Piracetam - intravenous


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : PO Adjunct in cortical myoclonus Initial: 7.2 g/day in 2-3 divided doses; may increase by 4.8 g every 3-4 days. Max: 24 g/day. As a cognitive enhancer in cerebrocortical insufficiency 2.4 g daily in 2-3 divided doses. For severe cases: Up to 4.8 g daily or higher. IV Adjunct in cortical myoclonus Initial: 7.2 g/day in 2-3 divided doses; may increase by 4.8 g every 3-4 days. Max: 24 g/day in 2-3 divided doses. As a cognitive enhancer in cerebrocortical insufficiency 2.4 g daily in 2-3 divided doses. For severe cases: Up to 4.8 g daily or higher.
Dosage Details
Intravenous
Adjunct in cortical myoclonus
Adult: Initially, 7.2 g daily in 2-3 divided doses; may increase by 4.8 g every 3-4 days. Max: 24 g daily.

Intravenous
Cognitive enhancer in cerebrocortical insufficiency
Adult: 2.4 g daily in 2-3 divided doses. For severe cases: Up to 4.8 g daily or higher.

Oral
Adjunct in cortical myoclonus
Adult: Initially, 7.2 g daily in 2-3 divided doses; may increase by 4.8 g every 3-4 days. Max: 24 g daily in 2-3 divided doses.

Oral
Cognitive enhancer in cerebrocortical insufficiency
Adult: 2.4 g daily in 2-3 divided doses. For severe cases: Up to 4.8 g daily or higher.
Renal Impairment
 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.
Administration
May be taken with or without food. Take w/ a glass of water or soft drink to mask bitter taste.
Contraindications
Cerebral haemorrhage, Huntington’s chorea. ESRD (CrCl <20 mL/min). Pregnancy and lactation.
Special Precautions
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.
Adverse Reactions
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.
Patient Counseling Information
This drug may cause hyperkinesia, somnolence and nervousness, if affected, do not drive or operate machinery.
Drug Interactions
May cause confusion, irritability and sleep disorder w/ thyroid extract (T3 and T4). Increased pharmacological effect of anticoagulants, antiplatelet (e.g. acetylsalicylic acid).
Action
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.
Chemical Structure

Chemical Structure Image
Piracetam

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

Storage
Store below 25°C.
ATC Classification
N06BX03 - piracetam ; Belongs to the class of other psychostimulants and nootropics.
References
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.

Disclaimer: This information is independently developed by MIMS based on Piracetam from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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