Комбинированное лекарственное средство с выраженным антигипо... Инструкция
Показания к применению
Заболевания центральной нервной системы, сопровождающиеся снижением интеллектуально-мнестических функций.
В составе комплексной терапии: недостаточность мозгового кровообращения (атеросклероз сосудов головного мозга, восстановительный период после ишемического и геморрагического инсульта); энцефалопатия постинтоксикационная или посттравматическая; депрессия; психоорганический синдром с преобладанием признаков астении и адинамии; вестибулярные нарушения; синдром Меньера; отставание интеллектуального развития у детей; профилактика мигрени; профилактика кинетозов у взрослых и детей.
Противопоказания
Гиперчувствительность к основным и/или вспомогательным компонентам препарата; тяжелая печеночная недостаточность; тяжелая почечная...
Круглые плоскоцилиндрические таблетки белого цвета с риской с одной стороны и с фаской с двух сторон. Допускается мраморность поверхности.
Фармакотерапевтическая группа
Ноотропное средство
Фармакологические свойства
Комбинированное лекарственное средство с выраженным антигипоксическим, ноотропным и сосудорасширяющим эффектом.
Пирацетам активирует метаболические процессы в головном мозге посредством усиления энергетического и белкового обмена, ускорения утилизации глюкозы клетками и повышения их устойчивости к гипоксии; улучшает межнейрональную передачу в центральной нервной системе, улучшает регионарный кровоток в ишемизированной зоне. Циннаризин — селективный блокатор «медленных» кальциевых каналов, снижает поступление в клетки ионов кальция и уменьшает его содержание в депо плазмолеммы, снижает тонус гладкой мускулатуры артериол, уменьшает их реакцию на биогенные сосудосуживающие вещества (адреналин, норадреналин, дофамин, ангиотензин II, вазопрессин, серотонин). Обладает сосудорасширяющим эффектом (особенно в отношении сосудов головного мозга, усиливая антигипоксическое действие пирацетама), не оказывая существенного влияния на артериальное давление. Проявляет умеренную антигистаминную активность, уменьшает возбудимость вестибулярного аппарата, понижает тонус симпатической нервной системы. Повышает эластичность мембран эритроцитов, их способность к деформации, снижает вязкость крови.
Всасывание. После приема внутрь пирацетам и циннаризин быстро и практически полностью всасываются в желудочно-кишечном тракте. Биодоступность пирацетама составляет около 100 %. Максимальная концентрация (Сmax) пирацетама достигается через 0,5-1 час после приёма. Максимальная концентрация циннаризина в плазме достигается через 1-3 часа. Биодоступность циннаризина увеличивается в кислой среде.
Распределение. Пирацетам не связывается с белками плазмы крови. Объем распределения составляет около 0,6 л/кг. Проникает через гематоэнцефалический и плацентарный барьеры, во все органы и ткани, а также через фильтрующие мембраны, используемые при гемодиализе. В исследованиях на животных обнаружено, что пирацетам избирательно накапливается в тканях коры головного мозга, преимущественно в лобных, теменных и затылочных долях, мозжечке и базальных ганглиях.
Циннаризин. Связь с белками плазмы составляет 91%. Через 1-4 часа после приема внутрь обнаруживается в печени, почках, сердце, легких, селезенке и мозге.
Метаболизм. Пирацетам практически не метаболизируется в организме. Циннаризин активно и полностью метаболизируется путем деалкилирования; процесс метаболизма начинается через 30 мин после приема внутрь.
Выведение. Пирацетам. Более 95% принятой внутрь дозы выводится почками в неизмененном виде путем почечной фильтрации в течение 30 часов. Почечный клиренс пирацетама у здоровых добровольцев составляет 86 мл/мин. Период полувыведения (Т1/2)- 4-5 час из плазмы крови и 8,5 час из спинномозговой жидкости. У пациентов с почечной недостаточностью Т1/2 удлиняется. У пациентов с печеночной недостаточностью фармакокинетика пирацетама не изменяется.
