Piracetam Uses & Side-Effects

Piracetam Uses & Side-Effects

Piracetam Uses & Side-Effects

Piracetam is the original member of the racetam family of synthetic nootropics, or “cognitive-enhancing” compounds. Although much less potent than some other racetams, piracetam is widely used mainly to enhance cognitive function.

Unfortunately, there are only a few studies that have been done on its effects in healthy individuals, and its overall role in enhancing cognition is not completely certain.

Read on to learn more about this popular nootropic, its potential uses and mechanisms, and side-effects!

Disclaimer: This post is not a recommendation or endorsement for the use of piracetam.

The FDA has not approved this drug for any specific medical or other use, and the available research on it is still in a very early stage.

We have written this post for informational purposes only, and our goal is solely to inform people about what science currently says about piracetam’s potential effects, mechanisms, and side-effects.

What is Piracetam?

Piracetam is the “original” racetam, and is believed to be much less potent than other compounds in the “racetam” family.

The racetam family of synthetic compounds are characterized by their chemical structures, which contain a pyrrolidone lactam ring. Piracetam and other racetams – such as oxiracetam and aniracetam – are considered cognitive enhancers or nootropics, while others – levetiracetam – are used to as anticonvulsants to treat some forms of epilepsy.

Unfortunately, despite its popularity among the “nootropics” community, there appears to be little well-controlled, clinical research on the effects of piracetam in young, healthy human users.

However, there is a decent amount of research on the use of piracetam in elderly populations with dementia, as well as in schizophrenics, and those suffering from neurodegenerative disorders caused by head trauma, stroke, and alcoholism.

Mechanism of Action

How piracetam exactly works is not fully understood. However, according to some preliminary research, it has been proposed to have several actions in the brain, such as [1]:

  • Increasing the number of acetylcholine (ACh) receptors in the brain
  • Enhancing energy metabolism (such as increased oxygen utilization, mitochondrial permeability, and cytochrome B5 synthesis)
  • GABA- characteristics
  • Antioxidant properties

According to reports from many of its users, racetams are often supplemented alongside choline donors (such as alpha-GPC and citicoline), as their mechanism is thought to deplete choline stores in the brain [2].

For example, administration of piracetam has been reported to cause a decrease in acetylcholine levels in the hippocampus of animals. Piracetam and choline taken together have also been reported to increase memory and cognition in animals [3, 4, 5].

Additionally, injections of piracetam increase high-affinity choline uptake (“HACU”) in the rat hippocampus [6].

However, corresponding studies of these potential mechanisms and effects in humans are relatively lacking – so it’s wise not to read too much into findings from animals only.

The Most Widely-Cited Study On Healthy Users of Piracetam

In one of the most widely-discussed studies on Piracetam, 16 healthy university students were given 1,600 mg 3 times a day (double-blind randomized controlled trial). 8 people were given piracetam and 8 people were given the placebo. This study concluded that no effects were observed after 7 days, but after 14 days verbal learning had significantly increased [7].

However, there are some significant limitations and flaws with this study:

  1. This was a very small trial, with a tiny sample size (only 8 people per study group – i.e. many times smaller than the sample size that would be needed to fully establish a beneficial cognitive effect in the general population)
  2. There was no significant effect during the first week, and the study’s authors continued the study just until the effect became significant in the second week – and then stopped it.
  3. The core finding – enhanced cognitive performance – hasn’t been replicated since.
  4. This isn’t a long-term trial: this raises questions both about the long-term stability of any purported beneficial effects, as well as its safety when used for extended periods of time.

Of course, this study can’t be used to claim that piracetam doesn’t have potentially-noticeable effects on cognitive performance – but nor does it show conclusively that it does have these effects.

For these reasons, you should remain skeptical when encountering claims about piracetam online, as many people unfortunately cite relatively low-quality studies this one when making significant claims about its supposed nootropic benefits. The reality is that many additional (and better-designed) studies will be needed to fully back up many of the claims that are made about piracetam online.

POSSIBLY EFFECTIVE:

In addition to some of the preliminary – and rather inconclusive – findings regarding its “nootropic” effects, piracetam has also been studied for its potential uses in other health-related conditions.

