Actovegin - instructions for use, side effects and contraindications. Actovegin - instructions for use, reviews, analogs and forms of release (tablets, injections in ampoules for injection, ointment, gel and cream) drugs for the treatment of metabolic disorders

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The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Varieties, names, composition and forms of release

• Gel for external use;
• Ointment for external use;
• Cream for external use;
• Solution for infusions ("droppers") on dextrose in 250 ml bottles;
• Solution for infusion in 0.9% sodium chloride (in saline) in 250 ml bottles;
• Solution for injection in ampoules of 2 ml, 5 ml and 10 ml;
• Tablets for oral administration.

All dosage forms of Actovegin as an active (active) component contain deproteinized hemoderivat derived from blood collected from healthy calves fed exclusively on milk. Deproteinized hemoderivat is a product obtained from the blood of calves by cleaning it from large protein molecules (deproteinization). As a result of deproteinization, a special combination of biologically active blood molecules of calves, small in mass, is obtained, which are able to activate the metabolism in any organ and tissue. Moreover, such a combination of active substances does not contain large protein molecules that can cause allergic reactions.

Deproteinized hemoderivat from the blood of calves is standardized according to the content of certain classes of biologically active substances. This means that chemists strive to ensure that each hemoderivative fraction contains the same amount of biologically active substances, despite the fact that they are obtained from the blood of different animals. Accordingly, all hemoderivate fractions contain the same amount of active ingredients and have the same intensity of therapeutic action.

The active component of Actovegin (deproteinized derivative) is often called in official instructions "Actovegin concentrate".

Various dosage forms of Actovegin contain different amounts of the active ingredient (deproteinized hemoderivat):

• Gel Actovegin - contains 20 ml of gemoderivate (0.8 g in dried form) in 100 ml of gel, which corresponds to 20% concentration of the active ingredient.
• Ointment and cream Actovegin - contain 5 ml of gemoderivate (0.2 g in dried form) in 100 ml of ointment or cream, which corresponds to 5% concentration of the active ingredient.
• Solution for infusion in dextrose - contains 25 ml of hemoderivate (1 g in dried form) per 250 ml of a ready-to-use solution, which corresponds to an active ingredient concentration of 4 mg / ml or 10%.
• Solution for infusion in 0.9% sodium chloride - contains 25 ml (1 g dried) or 50 ml (2 g dried) hemoderivat per 250 ml ready-to-use solution, which corresponds to an active ingredient concentration of 4 mg / ml ( 10%) or 8 mg/ml (20%).
• Solution for injection - contains 40 mg of dry hemoderivat per 1 ml (40 mg / ml). The solution is available in ampoules of 2 ml, 5 ml and 10 ml. Accordingly, ampoules with 2 ml of solution contain 80 mg of the active ingredient, with 5 ml of solution - 200 mg and with 10 ml of solution - 400 mg.
• Tablets for oral administration - contain 200 mg of dry hemoderivate.

Hemoderivative, which is part of all dosage forms of Actovegin, contains sodium chloride in the form of sodium and chlorine ions, which appeared in it, since the blood of calves contains this salt, and it is not removed during deproteinization. That is, sodium chloride is not added specifically to hemoderivative obtained from the blood of calves. Manufacturers indicate that the solution for injection contains approximately 26.8 mg of sodium chloride per 1 ml. The content of sodium chloride in other dosage forms of Actovegin is not indicated, since it is not calculated.

Solution for injection in ampoules as an auxiliary component contains only sterile distilled water. Solution for infusion on dextrose as auxiliary components contains distilled water, dextrose and sodium chloride. Solution for infusion on 0.9% sodium chloride contains only sodium chloride and water as auxiliary components.

Actovegin tablets as auxiliary components contain the following substances:

• Mountain wax glycolate;
• Titanium dioxide;
• Diethyl phthalate;
• Dried gum arabic;
• Microcrystalline cellulose;
• Povidone K90 and K30;
• Sucrose;
• magnesium stearate;
• Talc;
• Dye quinoline yellow varnish aluminum (E104);
• Hypromellose phthalate.

Solutions for infusion Actovegin based on dextrose or 0.9% sodium chloride are clear, colorless or slightly yellow liquids that do not contain impurities. The solutions are produced in 250 ml transparent glass bottles, which are closed with a cork and an aluminum cap with control of the first opening.

Actovegin injection solutions are available in 2 ml, 5 ml or 10 ml ampoules. Sealed ampoules are placed in a carton box of 5, 10, 15 or 25 pieces. The solutions themselves in ampoules are a transparent liquid of slightly yellow or colorless color with a small amount of floating particles.

Actovegin tablets are colored greenish-yellow, shiny, round biconvex. Tablets are packed in dark glass bottles of 50 pieces.

The volume of Actovegin ampoules in ml

Currently, the solution is available in ampoules of 2 ml, 5 ml and 10 ml. Moreover, ampoules of different volumes contain a solution with the same concentration of the active substance - 40 mg / ml, but the total content of the active ingredient in ampoules of different volumes is different. Thus, 2 ml ampoules contain 80 mg of the active substance, 5 ml ampoules contain 200 mg, and 10 ml ampoules contain 400 mg, respectively.

