Medicine mexidol indications for use. Mexidol is a mild treatment for severe neurological disorders. Contraindications to the use of "Mexidol"

Original domestic antihypoxant and antioxidant direct action, which optimizes the energy supply of cells and increases the reserve capacity of the body



Mexidol main effects, mechanism of action, application

Domestic drug new generation

T.A. Voronin

REVIVING THE ENERGY OF LIFE!

NEUROLOGY: acute disorders of cerebral circulation (stroke), atherosclerotic disorders of the brain, dyscirculatory encephalopathy.

SURGERY: acute purulent inflammatory processes abdominal cavity (acute destructive pancreatitis, peritonitis).

PSYCHIATRY: relief of withdrawal syndrome with the presence of neurosis-like and vegetative-vascular disorders in the clinical picture, as well as acute intoxication with antipsychotics

MEXIDOL (ethylmethylhydroxypyridine succinate)

Dosage form:

  • 5% solution for injection in ampoules of 2 ml No. 10,
  • coated tablets 125 mg No. 30 Mexidol - 2-ethyl-6-methyl-3-oxypyridine succinate was synthesized at the Institute of Biochemical Physics of the Russian Academy of Sciences; studied and developed at the Research Institute of Pharmacology of the Russian Academy of Medical Sciences and the All-Russian Scientific Center for the safety of biologically active substances. Mexidol is allowed for a wide range of medical use and is indicated for the treatment of acute disorders of cerebral circulation, dyscirculatory encephalopathy, vegetovascular dystonia, atherosclerotic disorders of the brain, neurotic and neurosis-like disorders with anxiety, for the relief of withdrawal symptoms in alcoholism, for the treatment of acute intoxication with neuroleptics and a number of other diseases. Mexidol is a new type of drug, both in terms of mechanism and spectrum of pharmacological action, and has significant advantages over known neuro- psychotropic drugs. MECHANISM OF ACTION Mexidol has an original mechanism of action, fundamental difference which from the mechanism of action of traditional neuro-psychotropic drugs is the lack of specific binding to known receptors. Mexidol is an inhibitor of free radical processes, lipid peroxidation, it activates superoxide dismutase, affects the physicochemical properties of the membrane, increases the content of polar lipid fractions (phosphatidylserine and phosphotidylinositol, etc.) in the membrane, reduces the ratio of cholesterol / phospholipids, reduces the viscosity of the lipid layer and increases membrane fluidity, activates the energy-synthesizing functions of mitochondria and improves energy metabolism in the cell and, thus, protects the cell apparatus and the structure of their membranes. The change in the functional activity of the biological membrane caused by Mexidol leads to conformational changes in the protein macromolecules of synaptic membranes, as a result of which Mexidol has a modulating effect on the activity of membrane-bound enzymes, ion channels and receptor complexes, in particular, benzodiazepine, GABA, acetylcholine, enhancing their ability to bind to ligands, increasing the activity of neurotransmitters and the activation of synaptic processes. Along with this, Mexidol has a pronounced hypolipidemic effect, reduces the level total cholesterol and low density lipoproteins and increases high density lipoproteins. Thus, the mechanism of action of Mexidol is determined primarily by its antioxidant properties, the ability to stabilize cell biomembranes, activate the energy-synthesizing functions of mitochondria, modulate the work of receptor complexes and the passage of ionic currents, enhance the binding of endogenous substances, improve synaptic transmission and interconnection of brain structures. Due to this mechanism of action, Mexidol affects the key basic links of pathogenesis. various diseases, has a wide range of effects, extremely low side effects and low toxicity, has the ability to potentiate the action of other centrally acting substances, especially those that realize their action as direct receptor agonists. PHARMACODYNAMICS Mexidol, in contrast to well-known drugs, has a wide range of pharmacological effects that are realized according to at least , at two levels - neuronal and vascular. It has a cerebroprotective, anti-alcohol, nootropic, antihypoxic, tranquilizing, anticonvulsant, anti-Parkinsonian, anti-stress, vegetotropic effect. In addition, it has the ability to improve cerebral circulation, inhibit platelet aggregation, lower total cholesterol levels, and have an anti-atherosclerotic effect. The therapeutic effects of Mexidol are revealed in the dose range from 10 to 300 mg/kg. Mexidol increases the body's resistance to various extreme damaging factors, such as sleep disturbance, conflict situations, stress, brain injury, electric shock, exercise, hypoxia, ischemia, and various intoxications, including ethanol. Mexidol has a pronounced tranquilizing and anti-stress effect, the ability to eliminate anxiety, fear, tension, anxiety, in particular in conflict situations. When administered parenterally, it has an effect similar in depth to diazepam (Seduxen) and alprazolam (Xanax). The anti-stress effect of Mexidol is expressed in the normalization of post-aggressive behavior, somatovegetative indicators, the restoration of sleep-wake cycles and impaired learning and memory processes, the reduction of stomach ulcers, the reduction of dystrophic, morphological changes that occur after stress in various brain structures and in the myocardium. Mexidol has a distinct anticonvulsant effect, affecting both primary generalized convulsions caused primarily by the administration of GABAergic substances, and epileptiform brain activity with a chronic epileptogenic focus. The nootropic properties of Mexidol are expressed in the ability to improve learning and memory, contribute to the preservation of a memorable trace and counteract the process of fading instilled skills and reflexes. Mexidol has a pronounced antiamnestic effect, eliminating memory impairment caused by various influences (electric shock, brain injury, sleep deprivation, administration of scopolamine, ethanol, benzodiazepines, etc.). Mexidol has a distinct antihypoxic and antiischemic effect, which is expressed in the ability of the drug to increase the life expectancy and the number of surviving animals in various hypoxic conditions: hypobaric hypoxia, hypoxia with hypercapnia in the hermetic volume and hemic hypoxia. In terms of antihypoxic activity, Mexidol is significantly superior to pyritinol and piracetam, which, at doses of 300 and even 500 mg/kg, has weak antihypoxic activity in conditions of acute hypobaric hypoxia and hypoxia with hypercapnia. In addition, mexidol has a pronounced antihypoxic effect on the myocardium in experiments on an isolated, perforated, beating heart. According to the mechanism of realization of these effects, Mexidol is an antihypoxant with a direct energizing effect, the effect of which is associated with an effect on the endogenous respiration of mitochondria, with the activation of the energy-synthesizing function of mitochondria. The antihypoxic effect of Mexidol is due not only to its own antioxidant properties, but also to its constituent succinate, which, under conditions of hypoxia, entering the intracellular space, is able to be oxidized by the respiratory chain. Mexidol has a pronounced anti-alcohol effect. It eliminates neurological and neurotoxic manifestations of acute alcohol intoxication caused by a single administration of high doses of ethanol, and also restores behavioral disorders of the vegetative and emotional status, deterioration of cognitive functions, learning and memory processes caused by prolonged (5 months) administration of ethanol and its withdrawal, and prevents the accumulation of lipofuscin in the brain of alcoholic animals. Mexidol has a pronounced geroprotective effect, has a clear corrective effect on learning and memory processes disturbed by aging, improves the process of fixing, storing and reproducing information, helps restore emotional and vegetative status, reduces manifestations of neurological deficit, reduces the level of aging markers - lipofuscin in the brain and blood , malonaldehyde, cholesterol. The mechanism of Mexidol's geroprotective action is associated with its antioxidant properties, the ability to inhibit lipid peroxidation processes, its direct membranotropic action, the ability to restore ultrastructural changes in the granular endoplasmic reticulum and mitochondria, and modulate the functioning of receptor complexes. Mexidol has an anti-atherogenic effect. The drug inhibits the humoral manifestations of atheroarteriosclerosis: reduces hyperlipidemia, prevents the activation of lipid peroxidation, increases the activity of the antioxidant system, prevents the development pathological changes in vascular wall and reduce the degree of damage to the aorta. Mexidol reduces the content of atherogenic lipoproteins and triglycerides, increases the level of high-density lipoproteins in blood serum, and prevents deficiency of highly unsaturated phospholipids. Mexidol not only causes regression of atherosclerotic changes in the main arteries and restores lipid homeostasis, but also corrects disturbances in the regulatory and microcirculatory systems, which is expressed in the fact that there is no construction of arterioles and precapillaries, and their diameter differs little from the control, only focal aggregates, as well as complete elimination of spasm of the afferent microvessels. In addition, derivatives of 2-ethyl-6-methyl-3-hydroxypyridine, which include Mexidol, inhibit platelet aggregation caused by collagen, thrombin, ADP and arachidonic acid, inhibit phosphodiesterase of platelet cyclic nucleotides, and also protect blood cells during mechanical injury. In particular, stabilization resistance of erythrocyte membranes to hemolysis is observed and the process of hematopoiesis is accelerated (restoration of the number of erythrocytes) after acute blood loss or chemical hemolysis. The hepatoprotective effect of Mexidol was established on three models of acute toxic injury liver, in which hepatocyte cytolysis syndrome was caused by various hepatotoxins. Under conditions of liver damage with carbon tetrachloride, Mexidol reduces the areas of necrosis of the liver tissue and the amount of fatty degeneration of hepatocytes, normalizes the energy balance of hepatocytes, and has a protective effect on the nuclear and cytoplasmic pool of nucleic acids. With alcoholic liver damage, the effect of Mexidol is expressed in a decrease in the number of hepatocytes with lysis of nuclei and chromatin, an acceleration in the recovery of the total genome of hepatocytes and an increase in the content of nucleic acids in the liver tissue and nuclei of hepatocytes. 3-hydroxypyridine derivatives have a protective effect against the toxic effect on the liver of the strong hepatotropic carcinogen diethylnitrosamine (DENA), since they form complexes with cytochrome P-450 and thereby prevent its complexation with DENA. Mexidol has a pronounced ability to have a potentiating effect on the effects of other neuropsychotropic drugs. Under the influence of Mexidol, the action of tranquilizers, neuroleptics, antidepressants, hypnotics and anticonvulsants is enhanced, which makes it possible to reduce their doses and reduce side effects. In particular, when Mexidol is combined with carbamazepine, the dose of the anticonvulsant can be reduced by 2 times without reducing its therapeutic effect. The combined use of Mexidol with carbamazepine allows for adequate pathogenetic therapy of partial epilepsy, to reduce the side effects of carbamazepine in long-term use without reducing its therapeutic efficacy, and thereby optimize the treatment of patients with epilepsy. Side effects and toxicity A significant advantage of Mexidol is that it has minor side effects and low toxicity. When studying side effects Mexidol found that even in the upper range of therapeutic doses, it does not have either a depressing or stimulating effect on spontaneous motor activity, does not change the coordination of movements, orienting-exploratory behavior of animals, rectal temperature, corneal and pinneal reflexes, does not cause drowsiness. Against the background of the drug, the adequacy of the animals' response to test-provoking stimuli is preserved, simple reflexes. With an increase in the average therapeutic dose by 4-5.5 times, Mexidol does not have a muscle relaxant effect. Along with this, Mexidol, even in super high doses, does not impair memory and does not cause amnesia, but, on the contrary, has an anti-amnestic effect in memory disorders. Mexidol does not provide negative impact on the liver, but on the contrary, it has a hepatoprotective effect. The drug does not change the heart rate, does not change blood pressure, ECG, hemodynamics and respiratory rhythm, does not cause changes in blood composition, skin color and mucous membranes, urination, defecation and salivation. Side effects Mexidol are expressed mainly in oppression motor activity and impaired coordination of movements and begin to manifest in individual animals with increasing doses to 300 mg / kg and above with intraperitoneal administration and at doses of 400 mg / kg and above with the introduction of Mexidol inside. Long introduction Mexidol (2-3 months) does not cause a decrease in its therapeutic effect or the appearance of additional undesirable manifestations. After the cessation of long-term administration of Mexidol, no withdrawal syndrome is observed. Acute toxicity Mexidol was determined by registering the death of animals 24 hours after the administration of the drug. The lethal dose of Mexidol, which causes the death of 50% of animals (LD50), is 820 (625 - 1025) mg / kg for rats and 475 (365 - 617) mg / kg for mice, and when administered orally - more than 3000 mg / kg in rats and 2010 (1608 - 2513) mg/kg in mice. The study chronic toxicity Mexidol with prolonged use inside and parenterally in experimental animals did not reveal significant changes in the organs and tissues of the body. Comparison of effective therapeutic doses of Mexidol with doses that cause