However, much of this research is still in a relatively early stage, and in most cases it is difficult to come to any firm conclusions about its relative efficacy and safety in healthy human users.

This is a common situation for many so-called “nootropic” supplements and compounds, as these tend not to receive as much scientific attention as other drugs, such as pharmaceutical medications that are used by doctors to treat specific medical conditions. As a result, even supplements and compounds that are relatively “well-studied” often still don’t have the amount of research needed to officially classify them as effective, or get FDA approval for specific uses.

Nonetheless, a few of the potential effects listed below have enough preliminary data that they could be considered “possibly effective.” While this indicates that some of the early research on these applications has shown promising results, it also still means that these uses have not been officially approved, and much more research will be needed to fully verify them.

1) Learning Deficits in Dyslexia

According to one small-scale clinical trial lasting 21 days, piracetam was reported to improve verbal learning by 8.6% in healthy student volunteers, and by up to 15% in dyslexic patients [8].

Similarly, in another short-term study, children who took 3.3 grams of piracetam per day (for 36 weeks) reportedly showed faster reaction times, and reported that they found it easier to recognize language-related test prompts [9].

However, these studies were relatively small, short-term, and only tested a limited set of very specific cognitive functions – so much more extensive research work would need to be done to see what effect (if any) piracetam has on learning abilities in general.

2) Myoclonus Epilepsy

According to one early study, patients suffering from myoclonus epilepsy reportedly showed significant improvements in the ratings of their neurological symptoms after the 1st, 6th and 12th month of piracetam use [10].

INSUFFICIENT EVIDENCE:

The potential uses listed below are those which have received some scientific attention, although the results so far have been mixed, and do not permit any strong conclusions to be made regarding piracetam’s efficacy or safety for these applications.

Therefore, these potential uses are still considered to have “insufficient evidence”, and should be taken with a grain of salt until further research work – including large-scale clinical trials in healthy human users – is performed.

1) Stroke and Cerebrovascular Recovery

Some very preliminary studies report findings that have been taken by some to suggest that piracetam may have some potential benefits for stroke victims, as well as patients with cerebrovascular conditions in general (i.e.

conditions that negatively affect the flow of blood to the brain). However, the evidence so far is far from conclusive, and will need to be extensively followed up on by additional studies to fully confirm these early findings.

According to one early study, piracetam was reported to have positive effects on cognitive function, memory, and concentration in patients with cerebrovascular disorders (which often impair the flow of blood throughout the brain) [11].

However, one study reported no post-stroke language benefits from taking 4.8 grams of piracetam for 6 months [12].

Another clinical study reported increased blood flow in three regions of the brain associated with sensory processing and linguistic ability, as well as noticeable improvements in six specific language functions [13].

Finally, one other clinical study reported that after six weeks of treatment, piracetam caused a significant shift in alpha-waves – a type of “brain wave” sometimes associated with wakefulness, vigilance, and attention – as measured by EEG. These effects were attributed to the repair of “thalamo-cortical” circuits, although these mechanisms remain only speculative, and have not been conclusively demonstrated [14].

According to one relatively large-scale meta-analysis of over 30 years of research, the study’s authors concluded that piracetam showed potential efficacy for the treatment of cognitive impairment in diverse groups of older subjects [15].

Piracetam has also been reported to increase short-term memory after 14 days of treatment in healthy older patients [16].

Nonetheless, many more additional studies will be needed before piracetam could be firmly established as a valid way to prevent or treat age-related cognitive decline.

3) Post-Surgical Recovery

A handful of preliminary clinical studies have reported that piracetam may help with cognition – and possibly even prevent further neurodegeneration – in patients that underwent coronary bypass surgery [17, 18, 19].

However, according to another similar study, piracetam did not improve cognitive decline after open-heart surgery [20].

4) “Breath-Holding Spells” in Children

A handful of early studies suggest that piracetam may be effective at decreasing the number of “breath-holding spells” in children aged 5-60 months when taken at oral doses of 50-100 mg/kg [21, 22, 23].

LACKING EVIDENCE:

The following potential uses of piracetam are based solely on animal- and cell-based studies, and are “lacking evidence” from any appropriate human trials so far. Therefore, these are only potential “launching-points” for future clinical studies in humans, and no solid conclusions can be made about these effects in human users until additional research is done.

