BRAINMAX 2.5ml - injectable preparation to improve brain function

BRAINMAX® is a combined preparation whose effect is determined by its constituent components.
Structural analogue of gamma-butyrobetaine. Suppresses gamma-butyrobetaine hydroxinase, inhibits the synthesis of carnitine and the transport of long-chain fatty acids through cell membranes, and prevents the accumulation in cells of activated forms of unoxidized fatty acids - derivatives of acylcarnitine and acyl coenzyme A.
Under conditions of ischemia, it restores the balance of the processes of oxygen delivery and its consumption in cells, prevents disruption of adenosine triphosphate (ATP) transport; At the same time, it activates glycolysis, which occurs without additional oxygen consumption. As a result of a decrease in carnitine concentration, gamma-butyrobetaine, which has vasodilating properties, is intensively synthesized. Under conditions of ischemia, meldonium restores the balance of the processes of oxygen delivery and its consumption in cells, prevents disruption of ATP transport; At the same time, it activates glycolysis, which occurs without additional oxygen consumption. The mechanism of action determines the variety of its pharmacological effects: increased performance, reduced symptoms of mental and physical stress, activation of tissue and humoral immunity, cardioprotective effect.
In case of acute ischemic damage to the myocardium, it slows down the formation of the necrotic zone and shortens the rehabilitation period. In heart failure, it increases myocardial contractility, increases exercise tolerance, and reduces the frequency of angina attacks. In acute and chronic ischemic disorders of cerebral circulation, it improves blood circulation in the ischemic area and promotes the redistribution of blood in favor of the ischemic area. It has a tonic effect on the central nervous system, eliminates functional disorders of the somatic and autonomic nervous system in patients with chronic alcoholism with withdrawal syndrome.

Ethylmethylhydroxypyridine succinate is an inhibitor of free radical processes and a membrane protector. It has antihypoxic, stress-protective, nootropic, anticonvulsant and anxiolytic effects.
The mechanism of action of ethylmethylhydroxypyridine succinate is due to its antioxidant and membrane protective effect. The preparation inhibits lipid peroxidation, increases the activity of superoxide dismutase, increases the lipid-protein ratio, and improves the structure and function of the cell membrane. Ethylmethylhydroxypyridine succinate modulates the activity of membrane-bound enzymes (calcium-independent phosphodiesterase, adenylate cyclase, acetylcholinesterase), receptor complexes (benzodiazepine, gamma-aminobutyric acid, acetylcholine), which enhances their ability to bind to ligands, helps preserve the structural and functional organization of biomembranes, neurotransmitter transport and improve synaptic transmission. Ethylmethylhydroxypyridine succinate increases dopamine levels in the brain. Causes an increase in compensatory activation of aerobic glycolysis and a decrease in the degree of inhibition of oxidative processes in the Krebs cycle under hypoxic conditions with an increase in the content of ATP and creatine phosphate, activation of the energy-synthesizing functions of mitochondria.
Increases the body's resistance to the effects of various damaging factors (shock, hypoxia and ischemia, cerebrovascular accidents, intoxication with ethanol and antipsychotic preparation s).
In conditions of a critical decrease in coronary blood flow, it helps to preserve the structural and functional organization of cardiomyocyte membranes, stimulates the activity of membrane enzymes - phosphodiesterase, adenylate cyclase, acetylcholinesterase. Supports the activation of aerobic glycolysis that develops during acute ischemia and promotes the restoration of mitochondrial redox processes under hypoxic conditions, increases the synthesis of ATP and creatine phosphate. Ensures the integrity of the morphological structures and physiological functions of the ischemic myocardium.
Improves the clinical course of myocardial infarction, increases the effectiveness of therapy, reduces the incidence of arrhythmias and intracardiac conduction disorders.
Normalizes metabolic processes in ischemic myocardium, increases the antianginal activity of nitrates, improves the rheological properties of blood, reduces the consequences of reperfusion syndrome in acute coronary insufficiency.
Reduces enzymatic toxemia and endogenous intoxication in acute pancreatitis.
Improves metabolism and blood supply to the brain, microcirculation and rheological properties of blood, reduces platelet aggregation.
Stabilizes the membranes of blood cells (erythrocytes and platelets), reducing the likelihood of hemolysis. It has a lipid-lowering effect, reduces the content of total cholesterol and low-density lipoproteins.

The combined use of meldonium and ethylmethylhydroxypyridine succinate leads to a synergistic pharmacodynamic interaction between the two components, which increases the neuroprotective activity of the preparation . When using the combined preparation BRAINMAX®, the antihypoxic, antioxidant, nootropic and anti-ischemic effect of the two active substances exceeds the pharmacological effect of each of the components used separately, which leads to a decrease in the clinical manifestations of cerebrovascular insufficiency, improvement of cognitive functions, improvement of memory and attention, normalization of emotional condition, reducing symptoms of mental and physical stress, increasing performance, increasing tolerance to mental and physical stress.
Clinical studies have shown that the preparation BRAINMAX®, compared with monocomponents (meldonium and ethylmethylhydroxypyridine succinate), has a more pronounced positive effect on the condition of patients with ischemic stroke in the acute and early recovery period, increasing the level of capacity and mobility of patients, significantly reducing the severity of cognitive impairment and improving neurological status.