side effects (sedation, impaired coordination, ND50) or toxic, lethal doses (LD50) shows a significant therapeutic breadth of Mexidol. The therapeutic index calculated by the ratio of ND50/ED50 is 6.2, and by the ratio of LD50/ED50 is 16.4, which indicates the safety and harmlessness of the drug. PHARMACOKINETICS AND METABOLISM Mexidol has a high bioavailability. When administered parenterally to rats, it is rapidly absorbed from the abdominal cavity with a half-absorption period of 0.94 hours and maximum plasma concentrations are reached after 3 hours, and in the brain and liver of animals - after 2-3 hours. The study of the binding ability of the membranes of the endoplasmic reticulum of the liver and brain of rats with Mexidol showed that the substance is determined in significant quantities in the membranes for 72 hours, which indicates the membranotropic properties of Mexidol. After intravenous administration of Mexidol to rabbits, the substance is eliminated from the blood plasma bioexponentially and can be determined according to theoretical calculations in fairly high concentrations for 6-12 hours. The high lipophilicity of Mexidol, its ability to bind to blood plasma proteins and membranes of the endoplasmic reticulum suggest the formation of a tissue and blood depot of Mexidol in the body of animals. An analysis of the pharmacokinetic parameters of Mexidol in patients in the clinic showed that both with a single dose and with a course of use, the concentration of Mexidol in the blood increases quite quickly, reaching a maximum after an average of 0.58 hours. At the same time, Mexidol is rapidly eliminated from the blood and after 4 hours it is practically not registered. The pharmacokinetic profiles of the drug, both with single and chronic administration, did not differ significantly. The study of the excretion of Mexidol with urine showed that it is excreted both in unchanged form and in the form of a glucuronoconjugate, which is a significant amount. In the study of the metabolism of Mexidol in rats, 5 metabolites were identified. Metabolite I - phosphate (according to the hydroxy group) of 3-hydroxypyridine, the formation of which occurs in the liver. In the blood, under the influence of alkaline phosphatase, 3-hydroxypyridine phosphate is split into phosphoric acid and 3-hydroxypyridine. Metabolite II - 2-methyl-6-methyl-3-oxypyridine - is formed in large quantities and is found in the urine on the first and second days after the administration of Mexidol; this metabolite has a spectrum of pharmacological activity close to that of Mexidol. Metabolite III - 6-methyl-3-hydroxypyridine is contained and excreted in large quantities in the urine. Metabolite IV - glucuronoconjugate with 2-ethyl-6-methyl-3-oxypyridine. Metabolite V is a glucuronoconjugate with 2-ethyl-6-methyl-3-hydroxypyridine phosphate. APPLICATION OF MEXIDOL IN NEUROLOGY AND PSYCHIATRY Mexidol is an effective means of anti-ischemic protection of the brain in cerebral strokes. The drug has a pronounced therapeutic effect in patients with acute disorders of cerebral circulation, including patients with ischemic and hemorrhagic stroke, located in the circulation zone of the internal carotid artery and its branches, as well as in the vertebrobasilar basin. Mexidol, as a rule, is administered to patients in the first hours of admission to the clinic intravenously by stream or intravenous drip and intramuscularly, in doses of 50 mg. up to 400 mg. once, from 50 mg. up to 900 mg. per day with the frequency of administration - 3. The duration of the drug is about 4 hours. During the same time, the drug is determined in the blood of patients. One of the most significant manifestations of the action of Mexidol when it is included in the complex therapy of cerebral stroke is a significant decrease in the daily mortality of patients in the acute period of stroke, as well as a tendency to a general decrease in mortality in this disease. In the acute period of cerebral stroke, the mortality rate of patients who took Mexidol was -31.5%, and without it -52.5%; the number of bed-days significantly decreased: 38.2±2.7 with Mexidol and 45.2±4.0 days without Mexidol (B.A. Spasennikov). When using Mexidol, in the treatment of cerebral stroke, first of all, there is a faster regression of neurological symptoms, assessed by the Matthew scale. Thus, in patients in serious condition at the time of admission to the clinic, Matthew's index at the end of the acute period (21 days) was 51.5 ± 2.1, and after treatment with Mexidol it significantly increased to 59.7 ± 1.0. In the treatment of patients with the use of Mexidol, the dynamics of improvement in motor functions, detected using the ADL index, was also indicative. So, after 21 days, this indicator was 76.6±3.1 in patients using Mexidol, and 63.2±4.6 in the group of patients without using Mexidol (the difference is significant at P< 0,05). По данным ЭЭГ эффект Мексидола выявляется в виде повышения мощности спектра и активации быстроволновой ритмики. По результатам ультразвуковой плерографии магистральных сосудов мозга объемный кровоток в магистральных артериях головы после введения Мексидола увеличивается на 25-40 %. Мексидол оказывает церебральный вазодилятационный эффект, снижает показатели мозгового сосудистого сопротивления, существенно увеличивает пульсовые колебания мозговых сосудов и способствует гемодинамическим сдвигам, обеспечивающим отток крови в мозговые вены, не оказывая при этом существенного влияния на системное артериальное давление. У больных, получавших Мексидол, отмечается существенный регресс расстройств сознания при их оценке по платам Глазго-Питтсбург и А.Н. Коновалова. У этих больных значительно быстрее и отчетливее, в более ранние сроки восстанавливаются функции двигательной сферы, наблюдается положительная динамика в восстановлении координации движений. Мексидол заметно улучшает субъективное состояние больных, уменьшая проявления вегетативной дисфункции (чувство страха смерти, головные боли, колебания настроения, сердцебиения и т.д.). Под воздействием Мексидола редуцируются признаки вазомоторной нестабильности, гипертермия; потливость, тахикардия и др., уменьшается или устраняется психомоторное возбуждение, значительно улучшается сон. Высокой эффективностью Мексидол обладает при лечении дисциркуляторной энцефалопатии (ДЭ), которая определяется как прогредиентное множественное диффузное мелкоочаговое поражение головного мозга сосудистого генеза и характеризуется, ишемическим-гипоксическим поражением нейронов, прогрессирующим снижением энергетических процессов, активацией процессов перекисного окисления липидов, нарушением ионного гомеостаза. В этих условиях Мексидол, оказывающий нормализующее действие на церебральный метаболизм, на тонкую нейрохимическую регумцию, представляет special value. Cerebroprotective therapy with Mexidol differs from the traditional effect on homeostasis and hemodynamics by the safety of use, the possibility of long-term use, the ability to influence various levels and types of neurological and psychiatric disorders. Mexidol in ampoules (5% solution) is used intravenously by stream, drip or intramuscularly at a dose of 2 to 3 mg / kg once, from 100 to 1000 mg per day (1-3 injections). The course of the drug was 6-14 days. Mexidol has a therapeutic effect in patients with DE of all three stages. The drug causes a decrease in complaints of headaches of the frontotemporal localization of a compressive nature and pain of diffuse localization of a dull, aching nature, combined with a feeling that the ears are stuffed with cotton. Under the influence of Mexidol, a regression of symptoms is observed in patients with complaints of flies flickering, the appearance of a grid, fog before the eyes, noise in the head decreases; After a course of treatment with Mexidol, there was a statistically significant improvement in the main indicators of neuropsychological tests: an increase in the number of memorized words, an increase in accuracy, quality and pace of work, a decrease in the number of errors, which indicates that Mexidol improves memory. Along with this, Mexidol reduces the feeling of fatigue, weakness, eliminates the feeling of anxiety and fear that occurs in specific situations, and also has a therapeutic effect in sleep disorders of the presomnic, postsomnic and especially intrasomnic nature, increases the coefficients social adaptation. Mexidol has a positive effect on patients with vestibular disorders, reducing uncertainty when walking, non-systemic dizziness, a feeling of losing a sense of balance when walking. Mexidol reduces the phenomena of hyperesthesia, senestopathy, patients do not show progression of reflexes of oral automatism, smoothing of the nasolabial fold. The greatest dynamics during therapy with Mexidol are such symptoms as decreased performance, motor activity, dizziness, headache, memory impairment, anxiety, social maladaptation. Subjective and objective positive effect in the treatment with Mexidol is observed, as a rule, by the end of the week of therapy. Echopulsography of intracranial arteries and veins after intravenous administration of Mexidol showed that already 30 minutes after the injection and for 4-6 hours there was an increase in the amplitude (by an average of 25.5%) of the pulse oscillations of the cerebral vessels and the outflow of blood into the cerebral veins was facilitated. Under the influence of Mexidol, there is an increase in linear and volumetric blood flow in the extracranial sections of the main arteries of the head, which is recorded within 6 hours after the administration of the drug. Registration of rheoencephalography after a course of treatment with Mexidol revealed normalization of the waveform in 67% of patients, and improvement in venous outflow in 38%. There is an increase in pulse blood filling in the system of the external carotid artery and in the vertebrobasilar basin at its initially low level and normalization of the tone of small arteries and veins in both vascular basins. Mexidol causes normalization of the EEG of patients with DE, which is expressed in an increase in the total power of the spectrum due to the alpha and beta ranges without a significant change in the slow-wave part of the spectrum. In patients treated with Mexidol, the increased content hemoglobin, leukocytes, blood viscosity decreases, cholesterol level decreases, lecithin-cholesterol coefficient increases. Thus, Mexidol has a pronounced healing effect in patients with dyscirculatory encephalopathy of the 1st, 2nd and 3rd stages. Under the influence of Mexidol, remission, or regression of neurological syndromic deficit, is observed. As a result of treatment with Mexidol, 64% of patients showed a pronounced improvement in their condition, 32% had a moderate improvement, 20% had a slight improvement, and 16% had no effect. Comparison of the clinical efficacy of Mexidol and well-known drugs showed that the index of overall effectiveness in: treatment of DE was 2.05 for Mexidol. for cavinton, trental and sermion -2.1, arsdergin -1.8. Mexidol is effective in patients with vegetative-vascular dystopia with symptoms of vegetative crises of a sympatho-adrenal nature, in whom the improvement occurred within 5-14 days after the start of treatment. The intensity and frequency of headaches decreased, vasoactive imbalance and excitability decreased, and sleep improved. In 13% of patients, vegetative crises completely stopped and did not appear within the next 2-3 months. Mexidol has a positive effect in patients with mental pathology late age, especially with atherosclerotic dementia, in which Mexidol was used intramuscularly (for the first 5 days, patients received 100 mg, and on the remaining days, 300 mg daily, course -3 weeks). Mexidol had a positive effect on memory, especially on current events, improved concentration of attention, assimilation of instructions, caused a decrease in headaches and manifestations of anxiety and depression. In patients, the degree of dysarthria and tearfulness decreased. In some patients, dizziness completely disappeared, a confident gait appeared, asthenia decreased. In some patients with initial manifestations of the senile-atrophic process and in patients with atherosclerotic dementia, after treatment with Mexidol, "enlightenment" in the head, increased activity, and improved mood were noted. Thus, the use of Mexidol improves intellectual and mnestic activity in patients with age-related organic debilitating processes, mainly in patients with atherosclerotic dementia, helping to improve concentration, following instructions, memory for the present, reducing headaches, dizziness, tearfulness, dysarthria, and increasing activity. . Mexidol has a pronounced positive effect in the treatment of chronic neuroleptic syndrome with symptoms of tardive dyskinesia and subacute neuroleptic syndrome. Before treatment with Mexidol, all patients underwent active therapy for neuroleptic syndrome with cyclodol, norparkin, midantan, tiapride, cerucal, tremblex, detoxification therapy with intravenous administration of nootropil, vitamins B and C, which was assessed as ineffective. Mexidol had a pronounced antiparkinsonian and vegetotropic effect in these patients who were difficult to treat. The action of Mexidol began to manifest itself already from the 2-3rd day of therapy and consisted in a decrease in the severity of oral-lingual hyperkinesis, which completely disappeared by the 7-14th day of treatment, then under the influence of the drug there was a decrease in limb tremor, stiffness, hypokinesia and hypomia, improved, became more confident, free gait of patients, which ceased to be shuffling, mincing. The phenomena of orthosgatism, dizziness decreased and passed, there was a tendency to normalize blood pressure with drug hypotension, and Mexidol had no effect on normal blood pressure, weakness, lethargy, and dizziness decreased. The antiparkinsonian effect of Mexidol persisted for 3-5 days after its withdrawal. Mexidol also has the ability to overcome the body's resistance to the action of psychotropic drugs. Mexidol in this pathology was used at a dose of 300-500 mg per day with a duration of treatment of 2-4 weeks. The effect of Mexidol began to appear already on the 3rd day