Therapeutic action

The general effect of Actovegin, which consists in improving energy metabolism and increasing resistance to hypoxia, at the level of various organs and tissues is manifested by the following therapeutic effects:

• Accelerates the healing of any tissue damage(wounds, incisions, cuts, abrasions, burns, ulcers, etc.) and the restoration of their normal structure. That is, under the action of Actovegin, any wounds heal easier and faster, and the scar is formed small and inconspicuous.
• The process of tissue respiration is activated, which leads to a more complete and rational use of oxygen delivered with blood to the cells of all organs and tissues. Due to a more complete use of oxygen, the negative consequences of insufficient blood supply to tissues are reduced.
• Stimulates the use of glucose by cells in a state of oxygen starvation or metabolic depletion. And this means that, on the one hand, the concentration of glucose in the blood decreases, and on the other hand, tissue hypoxia decreases due to the active use of glucose for tissue respiration.
• Improves the synthesis of collagen fibers.
• Stimulates the process of cell division with their subsequent migration to areas where it is necessary to restore the integrity of the tissue.
• Stimulates the growth of blood vessels, which leads to improved blood supply to tissues.

In addition, improving energy metabolism and increased glucose utilization leads to a decrease in the severity of symptoms of circulatory disorders in any other tissues and organs.

Indications for use (Why is Actovegin prescribed?)

Ointment, cream and gel Actovegin - indications for use. All three dosage forms of Actovegin intended for external use (cream, gel and ointment) are indicated for use in the same following conditions:

• Acceleration of wound healing and inflammatory processes on the skin and mucous membranes (abrasions, cuts, scratches, burns, cracks);
• Improving tissue repair after burns of any origin (hot water, steam, solar, etc.);
• Treatment of weeping skin ulcers of any origin (including varicose ulcers);
• Prevention and treatment of reactions to the effects of radiation exposure (including radiation therapy of tumors) from the skin and mucous membranes;
• Prevention and treatment of bedsores (only for Actovegin ointment and cream);
• For pre-treatment of wound surfaces before skin grafting in the treatment of extensive and severe burns (only for Actovegin gel).

• Treatment of metabolic and vascular disorders of the brain (for example, ischemic stroke, the consequences of a traumatic brain injury, impaired blood flow in brain structures, as well as dementia and impaired memory, attention, ability to analyze due to vascular diseases of the central nervous system, etc.);
• Treatment of peripheral vascular disorders, as well as their consequences and complications (for example, trophic ulcers, angiopathy, endarteritis, etc.);
• Treatment of diabetic polyneuropathy;
• Healing of wounds of the skin and mucous membranes of any nature and origin (for example, abrasions, cuts, incisions, burns, bedsores, ulcers, etc.);
• Prevention and treatment of lesions of the skin and mucous membranes when exposed to radiation, including radiation therapy of malignant tumors;
• Treatment of thermal and chemical burns (only for injection solutions);

• As part of the complex therapy of metabolic and vascular diseases of the brain (for example, cerebrovascular insufficiency, traumatic brain injury, as well as dementia due to vascular and metabolic disorders);
• Treatment of peripheral vascular disorders and their complications (trophic ulcers, angiopathy);
• Diabetic polyneuropathy;
• Hypoxia of organs and tissues of any origin (this indication is approved only in the Republic of Kazakhstan).

Instructions for use

Ointment, cream and gel Actovegin - instructions for use

The choice of gel, cream or ointment Actovegin and the features of their use for various types of wounds

Actovegin gel does not contain fat, as a result of which it is easily washed off and promotes the formation of granulations (the initial stage of healing) with simultaneous drying of the wet discharge (exudate) from the wound surface. Therefore, it is advisable to use the gel for the treatment of weeping wounds with profuse discharge or at the first stage of therapy of any wet wound surfaces until they are covered with granulations and become dry.

Actovegin cream contains macrogols, which form a light film on the surface of the wound that binds the discharge from the wound. This dosage form is optimally used for the treatment of wet wounds with moderate discharge or for the treatment of dry wound surfaces with thin growing skin.

Ointment Actovegin contains paraffin in its composition, due to which the agent forms a protective film on the surface of the wound. Therefore, the ointment is best used for long-term treatment of dry wounds without detachable or already dried wound surfaces.

In general, Actovegin gel, cream and ointment are recommended to be used in combination as part of a three-stage therapy. At the first stage, when the surface of the wound is weeping and there is a copious discharge, the gel should be used. Then, when the wound dries up and the first granulations (crusts) form on it, you should switch to Actovegin cream and use it until the wound surface is covered with thin skin. Further, until the complete restoration of the integrity of the skin, Actovegin ointment should be used. In principle, after the wound stops getting wet and becomes dry, you can use either Actovegin cream or ointment until complete healing, without changing them sequentially.

• If the wound is weeping with copious discharge, then the gel should be used until the wound surface dries. When the wound dries up, it is necessary to switch to the use of a cream or ointment.
• If the wound is moderately wet, the discharge is poor or moderate, then a cream should be used, and after the wound surface has completely dried, switch to the use of an ointment.
• If the wound is dry, without discharge, then an ointment should be applied.

There are differences in the use of gel, cream and ointment for the treatment of various wounds and ulcers on the skin. Therefore, in the text below, under the term "wound" we will mean any damage to the skin, with the exception of ulcers. And, accordingly, we will separately describe the use of the gel, cream and ointment for the treatment of wounds and ulcers.

The gel is used to treat weeping wounds with profuse discharge. Actovegin gel is applied exclusively to a previously cleaned wound (except for the treatment of ulcers), from which all dead tissues, pus, exudate, etc. have been removed. It is necessary to clean the wound before applying the Actovegin gel because the drug does not contain antimicrobial components and is not able to suppress the onset of the infectious process. Therefore, in order to avoid infection of the wound, it should be washed with an antiseptic solution (for example, hydrogen peroxide, chlorhexidine, etc.) before treatment with Actovegin healing gel.

