A fixed-dose combination (FDC) of two nootropic agents, Citicoline and Piracetam, used primarily for the management of cognitive deficits, post-stroke recovery, and other neurological conditions. Citicoline is a nucleotide essential for the synthesis of phosphatidylcholine, a key component of neuronal membranes, and also serves as a source of choline for acetylcholine synthesis. Piracetam is a cyclic derivative of GABA (gamma-aminobutyric acid) that modulates neurotransmission, enhances neuronal membrane fluidity, and improves cerebral microcirculation. This combination is postulated to have a synergistic effect on cognitive recovery and neuroprotection.
Adult: 5ml (1 teaspoon) twice or thrice daily, providing 1000-1500mg Citicoline and 800-1200mg Piracetam per day. For post-stroke recovery, higher doses (e.g., 5ml thrice daily) are often initiated.
Note: Oral administration. The 5ml syrup should be measured using the provided measuring cup or spoon. Can be taken with or without food. If gastrointestinal upset occurs, administer with meals.
The combination works via complementary mechanisms to support brain metabolism, membrane integrity, and neurotransmission. Citicoline provides the rate-limiting substrates (cytidine and choline) for the synthesis of phosphatidylcholine, a critical phospholipid for neuronal membrane repair and integrity. It also increases acetylcholine synthesis, reduces free fatty acid accumulation, and restores Na+/K+ ATPase activity post-ischemia. Piracetam modulates neuronal and vascular functions by increasing membrane fluidity, facilitating interhemispheric communication via the corpus callosum, and potentially enhancing neuroplasticity. It may also have mild antiplatelet and rheological effects, improving cerebral microcirculation.
Pregnancy: Category B (US FDA classification not officially assigned, but considered). Animal studies show no risk, but human data is limited. Use only if clearly needed and potential benefit justifies potential risk to the fetus.
Driving: May cause dizziness, drowsiness, or blurred vision. Patients should not drive or operate machinery until their individual response is known.
| Anticoagulants (Warfarin, NOACs) & Antiplatelets (Clopidogrel, Aspirin) | Piracetam may have mild antiplatelet effects; potential increased risk of bleeding. Monitor for bruising, bleeding time. | Moderate |
| Antihypertensives | Additive hypotensive effect possible. Monitor blood pressure. | Moderate |
| Levodopa | Piracetam may potentiate the effects of levodopa in Parkinson's disease, potentially increasing dyskinesias. | Moderate |
| Thyroid hormones | Piracetam may increase serum T4 levels. Monitor thyroid function. | Minor |
| Central Nervous System Depressants (Alcohol, Benzodiazepines) | May potentiate sedative effects. Impaired alertness. | Moderate |
Same composition (Citicoline (500mg/5ml) + Piracetam (400mg/5ml)), different brands: