Citicoline Sodium
Indications
Citicoline Sodium is indicated in-
- Cerebrovascular disease e.g. ischemia due to stroke, where Citicoline accelerates the recovery of consciousness & overcoming motor deficit. Treatment within the first 24 hours after onset in patients with moderate to severe stroke increases the probability of complete recovery in 3 months.
- Cerebral insufficiency (e.g. dizziness, memory loss, poor concentration & disorientation) due to head trauma or brain injury.
- Cognitive dysfunction due to degenerative disease (Alzheimer's disease)
- Parkinson's disease: Citicoline has been shown to be effective as co-therapy for Parkinson's disease.
Pharmacology
Citicoline is a naturally occurring substance that is an essential intermediate in the synthesis of structural phospholipids of cell membrane. Oral dose of Citicoline is metabolized to choline & cytidine. These then enter into the systemic circulation, cross the blood-brain barrier and recombine to form Citicoline within the central nervous system. Citicoline activates the biosynthesis of structural phospholipids in the neuronal membrane, promotes rapid repair of injured cell surface & mitochondrial membrane & increases the level of various neurotransmitters like acetylcholine & dopamine. Citicoline has neuroprotective effects in situations of hypoxia & ischemia, as well as improved learning & memory performance in animal models for the aging brain. Citicoline inhibits the activation of Phospholipase A2 to prevent apoptotic & necrotic cell death.
Dosage & Administration
Oral:
- Immediate treatment of stroke due to a clot (ischemic stroke): 500-2000 mg of Citicoline per day, start within 24 hours of stroke.
- For decline in thinking skills due to stroke: 1000-2000 mg of Citicoline per day.
- Chronic cerebrovascular disease: 1000 mg daily in divided dose with or between meals for ongoing disease of the blood vessels that serve the brain.
- 1 to 2 injections daily.
- Adjust dosage according to the severity.
- Can be administered through intramuscular (IM), or intravenous (IV) [ 3 to 5 minutes] route.
Interaction
Citicoline may enhance the effects of levodopa, carbidopa & entacapone. Citicoline must not be administered with products containing meclophenoxate.
Contraindications
Must not be administered to patients with hypertonia of the parasympathetic nervous system.
Side Effects
Occasionally Citicoline may exert stimulating action of the parasympathetic system as well as a fleeting & discrete hypotensive effect.
Pregnancy & Lactation
There are no adequate & well controlled studies of Citicoline during pregnancy & lactation. Citicoline should be used during pregnancy & lactation only if the potential benefits justify the potential risks.
Precautions & Warnings
Citicoline is known to cause increased dizziness or drowsiness. So, it is strongly recommended that patients do not operate any type of machinery throughout the course of treatment. Citicoline may cause hypotension and in case necessary the hypotensive effect can be treated with corticosteroids or sympathomimetic. In case of persistent intracranial hemorrhage, the very slow administration [30 drops/minutes] is recommended; the administration of larger doses could provoke an increase of the cerebral blood flow. The patient should not consume alcohol while taking Citicoline.
Therapeutic Class
CNS stimulant drugs
Storage Conditions
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