Циннаризин выводится из организма в виде метаболитов (1/3 — почками, 2/3 — через кишечник), Т1/2 — около 4 часов.
Показания к применению
Заболевания центральной нервной системы, сопровождающиеся снижением интеллектуально-мнестических функций.
В составе комплексной терапии: недостаточность мозгового кровообращения (атеросклероз сосудов головного мозга, восстановительный период после ишемического и геморрагического инсульта); энцефалопатия постинтоксикационная или посттравматическая; депрессия; психоорганический синдром с преобладанием признаков астении и адинамии; вестибулярные нарушения; синдром Меньера; отставание интеллектуального развития у детей; профилактика мигрени; профилактика кинетозов у взрослых и детей.
Противопоказания
Гиперчувствительность к основным и/или вспомогательным компонентам препарата; тяжелая печеночная недостаточность; тяжелая почечная недостаточность (клиренс креатинина менее 20 мл/мин); геморрагический инсульт; паркинсонизм (в т.ч. болезнь Паркинсона); психомоторное возбуждение; болезнь Гентингтона; беременность; период лактации; детский возраст до 5 лет; непереносимость лактозы, лактазная недостаточность, синдром глюкозо-галактозной мальабсорбции (препарат содержит лактозу).
Взрослым: по 1-2 таблетки 3 раза в день в течение 1-3 месяцев, в зависимости от тяжести заболевания. Возможно проведение повторных курсов лечения — 2-3 раза в год.
Детям старше 5 лет: по 1-2 таблетки 1-2 раза в день. Не применять более 3 месяцев.
Для профилактики кинетозов: у взрослых — по 1 таблетке, у детей старше 5 лет — по ½ таблетки за 30 минут до начала путешествия, с повторным приемом (при необходимости) каждые 6-8 часов.
Пациенты с нарушением функции почек: при хронической почечной недостаточности (клиренс креатинина 20-80 мл/мин) — по 1 таблетке 2 раза в день.
Побочное действие
Со стороны центральной и периферической нервной системы: двигательная расторможенность, раздражительность, сонливость, депрессия, астения, головная боль.
В единичных случаях отмечается головокружение, атаксия, обострение эпилепсии, экстрапирамидные нарушения, тремор, неуравновешенность, снижение способности к концентрации внимания, бессонница, возбуждение, тревога, галлюцинации, повышение сексуальности.
Со стороны сердечно-сосудистой системы: снижение или повышение артериального давления.
Со стороны пищеварительной системы: диспептические явления, ощущение сухости во рту; в единичных случаях — тошнота, рвота, диарея, боли в животе, холестатическая желтуха.
Со стороны кожных покровов: в единичных случаях дерматит, зуд, кожная сыпь.
Со стороны обмена веществ: увеличение массы тела.
Аллергические реакции: ангионевротический отек.
Прочие: усиление потоотделения; в единичных случаях — волчаночноподобный синдром, красный плоский лишай.
Передозировка
Симптомы передозировки обусловленные, главным образом, м-холиноблокирующей активностью циннаризина, включают: нарушения сознания, рвоту, экстрапирамидные симптомы, снижение артериального давления. После перорального приема пирацетама в дозе 75 г наблюдались диарея с кровью и боли в животе.
Лечение: специфического антидота не существует. В случае передозировки необходимо промывание желудка и приём активированного угля, проведение симптоматической и поддерживающей терапии. Эффективность гемодиализа для пирацетама составляет 50-60%.
Взаимодействие с другими лекарственными средствами
При одновременном применении возможно усиление седативного действия средств, угнетающих деятельность центральной нервной системы, а также этанола, ноотропных и антигипертензивных средств.
Вазодилатирующие средства усиливают действие препарата.
Улучшает переносимость антипсихотических лекарственных средств и трициклических антидепрессантов.
