Mexidol is a medicine that stops destructive processes in the body, restores tissues and nourishes them. useful substances. In order not to harm the body during treatment, you need to know exactly how to take such a drug. We will talk about the action of Mexidol, describe its beneficial properties and contraindications.

The medicine includes active substance ethylmethylhydroxypyridine, sodium metabisulfite, povidone, lactose, polyethylene glycol, titanium dioxide.

Description of the drug

Mexidol increases the body's resistance to various damages, protects against shock, ischemia and nervous disorders. It is an anticonvulsant and nootropic agent. The drug increases dopamine content in the brain, improves blood circulation and microcirculation. Has an effective anti-stress effect.

Release form of the drug Mexidol

The medicine can be purchased in the form of tablets and ampoules for injection. They produce packs of tablets of 50 or 30 pieces. The medicine is covered with a white shell. The drugs should be stored at a temperature of no more than 25 degrees in a dark place. The standard shelf life of the medicine is 3 years.

Indications for use of Mexidol

A doctor can prescribe Mexidol therapy only after a complete examination of the patient, diagnosis and testing. The drug has wide range actions and is prescribed in the following cases:

• After ischemic attacks in the body.
• If there is a circulatory disorder in the patient's brain.
• As a prevention of ischemic stroke.
• After head and skull injuries.
• With vegetative dystonia syndrome.
• At the moment nervous disorders, when feeling anxious.
• To combat withdrawal symptoms in alcoholism.
• Prescribed after severe intoxication in the body.
• In case of defeat nervous system severe stress.
• After strong psychological stress.
• At the time of myocardial infarction.
• With a purulent process in the abdominal area.
• At the time of glaucoma of different stages.

Contraindications to taking the medicine

The doctor must warn the patient when Mexidol is prohibited from taking. If you neglect these recommendations, you can significantly harm your health. So, the drug is prohibited in the following cases:

1. If the patient has kidney problems, liver failure.
2. At hypersensitivity to the composition of the drug. The patient may be allergic to one of the components of Mexidol. In this case, you need to stop therapy with this drug.
3. Prohibited for children under 16 years of age.
4. Should not be taken by pregnant women.
5. Dangerous for the baby during breastfeeding. The substances of the drug can reach the child through milk and seriously harm his health.

If you have an individual intolerance to the product, you should immediately inform your doctor. He can prescribe analogues of Mexidol, which will help with the disease and will not cause harm to the body.

Side effects from Mexidol

The doctor is obliged to tell the patient about possible side effects. They may not appear, but you still need to get information about them. Please note that side effects can greatly harm the body. Therefore, when sharp deterioration the condition should be reported to the doctor immediately. Here are the main side effects of Mexidol:

1. Nausea or vomiting.
2. Severe dry mouth constant feeling thirst.
3. Allergies on the body.
4. Fatigue, constant drowsiness during the day.
5. Fear, anxiety and depression.
6. Emotional activity.
7. Hyperhidrosis.
8. The patient has frequent headaches.
9. Poor coordination, a person may even fall.
10. High blood pressure.
11. Dizziness.

If side effects appear immediately, the doctor should urgently reduce the dose of the prescribed drug or, as a last resort, stop therapy with this drug.

How to use Mexidol tablets?

Doctors usually prescribe the drug in 250 mg tablets no more than 3 times a day. Mexidol tablets should be taken orally and washed down with plenty of water. The maximum dose per day is 800 mg. This is approximately 6 tablets. It is not recommended to exceed this limit without a doctor's prescription.

The usual course of treatment with Mexidol lasts about 4 weeks. To stop alcohol withdrawal, it is enough to take the drug for a week.

The course of treatment for cardiac ischemia usually lasts 2 months. The doctor may prescribe a repeat course of Mexidol. It is best to re-do it in the spring or autumn.

Method of using Mexidol in ampoules

The doctor may prescribe Mexidol injections intravenously or intramuscularly. The dose of the drug is prescribed by a specialist individually based on the patient’s diagnosis and stage of the disease. Sometimes it is necessary to dilute the product with sodium chloride when injecting, using 200 ml per ampoule.

Standard treatment begins with 100 mg of Mexidol 2-3 times a day. The doctor may increase the dose gradually if no side effects are observed. The maximum dose of the drug is 800 mg. Mexidol can be administered:

1. Jet. The injection must be given slowly, over approximately 7 minutes.
2. Drip. Inject 50 drops in 1 minute.

Basic doses for diseases

It is important to use Mexidol correctly for each disease:

• For skull injuries, you need to take Mexidol injections for 2 weeks. You will have to administer 300 mg of the drug 3-4 times a day.
• If you need to improve blood circulation in the brain, use the drug for 10 days. Administer 300 mg once daily as a drop. Then you can administer the drug intramuscularly three times a day, 100 mg.
• In case of myocardial infarction, it is recommended to administer Mexidol intramuscularly for 14 days. In this case, it is necessary to use complex treatment.
• Glaucoma requires treatment for at least 14 days. Administer 200 mg of Mexidol intramuscularly 2 times a day.
• At the time of alcohol withdrawal syndrome, the drug must be administered intravenously 2 times a day. The course of treatment is 7 days.
• In case of severe intoxication by other means, Mexidol should be administered intravenously at 100-200 mg. The course of treatment lasts at least 10 days.
• For pancreatitis, 400 mg of the drug is required 2 times a day. It is advisable to gradually reduce the dose until recovery.

Taking too many pills or injecting too much can cause complications. Most often, a person begins to feel very drowsy. However, other side effects from the drug may become more serious and cause great harm to your health.

Medicine and driving

Doctors do not recommend getting behind the wheel or driving a car while being treated with Mexidol. The medicine slows down a person's natural reactions and reduces concentration. This may lead to an accident and other dangerous consequences. It is also not recommended to engage in other activities that may require a lot of concentration from a person.

Interaction of tablets with other drugs

Mexidol combines well with other drugs and does not weaken their effect. The product will reduce the effect and toxicity of ethyl alcohol. The drug will enhance the effect of antidepressants and anticonvulsants.

Prices for Mexidol drugs

You can buy Miksidol tablets and ampoules at any pharmacy without a doctor's prescription. Prices vary everywhere, but it can be noted average cost medications:

• Mexidol in tablets of 0.125 g - 50 pieces cost 410-460 rubles.
• Mexidol in tablets of 0.125 g - 30 tablets will cost 270-300 rubles.
• Mexidol in ampoules of 5 ml - 5 pieces cost -450-500 rubles.
• Mexidol in ampoules of 2 ml - 10 ampoules cost 460-510 rubles.

Mexidol analogues

The doctor may prescribe another drug, which, in terms of properties and active components will be similar to Mexidol. Now there are such analogues of this tool:

• Antifront.
• Armandine.
• Glycine.
• Glycised.
• Glutamic acid.
• Instenon.
• Keltican.
• Mexiprim.
• Memory plus.
• Rilutek.
• Tenoten.
• Tryptophan.
• Cytoflavin.

