Sermion tablets 10 mg. Medicine for the treatment of vascular disorders Sermion: indications, instructions, reviews

General characteristics. Compound:

Active ingredient: 5 mg, 10 mg or 30 mg of nicergoline in each tablet.

Excipients: calcium hydrogen phosphate dihydrate, microcrystalline cellulose, magnesium stearate, sodium carboxymethylcellulose.

Sugar coating (5 mg tablets): sucrose, talc, acacia resin, sandarac resin, magnesium carbonate, titanium dioxide (E171), rosin, carnauba wax, sunset yellow (E110).

Sugar coating (10 mg tablets): sucrose, talc, acacia resin, sandarac resin, magnesium carbonate, titanium dioxide (E171), rosin, carnauba wax.

Film coating (30 mg tablets): hypromellose, titanium dioxide (E171), polyethylene glycol 6000, yellow iron oxide (E172), silicone.

Pharmacological properties:

Pharmacodynamics. Nicergoline is a derivative of ergoline, improves metabolic and hemodynamic processes in the brain, reduces platelet aggregation and improves hemorheological blood parameters, increases the speed of blood flow in the upper and lower limbs. Nicergoline exhibits an α1-adrenergic blocking effect, leading to improved blood flow and has a direct effect on the cerebral neurotransmitter systems - noradrenergic, dopaminergic and acetylcholinergic. With the use of the drug, the activity of the noradrenergic, dopaminergic and acetylcholinergic cerebral systems increases, which helps to optimize cognitive processes. As a result long-term therapy nicergoline observed a persistent improvement in cognitive function and a decrease in the severity of behavioral disorders associated with dementia.

Pharmacokinetics. After oral administration, nicergoline is quickly and almost completely absorbed. The main metabolic products of nicergoline are 1,6-dimethyl-8β-hydroxymethyl-10α-methoxyergoline (MMDL, a hydrolysis product) and 6-methyl-8β-hydroxymethyl-10α-methoxyergoline (MDL, a demethylation product by the CYP2D6 isoenzyme). The ratio of the area under the concentration-time curve (AUC) for MMDL and MDL when administered orally to nicergoline indicates a pronounced first-pass metabolism through the liver. After oral administration of 30 mg of nicergoline, maximum concentrations of MMDL (21 ± 14 ng/ml) and MDL (41 ± 14 ng/ml) were achieved after approximately 1 and 4 hours, respectively, then the concentration of MDL decreased with a half-life of 13-20 hours. Studies confirm no accumulation of other metabolites (including MMDL) in the blood. Eating or dosage form do not have a significant effect on the degree and rate of absorption of nicergoline.

Nicergoline actively (> 90%) binds to plasma proteins, and the degree of its affinity for α1-acid glycoprotein is greater than for serum albumin. It has been shown that nicergoline and its metabolites can be distributed in blood cells. The pharmacokinetics of nicergoline when using doses up to 60 mg is linear and does not change depending on the age of the patient.

Nicergoline is excreted in the form of metabolites, mainly by the kidneys (approximately 80% of the total dose), and in small quantities (10-20%) through the intestines. In patients with severe renal failure There was a significant decrease in the degree of excretion of metabolic products in the urine compared to patients with normal function kidney

Indications for use:

Acute and chronic cerebral metabolic and vascular disorders (due to, or cerebral vessels, including transient cerebral attack, vascular and caused by vasospasm);

Acute and chronic peripheral metabolic and vascular disorders (organic and functional limbs, Raynaud's disease, syndromes caused by impaired peripheral blood flow).

Important! Get to know the treatment

Directions for use and dosage:

Nicergoline is administered orally at a dose of 5-10 mg 3 times a day, at regular intervals, for a long time, at a dose of 30 mg 2 times a day.

For chronic cerebrovascular accidents, vascular cognitive impairment, and post-stroke conditions, nicergoline is prescribed orally at a dose of 10 mg 3 times a day. The therapeutic effectiveness of the drug develops gradually and the course of treatment should be at least 3 months.

For vascular dementia, oral use of tablets at a dosage of 30 mg 2 times a day is indicated (it is recommended to consult a doctor every 6 months about the advisability of continuing therapy).

At acute disorders cerebral circulation, ischemic stroke due to atherosclerosis, thrombosis and embolism cerebral vessels, transient disorders cerebral circulation (transient ischemic attacks, hypertensive cerebral crises), it is preferable to begin the course of treatment with parenteral administration drug, then continue taking the drug orally.

