Ginkgoba kaps. 120 mg No. 20

Pharmacological properties

Pharmacodynamics. the ginkgoba — medicament of plant origin, normalizes a metabolism in cells, rheological properties of blood, microcirculation, mediator processes in central nervous system.

Drug increases a blood stream, especially microcirculator, increases shipping of a hypoxia, especially in brain tissues, prevents aggregation of erythrocytes, brakes a factor of activation of thrombocytes. Shows the dose-dependent regulating influence on the vascular system, stimulates development of the endoteliyzavisimy weakening factor (nitrogen oxide — NO), expands small arteries, raises a tone of veins, thereby regulates a krovenapolneniye of vessels. Reduces permeability of a vascular wall (antiedematous effect — both at the level of a brain, and by peripheries). Reduces hypostasis of a retina of an eye and damage of a cornea. Improves compensation of disturbances of balance. Has antitrombotichesky action (due to stabilization of membranes of thrombocytes and erythrocytes, antagonism to a platelet activating factor). Prevents education of free radicals and the FLOOR of cellular membranes. Normalizes release, repeated absorption and catabolism of neurotransmitters (Norepinephrinum, a dopamine, acetylcholine) and their ability to be combined with receptors. Improves memory and ability to training. Has anti-hypoxemic effect, improves a metabolism in bodies and fabrics, promotes accumulation in cells of makroerg, increase in utilization of oxygen and glucose, has neurotyre-tread effect.

Pharmacokinetics. At intake bioavailability of ginkgolid And, In and the bilobalida (biologically active agents of extract of a ginkgo) makes 80–90%. The C _max is reached in 1–2 h after administration of drug. T _½ make about 4 h (a ginkgolid And, bilobalid) and 10 h (ginkgolid C). Ginkgolida And, In and bilobalid in an organism do not break up, are almost completely removed with urine, the insignificant quantity is removed with a stake.

Indication

Symptomatic treatment of patients of advanced age with cognitive disorders, except for persons with the confirmed dementia, Parkinson's disease, cognitive disorders of iatrogenic origin or resulted from a depression or disbolism.

Combined treatment in dizziness of vestibular origin as addition to vestibular rehabilitation.

Symptomatic treatment at sonitus.

Use

For oral administration. to swallow of capsules whole at meal time, washing down ½ glasses of water.

Cognitive disorders

Dosage of 40 mg

On 1–2 capsule 3 times a day.

Dosage of 80 mg

On 1 capsule 2–3 times a day.

Dosage of 120 mg

On 1 capsule 1–2 times a day in the morning or in the morning and in the evening.

Duration of treatment is not less than 8 weeks. The average duration of a course of treatment — 3 months. In 3 months of therapy it is necessary to consult with the doctor about need of further use of medicine.

Neurosensory disorders, such as dizziness, sonitus

Dosage of 40 mg

On 1 capsule 3 times a day.

Dosage of 80 mg

On 1 capsule 2 times a day in the morning and in the evening.

Dosage of 120 mg

On 1 capsule of 1 times a day in the morning.

Duration of treatment is no more than 6-8 weeks

Children. There is no sufficient experience of use of medicament for children therefore it is not recommended to use medicament at this category of patients.

Contraindication

Hypersensitivity to any component of drug.

Side effects

Occasionally note the following reactions:

from the immune system: reactions of hypersensitivity, including a Quincke's disease, a small tortoiseshell, an asthma;

from nervous system: headache, dizziness, syncope (including vazovagalny);

from digestive system: nausea, vomiting, diarrhea, dyspepsia, digestive disturbances, abdominal pain;

from skin and hypodermic cellulose: rash, itching, reddening, hypostasis, inflammation of skin, eczema.

to hemorrhages (gastrointestinal, in eyes, in a brain). There is an increased probability of these side effects at accompanying therapy by anticoagulants and NPVP.

in case of any undesirable reactions should stop use of medicament and it is obligatory to see a doctor.

Special instructions

Before an initiation of treatment whether observed pathological symptoms are a consequence of a basic disease which demands special treatment.

before use of the medicament Ginkgoba needs to consult with the doctor to patients with the increased tendency to bleeding (hemorrhagic diathesis), patients who are treated by drugs, anticlotting, medicines for decrease in level of glucose in blood, medicaments for decrease in the ABP.

At identification of hypersensitivity to components of medicament should stop medicine use.

Before surgical intervention to the doctor about medicament Ginkgoba use.

Needs extra care at simultaneous use of medicaments which are metabolized by P450 3A4 cytochrome.

It is possible that medicaments with extract of a ginkgo provoke convulsive attacks at patients with epilepsy. Relationship of cause and effect of this phenomenon is not established with administration of drug.

Data on abuses of medicaments of a ginkgo are absent. Proceeding from pharmacological characteristics of medicine, medicaments of a ginkgo have no potential for abuse.

At the established intolerance of some sugars should consult with the doctor before taking this drug. Drug contains lactose therefore it should not be applied to patients with rare hereditary intolerance of a galactose, deficiency of Lappa lactase or malabsorption of glucose galactose.

First signs of improvement of a state usually arise in 1 month after an initiation of treatment.

Use during pregnancy or feeding by a breast. Due to the lack of clinical data medicament is not recommended to be used during pregnancy and feeding by a breast.

Ability to influence speed of response at control of vehicles or other mechanisms. Researches on assessment of the impact on speed of response at control of vehicles or other mechanisms were not conducted. However dizziness can worsen ability to run vehicles or other mechanisms.

Interaction

At simultaneous use of medicaments of a ginkgo with medicines which inhibit blood coagulation (anticoagulants of a coumarinic row (fenprokumon and warfarin), acetylsalicylic acid) the effect of the last can amplify — risk of developing bleeding increases. the medicament should not be taken at prolonged use of thiazide diuretics.

(in rare instances there is a possibility of inhibition or induction of some isoenzymes). Drugs of a ginkgo accelerate metabolism of the antiepileptic medicaments (Valproatum, Phenytoinum) which are metabolized through the system of CYP enzymes 2C. At combined use with antiepileptic means the convulsive threshold can decrease that increases a possibility of an epileptic attack. Level of concentration of midazolam changed after the combined administration of medicament of a ginkgo that allows to assume existence of interaction through CYP 3A4. Therefore medicines which are generally metabolized through CYP 3A4 and have the narrow therapeutic index, it is necessary to apply with care.

Overdose

At overdose of medicine dispeptic disorders, disturbances of consciousness and a headache can arise. symptomatic treatment.

Storage conditions

In original packing at a temperature not above 25 °C.