On wounds with liquid discharge (except for ulcers), the gel is applied in a thin layer 2-3 times a day. In this case, the wound may not be covered with a bandage if there is no risk of infection and additional injury during the day. If the wound can be contaminated, then it is better to cover it with a regular gauze bandage after applying Actovegin gel, and change it 2-3 times a day. The gel is applied until the wound becomes dry and granulations appear on its surface (uneven surface at the bottom of the wound, indicating the beginning of the healing process). Moreover, if part of the wound is covered with granulations, then they begin to treat it with Actovegin cream, and the weeping areas continue to be lubricated with gel. Since granulations are most often formed from the edges of the wound, after their formation, the perimeter of the wound surface is smeared with cream, and the center with gel. Accordingly, as the granulation area increases, the area treated with the cream increases, and the area treated with the gel decreases. When the whole wound becomes dry, it is lubricated only with cream. Thus, both the gel and the cream can be applied to the surface of the same wound, but to different areas.

However, if ulcers are being treated, then their surface can not be washed with an antiseptic solution, but immediately apply Actovegin gel in a thick layer, and cover it with a gauze bandage soaked in Actovegin ointment from above. Such a bandage is changed once a day, but if the ulcer is too wet and the discharge is plentiful, then the treatment is carried out more often: 2-4 times a day. In the case of strongly weeping ulcers, the bandage is changed as the bandage gets wet. In this case, each time a thick layer of Actovegin gel is applied to the ulcer, and the defect is closed with a gauze bandage soaked in Actovegin cream. When the surface of the ulcer stops getting wet, they begin to treat it with Actovegin ointment 1 to 2 times a day, until the defect is completely healed.

Actovegin cream is used to treat wounds with a small amount of discharge or dry wound surfaces. The cream is applied in a thin layer on the surface of the wounds 2-3 times a day. A bandage is applied to the wound if there is a risk of lubricating Actovegin cream. The cream is usually used until the wound is covered with a layer of thick granulation (thin skin), after which they switch to the use of Actovegin ointment, which treats the defect until it is completely healed. The cream should be applied at least twice a day.

Actovegin ointment is applied only to dry wounds or to wounds covered with thick granulation (thin skin), a thin layer 2-3 times a day. Before using the ointment, the wound must be washed with water and treated with an antiseptic solution, such as hydrogen peroxide or chlorhexidine. A regular gauze bandage can be applied over the ointment if there is a risk of lubricating the preparation from the skin. Actovegin ointment is used until the wound is completely healed or until a strong scar is formed. The product should be used at least twice a day.

In general, it is obvious that Actovegin gel, cream and ointment are used in stages to treat wounds at various stages of healing. At the first stage, when the wound is wet, with discharge, a gel is applied. Then, at the second stage, when the first granulations appear, a cream is used. And then, at the third stage, after the formation of a thin skin, the wound is lubricated with ointment until the integrity of the skin is completely restored. However, if for some reason it is not possible to treat wounds sequentially with gel, cream and ointment, then only one Actovegin agent can be used, starting to use it at the appropriate stage from which it is recommended. For example, Actovegin gel can be used at any stage of wound healing. Actovegin cream begins to be applied from the moment the wound dries up, it can be used until the defect is completely healed. Actovegin ointment is used from the moment the wound is completely dry and until the skin is restored.

To prevent bedsores and skin damage from radiation, you can use either a cream or ointment Actovegin. In this case, the choice between cream and ointment is made solely on the basis of individual preferences or considerations of the convenience of using any one form.

To prevent bedsores, a cream or ointment is applied to areas of the skin in the area of ​​\u200b\u200bwhich there is a high risk of forming the latter.

To prevent damage to the skin by radiation, Actovegin cream or ointment is applied to the entire surface of the skin after radiotherapy, and daily, once a day, in the intervals between regular sessions of radiation therapy.

If it is necessary to carry out therapy for severe trophic ulcers on the skin and soft tissues, then Actovegin gel, cream and ointment are recommended to be combined with an injection of the solution.

If, when applying Actovegin gel, cream or ointment, pain and discharge appear in the area of ​​​​a wound defect or ulcer, the skin turns red next to it, body temperature rises, then this is a sign of infection of the wound. In such a situation, you should immediately stop using Actovegin and consult a doctor.

If, against the background of the use of Actovegin, a wound or ulcer does not heal within 2 to 3 weeks, then you should also consult a doctor.

Gel, cream or ointment Actovegin for the full healing of defects should be used for at least 12 days in a row.

Actovegin tablets - instructions for use (adults, children)

However, tablets can also be taken without prior parenteral administration of Actovegin, if for some reason injections are not possible or the condition is not severe, for the normalization of which the effect of the tablet form of the drug is quite sufficient.

Tablets should be taken 15 to 30 minutes before meals, swallowing them whole, not biting, chewing, breaking or crushing in other ways, but drinking a small amount of non-carbonated clean water (half a glass is enough). As an exception, when using Actovegin tablets for children, it is allowed to divide them into halves and quarters, which are then dissolved in a small amount of water and given to babies in a diluted form.