In case of violations peripheral circulation nicergoline is prescribed orally 10 mg 3 times a day for long period time (up to several months).

In patients with impaired renal function (serum creatinine ≥ 2 mg/dl), Sermion® is recommended to be used at lower levels. therapeutic doses.

Features of application:

In therapeutic doses, Sermion®, as a rule, does not affect blood pressure, but in patients with arterial hypertension it can cause it gradual decline. The drug acts gradually, so it should be taken for a long time, and the doctor should periodically (at least every 6 months) evaluate the effect of treatment and the advisability of continuing it.

Effect on the ability to drive a car and other mechanisms Despite the fact that Sermion® improves reaction and concentration, its effect on the ability to drive and use complex technology has not been specifically studied. In any case, caution should be exercised given the nature of the underlying disease.

Pregnancy and period breastfeeding. Due to the lack special research Sermion® is contraindicated during pregnancy. While taking the drug, you must stop breastfeeding, since nicergoline and its metabolic products pass into mother's milk.

Side effects:

Marked decrease blood pressure(BP), mainly after parenteral administration, dyspeptic symptoms, a feeling of discomfort in the abdomen, skin rashes, feeling hot, drowsiness or insomnia.

Possible increase in concentration uric acid in the blood, and this effect does not depend on the dose and duration of therapy.

Interaction with other drugs:

Sermion® may enhance the effect antihypertensive drugs. Sermion® is metabolized by the CYP2D6 isoenzyme, so the possibility of its interaction with drugs that are metabolized with the participation of the same enzyme cannot be excluded.

When using nicergoline with acetylsalicylic acid, possible increase in bleeding time.

Contraindications:

Recent myocardial infarction, acute bleeding, severe bradycardia, impaired orthostatic regulation, increased sensitivity to nicergoline, other ergotamine derivatives or other components of the drug, sucrase/isomaltase deficiency, glucose-galactose malabsorption, age under 18 years, pregnancy, breastfeeding.

Carefully. or a history of and/or in combination with drugs that interfere with the metabolism or excretion of uric acid.

Overdose:

Symptoms: transient pronounced decrease in blood pressure. Special treatment is usually not required; the patient just needs to take a horizontal position for a few minutes. In exceptional cases when sharp violation blood supply to the brain and heart, it is recommended to administer sympathomimetic drugs under constant blood pressure monitoring.

Storage conditions:

At a temperature not higher than 25 °C. Keep out of the reach of children. Shelf life - 3 years. Do not use after the expiration date stated on the packaging.

Vacation conditions:

On prescription

Package:

5 mg film-coated tablets: 15 tablets per blister (PVC/PVDC-aluminum foil/PVDC). 2 blisters along with instructions for use are placed in a cardboard box.

10 mg film-coated tablets: 25 tablets per blister (PVC/PVDC-aluminum foil/PVDC). 2 blisters along with instructions for use are placed in a cardboard box.

Film-coated tablets 30 mg. 15 tablets per blister (PVC/PVDC-aluminum foil/PVDC). 2 blisters along with instructions for use are placed in a cardboard box.

A drug that improves cerebral and peripheral blood circulation, an alpha-blocker.

Nicergoline, a derivative of ergoline, improves metabolic and hemodynamic processes in the brain. Reduces platelet aggregation and improves rheological properties blood, increases the speed of blood flow in the upper and lower extremities. It has an alpha 1-adrenergic blocking effect, which improves blood flow. It has a direct effect on the cerebral neurotransmitter systems (noradrenergic, dopaminergic and acetylcholinergic), increasing their activity, which helps optimize cognitive processes.

As a result of long-term therapy with nicergoline, a persistent improvement in cognitive function and a decrease in the severity of behavioral disorders associated with dementia were observed.

Pharmacokinetics

Suction

After oral administration, nicergoline is quickly and almost completely absorbed.

Food intake or dosage form do not have a significant effect on the degree and rate of absorption of nicergoline. The pharmacokinetics of nicergoline when used in doses up to 60 mg is linear and does not change depending on the age of the patient.

Distribution and metabolism

Nicergoline actively (>90%) binds to plasma proteins, and the degree of its affinity for the α-acid of the glycoprotein is greater than for serum albumin. It has been shown that nicergoline and its metabolites can be distributed in blood cells.

The main metabolic products of nicergoline are 1,6-dimethyl-8β-hydroxymethyl-10α-methoxyergoline (MMDL, a hydrolysis product) and 6-methyl-8β-hydroxymethyl-10α-methoxyergoline (MDL, a demethylation product by the CYP2D6 isoenzyme).