При одновременном применении пирацетам усиливает центральные эффекты гормонов щитовидной железы (возможны тремор, беспокойство, раздражительность, нарушения сна); может усилить действие пероральных антикоагулянтов.
Особые указания
При длительном применении рекомендуется контроль функции печени и почек (особенно у пациентов с хронической почечной недостаточностью).
В период лечения у пациентов с артериальной гипотензией возможно более значительное снижение артериального давления.
Не рекомендуется употребление алкоголя в период лечения.
Возможно искажение результатов допинговой пробы и аллергических кожных тестов; за 4 дня до исследования препарат следует отменить.
Влияние на способность управлять автомобилем и движущимися механизмами
В период лечения необходимо соблюдать осторожность при вождении автотранспорта и занятии другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций.
Форма выпуска
Таблетки 400 мг+25 мг.
По 10 таблеток в контурную ячейковую упаковку из пленки поливинилхлоридной и фольги алюминиевой печатной лакированной.
3, 6 или 9 контурных ячейковых упаковок вместе с инструкцией по применению лекарственного препарата в пачку из картона.
Условия хранения
В защищенном от света месте при температуре не выше 25 °С.
Хранить в недоступном для детей месте.
Срок годности
3 года. Не использовать по истечении срока годности, указанного на упаковке.
Условия отпуска
Отпускают по рецепту
Производитель
АО «Нижфарм», Россия
603950, г. Нижний Новгород, ул. Салганская, д. 7
Тел.: (831) 278-80-88; факс: (831) 430-72-28
или
ООО «Хемофарм», Россия
249032, Калужская обл., г. Обнинск, Киевское шоссе, д. 62
Для описания товара использована информация от партнера 36.6
Мобильное приложение «Все аптеки»
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Допускается мраморность поверхности."}}]},{"id":6,"name":"Фармакотерапевтическая группа","slug":"","body":[{"type":"paragraph","data":{"text":"Ноотропное средство"}}]},{"id":7,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"paragraph","data":{"text":"Комбинированное лекарственное средство с выраженным антигипоксическим, ноотропным и сосудорасширяющим эффектом."}},{"type":"paragraph","data":{"text":"Пирацетам активирует метаболические процессы в головном мозге посредством усиления энергетического и белкового обмена, ускорения утилизации глюкозы клетками и повышения их устойчивости к гипоксии; улучшает межнейрональную передачу в центральной нервной системе, улучшает регионарный кровоток в ишемизированной зоне. Циннаризин — селективный блокатор «медленных» кальциевых каналов, снижает поступление в клетки ионов кальция и уменьшает его содержание в депо плазмолеммы, снижает тонус гладкой мускулатуры артериол, уменьшает их реакцию на биогенные сосудосуживающие вещества (адреналин, норадреналин, дофамин, ангиотензин II, вазопрессин, серотонин). Обладает сосудорасширяющим эффектом (особенно в отношении сосудов головного мозга, усиливая антигипоксическое действие пирацетама), не оказывая существенного влияния на артериальное давление. Проявляет умеренную антигистаминную активность, уменьшает возбудимость вестибулярного аппарата, понижает тонус симпатической нервной системы. Повышает эластичность мембран эритроцитов, их способность к деформации, снижает вязкость крови."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВсасывание. \u003c/i\u003eПосле приема внутрь пирацетам и циннаризин быстро и практически полностью всасываются в желудочно-кишечном тракте. Биодоступность пирацетама составляет около 100 %. Максимальная концентрация (Сmax) пирацетама достигается через 0,5-1 час после приёма. Максимальная концентрация циннаризина в плазме достигается через 1-3 часа. Биодоступность циннаризина увеличивается в кислой среде."}},{"type":"paragraph","data":{"text":"\u003ci\u003eРаспределение.\u003c/i\u003e Пирацетам не связывается с белками плазмы крови. Объем распределения составляет около 0,6 л/кг. Проникает через гематоэнцефалический и плацентарный барьеры, во все органы и ткани, а также через фильтрующие мембраны, используемые при гемодиализе. В исследованиях на животных обнаружено, что пирацетам избирательно накапливается в тканях коры головного мозга, преимущественно в лобных, теменных и затылочных долях, мозжечке и базальных ганглиях."