For various conditions and diseases, adults are recommended to take tablets 1-2 pieces 3 times a day for 4-6 weeks. Actovegin tablets are given to children 1/4 - 1/2 2 - 3 times a day for 4 - 6 weeks. The indicated adult and children's dosages are averaged, indicative, and the specific dose and frequency of taking the tablets in each case should be determined by the doctor individually, based on the severity of the symptoms and the severity of the pathology. The minimum course of therapy should be at least 4 weeks, since the necessary therapeutic effect is not achieved with shorter periods of use.

In diabetic polyneuropathy, Actovegin is always first administered intravenously at 2000 mg per day daily for three weeks. And only after that they switch to taking the drug in tablets of 2-3 pieces 3 times a day, for 4-5 months. In this case, taking Actovegin tablets is a maintenance phase of therapy, which allows you to consolidate the positive therapeutic effect achieved by intravenous injections.

If, while taking Actovegin tablets, a person develops allergic reactions, then the drug is urgently canceled, and treatment is carried out with antihistamines or glucocorticoids.

The tablets contain dye quinoline yellow aluminum lacquer (E104), which is considered potentially harmful, and therefore Actovegin tablets are prohibited for use in children under 18 years of age in the territory of the Republic of Kazakhstan. Such a norm, which prohibits taking Actovegin tablets by children under 18 years old, is currently only available in Kazakhstan among the countries of the former USSR. In Russia, Ukraine and Belarus, the drug is approved for use in children.

Actovegin injections - instructions for use

Actovegin in ampoules of 2 ml, 5 ml and 10 ml is intended for parenteral administration - that is, for intravenous, intra-arterial or intramuscular injections. In addition, the solution from the ampoules can be added to ready-made infusion formulations ("droppers"). Solutions in ampoules are ready for use. This means that they do not need to be pre-diluted, added or otherwise prepared for use. To use the solutions, you just need to open the ampoule and draw its contents into the syringe of the required volume, and then inject.

The concentration of the active ingredient in 2 ml, 5 ml and 10 ml ampoules is the same (40 mg/ml), and the difference between them is only in the total amount of the active ingredient. It is obvious that the total dose of the active ingredient is minimal in 2 ml ampoules (80 mg), the average is in 5 ml ampoules (200 mg) and the maximum is in 10 ml ampoules (400 mg). This is done for the convenience of using the drug, when for the production of an injection you just need to choose an ampoule with such a volume of solution that contains the required dosage (amount of active substance) prescribed by the doctor. In addition to the total content of the active substance, there is no difference between the ampoules with a solution of 2 ml, 5 ml and 10 ml.

Ampoules with a solution should be stored in a dark, dark place at an air temperature of 18 - 25 o C. This means that the ampoules should be stored in the cardboard box in which they were sold, or in any other available. After opening the ampoule, the solution should be used immediately, its storage is not allowed. Do not use a solution that has been stored in an opened ampoule for some time, as microbes from the environment can get into it, which will violate the sterility of the drug and can cause negative consequences after injection.

The solution in ampoules has a yellowish tint, the intensity of which may be different in different batches of the drug, since it depends on the characteristics of the feedstock. However, the difference in the color intensity of the solution does not affect the effectiveness of the drug.

Do not use a solution containing particles or cloudy. This solution should be discarded.

Since Actovegin can cause allergic reactions, it is recommended to make a test injection before starting therapy by injecting 2 ml of the solution intramuscularly. Further, if a person does not show signs of an allergic reaction for several hours, therapy can be safely carried out. The solution is administered in the required dosage intramuscularly, intraarterially or intravenously.

Ampoules with solutions are equipped with a break point for easy opening. The breaking point is bright red applied to the tip of the ampoule. Ampoules should be opened as follows:

• Take the ampoule in your hands so that the breaking point is directed upwards (as shown in Figure 1);
• Tap the glass with your finger and gently shake the ampoule so that the solution drains from the tip to the bottom;
• With the fingers of the second hand, break off the tip of the ampoule in the area of ​​the point by moving away from you (as shown in Figure 2).

Figure 2- Correct breaking off of the tip of the ampoule for its opening.

Dosages and method of administration of Actovegin solutions are determined by the doctor. However, you need to know that in order to achieve the fastest possible effect, it is optimal to administer Actovegin solutions intravenously or intraarterially. A somewhat slower therapeutic effect is achieved with intramuscular injection. With intramuscular injections, more than 5 ml of Actovegin solution cannot be administered at a time, and with intravenous or intra-arterial injections, the drug can be administered in a much larger amount. This should be taken into account when choosing the route of administration of the drug.

Depending on the severity of the course of the disease and the severity of clinical symptoms, 10-20 ml of the solution is usually prescribed on the first day intravenously or intra-arterially. Further, from the second day until the end of therapy, 5-10 ml of the solution is administered intravenously or 5 ml intramuscularly.

If it is decided to administer Actovegin by infusion (in the form of a "dropper"), then 10 - 20 ml of the solution from the ampoules (for example, 1 - 2 ampoules of 10 ml each) is poured into 200 - 300 ml of the infusion solution (physiological saline or glucose solution 5%) . The resulting solution is then injected at a rate of 2 ml/min.