The ratio of AUC values for MMDL and MDL after oral administration of nicergoline indicates a pronounced first-pass metabolism through the liver. After taking 30 mg of nicergoline orally, C max MMDL (21 ± 14 ng/ml) and MDL (41 ± 14 ng/ml) were achieved after approximately 1 and 4 hours, respectively, then the concentration of MDL decreased from T 1/2 13-20 hours Studies confirm the absence of accumulation of other metabolites (including MMDL) in the blood.

Removal

Nicergoline is excreted in the form of metabolites, mainly in the urine (approximately 80% of the total dose), and in small amounts (10-20%) in feces.

Pharmacokinetics in special clinical cases

In patients with severe renal failure, there was a significant decrease in the rate of excretion of metabolic products in the urine compared with patients with normal renal function.

Release form

Film-coated tablets white, round, convex.

Excipients: calcium hydrogen phosphate dihydrate - 94.3 mg, microcrystalline cellulose - 22.4 mg, magnesium stearate - 2 mg, sodium carboxymethylcellulose - 1.3 mg.

Sugar shell composition: sucrose - 33.4 mg, talc - 10.9 mg, acacia gum - 2.7 mg, sandarac gum - 1 mg, magnesium carbonate - 0.7 mg, titanium dioxide (E171) - 0.7 mg, rosin - 0.6 mg, carnauba wax - 0.06 mg.

25 pcs. - blisters (2) - cardboard packs.

Dosage

The drug is prescribed orally at 5-10 mg 3 times a day or 30 mg 2 times a day, at regular intervals, for a long time.

For chronic cerebrovascular accidents, vascular cognitive impairment, post-stroke conditions, Sermion ® is prescribed 10 mg 3 times a day. Therapeutic effect The drug develops gradually, and the course of treatment should be at least 3 months.

For vascular dementia, 30 mg 2 times a day is prescribed. In this case, the patient is recommended to consult with a doctor every 6 months about the advisability of continuing therapy.

In acute cerebrovascular accidents, ischemic stroke due to atherosclerosis, thrombosis and embolism of cerebral vessels, transient ischemic attacks (transient ischemic attacks, hypertensive cerebral crises), it is preferable to begin the course of treatment with parenteral administration of nicergoline, then continue taking the drug orally.

For peripheral circulatory disorders, Sermion ® is prescribed 10 mg 3 times a day for a long time (up to several months).

Overdose

Symptoms: transient pronounced decrease in blood pressure.

Treatment: special treatment usually not required; the patient only needs to take a horizontal position for a few minutes. In exceptional cases, in case of a sharp disruption of the blood supply to the brain and heart, it is recommended to administer sympathomimetic drugs under constant blood pressure monitoring.

Interaction

At simultaneous use Sermion ® may enhance the effect of antihypertensive drugs.

Nicergoline is metabolized by the CYP2D6 isoenzyme, so the possibility of interaction of Sermion with drugs that are metabolized with the participation of the same enzyme cannot be excluded.

With the simultaneous use of nicergoline with acetylsalicylic acid, an increase in bleeding time is possible.

Side effects

From the outside of cardio-vascular system: marked decrease in blood pressure (mainly after parenteral administration), dizziness, feeling of heat.

From the nervous system: confusion, headache, drowsiness or insomnia.

From the outside digestive system: dyspeptic symptoms, abdominal discomfort, diarrhea, constipation, nausea.

From the metabolic side: it is possible to increase the concentration of uric acid in the blood, and this effect does not depend on the dose and duration of therapy.

Other: skin rashes.

Indications

acute and chronic cerebral metabolic and vascular disorders (due to atherosclerosis, arterial hypertension, thrombosis or embolism of cerebral vessels, incl. acute transient disorder cerebral circulation, vascular dementia (30 mg tablets should be used) and headache caused by vasospasm);
acute and chronic peripheral metabolic and vascular disorders (organic and functional arteriopathy of the extremities, Raynaud's disease, syndromes caused by impaired peripheral blood flow).

Contraindications

recently transferred acute heart attack myocardium;
acute bleeding;
severe bradycardia;
violation of orthostatic regulation;
sucrase/isomaltase deficiency, fructose intolerance, glucose-galactose malabsorption;
children and adolescents up to 18 years of age;
pregnancy;
lactation period (breastfeeding);
hypersensitivity to nicergoline, other ergotamine derivatives, auxiliary components drug.

Use with caution if you have a history of hyperuricemia or gout and/or in combination with drugs that interfere with the metabolism and/or excretion of uric acid.