}},{"type":"paragraph","data":{"text":"Циннаризин. Связь с белками плазмы составляет 91%. Через 1-4 часа после приема внутрь обнаруживается в печени, почках, сердце, легких, селезенке и мозге."}},{"type":"paragraph","data":{"text":"\u003ci\u003eМетаболизм.\u003c/i\u003e Пирацетам практически не метаболизируется в организме. Циннаризин активно и полностью метаболизируется путем деалкилирования; процесс метаболизма начинается через 30 мин после приема внутрь."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВыведение.\u003c/i\u003e Пирацетам. Более 95% принятой внутрь дозы выводится почками в неизмененном виде путем почечной фильтрации в течение 30 часов. Почечный клиренс пирацетама у здоровых добровольцев составляет 86 мл/мин. Период полувыведения (Т1/2)- 4-5 час из плазмы крови и 8,5 час из спинномозговой жидкости. У пациентов с почечной недостаточностью Т1/2 удлиняется. У пациентов с печеночной недостаточностью фармакокинетика пирацетама не изменяется."}},{"type":"paragraph","data":{"text":"Циннаризин выводится из организма в виде метаболитов (1/3 — почками, 2/3 — через кишечник), Т1/2 — около 4 часов."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Заболевания центральной нервной системы, сопровождающиеся снижением интеллектуально-мнестических функций."}},{"type":"paragraph","data":{"text":"В составе комплексной терапии: недостаточность мозгового кровообращения (атеросклероз сосудов головного мозга, восстановительный период после ишемического и геморрагического инсульта); энцефалопатия постинтоксикационная или посттравматическая; депрессия; психоорганический синдром с преобладанием признаков астении и адинамии; вестибулярные нарушения; синдром Меньера; отставание интеллектуального развития у детей; профилактика мигрени; профилактика кинетозов у взрослых и детей."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":" Гиперчувствительность к основным и/или вспомогательным компонентам препарата; тяжелая печеночная недостаточность; тяжелая почечная недостаточность (клиренс креатинина менее 20 мл/мин); геморрагический инсульт; паркинсонизм (в т.ч. болезнь Паркинсона); психомоторное возбуждение; болезнь Гентингтона; беременность; период лактации; детский возраст до 5 лет; непереносимость лактозы, лактазная недостаточность, синдром глюкозо-галактозной мальабсорбции (\u003ci\u003eпрепарат содержит лактозу\u003c/i\u003e). "}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Заболевания печени и/или почек, хроническая почечная недостаточность (клиренс креатинина 20-80 мл/мин); повышенное внутриглазное давление; порфирия; нарушение гемостаза; обширные хирургические вмешательства; тяжелое кровотечение; гипертиреоз; эпилепсия; выраженный атеросклероз сосудов головного мозга; склонность к невротическим реакциям."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Внутрь, во время или после еды."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВзрослым:\u003c/i\u003e по 1-2 таблетки 3 раза в день в течение 1-3 месяцев, в зависимости от тяжести заболевания. Возможно проведение повторных курсов лечения — 2-3 раза в год."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДетям старше 5 лет:\u003c/i\u003e по 1-2 таблетки 1-2 раза в день. Не применять более 3 месяцев."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДля профилактики кинетозов:\u003c/i\u003e у взрослых — по 1 таблетке, у детей старше 5 лет — по ½ таблетки за 30 минут до начала путешествия, с повторным приемом (при необходимости) каждые 6-8 часов."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПациенты с нарушением функции почек:\u003c/i\u003e при хронической почечной недостаточности (клиренс креатинина 20-80 мл/мин) — по 1 таблетке 2 раза в день."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны центральной и периферической нервной системы:\u003c/i\u003e двигательная расторможенность, раздражительность, сонливость, депрессия, астения, головная боль."