Depending on the type of disease in which Actovegin is used, the following dosages are currently recommended for injection of the solution:

• Metabolic and vascular disorders of the brain (traumatic brain injury, cerebrovascular insufficiency) - 5-25 ml of solution is administered daily for two weeks. After completing the course of injections of Actovegin, they switch to taking the drug in tablets in order to maintain and consolidate the achieved therapeutic effect. In addition, instead of switching to a maintenance pill, you can continue injecting Actovegin by injecting 5-10 ml of the solution intravenously 3-4 times a week for two weeks.
• Ischemic stroke - Actovegin is administered by infusion ("dropper"), adding 20 - 50 ml of solution from ampoules to 200 - 300 ml of saline or 5% dextrose solution. In this dosage, the drug is infused daily for a week. Then, in 200-300 ml of infusion solution (saline solution or dextrose 5%), add 10-20 ml of Actovegin solution from ampoules and inject at this dosage daily in the form of "droppers" for another two weeks. After completing the course of "droppers" with Actovegin, they switch to taking the drug in tablet form.
• Angiopathy (peripheral vascular disorders and their complications, for example, trophic ulcers) - Actovegin is administered by infusion ("dropper"), adding 20-30 ml of the solution from the ampoules to 200 ml of saline or 5% dextrose solution. In this dosage, intravenous infusion, the drug is administered daily for four weeks.
• Diabetic polyneuropathy - Actovegin is administered intravenously, 50 ml of a solution from ampoules, daily for three weeks. After completing the course of injections, they switch to taking Actovegin in the form of tablets for 4 to 5 months to maintain the achieved therapeutic effect.
• Healing of wounds, ulcers, burns and other wound damage to the skin - a solution is injected from 10 ml ampoules intravenously or 5 ml intramuscularly either daily or 3-4 times a week, depending on the rate of healing of the defect. In addition to injections, Actovegin can be used in the form of an ointment, cream or gel to accelerate wound healing.
• Prevention and treatment of radiation damage (during radiation therapy of tumors) of the skin and mucous membranes - Actovegin is injected with 5 ml of a solution from ampoules intravenously daily, in between radiation therapy sessions.
• Radiation cystitis - inject 10 ml of a solution from ampoules transurethral (through the urethra) daily. Actovegin in this case is used in combination with antibiotics.

Intramuscularly, no more than 5 ml of solutions from ampoules can be administered at a time, since in a larger amount the drug can have a strong irritating effect on tissues, which is manifested by severe pain. Therefore, for intramuscular administration, only ampoules of 2 ml or 5 ml of Actovegin solution should be used.

To produce an intramuscular injection, you first need to select a part of the body where the muscles come close to the skin. These areas are the lateral upper thigh, the lateral upper third of the shoulder, the abdomen (in non-obese people), and the buttocks. Next, the area of ​​\u200b\u200bthe body into which the injection will be made is wiped with an antiseptic (alcohol, Belasept, etc.). After that, the ampoule is opened, the solution is drawn from it into the syringe and turned upside down with the needle. Gently tap the surface of the syringe with your finger in the direction from the piston to the needle to peel off air bubbles from the walls. Then, to remove air, press the plunger of the syringe until a drop or trickle of solution appears at the tip of the needle. After that, the syringe needle is inserted perpendicular to the skin surface deep into the tissues. Then, pressing the piston, slowly release the solution into the tissue and remove the needle. The injection site is re-treated with an antiseptic.

Each time, a new place is chosen for the injection, which should be 1 cm away from the marks from previous injections on all sides. You should not prick twice in the same place, focusing on the mark left after the injection on the skin.

Since Actovegin injections are painful, it is recommended to sit quietly for 5-10 minutes after the injection and wait until the pain subsides.

Actovegin solution for infusion - instructions for use

Since Actovegin can cause allergic reactions, it is recommended to make a test injection before the "dropper", for which 2 ml of the solution is injected intramuscularly. If after a few hours an allergic reaction has not developed, then you can safely start administering the drug intravenously or intraarterially in the required amount.

If, against the background of the use of Actovegin, a person develops allergic reactions, then the use of the drug should be stopped and the necessary therapy with antihistamines should be started (Suprastin, Diphenhydramine, Telfast, Erius, Cetirizine, Cetrin, etc.). If the allergic reaction is very severe, then not only antihistamines should be used, but also glucocorticoid hormones (Prednisolone, Betamethasone, Dexamethasone, etc.).

Solutions for infusion are colored yellowish, the shade of which may be different for preparations of different batches. However, such a difference in color intensity does not affect the effectiveness of the drug, since it is due to the characteristics of the raw materials used to manufacture Actovegin. Turbid solutions or solutions containing floating particles visible to the eye should not be used.

The total duration of therapy is usually 10-20 infusions ("droppers") per course, but if necessary, the duration of treatment can be increased by the doctor. Dosages of Actovegin for intravenous infusion administration under various conditions are as follows:

• Circulatory and metabolic disorders in the brain (traumatic brain injury, lack of blood supply to the brain, etc.) - 250-500 ml (1-2 bottles) are administered once a day, daily for 2-4 weeks. Further, if necessary, in order to consolidate the obtained therapeutic effect, they switch to taking Actovegin tablets, or continue to inject the solution intravenously, 250 ml (1 bottle) 2-3 times a week for another 2 weeks.
• Acute disorders of cerebral circulation (stroke, etc.) - 250 - 500 ml (1 - 2 bottles) are administered once a day, daily, or 3 - 4 times a week for 2 - 3 weeks. Further, if necessary, they switch to taking Actovegin tablets in order to consolidate the obtained therapeutic effect.
• Angiopathy (impaired peripheral circulation and its complications, for example, trophic ulcers) - 250 ml (1 vial) is administered once a day, daily, or 3-4 times a week for 3 weeks. Simultaneously with "droppers", Actovegin can be applied externally in the form of an ointment, cream or gel.
• Diabetic polyneuropathy - 250 - 500 ml (1 - 2 bottles) are administered once a day, daily, or 3 - 4 times a week for 3 weeks. Next, be sure to switch to taking Actovegin tablets in order to consolidate the resulting therapeutic effect.
• Trophic and other ulcers, as well as long-term non-healing wounds of any origin - 250 ml (1 bottle) are administered once a day, daily, or 3-4 times a week, until the wound defect is completely healed. Simultaneously with infusion administration, Actovegin can be used topically in the form of a gel, cream or ointment to accelerate wound healing.
• Prevention and treatment of radiation damage (during radiation therapy of tumors) of the skin and mucous membranes - 250 ml (1 vial) is administered one day before the start, and then daily during the entire course of radiation therapy, and additionally for another two weeks after last irradiation session.