Mexidol reviews

Since the drug has a wide spectrum of action, you can find many patient reviews about it. To learn about the real effect of Mexidol, we recommend reading some of them:

• Yana, 37 years old. The doctor prescribed me to take Mexidol for osteochondrosis in order to improve my nervous condition. During my illness, I often experienced bouts of depression and fear, especially in its advanced stages. There was no desire to start treatment or go to procedures. After the first week of taking Mexidol, my condition immediately improved, my mood lifted, and motivation appeared. I had more strength and I stopped being afraid of sudden back pain. At the same time, I began to comprehensively treat osteochondrosis, do gymnastics and undergo physical procedures.
• Anton, 29 years old. I started taking Mexidol to quickly cope with attacks at the moment vegetative-vascular dystonia. This disease causes a sharp feeling of fear, chest pain, panic and lack of air. It feels like you are dying. The doctor advised me to take Mexidol for a month. I took 1 tablet a day and immediately noticed improvements. At night I began to sleep well, I was no longer tormented by insomnia and fear. I took the drug for a month and even forgot about my attacks. I stopped worrying and took up my favorite hobbies.

• Irina, 41 years old. The doctor prescribed me Mexidol along with complex treatment cervical osteochondrosis. At that moment I had vertebral artery syndrome, which was accompanied by severe pain and impaired blood flow to the brain. Because of this, I suffered from headaches, depression, irritability and even dizziness. I was given regular injections of Mexidol in ampoules. The drug improved my blood circulation, I began to sleep easily again and stopped being nervous. After a long course of Mexidol, the pain subsided, vision improved, and the overall activity of the body increased. I immediately began to work productively, and there was no unpleasant fatigue. Side effects did not bother me even after long injections.

Conclusion

Now you know how Mexidol works in the form of tablets and ampoules. We have described for which diseases such a drug is suitable and how to use it correctly for effective recovery. Have you met someone nearby? side effects and contraindications to the medicine. Mexidol really improves blood circulation, stops destructive processes in the body, and calms the patient’s nervous system. But for such results, you need to take Mexidol exactly as prescribed by the doctor, do not exceed the dosage and inform the doctor about any changes in the body.

An original domestic antihypoxant and direct-acting antioxidant that optimizes the energy supply of cells and increases the body's reserve capabilities

Mexidol main effects, mechanism of action, application

Domestic drug of a new generation

T.A. Voronina

REVIVING THE ENERGY OF LIFE!

NEUROLOGY: acute cerebrovascular accidents (stroke), atherosclerotic disorders of brain function, dyscirculatory encephalopathy.

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

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

MEXIDOL (ethylmethylhydroxypyridine succinate)

Dosage form:

5% solution for injection in ampoules of 2 ml No. 10,

film-coated tablets 125 mg No. 30 Mexidol - 2-ethyl-6-methyl-3-hydroxypyridine 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 Biological Safety active substances. Mexidol is approved for wide medical use and is indicated for the treatment of acute cerebrovascular accidents, discirculatory encephalopathy, vegetative-vascular dystonia, atherosclerotic disorders of brain function, neurotic and neurosis-like disorders with anxiety, for the relief of withdrawal syndrome 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 mechanism and in the spectrum of pharmacological action and has significant advantages over known neuropsychotropic drugs. MECHANISM OF ACTION Mexidol has an original mechanism of action, the fundamental difference of which from the mechanism of action of traditional neuropsychotropic drugs is its 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 (phosphotidylserine and phosphotidylinositol, etc.) in the membrane, reduces the cholesterol/phospholipid ratio, reduces the viscosity of lipid layer and increases the fluidity of the membrane, 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 of 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 functioning of receptor complexes and the passage of ionic currents, enhance the binding of endogenous substances, improve synaptic transmission and the interconnection of brain structures. Thanks to this mechanism of action, Mexidol influences the key basic links in the pathogenesis of various diseases, has a wide range of effects, extremely few side effects and low toxicity, and has the ability to potentiate the action of other centrally active substances, especially those that act as direct receptor agonists. PHARMACODYNAMICS Mexidol, unlike well-known drugs, has a wide range of pharmacological effects, realized at least at two levels - neuronal and vascular. It has cerebroprotective, anti-alcohol, nootropic, antihypoxic, tranquilizing, anticonvulsant, antiparkinsonian, anti-stress, vegetotropic effects. In addition, it has the ability to improve cerebral circulation, inhibit platelet aggregation, reduce general level cholesterol, have an antiatherosclerotic effect. The therapeutic effects of Mexidol are detected 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, physical activity, hypoxia, ischemia, and various intoxications, including ethanol. Mexidol has a pronounced tranquilizing and anti-stress effect, the ability to eliminate anxiety, fear, tension, restlessness, in particular in conflict situations. When administered parenterally, it has a similar depth of effect to diazepam (Seduxen) and alprazolam (Xanax). The anti-stress effect of Mexidol is expressed in the normalization of post-aggressive behavior, somato-vegetative indicators, restoration of sleep-wake cycles and impaired learning and memory processes, reduction of stomach ulcers, reduction of dystrophic, morphological changes arising after stress in various structures brain and myocardium. Mexidol has a distinct anticonvulsant effect, influencing both primary generalized seizures, caused primarily by the administration of GABAergic substances, and the epileptiform activity of the brain with a chronic epileptogenic focus. The nootropic properties of Mexidol are expressed in the ability to improve learning and memory, promote the preservation of a memorable trace and counteract the process of extinction of acquired skills and reflexes. Mexidol has a pronounced anti-amnestic 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 life expectancy and the number of surviving animals under various hypoxic conditions: hypobaric hypoxia, hypoxia with hypercapnia in a 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 have weak antihypoxic activity under 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, contracting heart. According to the mechanism by which these effects are realized, Mexidol is an antihypoxant with a direct energizing effect, the effect of which is associated with the influence 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 hypoxic conditions, entering the intracellular space, can be oxidized by the respiratory chain. Mexidol has a pronounced anti-alcohol effect. It eliminates the neurological and neurotoxic manifestations of acute alcohol intoxication caused by a single injection 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 long-term (5 months) administration of ethanol and its withdrawal, and prevents accumulation of lipofuscin in the brain of alcoholized animals. Mexidol has a pronounced geroprotective effect, has a clear corrective effect on learning and memory processes impaired during aging, improving the process of fixation, storage and reproduction of information, helps restore emotional and vegetative status, reduces manifestations of neurological deficits, reduces the level of aging markers - lipofuscin - in the brain and blood , malonaldehyde, cholesterol. The mechanism of the geroprotective action of Mexidol is associated with its antioxidant properties, the ability to inhibit lipid peroxidation processes, its direct membranotropic effect, the ability to restore ultrastructural changes in the granular endoplasmic reticulum and mitochondria, and modulate the functioning of receptor complexes. Mexidol has an antiatherogenic 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 of pathological changes in vascular wall and reduces the degree of damage to the aorta. Mexidol reduces the content of atherogenic lipoproteins and triglycerides, increases the level of high-density lipoproteins in the 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 structure of arterioles and precapillaries, and their diameter differs little from the control, only focal ones are determined in venules aggregates, and complete elimination of spasm of afferent microvessels is observed. In addition, 2-ethyl-6-methyl-3-hydroxypyridine derivatives, which include Mexidol, suppress platelet aggregation caused by collagen, thrombin, ADP and arachidonic acid, inhibit platelet cyclic nucleotide phosphodiesterase, and also protect blood cells during mechanical injury . In particular, stabilizing resistance of erythrocyte membranes to hemolysis is observed and the process of hematopoiesis (restoration of the number of erythrocytes) is accelerated after acute blood loss or chemical hemolysis. The hepatoprotective effect of Mexidol was established in three models of acute toxic damage livers in which hepatocyte cytolysis syndrome was caused by various hepatotoxins. In conditions of liver damage caused by carbon tetrachloride, Mexidol reduces areas of liver tissue necrosis and the volume 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. In case of alcoholic liver damage, the effect of Mexidol is expressed in a decrease in the number of hepatocytes with lysis of nuclei and chromatin, acceleration of restoration of the total genome of hepatocytes and an increase in the content of nucleic acids in liver tissue and hepatocyte nuclei. Derivatives of 3-hydroxypyridine have a protective effect against the toxic effect on the liver of the strong hepatotropic carcinogen diethylnitrosoamine (DENA), since they form complexes with cytochrome P-450 and thereby prevent its complex formation 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 effects of tranquilizing, neuroleptic, antidepressant, hypnotic and anticonvulsants, which allows you 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. Combined use Mexidol with carbamazepine allows for adequate pathogenetic therapy partial epilepsy, reduce the side effects of carbamazepine with long-term use without reducing its therapeutic effectiveness 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 the side effects of Mexidol, it was found that even in the upper range of therapeutic doses it has neither a depressing nor a stimulating effect on spontaneous motor activity, does not change the coordination of movements, the exploratory behavior of animals, rectal temperature, corneal and pineal reflexes, and does not cause drowsiness . The drug maintains the adequacy of the animals' response to the stimuli provoking the test, and simple reflexes are not impaired. 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 excess high doses does not impair memory and does not cause amnesia, but on the contrary, has an anti-amnestic effect in case of memory impairment. Mexidol does not provide negative impact on the liver, but on the contrary, 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 the composition of the blood, skin color and mucous membranes, urination, defecation and salivation. Side effects Mexidol is expressed mainly in oppression motor activity and impaired coordination of movements and begin to appear in individual animals when doses are increased to 300 mg/kg and higher when administered intraperitoneally and at doses of 400 mg/kg and higher when Mexidol is administered orally. Long-term administration Mexidol (2-3 months) does not cause a decrease in its therapeutic effect or the appearance of additional undesirable manifestations. After stopping long-term administration of Mexidol, no withdrawal syndrome is observed. Acute toxicity Mexidol was determined by recording the death of animals 24 hours after administration of the drug. The lethal dose of Mexidol, causing 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. Studying chronic toxicity Long-term use of Mexidol orally 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, incoordination, ND50) or toxic, lethal doses(LD50) shows the significant therapeutic breadth of Mexidol. The therapeutic index calculated from the LD50/ED50 ratio is 6.2, and from the LD50/ED50 ratio is 16.4, which indicates the harmlessness and safety of the drug. PHARMACOKINETICS AND METABOLISM Mexidol has 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 concentrations in plasma are reached after 3 hours, and in the brain and liver of animals after 2-3 hours. A 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 quite high concentrations for 6-12 hours. The high lipophilicity of Mexidol, its ability to bind to blood plasma proteins and endoplasmic reticulum membranes suggest the formation of tissue and blood depots of Mexidol in the body of animals. An analysis of the parameters of the pharmacokinetics of Mexidol in patients in the clinic showed that both with a single and course 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 quickly eliminated from the blood and after 4 hours it is practically not registered. The pharmacokinetic profiles of the drug did not differ significantly between single and chronic administration. A study of the excretion of Mexidol in the urine showed that it is excreted both unchanged and in the form of a glucuronoconjugate, which constitutes a significant amount. When studying the metabolism of Mexidol in rats, 5 metabolites were identified. Metabolite I is phosphate (at the hydroxy group) of 3-hydroxypyridine, the formation of which occurs in the liver. In the blood under the influence alkaline phosphatase 3-hydroxypyridine phosphate is split into phosphoric acid and 3-hydroxypyridine. Metabolite II - 2-methyl-6-methyl-3-hydroxypyridine - is formed in large quantities and is found in the urine on the first and second days after Mexidol administration; this metabolite has a spectrum of pharmacological activity close to Mexidol. Metabolite III - 6-methyl-3-hydroxypyridine is contained and excreted in large quantities in the urine. Metabolite IV is a glucuronic conjugate with 2-ethyl-6-methyl-3-hydroxypyridine. Metabolite V is a glucuronic conjugate 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 cerebrovascular accidents, 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 system. Mexidol, as a rule, is administered to patients in the first hours of admission to the clinic intravenously in a stream or intravenously drip and intramuscularly, in doses of 50 mg. up to 400 mg. once, from 50 mg. up to 900 mg. per day with a frequency of administration of 3. The duration of action of the drug is about 4 hours. During the same time, the drug is detected in the blood of patients. One of the most significant manifestations of the effect of Mexidol when 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 an overall decrease in mortality in this disease. In the acute period of cerebral stroke, the mortality rate of patients was -31.5% for those taking Mexidol, and -52.5% without it; The bed days also decreased significantly: 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, a more rapid regression of neurological symptoms, assessed on the Matthew scale, is observed. Thus, in patients who are in in serious condition at the time of admission to the clinic, Matthew’s score 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. When treating patients with Mexidol, the dynamics of improvement in motor functions, revealed when using the ADL index, was also indicative. So, after 21 days this indicator was 76.6±3.1 in patients using Mexidol, and in the group of patients without using Mexidol it was 63.2±4.6 (the difference is significant at P< 0,05). По EEG data the effect of Mexidol is revealed in the form of an increase in spectrum