Piracetam

Intravenous
Adjunct in cortical myoclonus

Intravenous
Cognitive enhancer in cerebrocortical insufficiency

Oral
Adjunct in cortical myoclonus

Oral
Cognitive enhancer in cerebrocortical insufficiency

CrCl (mL/min)	Dosage
<20 mL/min	Contraindicated.
20-<30	1/6 of the usual dose once daily.
30-<50	1/3 of the usual dose in 2 divided doses.
50-80	2/3 of the usual dose in 2-3 divided doses.

May be taken with or without food. Take w/ a glass of water or soft drink to mask bitter taste.

Cerebral haemorrhage, Huntington’s chorea. ESRD (CrCl <20 mL/min). Pregnancy and lactation.

Patient w/ history of haemorrhagic CVA, risk of bleeding (e.g. GI ulcer), underlying haemostasis disorder, severe haemorrhage; to undergo major surgery including dental surgery. Mild to moderate renal impairment. Avoid abrupt withdrawal.

Nervous: Hyperkinesia, somnolence, nervousness, confusion, hallucinations, depression, asthenia, ataxia, vertigo, headache, insomnia, aggravated epilepsy, impaired balance.
GI: Abdominal pain, diarrhoea, nausea, vomiting.
Endocrine: Wt gain.
Haematologic: Haemorrhagic disorder.
Dermatologic: Angioneurotic oedema, dermatitis, pruritus, urticaria.

This drug may cause hyperkinesia, somnolence and nervousness, if affected, do not drive or operate machinery.

May cause confusion, irritability and sleep disorder w/ thyroid extract (T3 and T4). Increased pharmacological effect of anticoagulants, antiplatelet (e.g. acetylsalicylic acid).

Description: Piracetam is a GABA derivative classified as a nootropic agent. The exact mechanism of action is not yet fully elucidated however, it has neuronal and vascular properties. It exerts neuronal effect by protecting the cerebral cortex from various insults (e.g. hypoxia, intoxications). It also has vascular effects on platelets, RBC, and vessel walls by inhibiting platelet aggregation, improves erythrocyte deformability and reduces blood viscosity.
Pharmacokinetics:
Absorption: Rapidly and almost completely absorbed from the GI tract. Time to peak plasma concentration: W/in 1.5 hr.
Distribution: Crosses the blood brain barrier, placenta and enters breast milk. Volume of distribution: 0.7 L/kg.
Excretion: Mainly via urine (approx 90%, as unchanged drug). Plasma elimination half-life: 5 hr.

Source: National Center for Biotechnology Information. PubChem Database. Piracetam, CID=4843, https://pubchem.ncbi.nlm.nih.gov/compound/Piracetam (accessed on Jan. 22, 2020)

Store below 25°C.

Nootropics & Neurotonics/Neurotrophics

N06BX03 - piracetam ; Belongs to the class of other psychostimulants and nootropics.

Anon. Piracetam. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 21/11/2017.

Buckingham R (ed). Piracetam. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 21/11/2017.

Joint Formulary Committee. Piracetam. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 21/11/2017.

Piracetam. Gold Standard Drug Database in ClinicalKey [online]. Elsevier Inc. https://www.clinicalkey.com/. Accessed 24/11/2017.