1) Reducing Blood Clotting

While this research is still in an extremely early stage, one cell study has reported that piracetam may have some role in inhibiting blood clotting, which could suggest a potential use as a way to prevent the formation of blood clots (which could theoretically give it some future potential application in preventing strokes) [24].

Some preliminary studies into the possible mechanisms for this effect have proposed that piracetam may indirectly prevent blood clotting through four sites of action: the vessel wall, platelets, plasma and cell membranes (RBC, WBC) [25, 26].

2) Neurodegeneration in Alcoholism

According to one preliminary animal study, piracetam was reported to reduce neuron loss in the hippocampi of rats going through alcohol withdrawal [27].

Piracetam has also been reported to increase synaptic density and stimulate synaptic reorganization in the brains of alcohol-withdrawn rats [27].

However, these mechanisms may not necessarily translate over to human users, so more research would be needed to know for sure.

Piracetam Side-Effects

any drug, piracteam has the potential to cause adverse side-effects.

In general, the best way to minimize the risk of experience negative side-effects – from piracetam or any other supplement compound – is to have a thorough discussion with your doctor before deciding to experiment with any new supplements.

It is also extremely important that you keep your doctor informed about any other medications or drugs you are taking, any pre-existing health conditions, or any other relevant dietary or lifestyle factors that could potentially affect your health, as they need this information in order to help you make the most informed decisions about your health.

While hard clinical data about the safety of piracetam in healthy human users is generally lacking, the relatively little data that is available – as well as reports from nootropics users online – generally suggests that piracetam is usually well-tolerated by most people who take it. However, adverse side-effects have been reported in several clinical trials. You can read more about these here: Piracetam: Potential Side-Effects & Risks.

If you experience a headache, fatigue or “brain fog,” stop taking piracetam immediately.

Piracetam Dosage

Note: The information in this section contains information about the “typical” doses reportedly used by people who are experimenting with personal use of piracetam. The information below is not intended as a guide for personal use of piracetam, as adequate data about its potency, safety, or overall effects in healthy human populations is not currently available.

Piracetam is generally available as a powder, or sometimes comes in premade (pre-packaged and pre-dosed) capsules.

While actual clinical studies on piracetam dosages are lacking, according to reports from many of its users among the nootropic community, a “typical” adult piracetam dose for cognitive enhancement appears to be somewhere between 1,200 and 4,800 mg a day.

Among the small number of clinical trials that have been done on piracetam, most divided the dose into 2 or 3 separate doses, spread out throughout the day. However, no hard data is available about its bioavailability, half-life in the body, or the relative advantages or disadvantages that might arise from different dosing schedules.

Source: https://selfhacked.com/blog/top-12-benefits-piracetam/

Piracetam

Piracetam Uses & Side-Effects

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NamePiracetamAccession NumberDB09210TypeSmall MoleculeGroupsApproved, InvestigationalDescription

Piracetam is a nootropic drug in the racetams group, with chemical name 2-oxo-1-pyrrolidine acetamide. It shares the same 2-oxo-pyrrolidone base structure with pyroglutamic acid and is a cyclic derivative of the neurotransmitter γ-aminobutyric acid (GABA). However its mechanism of action differ from that of endogenous GABA.

Piracetam has neuroprotective and anticonvulsant properties and is reported to improve neural plasticity 1. Its efficacy is documented in cognitive disorders and dementia, vertigo, cortical myoclonus, dyslexia, and sickle cell anemia although the clinical application in these conditions is not yet established.

Piracetam has effects on the vascular system by reduce erythrocyte adhesion to vascular endothelium, hinder vasospasm and facilitate microcirculation 1.

Originally marketed by UCB Pharma in 1971, piracetam was the first nootropic drug to modulate cognitive function without causing sedation or stimulation 1. It is not approved for any medical or dietary use by the FDA.

In the UK, piracetam is prescribed mainly for myoclonus, but is used off-label for other conditions such as learning difficulties in children, memory loss or other cognitive defects in the elderly, and sickle-cell vaso-occlusive crises 4.