special instructions

Since Actovegin can cause allergic reactions, it is recommended to make a test injection before parenteral administration (intravenously, intramuscularly or intraarterially). To do this, 2 ml of solution for infusion or solution for injection of Actovegin is injected intramuscularly and wait 2 hours. If no signs of allergy appear within two hours, then Actovegin can be administered parenterally in the required quantities.

When using Actovegin tablets, gel, cream and ointment, it is not necessary to carry out a trial injection, since these dosage forms can be quickly canceled in case of an allergic reaction.

Before using Actovegin solutions, you should always carefully examine them. If the solution is cloudy or contains floating particles, then it should not be used. Only clear solutions with a yellowish color of any intensity can be used. If solutions from different batches differ greatly in the intensity of the yellowish color, but are not cloudy and do not contain particles, then they can be used without fear, since the color of the preparation may vary, as it is due to the characteristics of the raw material (bovine blood). Various variations in the color of the solution do not affect its effectiveness.

Solutions of Actovegin, both in ampoules and in vials, should be used immediately after opening the packages. Do not store open solutions. It is also unacceptable to use solutions that have been stored for some time in an opened package.

For intravenous infusion administration ("droppers"), both infusion solutions in 250 ml vials and solutions in 2 ml, 5 ml and 10 ml ampoules can be used. Only infusion solutions are ready for use and can be administered without preparation, and solutions from ampoules for installing a "dropper" must first be poured into the infusion solution in the required amount (200 - 300 ml of saline, or 200 - 300 ml of dextrose solution, or 200 - 300 ml glucose solution 5%).

Intramuscularly, a maximum of 5 ml of injection solution can be administered at a time. Intravenous and intra-arterial injections can be administered in large quantities (up to 100 ml at a time).

Overdose

An overdose of Actovegin gel, cream or ointment is not possible.

Influence on the ability to control mechanisms

Interaction with other drugs

Solutions and tablets of Actovegin also do not interact with other drugs, so they can be used as part of complex therapy with any other means. However, it must be remembered that Actovegin solutions cannot be mixed in one syringe or in one "dropper" with other drugs.

With caution, Actovegin solutions should be combined with potassium preparations, potassium-sparing diuretics (Spironolactone, Veroshpiron, etc.) and ACE inhibitors (Captopril, Lisinopril, Enalapril, etc.).

How to make an intramuscular injection (in the buttock) - video

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

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 studies has shown 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 of the 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 intensity of the color 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® injection solution 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 drugs, with the exception of those mentioned in the section "General Dosing Instructions".

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.

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, with disorders 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 skin diseases, treatment begins with 20% gel and 5% cream, then proceeds to 5% ointment (the so-called three-stage 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. So, with the intramuscular method of using the drug, it is allowed to inject 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 renal insufficiency, metabolic changes associated with advanced age, and metabolic features 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 radiation therapy, as well as 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.

Name:

Actovegin (Actovegin)

Pharmacological
action:

Actovegin activates cellular metabolism (metabolism) by increasing the transport and accumulation of glucose and oxygen, enhancing their intracellular utilization.
These processes lead to acceleration of ATP metabolism(adenosine triphosphoric acid) and increase the energy resources of the cell. Under conditions that limit the normal functions of energy metabolism (hypoxia / insufficient supply of oxygen to the tissue or impaired absorption /, lack of substrate) and with increased energy consumption (healing, regeneration / tissue repair /), actovegin stimulates the energy processes of functional metabolism (the process of metabolism in body) and anabolism (the process of assimilation of substances by the body). The secondary effect is increased blood supply.

Indications for
application:

Indications for use:
- cerebrovascular insufficiency, ischemic stroke (insufficient supply of oxygen to the brain tissue due to acute cerebrovascular accident);
- traumatic brain injury; violations of peripheral circulation (arterial, venous);
- angiopathy (impaired vascular tone);
- trophic disorders (malnutrition of the skin) with varicose veins of the lower extremities (changes in the veins characterized by an uneven increase in their lumen with the formation of a protrusion of the wall due to a violation of the function of their valvular apparatus);
- ulcers of various origins; bedsores (tissue necrosis caused by prolonged pressure on them due to lying down);
- burns;
- prevention and treatment of radiation injuries.

Corneal damage(transparent membrane of the eye) and sclera(opaque shell of the eye):
- burn of the cornea (acids, alkali, lime);
- corneal ulcers of various origins;
- keratitis (inflammation of the cornea), including after transplantation (transplantation) of the cornea;
- abrasions of the cornea in patients with contact lenses;
- prevention of lesions during the selection of contact lenses in patients with dystrophic processes in the cornea (for the use of eye jelly), as well as to accelerate the healing of trophic ulcers (slowly healing skin defects), bedsores (tissue necrosis caused by prolonged pressure on them due to lying), burns , radiation damage to the skin, etc.