Features of application

Use during pregnancy and breastfeeding

Due to the lack of special studies, the use of the drug during pregnancy is contraindicated.

While taking the drug, you must stop breastfeeding, because nicergoline and its metabolic products are excreted in breast milk.

Use for renal impairment

In patients with impaired renal function (serum creatinine ≥2 mg/dL), Sermion ® is recommended to be used in lower therapeutic doses.

Use in children

The use of the drug in children and children is contraindicated. adolescence up to 18 years old.

special instructions

In therapeutic doses, Sermion ®, as a rule, does not affect blood pressure, but in patients with arterial hypertension it can cause a gradual decrease in blood pressure.

The drug acts gradually, so it should be taken for a long time, and the doctor should periodically (at least every 6 months) evaluate the effect of treatment and the advisability of continuing it.

Impact on the ability to drive vehicles and operate machinery

Despite the fact that Sermion ® helps improve concentration, the effect of the drug on the ability to drive vehicles and operate machinery has not been specifically studied. Given the nature of the underlying disease, patients should exercise caution when potentially dangerous species activities.

For the treatment of diseases associated with circulatory disorders in blood vessels, medicines different groups. The list of most frequently prescribed drugs includes Sermion. Therefore, it is worth taking a closer look at when it is used and how it works, as well as how effective it is.

Sermion is a drug that is part of the group of peripheral vasodilators. Has an antispasmodic, adrenergic blocking effect. International generic name, similar to the active component - Nicergoline.

Principle of action and pharmacokinetics

Application of Sermion in the treatment of neurological and cardiovascular diseases explained by its properties active substance. Once in the body, it acts in several directions at once:

Therapy with the drug leads to an increase in the activity of the adrenergic, cholinergic and dopaminergic cerebral systems. Thanks to this, cognitive functions improve and the severity of behavioral disorders characteristic of dementia decreases.

The drug is quickly and almost completely absorbed into the body. Eating or the form of release of Sermion, the age of the patient does not affect the rate of absorption of nicergoline. Maximum dosage nicergoline in the blood is achieved 2-3 hours after application. The maximum concentration of active metabolites is after 1.5-4 hours.

Metabolic products of the drug are removed from the body naturally- along with urine and through the intestines. Its half-life is from 13 to 20 hours, but in patients with severe renal failure this figure is much longer.

Release form, composition

Sermion is produced in the form of tablets and lyophilisate for injection. Each tablet contains 5, 10 or 30 mg of the active substance – nicergoline. Their other components:

magnesium stearate;
calcium hydrogen phosphate dihydrate;
sodium carboxymethylcellulose.

It consists of:

titanium dioxide;
magnesium carbonate;
acacia, sandarac resins;
talc;
sucrose;
rosin;
carnauba wax.

Tablets containing 30 mg of nicergoline are coated film-coated. Its components:

silicone;
iron oxide yellow;
titanium dioxide;
hypromellose;
polyethylene glycol 6000.

The amount of active substance in the lyophilisate for injection is 4 mg. It also contains: tartaric acid, lactose monohydrate. The lyophilisate is dispensed from pharmacies along with a solvent. It is placed in 1 ml ampoules and consists of the following components: sodium chloride and benzalkonium chloride, water.

The choice of the dosage form of Sermion and the method of its use is made by the doctor depending on the diagnosis, age and general well-being sick.

Price

Sermion is available from pharmacies only with a doctor's prescription. The price may vary depending on the form of its release and the region of sale. Approximate prices presented in the table (Table 1).

Table 1 - Cost

Location of pharmacies where Sermion is available		Average cost of the drug, rub.
					Lyophilisate for solution preparation
		5 mg	10 mg	30 mg	Lyophilisate for solution preparation
Russia	Ufa	506	604	933	1732
	Moscow	495	578	906	1648
	Saint Petersburg	482	574	906	1691
	Krasnoyarsk	489	605	938	1771
	Novosibirsk	528	626	955	1760
	Krasnodar	506	606	940	1758
	Crimea	506	606	940	1758
	Permian	534	632	961	1764
	Kazan	517	603	942	1710
Belarus	Vitebsk region	9,32-12,90	19,11-25,49	17,22-22,83	Absent
	Minsk	5,00-12,91	18,80-25,49	17,18-22,84
	Brest region	9,74-12,90	19,11-25,52	18,02-22,83
	Gomel region	9,60-12,93	19,43-25,48	17,53-22,83
	Grodno and region	9,76-12,90	19,11-25,48	18,88-22,83
	Mogilev	5,00-12,90	19,17-25,49	17,69-22,83

The price for tablets in Russian pharmacies is the lowest in St. Petersburg, the highest in Perm. Cost of lyophilisate for preparation injection solution the lowest in Moscow.

