Nootropil, containing the active substance piracetam, is a clinically established nootropic agent designed to support and enhance cognitive function. It is primarily indicated for the management of cortical myoclonus but is also widely utilized off-label to improve memory, learning, and focus in various patient populations. Its mechanism of action, though not fully elucidated, is believed to involve modulation of neurotransmitter systems and improvement of neuronal membrane fluidity. This product card provides a comprehensive, expert-level overview for healthcare professionals considering its application.

Features

• Active ingredient: Piracetam 800mg or 1200mg per tablet
• Pharmaceutical form: Film-coated tablets
• Mechanism: Positively influences cognitive functions via neuromodulatory and neuroprotective actions
• High bioavailability following oral administration
• Extensive volume of distribution, crossing the blood-brain barrier
• Primarily excreted unchanged by the kidneys

Benefits

• Supports improvement of memory and learning capacity in cognitive impairment
• May aid in the recovery of cognitive function post cerebral ischemia
• Can reduce the severity and frequency of cortical myoclonus episodes
• Assists in enhancing focus and mental clarity in age-related cognitive decline
• Potentially beneficial in supporting dyslexia and sickle cell anemia management in combination therapies
• Contributes to neuronal protection under hypoxic conditions

Common use

Nootropil is officially approved for the treatment of cortical myoclonus, either as monotherapy or as an adjunctive therapy. Off-label, it is frequently employed in cases of cognitive decline associated with aging, post-stroke recovery, dyslexia, and vertigo of central origin. Its application is also noted in supportive therapy for sickle cell anemia due to its effects on red blood cell deformability. Use should always be guided by a healthcare provider based on individual patient assessment.

Dosage and direction

For cortical myoclonus, initial dosage is typically 7.2 g daily, divided into 2-3 doses, which may be increased by 4.8 g every 3-4 days up to a maximum of 24 g daily, based on response and tolerance. Maintenance doses are generally between 4.8–9.6 g/day. For other cognitive indications, dosing often ranges from 2.4–4.8 g/day in divided doses. Tablets should be taken with liquid, with or without food, though administration with meals may reduce gastrointestinal discomfort. Dosage adjustment is necessary in renal impairment.

Precautions

Use with caution in patients with a history of hemorrhagic diathesis or those undergoing surgery, due to potential effects on hemostasis. Renal function should be assessed before and during treatment, especially in the elderly. Discontinuation should be gradual to avoid withdrawal symptoms in myoclonus patients. Not recommended during pregnancy or lactation unless potential benefit justifies potential risk. Monitor for psychological effects such as nervousness or agitation.

Contraindications

Hypersensitivity to piracetam or any excipients in the formulation. Severe renal impairment (creatinine clearance <20 mL/min). Huntington’s chorea, due to potential exacerbation of symptoms. Hemorrhagic stroke or patients with active bleeding disorders. Not intended for use in children under 3 years of age.

Possible side effect

Common adverse reactions include nervousness, weight gain, somnolence, depression, and asthenia. Gastrointestinal effects such as nausea, vomiting, diarrhea, and abdominal pain may occur. Less frequently, hyperkinesia, dizziness, and insomnia have been reported. In rare instances, severe effects like anaphylactoid reactions, angioedema, or confusion may present. Patients should report any persistent or severe symptoms.

Drug interaction

May potentiate the effects of anticoagulants and antiplatelet drugs, increasing bleeding risk. Can interact with thyroid hormones, requiring monitoring of thyroid function. Concurrent use with other CNS acting drugs, including antipsychotics and antidepressants, may lead to additive sedative or stimulatory effects. No significant interactions with cytochrome P450 enzymes are known.

Missed dose

If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. In that case, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one. Consistent dosing is important for maintaining stable plasma levels, particularly in myoclonus management.

Overdose

Symptoms of overdose may include diarrhea, abdominal pain, and pronounced neurological effects such as lethargy or agitation. Management is supportive; there is no specific antidote. Gastric lavage may be considered if ingestion was recent. Hemodialysis can be effective due to piracetam’s low molecular weight and minimal protein binding. Monitor vital signs and provide symptomatic treatment.

Storage

Store at room temperature (15-30°C), in a dry place, protected from light. Keep the container tightly closed. Do not freeze. Keep out of reach of children and pets. Do not use after the expiration date printed on the packaging.

Disclaimer

This information is intended for healthcare professionals and should not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for personalized recommendations. Dosage and indications may vary based on regional licensing; refer to local prescribing information.

Reviews

Clinical studies and meta-analyses generally support the efficacy of piracetam in specific cognitive disorders and cortical myoclonus, though evidence for off-label uses is mixed. Many experts note its favorable safety profile and utility as an adjunct therapy. Patient reports often highlight subjective improvements in memory and concentration, though individual responses vary. Long-term data remains limited, and more rigorous trials are needed for broader cognitive claims.