Mode of application:

In / a, in / in(including in the form of infusion), i/m, transurethral.

In connection with the potential for the development of anaphylactic reactions, it is recommended to test for the presence of hypersensitivity to the drug before infusion.

Ischemic stroke. 250-500 ml solution for infusion (1000-2000 mg of the drug) per day i.v. for 2 weeks or 20-50 ml of solution for injection (800-2000 mg of the drug) in 200-300 ml of 0.9% sodium chloride or 5% dextrose solution IV drip for 1 week, then 10-20 ml (400-800 mg of the drug) IV drip for 2 weeks. Then - the transition to the tablet form.

Metabolic and vascular disorders of the brain. 250-500 ml of solution for infusion (1000-2000 mg of the drug) per day or 5-25 ml of solution for injection (200-1000 mg of the drug) per day intravenously for 2 weeks, followed by the transition to a tablet form.

Peripheral (arterial and venous) vascular disorders and their consequences. 250 ml (1000 mg) solution for infusion in / a or in / in daily or several times a week, followed by the transition to a tablet form. 20-30 ml solution for injection (800-1200 mg of the drug) in 200 ml of 0.9% sodium chloride solution or 5% dextrose solution intravenously or intravenously daily for 4 weeks.

Diabetic polyneuropathy. 250-500 ml of solution for infusion or 50 ml of solution for injection (2000 mg of the drug) per day intravenously for 3 weeks, followed by the transition to a tablet form.

Wound healing. 250 ml solution for infusion (1000 mg of the drug) IV daily or several times a week, depending on the rate of healing. 10 ml solution for injection (400 mg of the drug) IV or 5 ml IM daily or 3-4 times a week, depending on the rate of healing. Joint use with dosage forms of Actovegin® for external use is possible.

Prevention and treatment of radiation injuries of the skin and mucous membranes. 250 ml solution for infusion (1000 mg of the drug) intravenously the day before and daily during radiation therapy, as well as within 2 weeks after its completion, followed by the transition to a tablet form. The rate of administration is about 2 ml/min. 5 ml solution for injection (200 mg) IV daily during breaks in radiation exposure.

Radiation cystitis. Transurethral, ​​10 ml injection (400 mg of the drug) in combination with antibiotic therapy. The rate of administration is about 2 ml/min.

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

Instructions for use of ampoules with a break point

1. Place the tip of the ampoule with the breaking point up.
2. Gently tapping with your finger and shaking the ampoule, allow the solution to flow down from the tip of the ampoule.
3. Break off the tip of the ampoule at the break point by moving away from you.

Side effects:

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

Actovegin activates cellular metabolism (metabolism) by increasing the transport and accumulation of glucose and oxygen, enhancing their intracellular utilization. These processes lead to an acceleration of ATP (adenosine triphosphoric acid) metabolism and an increase in cell energy resources.

Under conditions that limit the normal functions of energy metabolism (hypoxia / insufficient supply of oxygen to the tissue or impaired absorption /, lack of substrate) and with increased energy consumption (healing, regeneration / tissue repair /), Actovegin stimulates the energy processes of functional metabolism (the process of metabolism in body) and anabolism (the process of assimilation of substances by the body). The secondary effect is increased blood supply.

They produce the following types:

• Solution for injection 2 ml, 5.0 No. 5, 10 ml No. 10. Actovegin injections fit in colorless glass ampoules that have a break 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.
• The cream is packaged in tubes of 20 g.
• Gel 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.

The composition of the drug Actovegin, which helps with insufficient blood flow, includes deproteinized hemoderivat from calf blood as an active substance. The injection also contains sodium chloride and water as additional substances.

According to the pharmacological properties, Actovegin belongs to the group of tissue regeneration stimulants. It improves the supply of oxygen and glucose to cells, accelerates metabolism and healing processes, and increases the energy resources of the body. It is used in neurology, ophthalmology, transplantology, dermatology and therapy. In the sports world, it is known as one of the doping drugs.

Active ingredient: deproteinized standardized hemodialysate (otherwise hemoderivat) from the blood of dairy calves.

The use of Actovegin has the following effect:

• The drug improves the absorption of oxygen by brain cells.
• It promotes the formation of acetylcholine and ATP in the brain cells.
• The drug helps glucose to better penetrate into neurons, which has a positive effect on the nutrition of brain cells.
• The tool acts as a strong antioxidant.
• The medicine also has a beneficial effect on liver cells and myocardial tissues.

Indications for use

Why is Actovegin prescribed? Indications differ depending on the form of release of the drug.

Indications for the appointment of Actovegin tablets:

• violations of blood circulation in the brain after diseases, injuries at the stage of recovery;
• violations of blood circulation in the peripheral arteries in the initial stages or after injections; obliterating atherosclerosis, obliterating endarteritis (inflammation of the walls of the arteries) of the extremities are subject to treatment;
• disorders of blood circulation in the veins - varicose veins, trophic ulcers of the lower extremities, thrombophlebitis at the recovery stage;
• diabetes mellitus, complicated by damage to blood vessels and nerves (diabetic angioneuropathy), in the initial stages or at the stage of recovery.