power and activation of fast-wave rhythms. According to the results of ultrasound plerography of the main vessels of the brain, volumetric blood flow in the main arteries of the head after the administration of Mexidol increases by 25-40%. Mexidol has a cerebral vasodilatory effect, reduces cerebral vascular resistance, significantly increases pulse fluctuations of cerebral vessels and promotes hemodynamic changes that ensure the outflow of blood into the cerebral veins, without having a significant effect on systemic blood pressure. In patients receiving Mexidol, there was a significant regression of disorders of consciousness when assessed according to the Glasgow-Pittsburgh and A.N. boards. Konovalova. In these patients, functions are restored much faster and more clearly, at an earlier date. motor sphere, there is a positive trend in the restoration of coordination of movements. Mexidol significantly improves the subjective state of patients, reducing the manifestations of autonomic dysfunction (fear of death, headaches, mood swings, palpitations, etc.). Under the influence of Mexidol, signs of vasomotor instability and hyperthermia are reduced; sweating, tachycardia, etc., psychomotor agitation is reduced or eliminated, and sleep is significantly improved. Mexidol is highly effective in the treatment of discirculatory encephalopathy (DE), which is defined as a progressive multiple diffuse small-focal lesion of the brain of vascular origin and is characterized by ischemic-hypoxic damage to neurons, a progressive decrease in energy processes, activation of lipid peroxidation processes, and disruption of ionic homeostasis. Under these conditions, Mexidol, which has a normalizing effect on cerebral metabolism and fine neurochemical regulation, is of particular value. Cerebroprotective therapy with Mexidol differs from traditional effects on homeostasis and hemodynamics in the safety of use, the possibility long-term use, the ability to influence various levels and types of neurological and mental disorders. Mexidol in ampoules (5% solution) is used intravenously by stream, drip or intramuscularly in a dose of 2 to 3 mg/kg once, from 100 to 1000 mg per day (1-3 injections). The course of use 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 a frontotemporal localization of a compressive nature and pain of a diffuse localization of a dull, aching nature, combined with a feeling that the ears are stuffed with cotton. Under the influence of Mexidol, regression of symptoms is observed in patients with complaints of flickering spots, the appearance of a grid, fog before the eyes, and 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 words learned, an increase in accuracy, quality and pace of work, a decrease in the number of errors, this indicates that Mexidol improves memory. Along with this, Mexidol reduces the feeling of fatigue, weakness, eliminates the feeling of anxiety and fear that arises in specific situations, and also has a therapeutic effect for sleep disorders of presomnic, post-somnic 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, and a feeling of loss of balance when walking. Mexidol reduces the phenomena of hyperesthesia and senestopathy; patients do not experience progression of oral automatism reflexes or smoothness 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 maladjustment. Subjective and objective positive effects during treatment with Mexidol are 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 is an increase in the amplitude (on average by 25.5%) of pulse oscillations of the cerebral vessels and the outflow of blood into the cerebral veins is facilitated. Under the influence of Mexidol, an increase in linear and volumetric blood flow in the extracranial regions is observed main arteries head, which is recorded within 6 hours after administration of the drug. Registration of rheoencephalography after a course of treatment with Mexidol revealed normalization of waveforms in 67% of patients, and improvement in venous outflow in 38%. There is an increase in pulse blood supply in the external carotid artery system and in the vertebrobasilar system, with its initially low level, and normalization of the tone of small arteries and veins in both vascular systems. 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 receiving Mexidol, the increased content of hemoglobin and leukocytes decreases, blood viscosity decreases, cholesterol levels decrease, and the lecithin-cholesterol ratio increases. Thus, Mexidol has a pronounced therapeutic effect in patients with dyscirculatory encephalopathy of stages 1, 2 and 3. 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 marked improvement in their condition, 32% had a moderate improvement, 20% had a slight improvement, and 16% had no effect. A comparison of the clinical effectiveness of Mexidol and known drugs showed that the index overall efficiency with: treatment 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 autonomic crises of a sympatho-adrenal nature, in whom 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 reappear over the next 2-3 months. Mexidol has a positive effect in patients with mental pathology of late age, especially with atherosclerotic dementia in whom Mexidol was administered intramuscularly (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, learning instructions, caused a decrease in headaches and symptoms of anxiety and depression. The degree of dysarthria and tearfulness in patients decreased. In some patients, dizziness completely disappeared, a confident gait appeared, and asthenia decreased. In some patients with initial manifestations senile-atrophic process and in patients with atherosclerotic dementia after treatment with Mexidol, there was a “clearing” in the head, an increase in activity, and an improvement in mood. Thus, the use of Mexidol improves intellectual-mnestic activity in patients with age-related organic weakening processes, mainly in patients with atherosclerotic dementia, helping to improve concentration, follow instructions, memory for the present, reduce headaches, dizziness, tearfulness, dysarthria, and increase 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 received active therapy for neuroleptic syndrome with the drugs 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 effect of Mexidol began to manifest itself already from the 2-3rd day of therapy and consisted of 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, a decrease in limb tremor, stiffness, hypokinesia and hypomimia was noted, it improved, became more confident, free gait of patients, which ceased to be shuffling and mincing. The phenomena of orthogatism and dizziness decreased and disappeared, there was a tendency to normalize blood pressure with drug-induced hypotension, and Mexidol had no effect on normal blood pressure, weakness, lethargy, and dizziness decreased. The antiparkinsonian effect of Mexidol persisted for another 3-5 days after its discontinuation. Mexidol also has the ability to overcome the body's resistance to the effects of psychotropic drugs. Mexidol for this pathology was used at a dose of 300-500 mg per day with a treatment duration of 2-4 weeks. The effect of Mexidol began to appear already on the 3rd day of administration. Patients showed improvement appearance, color and turgor of the skin, appetite, 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 administration 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 of condition. In neurotic and neurosis-like conditions, Mexidol has a distinct tranquilizing effect, combined with a vegeto-normalizing effect. The therapeutic effect of Mexidol was most fully manifested in patients with neuroses 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 tension against the background of Mexidol was accompanied by a peculiar activation with an increase in the background mood, a reduction in asthenic symptoms themselves. The tranquilizing effect of Mexidol is comparable in power to the effect of uxepam. Mexidol has a positive effect on sleep, restoring its duration and depth. The effect of Mexidol appears after 3-7 days of therapy. According to the spectrum of action, Mexidol can be classified as a daytime tranquilizer, which is effective both in a hospital setting and in outpatient practice, as well as in elderly people. Mexidol has shown high effectiveness 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 remedy 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 within 1-1.5 hours after administration of the drug, and a persistent improvement in the condition occurs after 2-3 days. Patients experience a feeling of enlightenment, clarity in the head, headaches disappear, the process of concentration and comprehension when reading literature improves, anxiety, unaccountable fear, internal tension decrease, relaxation and a comfortable state appear, nightmares disappear, hypnotic hallucinations disappear, dreams become alcohol-free topics, sleep disorders disappear. Patients note the appearance of vigor and 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 isolated side effects, which 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 went away on their own. Two patients with alcoholism experienced bitterness and dry mouth, dizziness, and 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. One patient with neurosis, at the beginning of therapy, had a pinpoint rash on the skin of the forearms, not accompanied by itching and peeling, which self-reduced within three days with continued therapy. The insignificance of side effects makes Mexidol stand out among the known neuroprotective, nootropic and tranquilizing agents. Arsenal used in modern medicine agents that improve cerebral circulation and are used in injection form are quite 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 drawback of these known drugs, which in many cases limits their use, is the significant number and frequency of side effects. Pentoxifylline (trental) causes headache, dizziness, tachycardia, facial flushing, 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, feeling of heaviness in the epigastrium, increased fragility of nails, change body weight, swelling, and in case of an overdose of the drug, convulsions, loss of consciousness, and 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 blood vessels of the brain and heart, severe disorders heart rate, pregnancy, lactation. Characteristic side effects of vinpocetine (Cavinton) are a decrease in blood pressure and tachycardia, and contraindications to the use of the drug are ischemic disease heart and severe forms of arrhythmias. Nicergoline (Sermion) causes arterial hypotension, dizziness, a feeling of heat and flushing, 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 drugs currently used to treat cerebrovascular accidents are associated with 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 traditional effects on homeostasis and hemodynamics in its safety of use, the possibility of long-term use, and 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 well-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 the 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 the cardiorespiratory depression inherent in these drugs. In contrast to noopropic drugs, when using Mexidol, there is no activating effect, sleep disturbances or increased convulsive readiness. In addition, Mexidol is significantly more effective than piracetam (nootropil). In comparison with benzodiazepine tranquilizers (seduxen, elenium, oxazepam, lorazepam, phenazepam, etc.), Mexidol does not have a muscle relaxant effect even in doses exceeding the average therapeutic anxiolytic dose by 4-5.5 times and does not cause such manifestations as impaired coordination movements, decreased muscle tone and muscle strength. Mexidol, in contrast to anxiolytics, does not have a sedative or amnesic effect, but, on the contrary, has a positive effect on memory, especially in conditions of impaired cognitive functions. With long-term administration of Mexidol and cessation of its use, there are no signs of withdrawal syndrome characteristic of benzodiazepine tranquilizers. Thus, Mexidol is a selective tranquilizer of “daytime” action, in which the 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 known neuroprotective, nootropic and tranquilizing drugs, which indicates its safety and significantly expands the possibilities of use. Directions for use and doses 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. Mexidol is administered in a stream over 1.5-3.0 minutes, and dropwise at a rate of 80-120 drops per minute. Duration of treatment and daily dose The drug depends 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 by drip 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 on a physiological NaCl solution daily for 15 days. In the future, it is recommended to administer Mexidol intramuscularly at a dose of 200 mg (4 ml) once a day for 10-15 days. In the subsequent comprehensive 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 distributed into 2-3 doses during the day. For the treatment of dyscirculatory encephalopathy (both against the background of cerebral atherosclerosis and against the background of hypertension):