Evidence to support its use for many conditions is unclear.

StructureSynonymsExternal IDs CL-871 / KT-801 / UCB 6215International/Other BrandsMyocalm (Taiho Pharmaceuticals)CategoriesUNIIZH516LNZ10CAS number7491-74-9WeightAverage: 142.1558
Monoisotopic: 142.074227574 Chemical FormulaC6H10N2O2InChI KeyGMZVRMREEHBGGF-UHFFFAOYSA-NInChI

InChI=1S/C6H10N2O2/c7-5(9)4-8-3-1-2-6(8)10/h1-4H2,(H2,7,9)

IUPAC Name

2-(2-oxopyrrolidin-1-yl)acetamide

SMILES

NC(=O)CN1CCCC1=O

Indication

Indicated in adult patients suffering from myoclonus of cortical origin, irrespective of aetiology, and should be used in combination with other anti-myoclonic therapies 5.

Pharmacodynamics

Piracetam is known to mediate various pharmacodynamic actions:

Neuronal effects:

Piracetam modulates the cholinergic, serotonergic, noradrenergic, and glutamatergic neurotransmission although the drug does not display high affinity to any of the associated receptors (Ki >10μM).

Instead, piracetam increases the density of postsynaptic receptors and/or restore the function of these receptors through stabilizing the membrane fluidity 1.

In the forebrain of aging mice, the density of NMDA receptors was increased by approximately 20% following 14 days of piracetam treatment.

the findings of various animal and human studies, the cognitive processses including learning, memory, attention and consciousness were enhanced from piracetam therapy without inducing sedation and psychostimulant effects 5. Piracetam mediate neuroprotective effects against hypoxia-induced damage, intoxication, and electroconvulsive therapy 5.

In two studies involving alcohol-treated rats with evidences of withdrawal-related neuronal loss, piracetam was shown to reduce the extent of neuronal loss and increase the numbers of synapses in the hippocampus by up to 20% relative to alcohol-treated or alcohol-withdrawn rats 1.

This suggests that piracetam is capable in promoting neuroplasticity when recoverable neural circuits are present 1.

Although the mechanism of action is not fully understood, administration of piracetam prior to a convulsant stimulus reduces the seizure severity and enhances the anticonvulsant effectiveness of conventional antiepileptics such as carbamazepine and diazepam 3.

Vascular effects:

Piracetam is shown to increase the deformability of erythrocytes, reduce platelet aggregation in a dose-dependent manner, reduce the adhesion of erythrocytes to vascular endothelium and capillary vasospasm.

In healthy volunteers, piracetam mediated a direct stimulant effect on prostacycline synthesis and reduced the plasma levels of fibrinogen and von Willebrand’s factors (VIII: C; VIII R: AG; VIII R: vW) by 30 to 40% 5.

Potentiated microcirculation is thought to arise from a combination of effects on erythrocytes, blood vessels and blood coagulation 1.

Mechanism of action

Piracetam interacts with the polar heads in the phospholipids membrane and the resulting mobile drug-lipid complexes are thought to reorganize the lipids and influence membrane function and fluidity 1.

Such interaction has been reported in a study that investigated the effects of neuronal outgrowth induced by beta amyloid peptides; while amyloid peptides cause lipid disorganization within the cell membranes leading to neuronal death, piracetam demonstrated to decrease the destabilizing effects of amyloid peptide 2.

The authors suggest that piracetam induces a positive curvature of the membrane by occupying the polar groups in the phospholipids to counteract the negative curvature induced by amyloid peptides , which in turn would decrease the lihood of membrane fusion 1.

This mechanism of action is thought to improve membrane stability, allowing the membrane and transmembrane proteins to maintain and recover the three-dimensional structure or folding for normal function 4 such as membrane transport, chemical secretion, and receptor binding and stimulation 1.

Through restored membrane fluidity, piracetam promotes restored neurotransmission such as glutamatergic and cholinergic systems, enhances neuroplasticity and mediates neuroprotective and anticonvulsant effects at the neuronal level 1.

It is also demonstrated that piracetam also improves the fluidity of platelet membranes.