}},{"type":"paragraph","data":{"text":"В единичных случаях отмечается головокружение, атаксия, обострение эпилепсии, экстрапирамидные нарушения, тремор, неуравновешенность, снижение способности к концентрации внимания, бессонница, возбуждение, тревога, галлюцинации, повышение сексуальности."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны сердечно-сосудистой системы:\u003c/i\u003e снижение или повышение артериального давления."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны пищеварительной системы:\u003c/i\u003e диспептические явления, ощущение сухости во рту; в единичных случаях — тошнота, рвота, диарея, боли в животе, холестатическая желтуха."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны кожных покровов:\u003c/i\u003e в единичных случаях дерматит, зуд, кожная сыпь."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны обмена веществ:\u003c/i\u003e увеличение массы тела."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАллергические реакции:\u003c/i\u003e ангионевротический отек."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПрочие:\u003c/i\u003e усиление потоотделения; в единичных случаях — волчаночноподобный синдром, красный плоский лишай."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы\u003c/i\u003e передозировки обусловленные, главным образом, м-холиноблокирующей активностью циннаризина, включают: нарушения сознания, рвоту, экстрапирамидные симптомы, снижение артериального давления. После перорального приема пирацетама в дозе 75 г наблюдались диарея с кровью и боли в животе."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение:\u003c/i\u003e специфического антидота не существует. В случае передозировки необходимо промывание желудка и приём активированного угля, проведение симптоматической и поддерживающей терапии. Эффективность гемодиализа для пирацетама составляет 50-60%."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"При одновременном применении возможно усиление седативного действия средств, угнетающих деятельность центральной нервной системы, а также этанола, ноотропных и антигипертензивных средств."}},{"type":"paragraph","data":{"text":"Вазодилатирующие средства усиливают действие препарата."}},{"type":"paragraph","data":{"text":"Улучшает переносимость антипсихотических лекарственных средств и трициклических антидепрессантов."}},{"type":"paragraph","data":{"text":"При одновременном применении пирацетам усиливает центральные эффекты гормонов щитовидной железы (возможны тремор, беспокойство, раздражительность, нарушения сна); может усилить действие пероральных антикоагулянтов."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"При длительном применении рекомендуется контроль функции печени и почек (особенно у пациентов с хронической почечной недостаточностью)."}},{"type":"paragraph","data":{"text":"В период лечения у пациентов с артериальной гипотензией возможно более значительное снижение артериального давления."}},{"type":"paragraph","data":{"text":"Не рекомендуется употребление алкоголя в период лечения."}},{"type":"paragraph","data":{"text":"Возможно искажение результатов допинговой пробы и аллергических кожных тестов; за 4 дня до исследования препарат следует отменить."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"В период лечения необходимо соблюдать осторожность при вождении автотранспорта и занятии другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Таблетки 400 мг+25 мг."}},{"type":"paragraph","data":{"text":"По 10 таблеток в контурную ячейковую упаковку из пленки поливинилхлоридной и фольги алюминиевой печатной лакированной."}},{"type":"paragraph","data":{"text":"\u003ca href=\"https://www.stada.ru/products/omaron.html#\"\u003e3\u003c/a\u003e, \u003ca href=\"https://www.stada.ru/products/omaron.html#\"\u003e6\u003c/a\u003e или \u003ca href=\"https://www.stada.ru/products/omaron.html#\"\u003e9\u003c/a\u003e контурных ячейковых упаковок вместе с инструкцией по применению лекарственного препарата в пачку из картона."