In the decompensation phase, Mexidol is administered:
- either 400 mg (8 ml) intravenously in drops per 100 ml of isotonic NaCl solution daily for 10-15 days;
- either 200 mg (4 ml) intravenously 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 a course of 10 days. Or 200 mg (4 ml) intramuscularly, daily for 10 days. Subsequently, oral administration of Mexidol 0.125 g three times a day is recommended for 4-6 weeks.

In the subcompensation phase, Mexidod is used:
- either 200 mg (4 ml) intravenously in a stream of 16.0 ml of physiological 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, for 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 in a stream of 10.0 ml of physiological NaCl solution, daily for 10 days;
- either 200 mg (4 ml) intramuscularly, daily, for a course of 10 days. Subsequently, it is advisable to take the tablet form, 0.125 g three times a day, for 2-6 weeks (in both cases - both intravenously and intramuscularly);
- or initially, a course of prophylaxis can be started with the use of a tablet form of 0.125 g three times a day, for at least 4-6 weeks. For vertebrobasilar insufficiency due to osteochondrosis cervical region spine Mexidol is used:

In the decompensation phase:
- either 400 mg (8 ml) intravenously, in 100 ml of physiological NaCl solution, daily, 10 days;
- either 200 mg (4 ml) intravenously in a bolus in 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. Upon completion of intramuscular injections, switch to oral administration of the drug at 0.125 mg three times a day, for a course of 2-6 weeks.