of administration. Patients showed an improvement in appearance, color and turgor of the skin, appetite, a decrease in lethargy, weakness, dizziness, dry mouth, they became less inhibited. Against the background of Mexidol, it was possible to increase the doses of antidepressants and antipsychotics by 1.5-2 times without the appearance of side effects. In a number of cases, the appointment of previously ineffective drugs against the background of Mexidol made it possible to overcome the body's resistance and caused a significant decrease in depressive disorders and improvement. In neurotic and neurosis-like states, Mexidol has a pronounced tranquilizing effect, combined with a vegetative-normalizing effect. The therapeutic effect of Mexidol was most fully manifested in patients with neurosis and organic damage to the central nervous system with asthenic and astheno-vegetative disorders. The drug was effective and well tolerated by elderly patients. In 6 patients with asthenic disorders, the reverse development of anxiety and emotional stress against the background of Mexidol was accompanied by a kind of activation with an increase in the mood background, a reduction in asthenic symptoms proper. The tranquilizing effect of Mexidol is comparable in power to that of uxepam. Mexidol has a positive effect on sleep, restoring its duration and depth. The action of Mexidol manifests itself after 3-7 days of therapy. According to the spectrum of action, Mexidol can be attributed to daytime tranquilizers, which is effective both in a hospital setting and in outpatient practice, as well as in the elderly. Mexidol showed high efficiency in the treatment of alcohol withdrawal syndrome with somato-neurological and mental symptoms. The dose of Mexidol was 100-400 mg per day intramuscularly with a course duration of 5-7 days (against the background of conventional detoxification agents). Mexidol is an effective tool for the rapid relief of alcohol withdrawal syndrome with a wide range of effects, both on its psychopathological components and on vegetative-vascular manifestations. The effect of Mexidol is observed already 1-1.5 hours after the administration of the drug, and a stable improvement in the condition occurs after 2-3 days. Patients have a feeling of enlightenment, clarity in the head, headaches disappear, the process of concentration of attention, comprehension when reading literature improves, anxiety decreases, unconscious fear, internal tension, relaxation appears, a comfortable state, nightmares disappear, hypnotic hallucinations, dreams become without alcohol theme, prosleep disorders disappear. Patients note the appearance of cheerfulness, activity. Along with this, under the influence of Mexidol, alcohol motivation was significantly suppressed. Side effects. Comparison with cerebroprotective and psychotropic drugs. Mexidol is well tolerated by patients and causes only a few side effects that quickly disappear on their own or when the drug is discontinued. Of the hundreds of patients treated with Mexidol, side effects occurred in exceptional cases. Two patients with dyscirculatory encephalopathy experienced nausea and dizziness a few minutes after the intramuscular injection of Mexidol, which subsided on their own. Two patients with alcoholism experienced bitterness and dry mouth, dizziness, weakness, which quickly disappeared when the drug was discontinued. In three patients with resistant depression, combined with manifestations of chronic neuroleptic syndrome, after the first two or three injections, a slight drowsiness appeared, which then disappeared on its own. In one patient with neurosis, at the beginning of therapy, a punctate rash on the skin of the forearms was noted, not accompanied by itching and peeling, which independently reduced within three days against the background of ongoing therapy. The insignificance of side effects favorably distinguishes Mexidol among the known neuroprotective, nootropic and tranquilizing agents. Arsenal used in modern medicine drugs that improve cerebral circulation and are used in injectable form are rather limited and include pentoxifylline (trental), vinpocetine (cavinton), nicergoline (sermion), dihydroergotoxin (redergan). Cinnarizine (stugeron), flunarizine, nimodipine are used in the form of tablets and capsules. A significant disadvantage of these known agents, which limits their use in many cases, is the significant number and frequency of side effects. Pentoxifylline (trental) causes headache, dizziness, tachycardia, flushing of the face, palpitations, angina pectoris, arterial hypotension, nervousness, drowsiness or insomnia, bleeding from the vessels of the skin and mucous membranes, urticaria, skin rashes, itching, nausea, vomiting, a feeling of heaviness in epigastrium, increased fragility of nails, changes in body weight, edema, and in case of an overdose of the drug, convulsions, loss of consciousness, fever may occur. In this regard, contraindications to the use of trental are acute myocardial infarction, massive bleeding, cerebral hemorrhage, retinal hemorrhage, severe atherosclerotic damage to the vessels of the brain and heart, severe cardiac arrhythmias, pregnancy, lactation. The characteristic side effects of Vinpocetine (Cavinton) are a decrease in blood pressure and tachycardia, and contraindications to the use of the drug are coronary heart disease and severe forms of arrhythmias. Nicergoline (sermion) causes arterial hypotension, dizziness, a feeling of heat and flushing to the face, drowsiness and sleep disturbance. Side effects of dihydroergotoxin (redergin) are nausea, vomiting, a feeling of heaviness in the stomach, loss of appetite, blurred vision, hyperemia of the nasal mucosa, skin rash, orthostatic hypotension, and contraindications to the use of the drug are severe coronary heart disease, severe bradycardia and arterial hypotension . Thus, all currently used drugs for the treatment of cerebrovascular accidents have significant side effects. In conditions of oxygen and energy deficiency that occurs with cerebrovascular lesions of the brain, Mexidol, which has a normalizing effect on cerebral metabolism, on fine neurochemical regulation and has minimal side effects, is of particular value. Cerebroprotective therapy with Mexidol differs from the traditional effect on homeostasis and hemodynamics by the safety of use, the possibility of long-term use, the ability to influence various levels and types of neurological and mental disorders. In contrast to traditional drugs, Mexidol does not cause a decrease in blood pressure, hemodynamic and ECG disturbances, and does not affect the heart rate. The positive effects of Mexidol in comparison with known drugs are its therapeutic effect on vasomotor instability, reduction of autonomic dysfunction, reduction of tachycardia, hyperemia, sweating, etc. In addition, Mexidol has a restorative effect on the functions of the motor sphere, improving coordination of movements and reducing psychomotor agitation, improves sleep, eliminates nervousness. Thus, having a high therapeutic effect, Mexidol does not have side effects characteristic of other neuroprotective drugs. In contrast to sodium hydroxybutyrate and seduxen, Mexidol does not change the rhythm and frequency of breathing, i.e. does not cause cardio-respiratory depression inherent in these drugs. In contrast to nooprop drugs, when using Mexidol, there is no activating effect, sleep disturbances and an increase in convulsive readiness. In addition, Mexidol is significantly superior in its effectiveness to piracetam (nootropil). In comparison with benzodiazepine tranquilizers (seduxen, elenium, oxazepam, lorazepam, phenazepam, etc.), Mexidol does not have a muscle relaxant effect even at doses 4-5.5 times higher than the average therapeutic anxiolytic dose and does not cause such manifestations as impaired coordination movement, decreased muscle tone and muscle strength. Mexidol, in contrast to anxiolytics, does not have a sedative and amnestic effect, but, on the contrary, has a positive effect on memory, especially in conditions of impaired cognitive functions. With prolonged administration of Mexidol and the termination of its use, there are no signs of a withdrawal syndrome characteristic of benzodiazepine tranquilizers. Thus, Mexidol is a selective "daytime" tranquilizer, in which anxiolytic and anti-stress effects are carried out without layering sedative, muscle relaxant and amnesic effects. Having a high therapeutic effect, Mexidol does not cause side effects characteristic of well-known neuroprotective, nootropic and tranquilizing drugs, which indicates its safety and significantly expands the possibilities of application. Dosage and administration Mexidol is prescribed intravenously (stream or drip), intramuscularly and orally. When administered intravenously, the drug should be diluted with water for injection or in physiological sodium chloride solution. For infusion administration, physiological NaCl solution should be used. Jet Mexidol is injected for 1.5-3.0 minutes, drip - at a rate of 80-120 drops per minute. The duration of treatment and the daily dose of the drug depend on the nosology of the disease and the severity of the patient's condition. For the treatment of acute cerebrovascular accident, Mexidol is prescribed intravenously in drops of 400 mg (8 ml) in isotonic sodium chloride solution (100-150 ml) twice a day for the first 15 days in intensive care or a specialized neurological department (maximum daily dose 1600 mg) . Then 400 mg (8 ml) 1 time per day intravenously in saline NaCl daily for 15 days. In the future, the introduction of Mexidol intramuscularly at 200 mg (4 ml) 1 time per day for 10-15 days is recommended. In the subsequent complex drug therapy, it is advisable to include a tablet form of the drug, 0.25-0.5 g / day for 4-6 weeks. The daily dose is divided into 2-3 doses during the day. For the treatment of dyscirculatory encephalopathy (both against the background of atherosclerosis of cerebral vessels, and against the background of hypertension):
  • In the decompensation phase, Mexidol is administered:
    - either 400 mg (8 ml) intravenously per 100 ml of isotonic NaCl solution daily for 10-15 days;
    - either 200 mg (4 ml) intravenously by bolus in 16.0 ml of water for injection or in isotonic sodium chloride solution (16.0 ml) twice a day for 10-15 days. Then the drug is administered intravenously in a stream of 100 mg (2 ml) per 10.0 ml of isotonic sodium chloride solution, daily, for 10 days. Or 200 mg (4 ml) intramuscularly daily for 10 days. Subsequently, it is recommended oral intake Mexidol 0.125 g three times a day for 4-6 weeks.
  • In the subcompensation phase, Meksidod is used:
    - either 200 mg (4 ml) intravenously by bolus per 16.0 ml of saline NaCl solution (or 16.0 ml of water for injection), daily, for 10-15 days;
    - either 200 mg (4 ml) intramuscularly, twice a day, for 10-15 days. Then you can continue treatment with a tablet form of 0.125 g three times a day, a course of 4-6 weeks. For course prevention of dyscirculatory encephalopathy (compensation phase), Mexidol is recommended to be administered:
    - either 100 mg (2 ml) intravenously by bolus per 10.0 ml of physiological NaCl solution, daily for 10 days;
    - either 200 mg (4 ml) intramuscularly, daily, for 10 days. Subsequently, it is advisable to take a tablet form of 0.125 g three times a day, for 2-6 weeks (in both cases - both intravenously and intramuscularly);
    - or initially course prevention can be started with the use of a tablet form of 0.125 g three times a day, for at least 4-6 weeks. With vertebrobasilar insufficiency due to osteochondrosis cervical spine Mexidol is used:
  • In the decompensation phase:
    - either 400 mg (8 ml) intravenously, in 100 ml of saline NaCl solution, daily for 10 days;
    - either 200 mg (4 ml) intravenously by bolus per 16.0 ml of isotonic sodium chloride solution, twice a day, for 10 days; In the future, intramuscular administration of 200 mg (4 ml) is recommended for 10-15 days. At the end of intramuscular injections - the transition to oral administration of the drug at 0.125 mg three times a day, a course of 2-6 weeks.
  • In the subcompensation phase:
    - either 200 mg (4 ml) Mexidol is administered intravenously, per 16.0 ml of isotonic sodium chloride solution, for 10 days;
    - or 200 mg (4 ml) intramuscularly, twice a day, for 10 days. In the future, it is advisable to prescribe a tablet form in the above doses. In the acute period of traumatic brain injury, the appointment of Mexidol is pathogenetically justified, since, in addition to its cerebroprotective properties, its anticonvulsant activity and potentiation of the action of dehydration agents are of great importance. Recommended doses of the drug:
    - in the acute period - 200 mg (4 ml) intravenously by bolus, per 16.0 ml of isotonic sodium chloride solution, twice a day, 10-15 days;
