Ethylmethylhydroxypyridine succinate (Mexicor) injections 50 mg/ml 5 ml – [5 ampoules]

Description

Mexicor Pharmacodynamics
Mexicor® has antioxidant, antihypoxic, membrane-protective, nootropic, stress-protective, anticonvulsant, anxiolytic action.
The drug increases resistance to the effects of major damaging factors, oxygen-dependent pathological states (shock, hypoxia and ischemia, impaired cerebral circulation, intoxication with alcohol and antipsychotic agents (neuroleptics)).
The mechanism of action of Mexicor® is caused by antihypoxant, antioxidant and membranoprotective action of ethylmethylhydroxypyridine succinate and succinic acid contained in it.
The drug improves functional state of ischemic myocardium in myocardial infarction, improves cardiac contractile function, and reduces manifestations of left ventricular systolic and diastolic dysfunction.
The drug normalizes metabolic processes in the ischemic myocardium, reduces the zone of necrosis, restores and/or improves myocardial electrical activity and contractility, as well as increases its collateral blood supply, activating energy-synthesizing processes in the ischemic zone and helps to maintain the integrity of cardiomyocytes and maintain their functional activity.
It increases antianginal activity of nitro preparations, improves rheological properties of blood, reduces consequences of reperfusion syndrome in acute coronary insufficiency.
The drug improves blood supply to the brain and cerebral metabolism, improves microcirculation and rheological properties of blood, prevents reduction in cerebral blood flow in the reperfusion period after ischemia. It has hypolipidemic effect, decreases total cholesterol and low-density lipoproteins. Mexicor® prevents postischemic decrease in glucose and oxygen utilization by the brain, prevents progressive accumulation of lactate.
The drug inhibits lipid peroxidation processes, increases superoxide dismutase activity, increases lipid-protein ratio, improves cell membrane structure and function. It modulates the activity of membrane-bound enzymes – calcium-independent phosphodiesterase, adenylate cyclase, acetylcholinesterase, receptor complexes (benzodiazepine, gamma-aminobutyrate, acetylcholine), which increases their ability to bind to ligands, helps maintain the structural and functional organization of biomembranes, transport neurotransmitters and improve synaptic transmission. Mexicor® increases dopamine content in the brain.
Mexicor® causes enhancement of compensatory activity of aerobic glycolysis and promotes reduction of inhibition of oxidative processes in Krebs cycle under hypoxia with increase of adenosine triphosphate (ATP), creatine phosphate and activation of energy synthesizing functions of mitochondria, stabilization of cell membranes.

Indications
The drug is used in the treatment of
– acute myocardial infarction (from the first day);
– Acute disorders of cerebral circulation;
– craniocerebral trauma, consequences of craniocerebral injuries;
– dyscirculatory encephalopathy;
– vegetative (neurocirculatory) dystonia syndrome;
– Mild cognitive disorders of atherosclerotic genesis;
– Anxiety disorders in neurotic and neurosis-like conditions;
– management of withdrawal syndrome in alcoholism with a predominance of neurosis-like and vegetovascular disorders;
– acute intoxication with antipsychotic agents.

Contraindications .
Hypersensitivity to the drug, liver and kidney function abnormalities, age under 18 years (effectiveness and safety have not been established), pregnancy, breast-feeding.

Dosage and administration method

• Intramuscularly (i.m.) or intravenously (i.v.) (vesicoureteral drip). When administering by infusion method the drug should be diluted in 0.9% sodium chloride solution.
• Mexicor® is administered by jetting slowly during 5-7 minutes, by drip – at a rate of 40-60 drops per minute. Maximum daily dose should not exceed 1200 mg.
• In acute myocardial infarction, Mexicor® is administered as part of complex therapy by IV or IM within 14 days against standard therapy of myocardial infarction, including nitrates, beta-adrenoblockers, angiotensin-converting enzyme (ACE) inhibitors, thrombolytics, anticoagulants and antiaggregants as well as symptomatic drugs by prescription. During the first 5 days, to achieve maximum effect, the drug should be administered intravenously, in the next 9 days Mexicor® may be administered intravenously.
• Intravenous drug administration is performed by drop infusion, slowly (in order to avoid side effects), with 0.9% sodium chloride solution or 5% dextrose (glucose) solution in 100-150 ml volume during 30-90 minutes. If necessary, slow trickle IV administration of the drug, lasting at least 5 minutes, is possible.
• The drug is administered (intravenously or intramuscularly) 3 times a day, every 8 hours.
• The daily therapeutic dose is 6-9 mg/kg of body weight per day, a single dose is 2-3 mg/kg of body weight. The maximum daily dose should not exceed 800 mg, a single dose – 250 mg.
• In acute stroke (ischemic stroke), Mexicor® is used as a complex therapy in the first 10-14 days by IV drip 200-500 mg 2-4 times daily, then by intravenous injection 200-250 mg 2-3 times daily during 2 weeks.
• Later, if necessary, it is possible to switch to oral administration of the drug (as recommended by the physician).
• In case of craniocerebral trauma and craniocerebral injuries sequelae
  Mexicor® is used during 10-15 days by injection and injection of 200-500 mg 2-4 times per day.
• In patients with discirculatory encephalopathy in decompensation phase, Mexicor® is administered by IV streams or dropwise in dose 200-500 mg 1-2 times daily during 14 days. Then, 100-250 mg/day v/m for the next two weeks.
• Later, if necessary, it is possible to switch to oral administration (by doctor’s recommendation).
• For course prophylaxis of discirculatory encephalopathy the drug is administered in a monthly dose of 200-250 mg 2 times a day during 10-14 days.
• In cases of neurocirculatory dystonia, neurotic and neurosis-like conditions the drug is administered in/m by 50-400 mg per day for 14 days.
• In mild cognitive disorders in elderly patients and in anxiety disorders, the drug is administered in/m in a dose of 100-300 mg per day for 14-30 days.
• In withdrawal alcohol syndrome Mexicanor® is administered intravenously or by IV drop infusion in a dose of 200-500 mg 2-3 times daily during 5-7 days.
• In acute intoxication with antipsychotic drugs, the drug is administered by IV in a dose of 200-500 mg per day for 7-14 days.