Indications for Actovegin injections and droppers:

• acute period of illness, injury;
• violations of blood circulation in the brain with cervical osteochondrosis;
• decreased intelligence against the background of age-related or post-traumatic disorders;
• severe course of obliterating endarteritis, obliterating atherosclerosis, Raynaud's disease;
• severe venous insufficiency, recurrent thrombophlebitis, leg ulcers;
• extensive bedsores in bedridden patients, long-term non-healing wounds;
• extensive burn lesions;
• diabetic foot;
• radiation injury;
• skin transplant.

Actovegin is prescribed externally for:

• fresh wounds, small burns, frostbite;
• inflammatory skin diseases at the healing stage;
• extensive burns at the stage of recovery;
• bedsores, trophic ulcerative processes;
• radiation burns;
• skin graft.

20% eye gel for:

• corneal burns;
• corneal erosions;
• acute and chronic keratitis;
• processing of the cornea before its transplantation;
• radiation burns of the cornea;
• corneal microtrauma in contact lens wearers.

Instructions for use Actovegin, dosage

Intra-arterially, intravenously (including in the form of infusion) and intramuscularly. In connection with the potential for the development of anaphylactic reactions, it is recommended to test for the presence of hypersensitivity to the drug before infusion.

Depending on the severity of the clinical picture, the initial dose is 10-20 ml / day intravenously or intra-arterially; then 5 ml intravenously or 5 ml intramuscularly.

When administered in the form of an infusion, 10-20 ml of ACTOVEGIN© is added to 200-300 ml of the stock solution (0.9% sodium chloride solution or 5% dextrose solution). Injection rate: about 2 ml/min.

Metabolic and vascular disorders of the brain: at the beginning of treatment, 10 ml intravenously daily for two weeks, then 5-10 ml intravenously 3-4 times a week for at least 2 weeks.

Ischemic stroke: 20-50 ml in 200-300 ml of stock solution intravenously drip daily for 1 week, then 10-20 ml intravenously drip - 2 weeks.

Peripheral (arterial and venous) vascular disorders and their consequences: 20-30 ml of the drug in 200 ml of the stock solution intra-arterially or intravenously daily; the duration of treatment is about 4 weeks.

Wound healing: 10 ml intravenously or 5 ml intramuscularly daily or 3-4 times a week, depending on the healing process (in addition to local treatment of Actovegin in topical dosage forms).

Prevention and treatment of radiation damage to the skin and mucous membranes during radiation therapy: the average dose is 5 ml intravenously daily during breaks in radiation exposure.

Radiation cystitis: daily 10 ml transurethral in combination with antibiotic therapy.

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.

For people suffering from 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 and ointment Actovegin

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.

The ointment is applied in a thin layer to the skin. It is used for long-term treatment of wounds and ulcers in order to accelerate their epithelization (healing) after gel or cream therapy. For the prevention of bedsores, the ointment must be applied to the appropriate areas of the skin. To prevent radiation damage to the skin, the ointment should be applied after irradiation or in between sessions.

eye gel

Squeeze 1 drop of gel directly from the tube into the affected eye. Apply 2-3 times a day. After opening the package, the eye gel can be used for no more than 4 weeks.

Side effects

Most often, the drug is well tolerated. However, sometimes a side process may occur - allergies, anaphylactic shock or other reactions:

• hypersensitivity occurs;
• increase in temperature;
• trembling, angioedema;
• skin plethora;
• rash, irritation;
• increased sweat separation;
• swelling of the skin or mucous membranes;
• transformation in the injection zone;
• dyspeptic phenomena;
• pain in the epigastric area;
• vomiting, diarrhea;
• feeling of pain in the region of the heart, rapid pulse;
• shortness of breath, pale skin;
• jumps in blood pressure, frequent breathing, a feeling of squeezing in the chest;
• soreness in the throat;
• pain in the head, dizziness;
• agitation, trembling;
• soreness of muscles, joints;
• discomfort in the lumbar region.

When the use of Actovegin leads to the listed side effects, its use should be terminated, if necessary, symptomatic therapy is prescribed.

Use during pregnancy and lactation

Use Actovegin during pregnancy and lactation only when the expected benefit to the mother outweighs the possible risk to the fetus or child. During the use of the drug in placental insufficiency, although rarely, fatal cases were observed, which could be a consequence of the underlying disease. The use during lactation was not accompanied by negative effects either for the mother or for the child.

Contraindications

Actovegin is not used in the following conditions:

• individual intolerance to the drug or its components;
• during pregnancy is prescribed with caution;
• its use during lactation is undesirable;
• heart diseases;
• pulmonary edema;
• with oliguria and anuria.

Analogues and price Actovegin, list of drugs

The only analogue of Actovegin is Solcoseryl. It is produced by the German pharmaceutical concern Valeant.

An analogue of an external agent is produced by the Belarusian pharmaceutical enterprise "Dialek". This is a drug in the gel form Diavitol. The main active ingredient of the drug is a deproteinized extract from embryos and calf blood.

Analogues by scope, list:

• Divaza
• Anantavati
• Mexidol
• Noben
• Cinnarizine
• Armadin Solution
• Nootropil
• Vinpotropil
• Stugeron
• Metapainting
• Cardionate
• Dmae (Dmae)
• Tanakan

When choosing analogues, it is important to understand that the instructions for use of Actovegin, the price and reviews for drugs of similar action do not apply. It is important to consult a doctor and not to make an independent replacement of the drug.

Prices in Russian pharmacies: Actovegin, tablets 50 pcs. - 1612 rubles, solution for injection, 40 mg / ml ampoules 5 ml 5 pcs - 519 rubles.

Store in a place protected from light, at a temperature of 18–25 °C. Leave in pharmacies by prescription.