    - in the subacute period - 200 mg (4 ml) intravenously by bolus per 16.0 ml of isotonic sodium chloride solution, daily for 10 days; or 200 mg (4 ml) intramuscularly, twice a day, for 10-15 days. During the rehabilitation period, it is recommended to take a tablet form of 0.125 g three times a day for 4-6 weeks. The administration of the drug is very effective in the treatment of dysmetabolic, and, first of all, diabetic encephalopolyneuropathies. Mexidol, used in diabetes mellitus, improves the course of the disease itself, and also improves the uptake of glucose by cells in conditions of insulin resistance. It is recommended to administer the drug intravenously at a dose of 200 mg (4 ml) intravenously by bolus, per 16.0 ml of physiological NaCl solution, twice a day, for 10-15 days. In the future, 100 mg (2 ml) is administered intramuscularly daily for 15-30 days. At the end of parenteral administration, they switch to a tablet form - 0.125 g three times a day, for at least 4-6 weeks. Given the lack of a direct stimulating effect on the cerebral cortex, and having a pronounced anticonvulsant effect, Mexidol can also be used in the treatment of epilepsy. The drug enhances the action of anticonvulsants, which makes it possible, when prescribing it, to reduce the doses of drugs used. traditional medicines and thereby reduce their side effects. Mexidol is recommended to be administered at 100 mg (2 ml) intravenously by bolus per 18.0 ml of isotonic sodium chloride solution (or in the same amount of water for injection), twice a day, for 15 days. Then the drug is administered intramuscularly at 100 mg (2 ml) daily for 15 days. Degenerative-dystrophic lesions of the central nervous system. Mexidol has a pronounced positive effect in the treatment of chronic neuroleptic syndrome with symptoms of tardive dyskinesia and subacute neuroleptic syndrome. The drug reduces the severity of oral-lingual hyperkinesis, reduces limb tremor, stiffness, hypomimia and hypokinesia, improves motor functions sick. In addition, it potentiates the action of antiparkinsonian drugs, which allows you to reduce the doses of the drugs used and reduce their side effects. For the treatment of degenerative-dystrophic lesions of the central nervous system, Mexidol is recommended to be used at 200 mg (4 ml) intravenously by bolus per 16.0 ml of isotonic sodium chloride solution, twice a day, for 10 days. Then the drug is administered intramuscularly at 200 mg (4 ml), daily, for 15 days. In the next 4-6 weeks, it is advisable to prescribe a tablet form - 0.125 g three times a day. Autonomic dysfunction syndrome, neurotic and neurosis-like states. Mexidol has shown its high efficiency in vegetative-vascular dystonia, especially those occurring in the paroxysmal type. It has a vegetative-normalizing and pronounced tranquilizing effect in neurotic and neurosis-like states. Dosing regimen of the drug: 100-200 mg (2-4 ml) intravenously by bolus for 10.0-16.0 ml of isotonic sodium chloride solution, daily for 10 days. Perhaps intramuscular injection of the drug 200 mg (4 ml), daily, 15 days. After injections, it is advisable to prescribe a tablet form of 0.25-0.50 g per day. The daily dose is divided into 2-3 doses. The course of treatment is 2-6 weeks. Course therapy is completed in this case gradually, reducing the dose of the drug within 2-3 days. parasomnia disorders. Mexidol has a positive effect on sleep, restoring its duration and depth, while promoting recovery correct rhythm sleep. This is combined with the absence of sedative effects when taking the drug in the daytime. AT this case the drug is recommended to be administered intramuscularly, 100-200 mg (2-4 ml), daily, for 15-20 days. Then use a tablet form of 0.125 g three times a day for 4-6 weeks. The dose of the drug before cancellation is reduced gradually, within 2-3 days. Memory disorders and intellectual deficiency in the elderly. Mexidol is effective drug for the revitalization of the elderly. The drug has a positive effect on hypomnesia, increased distractibility and difficulty concentrating, improves the ability to concentrate and count, improves short term memory current events and long-term memory of the past. Recommended dosage regimen: 100-200 mg (2-4 ml) intramuscularly (depending on the degree of intellectual disability) for 10-15 days, then the drug is given orally at 0.125 g three times a day, for at least 4-6 weeks. Similar courses are repeated every 5-6 months. periods of extreme stress. Mexidol has a pronounced ability to improve mental and physical performance, especially under extreme conditions. It is advisable in such cases to start with intravenous administration of 200 mg (4 ml) intravenously by bolus, per 16.0 ml of isotonic sodium chloride solution, daily, for 10-15 days. Then the drug is administered intramuscularly at a dose of 200 mg (4 ml) per day for 10 days, followed by a transition to taking a tablet form of 0.25-0.50 g per day; course of treatment - 2-6 weeks. It is possible to switch to a tablet form immediately after intravenous administration. Exogenous organic diseases of the brain. The causes of exogenous organic brain lesions are: previous traumatic brain injury, intoxication (excluding alcohol), neuroinfections, as well as combinations of these factors. A number of drugs are known to be poorly tolerated by patients with exogenous organic diseases. Mexidol, as studies have shown, is not one of them. When using it, there is a clear positive effect on the already existing neurological deficits in this category of patients. The recommended dosing regimen of the drug: intravenous bolus of 200 mg (4 ml) per 16.0 ml of isotonic sodium chloride solution, daily, for 10-15 days; then the drug can be administered intramuscularly at 100-200 mg (2-4 ml) per day for 10-15 days, or switch to a tablet form of 0.125 g three times a day for 4-6 weeks. Ethyl alcohol intoxication. Given the antihypoxic, antioxidant, tranquilizing and hepatoprotective effects of Mexidol, it can be used as part of complex therapy for the relief of intoxication with ethyl alcohol. Mexidol prevents and weakens the toxic effect of alcohol. Dosage regimen: 400 mg (8 ml) intravenously by drip per 150.0 ml of isotonic sodium chloride solution twice a day for 3 days; then 200 mg (4 ml) intravenously by bolus per 16.0 ml of physiological NaCl solution, twice a day, for 7 days. If necessary, treatment can be continued using the tablet form of the drug at 0.125 g three times a day for 2-6 weeks. Alcohol withdrawal syndrome. Mexidol is effective as a remedy for the relief of alcohol withdrawal syndrome with somato-neurological and mental symptoms due to its pronounced antioxidant and tranquilizing effects. When comparing the speed of the relief effect of Mexidol in relation to individual symptoms of alcohol withdrawal syndrome with the effectiveness of traditional detoxification agents, a significant advantage of this drug was found. Mexidol is an effective tool for the rapid relief of alcohol withdrawal syndrome with a wide range of effects, both on its psychopathological components and on vegetative-vascular manifestations. The injection form, in contrast to the tablet form, is more effective in relation to affective pathology, eliminating anxiety in a significantly shorter time. Recommended dosage regimen: 200 mg (4 ml) intravenously by bolus, 16.0 ml of isotonic NaCl solution, daily, for 10-15 days, then it is possible to switch to intramuscular administration of the drug at a dose of 200 mg (4 ml), daily, within 10 days, followed by the transition to a tablet form of 0.125 g three times a day, 4-6 weeks. In some cases, a combination of only intramuscular injection drug (in the described dosages) and tablet form. It is also possible to use only the tablet form at a dose of 0.5 g per day (2 tablets twice a day) during the entire period of the existence of a hangover syndrome. Anxiety disorders in neurotic and neurosis-like states. With anxiety disorders - psychogenic (neurotic), with endogenous diseases, at organic lesion of the brain of traumatic, intoxication and vascular genesis Mexidol, used as an anxiolytic agent, is most effective in generalized anxiety and anxiety-asthenic conditions that are simple in structure. The anxiolytic effect of the drug, combined with the activating component and the vegetative normalizing effect, contributes to the rapid reduction of emotional stress, anxiety, asthenic and autonomic disorders, sleep disorders. For the treatment of these disorders, the drug is used intramuscularly at a daily dose of 200-400 mg, divided into 2 doses for 14-30 days, or orally 0.25 g (2 tablets of 0.125 g) twice a day for at least 4 weeks. Mild cognitive disorders of atherosclerotic genesis. With mild cognitive impairment of vascular origin, including those developing in elderly patients, the use of Mexidol has a positive effect on dysmnestic disorders, reduces the severity of cerebroasthenic symptoms and emotional instability. The drug is used intramuscularly at a dose of 200-400 mg per day, divided into 2 doses for 14-30 days or orally at 0.25 g (2 tablets of 0.125 g) for 4 weeks. Acute intoxication antipsychotics(neuroleptics). In acute intoxication with neuroleptics with symptoms of neuroleptic syndrome, Mexidol causes a decrease in the severity of hyperkinesis, tremor, and muscle rigidity. Used in combination with antiparkinsonian drugs, Mexidol potentiates their action. In acute intoxication with antipsychotics, the drug is administered intravenously at a dose of 50-300 mg per day for 7-14 days. Intellectual-mnestic disorders of various origins. In organic psychosyndrome caused by chronic disorders of cerebral circulation, craniocerebral injuries, neuroinfections and intoxications, initial manifestations of senile-atrophic processes, enhanced manifestations of mental aging, Mexidol therapy begins with parenteral administration of the drug, 200 mg (4 ml) intramuscularly, daily, for 10-15 days. In the future, they switch to the tablet form of the drug - 0.125 g three times a day, at least 4-6 weeks. Correction of insulin resistance. The inclusion of Mexidol in the complex therapy of diabetes mellitus makes it possible to achieve compensation for the disease, reduce the doses of hypoglycemic drugs, stop the progression of late complications and, thus, improve the quality and prognosis of life. The use of Mexidol is especially effective for the correction of chemical homeostasis in the group of diabetic patients in whom hypoglycemia cannot be stabilized by traditional therapy and who have high level atherogenic lipids in the blood, severe neuropathy, impaired microcirculation, hemostasis. Mexidol is especially necessary in the prevention of late complications of diabetes: retinopathy, nephropathy, syndrome " diabetic foot". At the same time, it is possible to correct tissue trophism by stimulating microcirculation, detoxification, enhancing oxidative processes in the energy cycle. The decrease in glycemia when Mexidol is included in the complex therapy of diabetes helps to reduce the percentage of purulent-septic complications during surgical interventions. The positive effect of using Mexidol in the clinic is observed with short courses of treatment (5 - 7) days at a dose of 100 - 200 mg per day. The dose is selected individually depending on the biochemical profile of lipid and carbohydrate metabolism. Complex therapy of acute purulent-inflammatory processes in the abdominal cavity. In acute destructive pancreatitis, peritonitis Mexidol is prescribed on the first day, both in the preoperative and in postoperative period. The administered doses depend on the form and severity of the disease, the prevalence of the process, and the variants of the clinical course. Cancellation of the drug should be made gradually, only after a stable positive clinical and laboratory effect.
    - In acute edematous (interstitial) pancreatitis, Mexidol is prescribed 100 mg (2 ml) three times a day intravenously, in isotonic sodium chloride solution.
    - Mild severity of necrotizing pancreatitis - 100-200 mg (2-4 ml) three times a day intravenously (in isotonic NaCl solution).
    - Severe course of necrotizing pancreatitis - the drug is administered in a pulse dosage of -800 mg (16 ml) on the first day, with a double injection regimen; then 300 mg (6 ml) twice a day with a gradual decrease in the daily dose.
    - Extremely severe course - at an initial dosage of 800 mg / day (16 ml) for persistent relief of manifestations of pancreatogenic shock, to stabilize the condition, 300-400 mg (6-8 ml) twice a day intravenously drip (in isotonic sodium chloride solution) With a gradual decrease in the daily dosage. In the complex therapy of peritonitis, Mexidol is administered at a dosage of 200-300 mg (4-6 ml) three times a day intravenously by drip in an isotonic sodium chloride solution during the first 3 days, then 200 mg (4 ml) per day with a gradual decrease daily dose. Use in dental medical practice. Rationale for the use of Mexidol in the complex therapy of chronic generalized periodontitis(CHP) was the ability to inhibit free radical oxidation, increase the activity of the antioxidant system. To achieve optimal exposure, it is advisable to use both the local and parenteral route of administration of Mexidol in combination. With mild severity of CGP, Mexidol is prescribed according to the following schemes. locally in the form:
    - rinsing with 2 ml of 5% solution for injection 3 times a day, for 12-14 days. Method of preparation: dilute 1 ampoule of the drug with warm boiled water and rinse for 5 minutes.
    - either applications of 2 ml of 5% solution of Mexidol 2-3 times a day for 12-14 days. Method of preparation: open 1 ampoule of the drug and moisten with a solution a piece of sterile gauze or bandage, folded in 4-6 layers. Apply along the outer perimeter of the gingival sulcus for 20 minutes. Additionally, it is recommended to brush your teeth with toothpaste from the "MEXIDOL dent" series 2 times a day for 3-5 minutes. Oral: 1-2 tablets orally 2 times a day for 12-14 days. In moderate and severe CGP, Mexidol is prescribed according to the following schemes. locally in the form:
    - rinsing (2 ml of 5% solution 3 times a day) for 12-14 days.
    - either applications (2 ml of 5% solution 2-3 times a day) for 12-14 days. In the presence of a periodontal pocket, apply:
    - Installations of 2 ml of 5% solution for injection. Method of preparation: open 1 ampoule of the drug and moisten with a solution of turunda, which is placed in a periodontal pocket for 20 minutes. Parenterally: intramuscularly 2 ml of a 5% solution (100 mg) 1 time per day for 12-14 days Orally: 1-2 tablets (0.125-0.25 g) 2-3 times a day for 12-14 days. Additionally, it is recommended to brush your teeth with toothpaste from the "MEXIDOL dent" series 2 times a day for 3-5 minutes. Contraindications The use of Mexidol is contraindicated in acute disorders x liver and kidney function. Hypersensitivity or intolerance to the drug. Side effects May be noted: from the side digestive system rarely - nausea, dry mouth. Adequate and strictly controlled clinical research the safety of the drug during pregnancy, lactation (breastfeeding) and in children has not been conducted. Interaction with other drugs Not installed. The drug is combined with almost all drugs used in complex therapy for these nosologies. Mexidol potentiates the action of anticonvulsants, tranquilizers, antiparkinsonian drugs, analgesics. The drug reduces the toxic effects of ethyl alcohol.