Indications:

As part of complex therapy for acute and chronic cerebrovascular accidents:

• ischemic stroke (cerebral infarction), transient ischemic attack;
• dyscirculatory encephalopathy, cerebrovascular insufficiency;
• mild cognitive disorders of atherosclerotic origin;
• reduced performance;
• mental and physical overload.

Directions for use and dosage:

For acute cerebrovascular accidents, including ischemic stroke, transient ischemic attack, the preparation is used in the first 10 days as part of complex therapy - 5 ml (500 mg + 500 mg) 1 time per day intravenously; over the next 14 days - 5 ml (500 mg + 500 mg) 2 times a day intramuscularly.

For discirculatory encephalopathy in the decompensation phase, the preparation is used 2.5 ml (250 mg + 250 mg) intravenously 2 times a day for 14 days. Then intramuscularly 2.5 ml 1 time per day for 14 days.

For chronic disorders of the blood supply to the brain and when treating the consequences of acute cerebrovascular accident, the preparation is used intramuscularly or intravenously, 2.5 ml (250 mg + 250 mg) 2 times a day for 10 days. Then orally, 2 capsules (500 mg + 500 mg) 1 time per day or 1 capsule of the preparation (250 mg + 250 mg) 2 times per day. The general course of treatment is 4-6 weeks.

For cognitive disorders and encephalopathy, the preparation is prescribed intramuscularly at 2.5 ml (250 mg + 250 mg) once a day for 14-30 days.

In case of reduced performance, asthenic conditions, mental and physical overload, the preparation is prescribed intramuscularly in 5 ml (500 mg + 500 mg) 1 time per day for 10-14 days. If necessary, treatment after consultation with a doctor is repeated after 2-3 weeks.
Due to the possible development of an stimulating effect, BRAINMAX® is recommended to be used in the first half of the day. The method of administration and duration of treatment are determined individually, depending on the indication, severity of the condition, etc.

Ingredients for 1 ml:

Active ingredients: ethylmethylhydroxypyridine succinate - 100.0 mg, meldonium dihydrate - 100.0 mg.
Excipients: hydrochloric acid solution 7 M - up to pH 4.0-5.0, water for injection - up to 1.0 ml.

Contraindications:

• Hypersensitivity to the components of the preparation
• Acute liver failure
• Acute renal failure
• Increased intracranial pressure (with impaired venous outflow and intracranial tumors)
• Pregnancy
• Breastfeeding period
• Children under 18 years old

Carefully:

Chronic liver and kidney diseases, bronchial asthma.
Use during pregnancy and breastfeeding
The preparation BRAINMAX® is contraindicated during pregnancy and breastfeeding due to insufficient data on the effectiveness and safety of the preparation during these periods. Breastfeeding should be discontinued before starting the preparation .

Special instructions:

Meldonium may give a positive result during doping control. Since January 1, 2016, meldonium has been included in the list of prohibited substances of the World Anti-Doping Agency.
Patients with chronic liver and kidney diseases should be careful with long-term use of the preparation .
There is insufficient data on the use of the preparation in children under 18 years of age.
Impact on the ability to drive vehicles and machinery
During the period of taking the preparation , care should be taken when performing work that requires increased concentration and speed of psychomotor reactions (driving vehicles, machinery, etc.).

Storage temperature: 2℃ to 25℃

Dosage form:

Transparent, light yellow to brownish-yellow liquid.

Effect:

After intramuscular administration of the preparation , the maximum concentration of active substances in the blood plasma is achieved after 0.25 -1 hour.
The preparation is well distributed throughout organs and tissues, with an apparent volume of distribution averaging 250-350 liters for ethylmethylhydroxypyridine and 35-80 liters for meldonium. The half-life of the preparation ranges from 0.26 to 0.73 hours for ethylmethylhydroxypyridine; T1/2 of meldonium with parenteral administration of 2-4 ml of BRAINMAX® is from 1 to 3.5 hours; when administered in higher doses (8 ml), T1/2 increases to 7 hours.

Overdose:

The preparation is low-toxic and does not cause severe adverse reactions.
Symptoms: decreased blood pressure, accompanied by headache, tachycardia, dizziness and general weakness. Drowsiness, insomnia.
Treatment: treatment, as a rule, is not required - the symptoms disappear on their own within 24 hours. In case of severe manifestations, supportive and symptomatic treatment is carried out.

Release form: 100 mg/ml + 100 mg/ml solution for intravenous and intramuscular administration 2.5 ml ampoule 10 pcs.

Storage temperature: 2℃ to 25℃

Guaranteed authenticity and quality:

100% Original from PROMOMED (Russian Federation)

Promomed Group of Companies is one of the leaders in the Russian pharmaceutical industry, an active participant in the country’s national preparation safety system. We specialize in the development, production and promotion of preparation s used in such areas of medicine as infection control (antiviral and antibiotics), endocrinology, neurology, oncology, and general therapy.

Development and production:

PROMOMED BIOCHIMIK (Russian Federation)