At the vascular level, piracetam decreases adhesion of erythrocytes to cell wall and reduces vasospasm which in turn improves microcirculation including cerebral and renal blood flow 1.

Absorption

Piracetam displays a linear and time-dependent pharmacokinetic properties with low intersubject variability over a large range of doses.

Piracetam is rapidly and extensively absorbed following oral administration with the peak plasma concentration is reached within 1 hour after dosing in fasted subjects. Following a single oral dose of 3.2 g piracetam, the peak plasma concentration (Cmax) was 84 µg/mL.

Intake of food may decrease the Cmax by 17% and increase the time to reach Cmax (Tmax) from 1 to 1.5 hours. Tmax in the cerebrospinal fluid is achieved approximately 5 hours post-administration 4.

The absolute bioavailability of piracetam oral formulations is close to 100% and the steady state plasma concentrations are achieved within 3 days of dosing 4.

Volume of distribution

Vd is approximately 0.6L/kg. Piracetam may cross the blood-brain barrier as it was measured in the cerebrospinal fluid following intravenous administration 4. Piracetam diffusesto all tissues except adipose tissues, crosses placental barrier and penetrates the membranes of isolated red blood cells 4.

Protein binding

Piracetam is not reported to be bound to plasma proteins 4.

Metabolism

As large proportion of total piracetam administered is excreted as unchanged drug, there is no known major metabolism of piracetam 4.

Route of elimination

Piracetam is predominantly excreted via renal elimination, where about 80-100% of the total dose is recovered in the urine. Approximately 90% of the dose of piracetam is excreted in the urine as unchanged drug 4.

Half life

The plasma half life of piracetam is approximately 5 hours following oral or intravenous administration. The half life in the cerebrospinal fluid was 8.5 hours 4.

Clearance

The apparent total body clearance is 80-90 mL/min 4.

Toxicity

The cases of overdose with piracetam is rare. The highest reported overdose with piracetam was oral intake of 75g which was associated with diarrhea and abdominal pain; the signs were most ly related to the extreme high dose of sorbitol contained in the used formulation.

In cases of acute, significant overdosage, stomach emptying by gastric lavage or induced emesis is recommended as there are no known antidotes for piracetam 4.

Management for an overdose will most ly be symptomatic treatment and may include hemodialysis, where the extraction efficacy of the dialyser is 50 to 60% for the drug 4.

Oral LD50 in a mouse acute toxicity study was 2000 mg/kg MSDS.

Affected organismsNot AvailablePathwaysNot AvailablePharmacogenomic Effects/ADRs Not AvailableDrug Interactions

This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.

DrugInteraction
AbacavirAbacavir may decrease the excretion rate of Piracetam which could result in a higher serum level.
AcarboseAcarbose may decrease the excretion rate of Piracetam which could result in a higher serum level.
AceclofenacAceclofenac may decrease the excretion rate of Piracetam which could result in a higher serum level.
AcemetacinAcemetacin may decrease the excretion rate of Piracetam which could result in a higher serum level.
AcetaminophenAcetaminophen may decrease the excretion rate of Piracetam which could result in a higher serum level.
AcetazolamideAcetazolamide may increase the excretion rate of Piracetam which could result in a lower serum level and potentially a reduction in efficacy.
Acetylsalicylic acidAcetylsalicylic acid may decrease the excretion rate of Piracetam which could result in a higher serum level.
AclidiniumAclidinium may decrease the excretion rate of Piracetam which could result in a higher serum level.
AcrivastinePiracetam may decrease the excretion rate of Acrivastine which could result in a higher serum level.
AcyclovirAcyclovir may decrease the excretion rate of Piracetam which could result in a higher serum level.