    • The drug Mexidol is recognized as one of the best medicines in the field of neurology, surgery and narcology. He has enough wide range applications: from vegetative-vascular dystonia to cerebrovascular accidents ().

    The development of this drug began in the distant 80s of the last century. The drug Mexidol was first synthesized at the State Research Institute of Pharmacology of the Russian Academy of Medical Sciences. Since then, the drug has been actively developed. By 2003, its creators received the Prize of the Government of the Russian Federation for the creation and introduction of Mexidol into medical practice.

    Indications for the use of tablets Mexidol

    Most often, Mexidol is used for:

    • stroke and its consequences;
    • vegetative-vascular dystonia;
    • epilepsy;
    • craniocerebral injuries;
    • Alzheimer's and Parkinson's diseases;
    • hypertension;
    • border neuropsychiatric disorders;
    • chronic;
    • alcohol intoxication;
    • withdrawal syndrome and post-abstinence disorders;
    • acute inflammatory processes of the abdominal cavity.

    The dosage of the drug is prescribed by the doctor depending on the disease. Most often, Mexidol is used in combination with other drugs.

    Side effects of Mexidol

    Mexidol has the following side effects:

    • dry mouth;
    • nausea;
    • allergic reactions;
    • drowsiness.

    An important feature of Mexidol is that it is not addictive and can be canceled at any time. The only side effect of Mexidol in case of an overdose is drowsiness. Therefore, the drug is not recommended for use during activities that require special concentration. For example, driving a car.

    As can be seen from the foregoing, Mexidol is a low-toxic drug and does not have a large number of side effects. Therefore, the drug is safe for almost all groups of people.

    Mexidol contraindications

    However, Mexidol, like any other drug, has a number of contraindications. Among them, individual intolerance to the components of the drug. Before using Mexidol, it is advisable to undergo a series of tests to detect allergic reactions. In addition, the drug Mexidol is contraindicated for use in people who suffer from kidney or liver diseases. For example, inflammation of the kidneys or any form of hepatitis.

    It is worth noting that when using the drug, attention should be paid to blood pressure. If you have high blood pressure, you will have to stop taking Mexidol for a while. First, it is better to carry out a series of procedures to normalize the pressure.

    Mexidol and alcohol

    The drug Mexidol does not belong to the group of antibiotics, therefore, when taking it, alcohol is allowed. Although not desirable.

    Moreover, one of the areas of application of this drugs are just the fight against alcoholism and the accompanying withdrawal syndrome.

    By the way, in this area the drug is considered one of the best. It removes toxins formed from alcohol intake and stops the resulting withdrawal syndrome.

    In alcoholism, the duration of treatment with Mexidol usually lasts from 2 to 6 weeks. Doctors do not recommend abruptly cutting off the course. It is advisable to gradually reduce the daily dosage of the drug. In the end, leading to its complete abolition.

    In 1996, a good composition of an antioxidant orientation appeared in Russian pharmacies - the drug "Mexidol". The composition has found wide application in neurology for the ability to normalize metabolic processes in brain tissues and protect them from harmful effects. free radicals. But its use is not limited to this. It is prescribed under appropriate conditions by narcologists, surgeons and psychiatrists. Specialists highly appreciate the new generation medicine for its unique properties and pharmacological advantages over other neuropsychotropic compounds:

    • Increase resilience to stressful situations.
    • Restore speech functions, improve memory properties after brain damage as a result of ischemic attacks and strokes.
    • Prevent seizures.
    • Neutralize various kinds body intoxication.

    The composition of the drug

    Instructions for use says that the active substance in Mexidol is 3-hydroxy-6-methyl-2-ethylpyridine succinate. Salts are called succinates. succinic acid- a metabolite natural for humans, a participant in energy metabolism reactions. Tissues in sufficient quantities receive acid with rye bread and at good nutrition there is no lack of it.

    Dosage forms of Mexidol:

    • tablets;
    • solutions for injections (50 mg AI/ml).

    The drug is produced with a mass fraction of active ingredient of 5%. The volume of ampoules is 2 ml/5 ml. One contour package includes 5 ampoules.

    2 times more, that is, 10 ampoules (2 boxes of 5 ampoules with a volume of 2 ml) each contains Mexidol 10, respectively. The drug is administered according to a certain scheme, depending on the pathology.

    There may also be preparations containing 5-10 ampoules with a solution of the same concentration (5%) and a volume of 2 ml / 5 ml.

    One tablet contains:

    • DV - 125 mg;
    • sodium carmellose;
    • lactose;
    • magnesium salt of stearic acid.

    Mechanism of action

    Cells are bounded by a plasma membrane consisting of a lipid bilayer. The active substance from the composition of the drug in question slows down or prevents peroxidation of membrane phospholipids. Hence its membrane-protective properties. As an antioxidant, DV inhibits oxidative processes involving free radicals, after which the antioxidant enzyme is activated, and the fluidity of biological membranes increases.

    This, in turn, leads to an improvement in the transport of neurotransmitters, an increase in the rate of binding of receptor complexes with membrane-binding enzymes. As a result, the body better resists oxygen deficiency and all the processes provoked by hypoxia.

