficacy and safety.

Carefully

Diseases of the digestive system (erosion, gastric and / or duodenal ulcers, gastritis and duodenitis (in acute stage), arterial hypotension, nephrolithiasis, concomitant gout, hyperuricemia. If you have one of these diseases, you should consult with your doctor before taking the drug.

Pregnancy and breastfeeding

It is not recommended to take during pregnancy and lactation, due to the lack of clinical data on the efficacy and safety of the drug during this period.

Dosage and administration

Inside 2 pills 2 times a day with an interval of 8-10 hours between doses. pills should be taken at least 30 minutes before a meal, without chewing, drinking water (100 ml).

Recommended medication in the morning and afternoon (no later than 18 hours).

Duration of treatment is 25 days. Appointment of re-rate is possible with an interval of at least 1 month.

Adverse Effects

Headache, pain or discomfort in the epigastric region. Allergic reactions in the form of skin flushing and itching are possible.Adverse reactions include: transient hypoglycemia, hyperuricemia, exacerbation of concomitant gout.

If any of the side effects indicated in the instruction are aggravated or you notice any other side effects that are not indicated in the instruction, inform your doctor.

Overdosage

To date, no cases of overdose have been identified with CYTOFLAVIN.

Interaction with other drugs

Succinic acid, inosine and nicotinamide are compatible with other drugs. Riboflavin reduces the activity of some antibiotics (tetracyclines, Erythromycin, lincomycin), and is incompatible with streptomycin. Ethanol, tricyclic antidepressants, tubular secretion blockers reduce riboflavin absorption, and thyroid hormones accelerate its metabolism.

Special notes

In hypertension, dosage adjustment of antihypertensive drugs may be required.

In patients with diabetes mellitus treatment should be carried out under the control of the concentration of glucose in the blood.

Perhaps intense staining of urine in yellow.

CYTOFLAVIN does not affect: the ability to drive vehicles, work with moving machinery, the work of dispatchers and operators.

Release form

Enteric-coated tablets.
On 10 pills in a blister strip packaging from a film of polyvinyl chloride and aluminum foil for packaging or from a material combined on the basis of aluminum foil andaluminum foil for packaging. On 5 or 10 blister strip packagings together with the application instruction in a pack from a cardboard.

Storage conditions

In the dark place at a temperature of no higher than 25 ºС. Keep out of the reach of children.