In the subcompensation phase:
- either 200 mg (4 ml) of Mexidol is administered intravenously, in 16.0 ml of isotonic sodium chloride solution, for 10 days;
- either 200 mg (4 ml) intramuscularly, twice a day, 10 days. In the future, it is advisable to prescribe the tablet form in the doses described above. In the acute period of traumatic brain injury, the prescription 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, per 16.0 ml of isotonic sodium chloride solution, twice a day, 10-15 days;
- in the subacute period - 200 mg (4 ml) intravenously in a bolus per 16.0 ml of isotonic sodium chloride solution, daily for 10 days; or 200 mg (4 ml) intramuscularly, twice a day, 10-15 days. During the rehabilitation period, it is recommended to take the tablet form 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 for diabetes, 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 200 mg (4 ml) intravenously in a 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. Upon completion of parenteral administration, switch to tablet form - 0.125 g three times a day, for at least 4-6 weeks. Considering 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 effect of anticonvulsants, which makes it possible, when prescribed, to reduce the doses of traditional medications used and, thereby, reduce their side effects. Mexidol is recommended to be administered 100 mg (2 ml) intravenously in a bolus of 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 tremors, stiffness, hypomimia and hypokinesia, improves motor functions sick. In addition, it potentiates the effect of antiparkinsonian drugs, which makes it possible to reduce the doses of 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 200 mg (4 ml) intravenously in a stream of 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 the tablet form - 0.125 g three times a day. Autonomic dysfunction syndrome, neurotic and neurosis-like states. Mexidol showed its high efficiency with vegetative-vascular dystonia, especially of the paroxysmal type. It has a vegetative-normalizing and distinct tranquilizing effect in neurotic and neurosis-like conditions. Dosage regimen of the drug: 100-200 mg (2-4 ml) intravenously in a bolus of 10.0-16.0 ml of isotonic sodium chloride solution, daily for 10 days. It is possible to administer the drug intramuscularly at 200 mg (4 ml), daily, for 15 days. After injections, it is advisable to prescribe a tablet form of 0.25-0.50 g per day. The daily dose is distributed into 2-3 doses. The course of treatment is 2-6 weeks. In this case, the course therapy is completed gradually, reducing the dose of the drug over 2-3 days. Parasomnic disorders. Mexidol has a positive effect on sleep, restoring its duration and depth, while helping to restore the correct sleep rhythm. This is combined with the absence of sedation effects when taking the drug during the day. In this case, the drug is recommended to be administered intramuscularly, 100-200 mg (2-4 ml), daily for 15-20 days. Then use the tablet form of 0.125 g three times a day for 4-6 weeks. Before discontinuation, the dose of the drug is reduced gradually over 2-3 days. Memory disorders and intellectual disability in the elderly. Mexidol is effective drug for revitalization of elderly people. The drug has a positive effect on hypomnesia, increased distractibility and difficulty concentrating, improves the ability to concentrate and count, improves short term memory for current events and long-term memory for 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 Such courses are repeated every 5-6 months. Periods of extreme stress. Mexidol has a pronounced ability to improve mental and physical performance, especially under conditions of extreme influences. In such cases, it is advisable to start with intravenous administration of 200 mg (4 ml) intravenously in a stream, per 16.0 ml of isotonic sodium chloride solution, daily for 10-15 days. Then the drug is administered intramuscularly at 200 mg (4 ml) per day for 10 days, followed by a transition to taking the tablet form at 0.25-0.50 g per day; course of treatment - 2-6 weeks. It is possible to switch to the tablet form immediately after intravenous administration. Exogenous-organic diseases of the brain. The causes of exogenous-organic brain damage are: previous traumatic brain injuries, intoxication (excluding alcohol), neuroinfections, as well as combinations of these factors. Patients with exogenous-organic diseases are known to have poor tolerance to a number of drugs. Mexidol, as studies have shown, is not one of them. When used, there is a clear positive effect on existing neurological deficits in this category of patients. Recommended dosage regimen: 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 the tablet form at 0.125 g three times a day for 4-6 weeks. Intoxication with ethyl alcohol. Considering the antihypoxic, antioxidant, tranquilizing and hepatoprotective effects of Mexidol, it can be used as part of complex therapy to relieve ethyl alcohol intoxication. Mexidol warns and weakens toxic effect alcohol. Dosage regimen: 400 mg (8 ml) intravenously in 150.0 ml of isotonic sodium chloride solution twice a day for 3 days; then 200 mg (4 ml) intravenously in a bolus with 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, 0.125 g three times a day for 2-6 weeks. Alcohol withdrawal syndrome. Mexidol is effective as a means for relieving 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 alcohol withdrawal syndrome with the effectiveness of traditional detoxification agents, a significant advantage of this drug was established. Mexidol is an effective remedy 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 injectable form, in contrast to the tablet form, turns out to be more effective in relation to affective pathology, eliminating anxiety in a significantly more short terms. Recommended dosage regimen: 200 mg (4 ml) intravenously in a bolus, per 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, for 10 days, followed by switching to the tablet form, 0.125 g three times a day, 4-6 weeks. In some cases, it is possible to combine 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) throughout the entire period of existence hangover syndrome. Anxiety disorders in neurotic and neurosis-like conditions. At anxiety disorders- psychogenic (neurotic), with endogenous diseases, with organic damage brain of traumatic, intoxication and vascular origin Mexidol, used as an anxiolytic agent, is most effective for generalized anxiety and anxiety-asthenic conditions that are simple in structure. The anxiolytic effect of the drug, combined with an activating component and a 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 in 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 origin. For 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 with antipsychotic drugs (neuroleptics). In acute intoxication with neuroleptics with symptoms of neuroleptic syndrome, Mexidol causes a decrease in the severity of hyperkinesis, tremor, and muscle rigidity. When used in combination with antiparkinsonian drugs, Mexidol potentiates their effect. In case of acute intoxication with neuroleptics, 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 cerebral circulation, traumatic brain injuries, neuroinfections and intoxications, initial manifestations of senile-atrophic processes, increased 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, for 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 glucose-lowering drugs, and stop the progression late complications and thus improve the quality and prognosis of life. The use of Mexidol is especially effective for correcting chemical homeostasis in the group of diabetic patients in whom hypoglycemia cannot be stabilized by traditional therapy and in whom hypoglycemia is noted. 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, diabetic foot syndrome. At the same time, it is possible to correct tissue trophism by stimulating microcirculation, detoxification, and enhancing oxidative processes in the energy cycle. A decrease in glycemia when Mexidol is included in complex therapy for 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 of the abdominal cavity. In acute destructive pancreatitis and 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, variants clinical course. Discontinuation of the drug should be done gradually, only after a stable positive clinical and laboratory effect.
- For acute edematous (interstitial) pancreatitis, Mexidol is prescribed 100 mg (2 ml) three times a day intravenously, in an 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 necrotizing pancreatitis - the drug is administered in a pulse dosage of 800 mg (16 ml) on the first day, with a double administration regimen; then 300 mg (6 ml) twice a day with a gradual reduction 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, upon stabilization of the condition, 300-400 mg (6-8 ml) twice a day intravenously (in isotonic sodium chloride solution) With a gradual reduction in daily dosage. In the complex therapy of peritonitis, Mexidol is administered in a dosage of 200-300 mg (4-6 ml) three times a day intravenously 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. The rationale for the use of Mexidol in the complex therapy of chronic generalized periodontitis (CGP) was the ability to inhibit free radical oxidation and increase the activity of the antioxidant system. To achieve optimal effects, it is advisable to use both local and parenteral routes of administration of Mexidol. At mild degree severity of CGP Mexidol is prescribed according to the following regimens. 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.
- or applications of 2 ml of 5% Mexidol solution 2-3 times a day, for 12-14 days. Method of preparation: open 1 ampoule of the drug and moisten a piece of sterile gauze or bandage, folded in 4 - 6 layers, with the solution. 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. Orally: 1-2 tablets orally 2 times a day, for 12-14 days. For moderate and severe degrees of CGP, Mexidol is prescribed according to the following regimens. Locally in the form:
- rinsing (2 ml of 5% solution 3 times a day) for 12-14 days.
- or applications (2 ml of 5% solution 2-3 times a day) for 1214 days. If there is a periodontal pocket, use:
- Installation of 2 ml of 5% solution for injection. Method of preparation: open 1 ampoule of the drug and moisten the turunda with the solution, which is placed in the periodontal pocket for 20 minutes. Parenteral: intramuscularly 2 ml of 5% solution (100 mg) 1 time per day for 12-14 days Oral: 1-2 tablets (0.125 - 0.25 g) 2 - 3 times per 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 of liver and kidney function. Hypersensitivity or intolerance to the drug. Side effects May be observed: from the digestive system, rarely - nausea, dry mouth. Adequate and strictly controlled clinical trials The safety of the drug during pregnancy, lactation (breastfeeding) and children has not been studied. Interaction with other drugs Not installed. The drug is combined with almost all drugs used in complex therapy for the specified nosologies. Mexidol potentiates the effect of anticonvulsants, tranquilizers, antiparkinsonian drugs, and analgesics. The drug reduces the toxic effects of ethyl alcohol.

Mexidol is a drug with the main active ingredient ethylmethylhydroxypyridine succinate. A pharmacological product with a complex name belongs to the family of membrane protectors. Let's study in detail what Mexidol helps with and how to take it correctly.

The medicine is produced in the form of tablets and ampoules for injection. Tablets are distributed in blisters of 50 or 30 pieces. Let's consider the key features of the composition using the example of a tablet preparation.

The active substance is ethyl methylhydroxypyridine succinate. It contains 125 mg in one tablet.

As auxiliary components use:

• lactose monohydrate;
• povidone;
• magnesium stearate;
• hypromellose;
• macrogol;
• triacetin.

Mexidol tablet round shape, biconvex. The shell is colored milky white or cream.

The membrane-stabilizing effect of the drug is due to the pharmacological properties of the main active ingredient in the basis of the medicinal product. Mexidol helps normalize oxygen metabolism in tissues, improves digestibility nutrients at the cellular level.

Considering the key effect that Mexidol provides, it is not difficult to guess why it is prescribed.

Main effects you can count on:

• antihypoxic;
• stress-protective;
• nootropic;
• antiepileptic;
• anxilitic;
• anticonvulsant;
• anti-sclerotic.

The drug improves metabolism and regulates blood supply to brain tissue. The rheological qualities of blood are optimized, platelet aggregation is reduced to an optimal level.

The medicine helps normalize post-stress behavior. With the help of this medicinal product, it is possible to eliminate degenerative processes in brain tissue and restore the normal work-rest cycle. The cognitive abilities of patients are significantly improved.

According to the instructions for use, Mexidol copes well with the consequences of alcohol intoxication, restoring vegetative potential, stabilizing behavioral reactions, and eliminating the neurotoxic consequences of poisoning of any origin.

The use of the drug in the treatment of patients in a state of ischemic myocardium is justified. In adverse conditions coronary insufficiency the drug increases collateral blood supply to the myocardium. The pharmacological product is capable of restoring myocardial contractility in case of reverse cardiac dysfunction.

Given its impressive pharmacological potential, Mexidol is prescribed in different regimens. What does the medicine help with?