Additional Data AvailableFood InteractionsNot AvailableManufacturers

Not Available

Packagers

Not Available

Dosage formsNot AvailablePricesNot AvailablePatentsNot AvailableDescriptionThis compound belongs to the class of organic compounds known as alpha amino acids and derivatives. These are amino acids in which the amino group is attached to the carbon atom immediately adjacent to the carboxylate group (alpha carbon), or a derivative thereof.KingdomOrganic compoundsSuper ClassOrganic acids and derivativesClassCarboxylic acids and derivativesSub ClassAmino acids, peptides, and analoguesDirect ParentAlpha amino acids and derivativesAlternative ParentsPyrrolidine-2-ones / N-alkylpyrrolidines / Tertiary carboxylic acid amides / Primary carboxylic acid amides / Lactams / Azacyclic compounds / Organopnictogen compounds / Organonitrogen compounds / Organic oxides / Hydrocarbon derivatives show 1 moreSubstituentsAlpha-amino acid or derivatives / N-alkylpyrrolidine / 2-pyrrolidone / Pyrrolidone / Pyrrolidine / Tertiary carboxylic acid amide / Carboxamide group / Lactam / Primary carboxylic acid amide / Azacycle show 10 moreMolecular FrameworkAliphatic heteromonocyclic compoundsExternal DescriptorsNot Available

Source: https://www.drugbank.ca/drugs/DB09210

Probable Nootropicinduced Psychiatric Adverse Effects: A Series of Four Cases

Piracetam Uses & Side-Effects

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PIRACETAM 800MG TABLETS | Drugs.com