Price for tablet drug in different regions Belarus is approximately at the same level. It is impossible to buy Sermion lyophilisate in pharmacies, but you can purchase its analogue in the same dosage form. Its cost is from 17 rubles.

Does this apply to hormonal drugs?

Due to the fact that the drug in some cases is prescribed in combination with hormonal drugs, patients often wonder whether Sermion is a drug that can affect the level of hormones in the body.

The answer is simple - Sermion is an alpha-blocker and has no effect on hormonal background patient.

Indications and contraindications

cerebral atherosclerosis;
senile disorders;
Alzheimer's disease;
vascular dementia;
dizziness;
consequences of stroke;
migraine;
hypertensive crisis;
arterial hypertension;
diabetic, dystrophic retinopathy;
Raynaud's disease;
hypertensive encephalopathy.

Like all medicines, Sermion has restrictions on its use. Drug therapy is not prescribed for:

acute bleeding;
orthostatic hypotension;
having an allergy to active substance, other components of the product;
bradycardia;
myocardial infarction (acute period);
angina pectoris.

Additional contraindications to taking Sermion tablets are:

minor age;
impaired absorption of glucose and galactose;
fructose intolerance;
lack of sucrase in the body.

The drug is prescribed with caution to patients with hyperuricemia, gout (history) and those taking medications that impair metabolism and the excretion of uric acid.

Sermion's active substance is capable of penetrating into breast milk. During the period of taking it, breastfeeding should be avoided. The effect of the drug on the fetus has not been studied enough. For this reason, the use of this product is not recommended for pregnant women.

Application diagram

The dosage, frequency and duration of use are determined by the doctor on an individual basis: the treatment regimen depends on the form of the drug, the nature of the vascular and neurological disorders.

Treatment with tablets

Patients with cognitive impairment vascular disorders, chronic disorders blood circulation in the brain, as well as those who have suffered a stroke, are prescribed Sermion tablets at a dosage of 10 mg. It is drunk three times a day for 3 months.

For patients with vascular dementia daily dose medications – 60 mg (2 tablets containing 30 mg of nicergoline). It is divided into 2 doses. The duration of therapy depends on the characteristics of the disease. Every six months the patient is recommended to consult with a specialist to determine the need for continued treatment.

For peripheral blood flow disorders, the optimal single dosage of Sermion is 10 mg (1 or 2 tablets). It is drunk three times a day for several months. Patients with kidney dysfunction take Sermion in a lower therapeutic dosage.

Features of the use of lyophilisate

Injection administration of Sermion is prescribed for ischemic stroke caused by thrombosis, atherosclerosis or embolism of cerebral vessels, as well as for acute or transient cerebrovascular accidents. This method of using the drug is recommended in the first days of treatment. To maintain the effect of therapy, they gradually switch to tablets.

The lyophilisate is injected into a muscle, vein or artery. The dosage is calculated as follows:

How to take: before meals or after?

According to the instructions, the speed and volume of suction active component nicergoline do not depend on the time of food intake. However, experts recommend taking the drug after meals, while drinking the drug big amount water. This will reduce the likelihood of irritation of the gastric mucosa and avoid the risk of developing side effects from the gastrointestinal tract.

Use in children

According to the instructions, Sermion is not prescribed until the age of 18. But since the drug significantly improves blood circulation in the brain, memory, thinking and concentration, and helps eliminate the problem of delayed speech development, some experts recommend its use for children.

The daily dosage when used in pediatrics is selected individually, based on the age of the child. But, as a rule, they are prescribed to take no more than 2.5-5 mg per day.

Possible side effects

In most cases, the drug does not cause negative reactions, but in some cases they are possible. Most severe consequences possible in case of overdose and sharing with alcohol.

Negative reactions and overdose

Sermion is usually well tolerated. IN in rare cases During therapy the following symptoms occur:

drowsiness;
decreased blood pressure;
insomnia;
dizziness;
skin rash;
dyspeptic symptoms;
increased levels of uric acid in the blood.

The likelihood of all these side effects increases if Sermion is used incorrectly - if the doctor’s recommendations are neglected.

The main symptom of overdose is pronounced transient arterial hypotension. As a rule, it does not require acceptance therapeutic measures: The blood pressure returns to normal after lying down for a few minutes.