    Indications for use

    The use of Mexidol showed that he:

    • increases the level of dopamine in brain cells;
    • normalizes cerebral blood supply and metabolism in the nervous tissue;
    • reduces platelet aggregation;
    • reduces the concentration of cholesterol in the blood;
    • reduces the manifestation of signs of intoxication of the body;
    • activates the aerobic stage of glycolysis;
    • increases the number of ATP and creatine phosphate molecules;
    • activates cellular respiration in mitochondria and energy production;
    • stabilizes biological membranes;
    • normalizes metabolism in the myocardium after ischemic attacks;
    • reduces necrotic phenomena in the myocardium;
    • improves the properties of the heart: contractility and conductivity;
    • improves visual acuity by improving the functionality of the retina.

    Tablets "Mexidol" help to overcome the consequences of high emotional stress, which is expressed:

    • in the restoration of functions that provide training;
    • in peaceful sleep;
    • in the elimination of somatovegetative problems.

    The drug Mexidol, administered intramuscularly, also helps to treat the consequences of alcohol intoxication:

    • restores human behavior;
    • eliminates withdrawal symptoms.

    The answer to the question "What helps mexidol?" can be supplemented with its geroprotective action, expressed:

    • in the correction of memorization and learning, which are violated during aging;
    • in reducing the level of aging markers.

    The drug enhances the effect of antidepressant, tranquilizing drugs, thereby reducing their side effects and reducing therapeutic dosages.

    Pharmakinetics

    The peak concentration of DV in the blood occurs half an hour after intramuscular injection. After this period, the active substance quickly penetrates into the tissues, from where it is also quickly excreted.

    In the liver, DV is converted into other pharmacologically active metabolites. It is excreted in the urine, partly in its original form.

    Mexidol in tablets is characterized by rapid absorption of the active substance, its distribution throughout the tissues and the same rapid release. After 4-5 hours, laboratory tests no longer detect DV in the blood.

    Why are Mexidol injections prescribed? Mexidol in ampoules is indicated for:

    • body poisoning;
    • withdrawal intoxication and its accompanying disorders;
    • primary open-angle glaucoma as part of complex treatment;
    • acute myocardial infarction as part of complex therapy;
    • anxiety states;
    • cognitive disorders due to atherosclerosis;
    • vegetovascular dystonia (VVD);
    • slowly progressing cerebrovascular insufficiency;
    • traumatic brain injury;
    • acute violation of cerebral blood supply.

    For Mexidol tablets, the indications are similar:

    • asthenic syndrome;
    • intoxication after taking antipsychotic drugs;
    • alcohol withdrawal;
    • ischemia of the heart;
    • anxiety as a consequence of neurotic conditions;
    • encephalopathy of various nature;
    • skull trauma;
    • epilepsy.

    There are few contraindications for taking Mexidol. It is not recommended for patients with acute renal or liver failure, as well as individual sensitivity to DV and auxiliary components in the composition of the drug.

    Pediatrics does not have statistically reliable data obtained in the study of the effect of the drug on the child's body. Therefore, only the attending physician prescribes Mexidol to children, and after administration, monitors the course of the disease. The composition is prescribed in case of a child with a traumatic brain injury, as well as for therapy purulent infections nervous tissue.

    Toxicity and side effects

    The instructions for use of the drug say that minor side effects, as well as low toxicity, are the undeniable advantages of the drug. Side effects of mexidol are rare and can be in the form of:

    • symptoms of an allergic reaction;
    • drowsiness;
    • excessive dryness of the oral mucosa;
    • nausea.

    The person taking the drug may complain of individual reactions:

    • lethargy;
    • general weakness;
    • lack of appetite;
    • flatulence;
    • allergic conditions.

    Taking the drug Mexidol (injections) may be accompanied by jumps in blood pressure, impaired coordination of movements, circadian rhythm "sleep-wakefulness", emotional reactivity. Taking the drug can be calm for the liver. Also kept in good order:

    • blood composition;
    • frequency of respiratory movements;
    • heart rate and electrocardiogram;
    • blood pressure parameters.

    Stopping the medication is not accompanied by a withdrawal effect.

    Instructions for the use of injections

    With intravenous administration, Mexidol (ampoules) is diluted with saline. The composition is administered intramuscularly for a duration of 1.5 to 3 minutes. Drip - carried out at a speed of 80-120 drops / minute. The severity of the pathology affects the dosage and duration of the course. When disturbed cerebral blood supply, when the patient is in a specialized department of neurology or intensive care, for 15 days, 400 mg (8 ml) of the drug is administered intravenously by drip intravenously for 15 days. The daily dose cannot exceed 1600 mg.

    For the next 15 days, the same dosage is observed, but it is already administered 1 time per day. In the future, Mexidol injections are administered intramuscularly for 10-15 days at a dosage of 200 mg (4 ml) of the drug. At the end of the course, the doctor recommends taking tablets: 0.25-0.5 g / day for 1-1.5 months, while the daily dose is divided into 2-3 doses.

    About compatibility with other medicines

    Mexidol may be prescribed to enhance the action of some compounds that have a psychotropic effect, such as:

    • tranquilizers;
    • analgesics;
    • anticonvulsants;
    • benzodiazepines;
    • carbamazepine and others.

    In any therapeutic schemes Mexidol shows compatibility with all components of complex treatment. Its advantages also include the ability to reduce the toxicity of ethanol. Its use in the treatment of alcohol dependence is based on how Mexidol and alcohol interact, as well as on the ability to remove ethyl alcohol metabolites from tissues.

    Comparison with other drugs

    Mexidol is a new generation drug, so it is compared with other already known formulations.

    In a number of drugs similar in purpose, a special place is occupied by an analogue of Mexidol - Actovegin, which has the appropriate use and is prescribed together with mexildol to achieve the desired therapeutic result. For those who are interested in what is the difference between them or what is better Actovegin or Mexidol, you need to know that the use of Actovegin is often accompanied by an allergic reaction, since calf blood is the raw material for its production. Although with it, the affected tissues recover faster. The active substances in the composition of both drugs can interact, influence the structure of each other and increase the manifestation of side effects. Therefore, they are not mixed in one syringe.

    Other analogues of Mexidol are also presented on the pharmaceutical market. For example, some cheap drug analogues differ only in additional components. It is impossible to use an analogue instead of a medicine such as Mexidol on its own. These questions are decided by the doctor on an individual basis for each. He also determines in each case which is better, for example, Mexiprim or Mexidol. Another thing is Mexicor and Mexidol, because the first is a generic or synonymous with the second. It also finds application as a means of improving the condition of patients after a stroke, relieving anxiety and fears, increasing attention, and eliminating the consequences of alcohol intoxication.

    The use of the drug in veterinary medicine

    Mexidol vet is an analogue of a well-known drug. It is intended for use in veterinary medicine, in particular in the treatment of cats and dogs, if they suffer from:

    • epilepsy;
    • heart failure in chronic or acute form;
    • disturbed cerebral blood supply;
    • brain injury.

    Mexidol vet helps to prepare animals for surgery, and after surgical treatment ensures the recovery of four-legged patients. Mexidol vet also serves to prevent disorders observed in the aging of animals. It helps to prepare dogs for exhibitions, to endure extreme loads during training.

    The medicine Mexidol vet can also be in the form of tablets or a solution intended for injection. Ampoules can have a volume of 1-2 ml. The active substance is the same as in the composition taken by people. The solution contains active ingredient at a concentration of 25-50 mg per 1 milliliter. It is administered intramuscularly. As part of No. 10, respectively, 10 ampoules of 1 ml of a solution with a mass fraction of active ingredient of 2.5% at a price of 320 rubles. For 200 rubles more expensive drug, in which 10 (5 ampoules of 2 ml) 5% solution. One tablet of the drug weighing 250 mg contains 50 mg of active ingredient.

    The duration of the course, as well as the dosage, is determined by the veterinarian. The drug is contraindicated if the animal is individually sensitive to any component of Mexidol vet.

    Toothpaste Mexidol Dent

    Dentistry was also able to take advantage of the anti-inflammatory and antioxidant properties of the drug in the form of Mexidol Dent toothpaste. It showed its effectiveness in the form of:

    • increase immunity;
    • reduce bleeding gums;
    • effective remedy in the treatment of periodontitis.

    Thanks to Mexidol Dent toothpaste in patients in the oral cavity:

    • micro-wounds heal faster;
    • mucosa is restored;
    • bacteria die.

    The above effects are possible if Mexidol Dent is used 2-3 times a day.

    For those who have hypersensitive gums, a variety of Mexidol Dent paste with potassium nitrate is provided to treat caries and reduce tooth sensitivity, which is usually observed with the loss of the main components from the mineral composition.

    Toothpaste Mexidol dent can whiten teeth, be used to treat stomatitis and gingivitis. The manufacturer took care of comprehensive care behind the teeth and, in addition to Mexidol dent paste, released an elixir for rinsing and healing the oral mucosa. Mexidol toothpaste costs about 70 rubles. For comparison: for tablets (50 pcs.) Mexidol, the price starts from 400 rubles.

    Patients, like doctors, leave positive reviews about the medication. Everyone notes from him: wide indications for use, minimal side effects, the ability to improve the condition of patients vegetovascular dystonia, as well as those who had microstrokes and other cerebrovascular accidents.


    Mexidol is included in the group of nootropics, improves metabolism in the brain. It acts directly on brain cells, protects them from oxygen starvation and from death as a result of ischemia.

    Also, the drug delivers more oxygen to neurons from the blood, increasing the threshold for generating convulsive impulses in the brain. In the process of using Mexidol, a person quickly recovers memory and skills lost as a result of a stroke or transient ischemic attack, improves memory, reproduction, speech, as well as resistance to various stressful situations and intoxications.

    Mexidol: Instructions for use

    Tradename Mexidol(Mexidolum)
    international name Methylethylpyridinol succinate(Methylethylpyridinol succinate)
    Active substance ethylmethylhydroxypyridine succinate
    Terms of dispensing from pharmacies By prescription
    Best before date 3 years
    Storage conditions List B. The drug should be stored in a dry, dark place, out of the reach of children, at a temperature not exceeding 25°C.
    Pharmacological group Antioxidant agent. Drugs for the treatment of diseases of the nervous system other (Other Nervous System Drugs).
    pharmachologic effect
    • anti-withdrawal
    • anti-alcohol
    • antioxidant
    • antihypoxic
    • nootropic
    • sedative

    Release form

    Tablets Mexidol

    Film-coated tablets from white to white with a creamy tint, biconvex, 30 or 50 tablets per pack. On the cross section, 2 layers are visible: the inner (core) is gray or gray with a creamy tint and the outer is white or white with a creamy tint.

    1 tablet contains:

    active substance: ethylmethylhydroxypyridine succinate 125 mg.
    Excipients: lactose monohydrate 97.5 mg; povidone 25 mg; magnesium stearate 2.5 mg
    film sheath: Opadry II white - 7.5 mg (hypromellose - 3 mg, titanium dioxide - 1.875 mg, lactose monohydrate - 1.575 mg, polyethylene glycol (macrogol) - 0.6 mg, triacetin - 0.45 mg).

    Packing: Tablets 0.125 g in blisters, cardboard pack.

    Injection

    Mexidol in ampoules of 2 or 5 ml. - the solution is colorless or slightly yellowish, transparent. Solution for intravenous and intramuscular administration, 50 mg/ml.

    1 ml solution contains: active substance- ethylmethylhydroxypyridine succinate 50 mg., excipient- water for injection.