1. Consequences of acute cerebrovascular accidents.
2. Combating the consequences of acute ischemic attacks.
3. Traumatic brain injury and its consequences.
4. Encephalopathies of various forms and origins.
5. Autonomic dystonia syndrome.
6. Decreased cognitive qualities due to atherosclerotic pathology.
7. Relief of withdrawal syndrome due to alcohol intoxication varying degrees gravity.
8. Treatment of post-withdrawal conditions.
9. Coronary heart disease.
10. Asthenic conditions.
11. Prevention of somatic disorders.
12. Helping the body under extreme stress conditions.
13. Anxiety disorders of a neurotic and neurosis-like kind.
14. Primary open-angle glaucoma.
15. Acute purulent-inflammatory processes in the abdominal cavity.

Main contraindications

Before offering Mexidol to the patient, the doctor tells why it is prescribed, in what doses, how long the medicine should be used, and what its main effect on the body is.

The doctor must also take a thorough medical history of his patient, taking into account all possible contraindications:

• acute renal failure;
• acute liver failure;
• increased susceptibility to the main pharmacological substance or auxiliary components;
• childhood;
• pregnancy;
• active lactation period.

The use of the drug for all of the above conditions is inappropriate. In the case of pregnant and lactating patients, the drug product is not prescribed due to the lack of any data on the safety of the pharmacological product.

If the patient cannot tolerate any component of the drug, it makes sense to select a suitable analogue that does not contain a potential allergen.

Instructions for use of Mexidol

The dosage and release form of the pharmacological product are selected taking into account the pathology, general condition the patient, the ultimate goals pursued by the attending physician. The table shows the main options for influencing the patient using the drug Mexidol.

Pathological condition	The form of the drug used	Dosage (daily)	Duration of therapeutic effect
TBI, consequences of injuries	Pills	800 mg, divided into three doses throughout the day. This is the maximum permissible dose. If possible, the minimum dosage is selected for the patient.	5 days – 2 months (it all depends on the severity of the injury and the body’s reaction to the medicinal products received).
Cerebrovascular accident	Solution for injection	For the first 4 days, 300 mg of the drug is administered by IV. For the remaining time, the patient is given an injection three times a day (100 mg at a time).	No more than 14 days.
Withdrawal syndrome	Pills	Two tablets twice a day. In especially severe cases, it is permissible to take 3 tablets per day for a short time.	5 – 7 days.
Atherosclerosis	Solution for injection	Over the course of 24 hours, the patient is given intramuscular injections. total amount 300 mg of the drug (maximum dosage).	The maximum allowable period of admission is 6 weeks.
Encephalopathy (dyscirculatory)	Solution for injection	250 mg is administered intramuscularly twice a day. The maximum daily dose is 500 mg.	2 weeks.
Intoxication with neuroleptics and other drugs of this kind	Solution for injection	The maximum dose is 500 mg. As a rule, it is divided into two steps.	1-2 weeks.
Necrotizing pancreatitis	Solution for injection	The maximum permissible dose is 800 mg. Administered in 2-3 doses.	Until there is a visible improvement in well-being. The dose is reduced gradually.

For the dropper, injection water is used, in which Mexidol is diluted. The approximate rate of drip administration of the drug is 60 drops/min.

Side effects

The task of any medicinal product is to help the patient cope with a particular pathology.

And everyone wants a high-quality and proven product for themselves.

However, even the most pronounced therapeutic effects can be overshadowed by a number of side effects.

As for the drug Mexidol, negative reactions from the body rarely occur.

Here are the main ones:

• dry mouth;
• nausea;
• fatigue;
• drowsiness;
• feeling of anxiety;
• poor coordination;
• hyperhidrosis;
• cephalgia;
• dizziness;
• allergic reactions.

The medicine is very different low level toxicity. The likelihood that a person will experience any adverse reactions is extremely low.

Ethylmethylhydroxypyridine succinate is a base for the creation of various medications. Mexidol can also be found on the market under other commercial names:

• Mexico;
• Mexibel;
• Mexicofor.

By chemical structure All the drugs listed are identical. The release form, dosage and other features of the composition do not differ. However, each drug is selected taking into account a specific pathology, but there are no specific justifications for such a distribution in official medicine.

As for other pharmacological products that are similar in composition and also identical in pharmacological action, the following medications are considered the most popular:

• Neurox;
• Cerecard;
• Hypoxene;
• Riluzole;
• Vitagamma;
• Emoxybel.

Drug interactions

The drug Mexidol is capable of enhancing the pharmacological potency of anxiolytics, antiparkinsonian drugs, and anticonvulsants. At the same time, the membrane protector minimizes the toxic effect of ethyl alcohol.

Mexidol is combined with all pharmacological products that are prescribed for somatic disorders. At the time of active therapeutic influence on the patient, one should, if possible, refrain from driving any vehicles. A similar rule applies to those areas of human activity that require maximum concentration and reaction speed.

Conclusion

In general, the prescription of the medicinal product Mexidol is 100% justified. Pronounced therapeutic effect, minimum side effects, affordable price, a wide range of effects on human body– all these qualities make the drug justifiably in demand.

The domestic drug Mexidol (active ingredient - ethylmethylhydroxypyridine succinate) belongs to the group of antioxidants. It suppresses the processes of free radical oxidation, has membrane-protective, nootropic, antihypoxic, stress-protective and anxiolytic (anti-anxiety) effects. Mexidol promotes the formation of the body's resistance to the effects of various destructive factors (shock, oxygen starvation, ischemia, poisoning with alcohol, antipsychotics or psychotropic substances, circulatory disorders in the brain). The drug suppresses lipid peroxidation reactions, “inspires” the antioxidant enzyme superoxide dismutase, harmonizes lipid-protein balance, reduces viscosity and increases fluidity (rheological properties) 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 for transport neurotransmitters and improve neurotransmission. The drug increases the concentration of dopamine in the brain, stimulates aerobic glycolysis reactions and compensates for the inhibition of oxidation processes within the Krebs cycle while simultaneously increasing the level of ATP and creatine phosphate under conditions of oxygen starvation, and 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 reflected in a decrease in the level of total and “bad” (LDL) cholesterol.

The anti-stress effect of the drug is expressed in debugging post-stress behavior, eliminating somato-vegetative dysfunctions, restoring normal sleep, improving the ability to learn and remember information, reducing degenerative and structural changes in the brain. Mexidol is a powerful detoxicant for alcohol withdrawal syndrome: it neutralizes the neurological and neurotoxic consequences of acute alcohol poisoning, eliminates behavioral and cognitive disorders caused by long-term alcohol abuse, and restores autonomic functions. The drug potentiates the effect 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 of 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 contractility of the heart muscle in case of 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 hospital settings. Tablets should be taken 125–250 mg 3 times a day. The duration of the medication course is on average from 2 to 6 weeks (for 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, 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 the drug Mexidol ® is due to its antihypoxic, antioxidant and membrane protective effects. The drug inhibits the processes of lipid peroxidation, increases the activity of superoxide dismutase, increases the lipid-protein ratio, reduces the viscosity of the membrane, and 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 preserve the structural and functional organization of biomembranes, neurotransmitter transport and improve synaptic transmission. Mexidol ® increases the content of dopamine in the brain. 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, stabilization of cell membranes.