Sometimes the application is too large doses Sermione can cause disruption of the blood supply to the heart and brain. In such situations, carry out symptomatic treatment, constantly monitoring blood pressure readings.

Effect of alcohol

Use alcoholic drinks during treatment with Sermion it is contraindicated: joint reception may cause the appearance severe violations in the functioning of the cardiovascular system. So, the following negative consequences may occur:

bradycardia;
tachycardia;
symptoms of acute heart failure;
orthostatic hypotension.

There are certain periods when drinking alcohol will be safe:

After 24-36 hours after a single dose.
14-20 hours before taking Sermion.
15 days after a long course of therapy.
During the entire course of treatment, taking the drug is prohibited.

Compatibility with Mexidol

The drugs belong to different pharmacological groups, namely Mexidol - to drugs that affect nervous system, and Sermion – to peripheral vasodilators. Sermion improves blood circulation and metabolism in the brain, reduces the risk of blood clots, Mexidol has an antihypoxic and anticonvulsant effect, normalizes intracranial pressure.

Both drugs have a positive effect on the restoration of peripheral and cerebral blood flow, and their joint use enhances the effect, therefore it is indicated in the case of the development of severe disorders of the central nervous system and brain structures. You can take Sermion tablets at the same time: there is no data on their incompatibility.

Analogs

If the use of Sermion is impossible, it is replaced structural analogues or drugs that have a similar principle of action.

Structural

The list of products with the same composition includes:

All these drugs have the same properties, indications, and application features as Sermion. They differ from each other only in the country of origin, trade name and price.

Drugs with similar effects

There are many drugs on the pharmacological market that have an effect similar to Sermion. You can replace it with the following drugs:

The decision to replace Sermion with structural analogues or drugs with a similar principle of action should be made by a doctor.

Efficiency

The positive effect of use is confirmed by reviews of neurologists and people who have taken this drug.

We have prepared a separate review article with, we recommend that you read it.

Experts' opinion

According to experts, Sermion is effective medicine. But it has disadvantages - side effects and high cost. Here are some reviews from doctors:

Gubarev I.A.: “Sermion is a good drug: it improves blood circulation in the body, especially in the vessels of the legs and brain. I prescribe it to patients who have symptoms of chronic cerebrovascular insufficiency and ischemia of the lower extremities. I always warn patients about possible side effects (they occur, but not often) and high cost this remedy."

FARMITALIA CARLO ERBA Jurgen Serr-Herb Service GmbH & Co.KG PFIZER PHARMACIA & UPJOHN PHARMACIA S.P.A TATA PHARMA Actavis Italy S.p.A. Pfizer Italy S.r.L. Pharmacia Italy S.p.A.

Country of origin

Italy

Product group

Cardiovascular drugs

A drug that improves cerebral circulation

Release forms

15 - blisters (2) - cardboard packs. 25 - blisters (2) - cardboard packs. Bottles (4) complete with solvent (amp. 4) - cardboard packs.

Description of the dosage form

Lyophilisate for the preparation of solution for injection Film-coated tablets

pharmachologic effect

Nicergoline is a derivative of ergoline, improves metabolic and hemodynamic processes in the brain, reduces platelet aggregation and improves hemorheological blood parameters, increases the speed of blood flow in the upper and lower extremities, and exhibits an alpha1-adrenergic blocking effect.

Pharmacokinetics

Absorption After oral administration, nicergoline is quickly and almost completely absorbed. Food intake or dosage form do not have a significant effect on the degree and rate of absorption of nicergoline. The pharmacokinetics of nicergoline when used in doses up to 60 mg is linear and does not change depending on the age of the patient. Distribution and metabolism Nicergoline actively (> 90%) binds to plasma proteins, and the degree of its affinity for the β-acid of the glycoprotein is greater than for serum albumin. It has been shown that nicergoline and its metabolites can be distributed in blood cells. The main metabolic products of nicergoline are 1,6-dimethyl-8beta-hydroxymethyl-10alpha-methoxyergoline (MMDL, a product of hydrolysis) and 6-methyl-8beta-hydroxymethyl-10alpha-methoxyergoline (MDL, a product of demethylation by the CYP2D6 isoenzyme). The ratio of AUC values for MMDL and MDL after oral and intravenous administration of nicergoline indicates a pronounced first-pass metabolism through the liver. After taking 30 mg of nicergoline orally, Cmax MMDL (21±14 ng/ml) and MDL (41±14 ng/ml) were achieved after approximately 1 and 4 hours, respectively, then the concentration of MDL decreased from T1/2 13-20 hours. Studies confirm no accumulation of other metabolites (including MMDL) in the blood. Excretion Nicergoline is excreted in the form of metabolites, mainly in the urine (approximately 80% of the total dose), and in small amounts (10-20%) in feces. Pharmacokinetics in special clinical situations: In patients with severe renal failure, a significant decrease in the rate of excretion of metabolic products in the urine was observed compared with patients with normal renal function.

