Piracetam
Mechanism :
It is a nootropic agent that improves the efficacy of higher functions of the brain involved in cognitive processes such as learning, memory, thought and consciousness. It is used in the treatment of mental retardation, cerebrovascular accidents or stroke.
Indication :
- Adjunct in cortical myoclonus
- As a cognitive enhancer in cerebrocortical insufficiency
Contraindications :
Hepatic and severe renal impairment; Cerebral haemorrhage; Pregnancy and lactation.
Dosing :
40-50 mg/kg/day in 3 divided doses PO. Decrease the dose by half once the desired effect is obtained.
Adverse Effect :
Dizziness, excitement, skin rash, sleep disturbances, diarrhea, depression and weight gain.
Interaction :
Warfarin: May increase prothrombin time in patients who are on warfarin.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 50-80 | 4.8 g in 2–3 divided doses |
| 30-50 | 1.2 g twice daily |
| 20-30 | 1.2 g daily |
| <20 | Contraindicated |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Likely dialysability. Avoid. Contraindicated |
| HD | Dialysed. Avoid. Contraindicated |
| HDF/High flux | Dialysed. Avoid. Contraindicated |
| CAV/VVHD | Unknown dialysability. Dose as in GFR=20–30 mL/min |
Hepatic Dose :
No dosage adjustments are recommended.