Piracetam Uses & Side-Effects

Active substance(s): PIRACETAM

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PACKAGE LEAFLET: INFORMATION FOR THE PATIENT NOOTROPIL® 800mg TABLETS / PIRACETAM 800mg TABLETS(piracetam)This product is available using any of the above names but will be referred to as NootropilTablets throughout the remainder of this leaflet.Read all of this leaflet carefully before you start taking this medicine because itcontains important information for you.• Keep this leaflet. You may need to read it again.• If you have any further questions, ask your doctor or pharmacist.• This medicine has been prescribed for you only. Do not pass it on to others. It mayharm them, even if their signs of illness are the same as yours.• If you get any side effects, talk to your doctor or pharmacist. This includes any possibleside effects not listed in this leaflet. See section 4.What is in this leaflet:1. What Nootropil Tablets are and what they are used for2. What you need to know before you take Nootropil Tablets3. How to take Nootropil Tablets4. Possible side effects5. How to store Nootropil Tablets6. Contents of the pack and other information1. WHAT NOOTROPIL TABLETS ARE AND WHAT THEY ARE USED FORNootropil Tablets belongs to a group of medicines known as GABA analogues.Nootropil Tablets contains the active ingredient Piracetam. It acts on the brain and nervoussystem and is thought to protect it against a shortness of oxygen.Nootropil Tablets are used in combination with other medicines to treat myoclonus. This is acondition in which the nervous system causes muscles, particularly in the arms and legs, tostart to jerk or twitch uncontrollably.2. WHAT YOU NEED TO KNOW BEFORE YOU TAKE NOOTROPIL TABLETSDo not take Nootropil Tablets:• if you are allergic to piracetam or any of the other ingredients of this medicine (listed insection 6).• if you have ever had serious kidney problems• if you suffer from Huntington‘s Disease (also known as Huntington‘s Chorea)• if you have ever experienced a brain haemorrhageIf any of the above applies to you, do not take Nootropil Tablets and talk to yourdoctor or pharmacist.Warnings and precautionsTalk to your doctor or pharmacist before taking Nootropil Tablets• if you think your kidneys may not be working perfectly. (Your doctor may need to start youon a lower dose.)• if you have ever had any kind of bleeding problem.Other medicines and Nootropil TabletsTell your doctor or pharmacist if you are taking, have recently taken or might take any othermedicines.Tell your doctor if you are taking any of the following medicines:Thyroid extract or thyroxineAnticoagulants such as warfarin or aceno-coumarolLow dose aspirinAny other medicines, including medicines obtained without a prescription. •••• Pregnancy and breast-feedingIf you are pregnant or breast-feeding, think you may be pregnant or are planning to have ababy, ask your doctor or pharmacist for advice before taking this medicine. If you are takingthis medicine, use contraception to avoid becoming pregnant. If you are taking NootropilTablets and you think you may be pregnant, consult your doctor immediately.Driving and using machinesNootropil Tablets may cause drowsiness and shakiness. If this happens to you, do not driveor use machinery.Warning about some of the ingredients in Nootropil TabletsThis medicine contains 46 mg sodium per dose. To be taken into consideration by patientson a controlled sodium diet.This medicine contains the colouring agent sunset yellow (E110) which may cause allergicreactions.3. HOW TO TAKE NOOTROPIL TABLETSAlways take this medicine exactly as your doctor or pharmacist has told you. Check withyour doctor or pharmacist if you are not sure.Important:Your doctor will choose the dose that is right for you. Your dose will be shownclearly on the label that your pharmacist puts on your medicine. If it does not, or youare not sure, ask your doctor or pharmacist.AdultsHow much medicine to take and when to take it• The recommended starting dose is 7.2 g each day (nine tablets).• It is best to split the dose so that the tablets are taken on two or three separate occasionsduring the day (3 tablets in the morning, 3 at midday and 3 in the evening).• When you start taking this medicine your doctor may tell you to gradually increase thedose to ensure that you receive the best dose to treat your condition.• Follow your doctor’s instructions carefully.How to take your medicine• Swallow the tablets whole with a glass of water.• Do not break or chew the tablets as piracetam has a very bitter taste.• If you find it difficult to swallow the tablets tell your doctor as soon as possible as they canprescribe piracetam in the form of a solution. Elderly and patients with kidney problemsIf you are elderly or have kidney problems your doctor may reduce your dose.If you take more Nootropil Tablets than you shouldIf you accidentally take too much, immediately go to the nearest hospital casualtydepartment or your doctor.If you forget to take Nootropil TabletsDo not take a double dose to make up for a forgotten dose. Simply take the next dose asplanned.If you stop taking Nootropil TabletsDo not stop taking Nootropil Tablets without first talking to your doctor. Abruptly stoppingyour medicine may cause twitching and jerking.If you have any further questions on the use of this medicine, ask your doctor or pharmacist.4. POSSIBLE SIDE EFFECTS all medicines, this medicine can cause side effects, although not everybody gets them.You may notice the following side effects:• An allergic reaction and experience difficulty breathing, swelling, fever• Spontaneous bleeding caused by defects in your blood clotting mechanism• Worse fits• Hallucinations• Difficulty balancing and unsteadiness when standing• Anxiety and agitation• Confusion• Restlessness• Nervousness• Sleepiness• Depression• Weakness• Vertigo• Weight increase• Stomach pain• Diarrhoea• Feeling or being sick• Headache• Being unable to sleep• Swelling of the skin, particularly around the face• Skin rash and itching.Reporting of side effectsIf you get any side effects, talk to your doctor or pharmacist. This includes any possible sideeffects not listed in this leaflet. You can also report side effects directly via the Yellow CardScheme at www.mhra.gov.uk/yellowcard.By reporting side effects you can help provide more information on the safety of thismedicine.5. HOW TO STORE NOOTROPIL TABLETS• Keep the sight and reach of children.• Do not use after the expiry date shown on the end panel of the carton. The expiry daterefers to the last day of that month.• If the tablets becomes discoloured or shows any other signs of deterioration, you shouldseek the advice of your pharmacist.• Medicines should not be disposed of via wastewater or household waste. Ask yourpharmacist how to dispose of medicines no longer required. These measures will help toprotect the environment.6. CONTENTS OF THE PACK AND OTHER INFORMATIONWhat Nootropil Tablets containEach pack of Nootropil Tablets contains 60 orange capsule shaped tablets marked Nbreakline N on one side and breakline on the reverse.The tablets have the letters N breakline N on one side and breakline on the reverse markedon them to allow them to be easily identified.Each tablet contains 800mg of piracetam as the active ingredient. Each tablet also containsmacrogol 6000. macrogol 400, colloidal anhydrous silica, magnesium stearate,hypromellose, titanium dioxide (E171), sunset yellow (E110), talc.PL No: 15814/0572 POM Manufactured by J. Uriach y Cia, S.A., Avda. Cami Reial 51-57, 08184 Palau-Solita iPlegamans (Barcelona), Spain and is procured from within the EU and repackaged by theProduct Licence holder: OPD Laboratories Ltd, Unit 6 Colonial Way, Watford, Herts WD244PR.Leaflet revision and issue date (Ref.) 10.04.2017.Nootropil is a registered trademark of UCB, Belgium. 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