Special conditions

In therapeutic doses, Sermion®, as a rule, does not affect blood pressure, but in patients with arterial hypertension it can cause a gradual decrease in blood pressure. After parenteral administration of Sermion®, patients are recommended to remain in horizontal position within a few minutes after injection, especially at the beginning of treatment, due to possible appearance hypotension. The drug acts gradually, so it should be taken for a long time, and the doctor should periodically (at least every 6 months) evaluate the effect of treatment and the advisability of continuing it. Influence on the ability to drive a car and other mechanisms. Although Sermion® improves reaction time and concentration, its effects on the ability to drive a car and use complex equipment have not been specifically studied. In any case, caution should be exercised given the nature of the underlying disease.

Compound

nicergoline 5 mg Excipients: calcium hydrogen phosphate dihydrate, microcrystalline cellulose, magnesium stearate, sodium carboxymethylcellulose. Shell composition: sucrose, talc, acacia resin, sandarac resin, magnesium carbonate, titanium dioxide (E171), rosin, carnauba wax, sunset yellow. nicergoline 10 mg Excipients: calcium hydrogen phosphate dihydrate, microcrystalline cellulose, magnesium stearate, sodium carboxymethylcellulose. Shell composition: sucrose, talc, acacia resin, sandarac resin, magnesium carbonate, titanium dioxide (E171), rosin, carnauba wax. nicergoline 30 mg Excipients: calcium hydrogen phosphate dihydrate, microcrystalline cellulose, magnesium stearate, sodium carboxymethylcellulose. Shell composition: hypromellose, titanium dioxide (E171), polyethylene glycol 6000, yellow iron oxide (E172), silicone. nicergoline 4 mg Excipients: lactose monohydrate, tartaric acid. Solvent: sodium chloride, benzalkonium chloride, water (up to 4 ml).

Sermion indications for use

- acute or chronic vascular or metabolic cerebral insufficiency (atherosclerosis, thrombosis or embolism of cerebral vessels, transient cerebral ischemic attacks); - acute or chronic peripheral vascular insufficiency (obliterating diseases vessels of the extremities, Raynaud's syndrome, other syndromes characterized by impaired peripheral circulation); - headache; - as additional means in the treatment of arterial hypertension and in the relief of hypertensive crises (parenteral administration).

My head became clearer

Grade: 5

I took 5 mg tablets 3 times a day, 1 tablet. This is the most basic dosage, but it helped me a lot. I felt the first clarity in my head within a week. I don’t know how to describe this state - it’s as if my vision has improved, but only this process has happened in my head. A month later it became much better. The headache has almost completely stopped. The condition itself became lighter and clearer. My mood was lifted, more of course from the feeling of freshness in my head. Reading books began to bring pleasure, and not as before, headache and heaviness after reading. And when I read them, I noticed that I don’t remember what they were about we're talking about. There was nothing left in my head.

Helped with migraines

Grade: 5

Migraines began to bother me very often. I went to the doctor and he prescribed Sermion. The cause was vascular disorders, and this antispasmodic helped me get rid of it. I took a tablet 2 times a day. After 2 weeks, improvements have already begun.

The result is not what we expected, but still good

Grade: 5

Sermion was prescribed to us by a neurologist after complaints that the child walked on tiptoes. We took half a tablet 2 times a day. The tablets are small and orange. Sometimes it was difficult to break them; they slipped out from under the knife. Well, I still managed to give the right dose.
Unusual color - orange. The child ate them with pleasure because they taste sweet. I chewed it myself and then washed it down with some water. The effect was obtained, but not the one we expected. After a course of these stimulant pills, my son began to speak. Even if not in sentences, he repeated many words after us. This is wonderful, after all, it’s almost 3 years old, and lexicon was pretty meager.
We had no side effects from the drug. Unfortunately, the tone in the leg muscles did not disappear, and the child did not stop walking on tiptoe. Now we are looking for another remedy, and Sermion did not help us in this regard, but in another way he helped us a lot. Tablets are affordable and available in pharmacies. Good drug, which has a positive effect on brain function. We won’t buy it again, it’s still tablets, not a dietary supplement (consultation is required). But we didn’t regret the course at all!