Mexidol ® normalizes metabolic processes in the ischemic myocardium, reduces the necrosis zone, restores and improves the electrical activity and contractility of the myocardium, and also increases coronary blood flow in the ischemic zone, reduces the consequences of reperfusion syndrome in acute coronary insufficiency. Increases the antianginal activity of nitro drugs. Mexidol ® promotes the preservation of retinal ganglion cells and optic nerve fibers during 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

When Mexidol is administered 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 intramuscular administration, the drug is determined in the blood plasma within 4 hours. The average retention time of the drug in the body is 0.7-1.3 hours.

Removal

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

Release form

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

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

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

Dosage

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

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

In case of acute cerebrovascular accidents, Mexidol ® is used in the first 10-14 days intravenously at a dose of 200-500 mg 2-4 times a day, then intramuscularly at a dose of 200-250 mg 2-3 times a day for 2 weeks. .

For traumatic brain injury and the consequences of traumatic brain injury, Mexidol ® is used intravenously for 10-15 days at a dose of 200-500 mg 2-4 times a day.

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

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

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

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

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

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

The drug is administered (IV or IM) 3 times a day every 8 hours. The daily therapeutic dose is 6-9 mg/kg body weight/day, single dose- 2-3 mg/kg body weight. The maximum daily dose should not exceed 800 mg, a single dose - 250 mg.

For 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.

With withdrawal symptoms alcohol syndrome Mexidol ® is administered in a dose of 200-500 mg intravenously or intramuscularly 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 variants of the clinical course. Discontinuation of the drug should be done gradually, only after a stable positive clinical and laboratory effect.

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

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

For necrotizing pancreatitis of moderate severity - 200 mg 3 times a day intravenously (in isotonic sodium chloride solution).

For necrotizing pancreatitis severe course- in a pulse dosage of 800 mg on the first day, with a double dose regimen, then - 200-500 mg 2 times a 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 the manifestations of pancreatogenic shock are persistently relieved, after stabilization of the condition - 300-500 mg 2 times a day intravenously (in 0.9% sodium chloride solution) with a gradual reduction in the daily dosage.

Overdose

In case of overdose, drowsiness may develop.

Interaction

Mexidol ® enhances the effect of benzodiazepine derivative anxiolytics, antiparkinsonian (levodopa) and anticonvulsant (carbamazepine) drugs.

Mexidol ® reduces the toxic effects of ethyl alcohol.

Side effects

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

Other: allergic reactions, drowsiness.

Indications

• acute cerebrovascular accidents;
• traumatic brain injury, consequences of traumatic brain injury;
• dyscirculatory encephalopathy;
• autonomic dystonia syndrome;
• mild cognitive disorders of atherosclerotic origin;
• 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 syndrome in alcoholism with a predominance of neurosis-like and vegetative-vascular disorders;
• acute intoxication with antipsychotic drugs;
• 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 the drug Mexidol ® in children, pregnancy and breastfeeding have not been conducted.

Features of application

Use during pregnancy and breastfeeding

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

Use for liver dysfunction

The drug is contraindicated in acute liver dysfunction.

Use for renal impairment

The drug is contraindicated in acute renal dysfunction.

Special instructions

In some cases, especially in predisposed patients With bronchial asthma with increased sensitivity to sulfites, severe hypersensitivity reactions may develop.

Antioxidant drug

Active ingredient

Ethylmethylhydroxypyridine succinate

Release form, composition and packaging

Film-coated tablets from white to white with a creamy tint, round, biconvex.

Excipients: lactose monohydrate - 97.5 mg, - 25 mg, magnesium stearate - 2.5 mg.

Compound film shell: opadry II white 33G28435 - 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).

10 pcs. - contour cellular packaging (1) - cardboard packs.
10 pcs. - contour cell packaging (2) - cardboard packs.
10 pcs. - contour cell packaging (3) - cardboard packs.
10 pcs. - contour cell packaging (4) - cardboard packs.
10 pcs. - contour cell packaging (5) - cardboard packs.

Pharmacological action

Mexidol is an inhibitor of free radical processes, a membrane protector with antihypoxic, stress-protective, nootropic, anticonvulsant and anxiolytic effects. The drug increases the body's resistance to the effects of various damaging factors (hypoxia and ischemia, cerebrovascular accidents, intoxication with alcohol and antipsychotics /neuroleptics).

The mechanism of action of the drug Mexidol is due to its antioxidant, antihypoxic and membrane protective effects. The drug inhibits lipid peroxidation, increases the activity of superoxide dismutase, increases the lipid-protein ratio, reduces membrane viscosity, and 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 preserve the structural and functional organization of biomembranes, neurotransmitter transport and improve synaptic transmission. Mexidol increases the content in the brain. Causes an increase in 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, stabilization of cell membranes.

The drug improves 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 lipid-lowering effect, reduces the content of total cholesterol and LDL.

The anti-stress effect is manifested in the normalization of post-stress behavior, somato-vegetative disorders, restoration of sleep-wake cycles, impaired learning and memory processes, reduction of dystrophic and morphological changes in various structures of the brain.

Mexidol has a pronounced antitoxic effect in withdrawal symptoms. Eliminates neurological and neurotoxic manifestations of acute alcohol intoxication, restores behavioral disorders, autonomic functions, and is also able to relieve cognitive impairment caused by long-term use of ethanol and its withdrawal. Under the influence of Mexidol, the effect of tranquilizing, neuroleptic, antidepressant, hypnotics and anticonvulsants is enhanced, which makes it possible to reduce their doses and reduce side effects.

Mexidol improves the functional state of ischemic myocardium. In conditions of coronary insufficiency, it increases collateral blood supply to the ischemic myocardium, helps maintain the integrity of cardiomyocytes and maintain their functional activity. Effectively restores myocardial contractility in reversible cardiac dysfunction.

Pharmacokinetics

Suction and distribution

Rapidly absorbed when taken orally. Cmax at doses of 400-500 mg is 3.5-4.0 mcg/ml.

Quickly distributed in organs and tissues. The average retention time of the drug in the body when taken orally is 4.9-5.2 hours.

Metabolism

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

Removal

T1/2 when taken orally - 2-2.6 hours. It is quickly excreted in the urine, mainly in the form of metabolites and in small quantities - unchanged. The most intensive elimination occurs during the first 4 hours after taking the drug. Rates of urinary excretion of unchanged drug and metabolites have individual variability.

Indications

- consequences of acute cerebrovascular accidents, incl. after transient ischemic attacks, in the subcompensation phase (as preventive courses);

- mild traumatic brain injury, consequences of traumatic brain injury;

- increased individual sensitivity to the drug.

Due to insufficient knowledge of the effect of the drug - childhood, pregnancy, breastfeeding.

Dosage

Orally 125-250 mg 3 times/day; the maximum daily dose is 800 mg (6 tablets). Duration of treatment - 2-6 weeks; For relief of alcohol withdrawal- 5-7 days. Treatment is stopped gradually, reducing the dose over 2-3 days.

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

Duration of therapy for patients with ischemic heart disease is at least 1.5-2 months. It is advisable to carry out repeated courses (on the recommendation of a doctor) in the spring and autumn.

Side effects

Individual adverse reactions may occur: dyspeptic, allergic reactions.

Overdose

In case of overdose, drowsiness may develop.