    Package: 1 or 2 blisters are placed in a pack of cardboard; 4, 10 or 20 blister packs are placed in a pack of box cardboard.

    Indications for use

    Mexidol is proposed for the treatment of acute cerebrovascular accidents, dyscirculatory encephalopathy (a disease of the brain caused by chronic cerebrovascular accident), vegetative dystonia (impaired vascular tone due to dysfunction of the autonomic nervous system), atherosclerotic disorders of the brain, for the relief of withdrawal symptoms (to relieve the condition resulting from abrupt discontinuation of narcotic substances or alcohol) in alcoholism and drug addiction, in other conditions accompanied by tissue hypoxia.

    • acute violation of cerebral circulation;
    • encephalopathy;
    • cardiopsychoneurosis;
    • mild cognitive disorders of atherosclerotic genesis;
    • neurotic and neurosis-like states with anxiety syndrome;
    • relief of withdrawal symptoms in alcoholism with the presence of neurotic and vegetative-vascular disorders in the clinical picture;
    • acute intoxication with antipsychotics (neuroleptics);
    • acute purulent-inflammatory processes of the abdominal cavity (acute pancreatitis, peritonitis) as part of complex therapy.

    Pharmacodynamics

    The drug has an antihypoxic, membrane-protective, nootropic, anticonvulsant, anxiolytic effect, increases the body's resistance to stress. Mexidol increases the body's resistance to various damaging factors, to oxygen-dependent pathological conditions (shock, hypoxia and ischemia, cerebrovascular accidents, intoxication with alcohol and antipsychotic drugs).

    Mexidol improves cerebral metabolism and blood supply to the brain, improves microcirculation and rheological properties of blood, and reduces platelet aggregation. Stabilizes the membrane structures of blood cells (erythrocytes and platelets) during hemolysis. It has a hypolipidemic effect, reduces the level of total cholesterol and LDL. Reduces enzymatic toxemia and endogenous intoxication in acute pancreatitis.

    The mechanism of action of Mexidol is due to its antihypoxant, antioxidant and membrane-protective action. It inhibits the processes of lipid peroxidation, increases the activity of superoxide oxidase, increases the lipid-protein ratio, reduces the viscosity of the membrane, and increases its fluidity. It modulates the activity of membrane-bound enzymes (calcium-independent phosphodiesterase, adenylate cyclase, acetylcholinesterase), receptor complexes (benzodiazepine, GABA, acetylcholine), which enhances their ability to bind to ligands, helps to preserve the structural and functional organization of biomembranes, transport of neurotransmitters and improve synaptic transmission.

    Mexidol increases the content of dopamine in the brain. It causes an increase in the compensatory activation of aerobic glycolysis and a decrease in the degree of inhibition of oxidative processes in the Krebs cycle under hypoxic conditions with an increase in the content of ATP and creatine phosphate, activation of the energy-synthesizing functions of mitochondria, and stabilization of cell membranes.

    Pharmacokinetics

    Rapidly absorbed when taken orally. When taken orally in doses of 400-500 mg C max is 3.5-4 μg / ml. It is rapidly distributed in organs and tissues. The average retention time of the drug in the body when taken orally is 4.9-5.2 hours.

    Metabolized in the liver by glucuronconjugation. 5 metabolites have been identified: 3-hydroxypyridine phosphate - formed in the liver and with the participation ALP breaks down into phosphoric acid and 3-hydroxypyridine; 2nd metabolite - pharmacologically active, formed in large quantities and found in the urine for 1-2 days after administration; 3rd - excreted in large quantities in the urine; 4th and 5th - glucuronconjugates.

    T 1/2 when taken orally - 2-2.6 hours. Rapidly excreted in the urine, mainly in the form of metabolites and in small quantities unchanged. Most intensively excreted during the first 4 hours after taking the drug. Urinary excretion rates of unchanged drug and metabolites are subject to individual variability.

    Dosing regimen

    Tablets Mexidol

    Inside, 125-250 mg 3 times a day; the maximum daily dose is 800 mg (6 tablets).

    Duration of treatment - 2-6 week; for the relief of alcohol withdrawal - 5-7 days. Treatment is stopped gradually, reducing the dose within 2-3 days.

    The initial dose is 125-250 mg (table 1-2) 1-2 times a day with a gradual increase until a therapeutic effect is obtained; the maximum daily dose is 800 mg (6 tablets).

    The duration of the course of therapy in patients IHD - at least 1.5-2 months. Repeated courses (on the recommendation of a doctor), it is desirable to conduct in the spring and autumn periods.

    Injection

    Mexidol is prescribed intramuscularly or intravenously (stream or drip). With the infusion method of administration, the drug should be diluted in an isotonic sodium chloride solution. Doses are selected individually. The recommended dose is 5-10 mg/kg per day, depending on the condition. Jet Mexidol is injected slowly over 5-7 minutes, drip - at a rate of 40-60 drops / min.

    During treatment acute cerebrovascular accident Mexidol is used as part of complex therapy by intravenous drip at a dose of 200-300 mg 2 times / day for the first 5-7 days, then IM at 200-300 mg 2 times / day. The duration of treatment is 10-14 days.

    At dyscirculatory encephalopathy in the phase of decompensation Mexidol should be administered in / in a stream or drip at a dose of 200 mg 2-3 times / day for 14 days. Then the drug is administered intramuscularly at 200-300 mg / day for the next 2 weeks.

    For course prevention of dyscirculatory encephalopathy the drug is administered intramuscularly (injections) at a dose of 200 mg 1-2 times / day for 10-14 days.

    At mild cognitive impairment of atherosclerotic origin in elderly patients and neurotic disorders with anxiety syndrome Mexidol is prescribed intramuscularly (injections) at a dose of 100-300 mg / day for 14-30 days.

    At alcohol withdrawal syndrome Mexidol is administered at a dose of 200-300 mg / m (injections) 2 times / day or in / in the drip 1-2 times / day for 5-7 days.

    At acute intoxication with antipsychotic drugs the drug is administered intravenously at a dose of 200-600 mg / day (up to 800 mg) for 7-14 days.

    At acute purulent-inflammatory processes of the abdominal cavity (acute necrotizing pancreatitis, peritonitis) Mexidol is prescribed on the first day both in the preoperative and postoperative period. The dose of the drug depends on the form and severity of the disease, the prevalence of the process, and the variants of the clinical course. Cancellation of the drug should be carried out gradually, only after a stable positive clinical and laboratory effect.

    • At acute edematous (interstitial) pancreatitis Mexidol is prescribed 200-600 mg 2-3 times / day in / in the drip and / m.
    • At mild necrotizing pancreatitis the drug is prescribed 200-400 mg 2-3 times / day in / in the drip and / m;
    • at moderate necrotizing pancreatitis- 200-600 mg 2-3 times / day in / in drip;
    • with a difficult course of the process- on the first day, it is prescribed in a pulse dose of 800 mg, divided into two injections, then 300 mg 2 times / day with a gradual decrease in the daily dose;
    • with extremely severe course of necrotizing pancreatitis- the initial dose is 800 mg / day until persistent relief of the manifestations of pancreatogenic shock, with stabilization of the condition - 300-400 mg 2 times / day in / in drip with a gradual decrease in the daily dose.

    Mexidol for children

    The use of Mexidol in pediatrics is indicated for the treatment of purulent neuroinfections, craniocerebral injuries, as well as for first aid in case of childhood craniocerebral injuries (100 mg once).

    For children, the drug should be prescribed by a doctor who will monitor the child all the time of its use. There are no statistically significant studies of the use of the drug in children. Local application in dental practice passes without complications.

    Side effect

    From the digestive system: rarely - nausea, dry mouth.
    Rarely- allergic reactions.

    Contraindications

    • acute liver dysfunction;
    • acute renal dysfunction;
    • hypersensitivity to the drug.

    Pregnancy and lactation

    Mexidol is contraindicated during pregnancy and lactation (breastfeeding) due to insufficient knowledge of the drug.

    special instructions

    Patients with blood pressure over 180/100 mm Hg, crisis course arterial hypertension and severe affective instability requires careful monitoring of blood pressure during Mexidol therapy.
    The inclusion of Mexidol in complex therapy in patients with acute cerebrovascular accident contributed to an increase in resistance to hypoxia and a decrease in the severity of manifestations of clinical syndromes of stroke.

    The use of Mexidol in complex treatment acute pancreatitis significantly reduces the level of enzymatic toxemia and endogenous intoxication.

    Shown high efficiency Mexidol in the combined route of administration for monotherapy of reactive arthritis.

    Overdose

    Due to the low toxicity of Mexidol, an overdose is unlikely, and so far no such cases have been reported.

    Perhaps the development of drowsiness.

    drug interaction

    With the simultaneous use of Mexidol enhances the action of anxiolytics, benzodiazepine derivatives, antiparkinsonian and anticonvulsants.

    Mexidol reduces the toxic effects of ethyl alcohol.

    Mexidol price

    Prices are approximate for November 2017, because differ in different pharmacies and cities.

    Mexidol reviews

    I drank Mexidol, and my effect was just wonderful, right before my eyes I came out of a state of hysteria. And saw pills and injections. And I am also picky, not every drug worked for me, and sometimes even a paradoxical effect, but maxidol was without side effects and very effective.

    I was injected with Mexidol. The reason was cerebrovascular insufficiency. The effect was amazing. Immediately brightened in the eyes, began to hear better, cleared up in the head, the mood, however, somehow strangely rose. But I clearly remember that this drug was sold on a separate special prescription with special print. So, it is better to give it the way the doctor prescribed, so that the effect is not too strong.

    Excellent pills for swinging nervous system. Of the tablets, the best that came across from dystonia. Helps? Definitely! All the symptoms of VVD I personally slept. But after the course most of symptoms will return. Both the cardiologist and the neurologist were praised; tablets are quite versatile. Sold officially by prescription, but almost everywhere they sell without it. I ate pills, I think injections will be much better.

    I understood from the reviews that Mexidol will help with disturbed vegetative, and with obsessive thoughts and conditions, does it help to fight or is it completely different? It did not help me, but I drank 1 tablet a day only. If you follow the recommended dosage, it may help. But in general intrusive thoughts, as I understand it, this is again my "favorite" anxiety. Afobazole helps with it, 2 tablets a day are enough for me.

    Domestic drug mexidol (active ingredient - ethylmethylhydroxypyridine succinate) belongs to the group of antioxidants. It inhibits the processes of free radical oxidation, has a membrane-protective, nootropic, antihypoxic, stress-protective and anxiolytic (anti-anxiety) effect. Mexidol contributes to the formation of the body's resistance to the effects of various destructive factors (shock, oxygen starvation, ischemia, alcohol poisoning, neuroleptics or psychotropic substances, circulatory disorders in the brain). The drug inhibits lipid peroxidation reactions, “inspires exploits” of the antioxidant enzyme superoxide dismutase, harmonizes the lipid-protein balance, reduces viscosity and increases the fluidity (rheological properties) of cell membranes. Mexidol controls the functional state of membrane-bound enzymes (adenylate cyclase, calcium-independent phosphodiesterase, acetylcholinesterase), regulates the activity of receptor groups (GABA, benzodiazepine, acetylcholine), increasing their ability to interact with ligands, promotes the inviolability of the structural and functional organization of biological membranes, creates optimal conditions to transport neurotransmitters and improve neurotransmission. The drug increases the concentration of dopamine in the brain, stimulates the reactions of aerobic glycolysis and compensates for the inhibition of oxidation processes within the Krebs cycle with a simultaneous increase in the level of ATP and creatine phosphate under conditions of oxygen starvation, stimulates energy-synthetic reactions in mitochondria. Mexidol regulates metabolic processes in the brain and improves its blood supply, reduces the ability of platelets to aggregate, and stabilizes blood cell membranes during hemolysis.