Helped a lot

Grade: 4

The drug was prescribed by a doctor after problems were discovered in terms of glucose consumption in the brain. Because of this, problems with memory, attention and headaches began to appear.
For the first 3 weeks, I was recommended to take the drug 5 mg 3 times a day. It’s good that in our city I was able to find tablets in the right dosage. Mostly everyone takes 30 mg, and 5 mg is not so easy to find.
There were no obvious results for a very long time, only by the second month I began to feel clarity in my memory, it became easier to perceive information, and absent-mindedness disappeared. True, my head still ached from time to time, but this was most likely due to something else.
From the third month of admission, the dose was increased to 30 mg twice a day. The body did not accept the sharp increase in dosage very well. He responded with dizziness and nausea, and lost his appetite. I suffered like this for a couple of days and went to the doctor, after an examination the dosage was reduced back to 15 mg per day. Let's see what will happen next. I feel improvements from the drug, I feel much more comfortable with mental stress at work.
The rating was reduced only for the occurrence of side effects when the dosage was increased. Everything else is good.

Improved health

Grade: 5

Survived a hypertensive crisis. Specialists like auxiliary treatment Sermion was prescribed. First I was given injections, and then I took Serimion orally. I need treatment for about six months, but I already feel better - headaches occur less frequently, and my performance has improved.

Helps in speech development

Grade: 5

At the age of one and a half years, my son was diagnosed with a delay in speech development. The neurologist prescribed Serimion. Within a month of taking it, his vocabulary began to expand faster. As the doctor said, progress occurred thanks to sermion, since it was this drug that was able to stimulate the speech centers.

Available

Grade: 5

I take Sermion to relieve headaches. The tablets are very cheap. Currently I take 1 tablet per day, the dosage is 10 mg, and there are 50 tablets in a package. It costs about 500 rubles and lasts for 2 months. This is very beneficial, considering that my condition is improving every time, and now I can sometimes skip a dose without particularly noticeable effects.
I started taking them about 4 months ago. The dosage was higher, I couldn’t miss a day. One day I forgot about taking it, the pain suddenly returned and I stupidly took 2 tablets. Apparently I had some kind of individual intolerance medication, because all this resulted in nausea and fever for the whole day. Fortunately, the next morning everything returned to normal, but still side effects were terrible.
Over time, I found the optimal dose, which could be reduced very slowly. Everything is much better now than it was at the beginning. So there is an effect, especially considering low cost medicines. However, you should still be very careful about overdosing, as the consequences can be serious.

Improves blood circulation

Grade: 5

Very useful drug not only for the brain, the active components improve the movement of blood in the vessels throughout the body. That is why the drug can be used as complex therapy to reduce blood pressure, I have to high blood pressure Headaches and nausea are also mixed in. In the evening, my eyes begin to hurt, and all because my blood pressure rises. There's no time for coffee here, not even strong tea. So I walk around like a sleepwalker. So Sermion is just what the doctor ordered.

The course is long, I took it for three months in a row. The first month, two tablets per day (30 mg), then switched to 1 tablet per day. I tried to take it in the morning so that I could sleep normally. The drug has a slightly stimulating effect, so there is a chance that you will suffer from insomnia all night. The drug is made in Italy, and if you consider that you need to take it for three whole months, then the course of treatment costs a pretty penny. Not long ago I found out that Sermion has a good Ukrainian equivalent, which is three times cheaper. I will consult a therapist to see if it can be replaced with a more cheap analogue. I looked at the dosages of the active component - everything is the same. I don’t really know how it will work, but I have a desire to try.

Fits well

The drug is good, if the doctor prescribed it, then you should take it! It definitely won't get any worse. And we also have improvements! The price is high and it is growing every year. It's only because of her that I give it a good rating rather than an excellent one.
I decided that I still needed to check, so I took a tablet once a day. The effect somehow immediately pleased me, it seemed like my head stopped hurting and flies no longer flew in my eyes as soon as I got nervous or physically tired. I was glad that I no longer had to give injections. But after two weeks, nausea and vomiting appeared, I somehow finished half the package and went to the doctor. Sent for tests and canceled the appointment. The nausea went away, but the headache began again. As a result, I returned to injections. Apparently the drug is not suitable for everyone, it did not suit me, but it’s still good that I was convinced of this at personal experience, otherwise I would have doubted everything. The drug is not bad, but the effect is short-lived and is spoiled by side effects.

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