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В защищенном от света месте при температуре не выше 25 °С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года. Не использовать по истечении срока годности, указанного на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Отпускают по рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"АО «Нижфарм», Россия"}},{"type":"paragraph","data":{"text":"603950, г. Нижний Новгород, ул. Салганская, д. 7"}},{"type":"paragraph","data":{"text":"Тел.: (831) 278-80-88; факс: (831) 430-72-28"}},{"type":"paragraph","data":{"text":"или"}},{"type":"paragraph","data":{"text":"ООО «Хемофарм», Россия"}},{"type":"paragraph","data":{"text":"249032, Калужская обл., г. Обнинск, Киевское шоссе, д. 62"}},{"type":"paragraph","data":{"text":"Тел.: (484) 399-05-00; факс: (484) 399-05-25"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"\n\nАО «Нижфарм», Россия"}},{"type":"paragraph","data":{"text":"603950, г. Нижний Новгород, ул. Салганская, д. 7"}},{"type":"paragraph","data":{"text":"Тел.: (831) 278-80-88; факс: (831) 430-72-28"}},{"type":"paragraph","data":{"text":"E-mail: \u003ca href=\"mailto:med@stada.ru\"\u003emed@stada.ru\u003c/a\u003e"}}]}],"source":null},"description_toggle":false,"short_description":"Комбинированное лекарственное средство с выраженным антигипоксическим, ноотропным и сосудорасширяющим эффектом. Пирацетам активирует метаболические процессы в головном мозге посредством усиления энергетического и белкового обмена, ускорения утилизации глюкозы клетками и повышения их устойчивости к гипоксии; улучшает межнейрональную передачу в центральной нервной системе, улучшает регионарный кровоток в ишемизированной зоне. Циннаризин — селективный блокатор «медленных» кальциевых каналов, снижает поступление в клетки ионов кальция и уменьшает его содержание в депо плазмолеммы, снижает тонус гладкой мускулатуры артериол, уменьшает их реакцию на биогенные сосудосуживающие вещества (адреналин, норадреналин, дофамин, ангиотензин II, вазопрессин, серотонин). Обладает сосудорасширяющим эффектом (особенно в отношении сосудов головного мозга, усиливая антигипоксическое действие пирацетама), не оказывая существенного влияния на артериальное давление. Проявляет умеренную антигистаминную активность, уменьшает возбудимость вестибулярного аппарата, понижает тонус симпатической нервной системы. Повышает эластичность мембран эритроцитов, их способность к деформации, снижает вязкость крови.Всасывание.После приема внутрь пирацетам и циннаризин быстро и практически полностью всасываются в желудочно-кишечном тракте. Биодоступность пирацетама составляет около 100 %. Максимальная концентрация (Сmax) пирацетама достигается через 0,5-1 час после приёма. Максимальная концентрация циннаризина в плазме достигается через 1-3 часа. Биодоступность циннаризина увеличивается в кислой среде.Распределение.Пирацетам не связывается с белками плазмы крови. Объем распределения составляет около 0,6 л/кг. Проникает через гематоэнцефалический и плацентарный барьеры, во все органы и ткани, а также через фильтрующие мембраны, используемые при гемодиализе. В исследованиях на животных обнаружено, что пирацетам избирательно накапливается в тканях коры головного мозга, преимущественно в лобных, теменных и затылочных долях, мозжечке и базальных ганглиях. Циннаризин. Связь с белками плазмы составляет 91%. Через 1-4 часа после приема внутрь обнаруживается в печени, почках, сердце, легких, селезенке и мозге.Метаболизм.Пирацетам практически не метаболизируется в организме. Циннаризин активно и полностью метаболизируется путем деалкилирования; процесс метаболизма начинается через 30 мин после приема внутрь.Выведение.Пирацетам. Более 95% принятой внутрь дозы выводится почками в неизмененном виде путем почечной фильтрации в течение 30 часов. Почечный клиренс пирацетама у здоровых добровольцев составляет 86 мл/мин. Период полувыведения (Т1/2)- 4-5 час из плазмы крови и 8,5 час из спинномозговой жидкости. У пациентов с почечной недостаточностью Т1/2 удлиняется. У пациентов с печеночной недостаточностью фармакокинетика пирацетама не изменяется. 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