    Along with this, the drug is also endowed with a hypolipidemic effect, which is expressed in a decrease in the level of total and "bad" (LDL) cholesterol.

    The anti-stress effect of the drug is expressed in the debugging of post-stress behavior, the elimination of somato-vegetative dysfunctions, the restoration of normal sleep, the improvement of the ability to learn and remember information, and the reduction of degenerative and structural changes in the brain. Mexidol is a powerful detoxifier for alcohol withdrawal syndrome: it eliminates neurological and neurotoxic effects acute poisoning alcohol, eliminates behavioral and cognitive impairments caused by prolonged alcohol abuse, restores vegetative functions. The drug potentiates the action of tranquilizers, neuroleptics, antidepressants, anticonvulsants and sleeping pills, which allows the doctor to reduce their dose and, to a certain extent, reduce the risk of adverse reactions. Mexidol increases the functional activity of ischemic myocardium: against the background coronary insufficiency the drug activates its collateral (bypass) blood supply, which helps to protect cardiomyocytes and maintain their performance. The drug is able to restore the contractility of the heart muscle with reversible cardiac dysfunction.

    Mexidol is available in the form of tablets and solution for intravenous and intramuscular administration. The second dosage form is used mainly in a hospital setting. Tablets should be taken at 125-250 mg 3 times a day. The duration of the drug course averages from 2 to 6 weeks (for the relief of withdrawal symptoms - up to 1 week).

    Pharmacology

    Antioxidant drug. It has antihypoxic, membrane-protective, nootropic, anticonvulsant and anxiolytic effects, increases the body's resistance to stress. The drug increases the body's resistance to the effects of major damaging factors, to oxygen-dependent pathological conditions (shock, hypoxia and ischemia, cerebrovascular accidents, intoxication with alcohol and antipsychotics /neuroleptics/).

    Mexidol ® improves cerebral metabolism and blood supply to the brain, improves microcirculation and rheological properties of blood, reduces platelet aggregation. Stabilizes the membrane structures of blood cells (erythrocytes and platelets) during hemolysis. It has a hypolipidemic effect, reduces the level of total cholesterol and LDL.

    Reduces enzymatic toxemia and endogenous intoxication in acute pancreatitis.

    The mechanism of action of the drug Mexidol ® is due to its antihypoxic, antioxidant and membrane-protective action. The drug inhibits the processes of lipid peroxidation, increases the activity of superoxide dismutase, increases the ratio of "lipid-protein", reduces the viscosity of the membrane, increases its fluidity. Mexidol ® modulates the activity of membrane-bound enzymes (calcium-independent phosphodiesterase, adenylate cyclase, acetylcholinesterase), receptor complexes (benzodiazepine, GABA, acetylcholine), which enhances their ability to bind to ligands, helps to preserve the structural and functional organization of biomembranes, transport of neurotransmitters and improve synaptic transmission. Mexidol ® increases the content of dopamine in the brain. It causes an increase in the compensatory activity of aerobic glycolysis and a decrease in the degree of inhibition of oxidative processes in the Krebs cycle under hypoxic conditions, with an increase in the content of ATP, creatine phosphate and activation of the energy-synthesizing functions of mitochondria, and stabilization of cell membranes.

    Mexidol ® normalizes metabolic processes in the ischemic myocardium, reduces the area of ​​necrosis, restores and improves electrical activity and myocardial contractility, and also increases coronary blood flow in the ischemic zone, reduces the consequences of reperfusion syndrome in acute coronary insufficiency. Increases antianginal activity of nitropreparations. Mexidol ® contributes to the preservation of retinal ganglion cells and optic nerve fibers in progressive neuropathy, the causes of which are chronic ischemia and hypoxia. Improves the functional activity of the retina and optic nerve, increasing visual acuity.

    Pharmacokinetics

    Suction

    With the introduction of Mexidol in doses of 400-500 mg, Cmax in plasma is 3.5-4.0 μg / ml and is achieved within 0.45-0.5 hours.

    Distribution

    After the / m administration, the drug is determined in the blood plasma for 4 hours. The average retention time of the drug in the body is 0.7-1.3 hours.

    breeding

    It is excreted from the body with urine mainly in the glucuron-conjugated form and in small quantities - unchanged.

    Release form

    The solution for intravenous and intramuscular administration is colorless or slightly yellowish, transparent.

    Excipients: sodium metabisulphite - 1 mg, water for injection - up to 1 ml.

    5 ml - glass ampoules (5) - blister packs (1) - cardboard packs.
    5 ml - glass ampoules (5) - blister packs (4) - cardboard packs (for hospitals).
    5 ml - glass ampoules (5) - blister packs (10) - cardboard packs (for hospitals).
    5 ml - glass ampoules (5) - blister packs (20) - cardboard packs (for hospitals).

    Dosage

    Mexidol ® is administered intramuscularly or intravenously (by jet or drip). To prepare a solution for infusion, the drug should be diluted in a 0.9% sodium chloride solution.

    Jet Mexidol ® is injected slowly over 5-7 minutes, drip - at a rate of 40-60 drops / min. The maximum daily dose should not exceed 1200 mg.

    In acute disorders of cerebral circulation, Mexidol ® is used in the first 10-14 days in / in the drip of 200-500 mg 2-4 times / day, then - in / m at 200-250 mg 2-3 times / day for 2 weeks .

    In case of traumatic brain injury and the consequences of traumatic brain injury, Mexidol ® is used for 10-15 days in / in the drip of 200-500 mg 2-4 times / day.

    With dyscirculatory encephalopathy in the decompensation phase, Mexidol ® is used intravenously in a stream or drip at a dose of 200-500 mg 1-2 times / day for 14 days, then - intramuscularly at 100-250 mg / day for the next 2 weeks.

    For course prevention of dyscirculatory encephalopathy, Mexidol ® is administered intramuscularly at a dose of 200-250 mg 2 times / day for 10-14 days.

    With mild cognitive impairment in elderly patients and with anxiety disorders, Mexidol ® is administered intramuscularly at a dose of 100-300 mg / day for 14-30 days.

    In acute myocardial infarction, as part of complex therapy, Mexidol ® is administered intravenously or intramuscularly for 14 days, against the background of traditional therapy for myocardial infarction, including nitrates, beta-blockers, ACE inhibitors, thrombolytics, anticoagulant and antiplatelet agents, as well as symptomatic remedies according to indications.

    In the first 5 days, to achieve maximum effect, it is desirable to administer the drug intravenously, in the next 9 days Mexidol ® can be administered intramuscularly.

    In / in the introduction of the drug is carried out by drip infusion, slowly (to avoid side effects) in 0.9% sodium chloride solution or 5% dextrose (glucose) solution in a volume of 100-150 ml for 30-90 minutes. If necessary, slow jet administration of the drug for at least 5 minutes is possible.

    The introduction of the drug (in / in or in / m) is carried out 3 times / day every 8 hours. The daily therapeutic dose is 6-9 mg / kg of body weight / day, single dose- 2-3 mg/kg body weight. The maximum daily dose should not exceed 800 mg, single - 250 mg.

    In case of open-angle glaucoma of various stages, as part of complex therapy, Mexidol ® is administered intramuscularly at 100-300 mg/day 1-3 times/day for 14 days.

    In alcohol withdrawal syndrome, Mexidol ® is administered at a dose of 200-500 mg intravenously by drip or intramuscular injection 2-3 times a day for 5-7 days.

    In case of acute intoxication with antipsychotic drugs, Mexidol ® is administered intravenously at a dose of 200-500 mg / day for 7-14 days.

    In acute purulent-inflammatory processes of the abdominal cavity (acute necrotizing pancreatitis, peritonitis), Mexidol ® is prescribed on the first day, both in the preoperative and postoperative periods. The administered doses depend on the form and severity of the disease, the prevalence of the process, and the variants of the clinical course. Cancellation of the drug should be made gradually, only after a stable positive clinical and laboratory effect.

    In acute edematous (interstitial) pancreatitis, Mexidol ® is prescribed 200-500 mg 3 times / day intravenously (in isotonic sodium chloride solution) and intramuscularly.

    In case of mild necrotizing pancreatitis, Mexidol ® is prescribed 100-200 mg 3 times / day intravenously (in isotonic sodium chloride solution) and intramuscularly.

    With necrotizing pancreatitis of moderate severity - 200 mg 3 times / day in / in drip (in isotonic sodium chloride solution).

    In case of severe necrotizing pancreatitis - at a pulse dosage of 800 mg on the first day, with a double regimen of administration, then - 200-500 mg 2 times / day with a gradual decrease in the daily dose.

    In an extremely severe form of necrotizing pancreatitis, the initial dose is 800 mg / day until persistent relief of the manifestations of pancreatogenic shock, after stabilization of the condition - 300-500 mg 2 times a day in / in drip (in 0.9% sodium chloride solution) with a gradual decrease in daily dosage.

    Overdose

    Overdose may cause drowsiness.

    Interaction

    Mexidol ® enhances the action of benzodiazepine anxiolytics, antiparkinsonian (levodopa) and anticonvulsant (carbamazepine) agents.

    Mexidol ® reduces the toxic effects of ethyl alcohol.

    Side effects

    On the part of the digestive system: nausea and dryness of the oral mucosa may occur.

    Other: allergic reactions, drowsiness.

    Indications

    • acute disorders of cerebral circulation;
    • traumatic brain injury, consequences of traumatic brain injury;
    • encephalopathy;
    • syndrome of vegetative dystonia;
    • mild cognitive disorders of atherosclerotic genesis;
    • anxiety disorders in neurotic and neurosis-like conditions;
    • acute myocardial infarction (from the first day) as part of complex therapy;
    • primary open-angle glaucoma of various stages, as part of complex therapy;
    • relief of withdrawal symptoms in alcoholism with a predominance of neurosis-like and vegetative-vascular disorders;
    • acute intoxication with antipsychotics;
    • acute purulent-inflammatory processes of the abdominal cavity (acute necrotizing pancreatitis, peritonitis) as part of complex therapy.

    Contraindications

    • acute liver dysfunction;
    • acute renal dysfunction;
    • increased individual sensitivity to the drug.

    Strictly controlled clinical studies of the safety of Mexidol ® in children, during pregnancy and lactation have not been conducted.

    Application features

    Use during pregnancy and lactation

    Mexidol ® is not recommended for use during pregnancy and lactation (breastfeeding) due to insufficient knowledge of the drug.

    Application for violations of liver function

    The drug is contraindicated in acute liver dysfunction.

    Application for violations of kidney function

    The drug is contraindicated in acute renal dysfunction.

    special instructions

    In some cases, especially in predisposed patients with bronchial asthma at hypersensitivity to sulfites, development is possible severe reactions hypersensitivity.

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