Effects on platelet aggregation: Due to the effect of piracetam (Nootropil) on platelet aggregation, caution is recommended in patients with severe haemorrhage, patients at risk of bleeding such as gastrointestinal ulcer, patients with underlying disorders of haemostasis, patients with history of haemorrhagic CVA, patients undergoing major surgery including dental surgery, and patients using anticoagulants or platelet antiaggregant drugs including low dose acetylsalicylic acid.
Renal insufficiency: Piracetam (Nootropil) is eliminated via the kidneys and care should thus be taken in cases of renal insufficiency (see Dosage & Administration).
Discontinuation: Abrupt discontinuation of treatment should be avoided as this may induce myoclonic or generalised seizures in some myoclonic patients.
Ability to perform tasks that require judgement, motor or cognitive skills: In view of the undesirable side effects, which were observed after the administration of the preparation, there is the possibility of
influence on the ability to drive and to operate machinery and this should be taken into consideration.
Use in Elderly: For long-term treatment in the elderly, regular evaluation of the creatinine clearance is required to allow dosage adaptation if needed (see Dosage & Administration).