Cheap analogues and substitutes for the drug gliatilin for children and adults

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Gliatilin is a nootropic drug that has a beneficial effect on the central nervous system. The effect of the drug is based on the content of the active substance choline alfoscerate, which has a pronounced restorative property.

The medicine is produced in ampoules for the preparation of injection solution, gelatin capsules.

The medication is prescribed for the following indications: cerebral circulatory disorders, the presence of traumatic brain injuries of various forms, the recovery period for cerebrovascular insufficiency, memory impairment in the elderly.

Use should be excluded for various allergic manifestations. The cost is in the range of 710–720 rubles.

pharmachologic effect

Manufacturer: ITALFARMACO SPA (Italy)
Release form: gelatin capsules, solution for intravenous and intramuscular administration

Active ingredient: choline alfoscerate

Analogs: Ceretol, Mexidol, Cerakson

Gliatilin takes part in complex biochemical processes, as a result of which the transmission of nerve impulses is stimulated and the functional abilities of receptors are increased. The accumulation of the drug occurs mainly in the brain, which leads to a significant improvement in motor and cognitive functions.

Indications for use of Gliatilin

Medicine is prescribed for the following diseases and conditions:

• cerebrovascular accident of ischemic and hemorrhagic type in the acute or recovery period;
• traumatic brain injury of varying severity;
• pathology of the central nervous system of a degenerative nature (amyotrophic lateral sclerosis, Parkinson's disease, Alzheimer's disease);
• cognitive disorders (memory, ability to analyze, learn) against the background of cerebral atherosclerosis;
• oligophrenia with cognitive impairment;
• senile dementia.

By increasing cerebral blood flow, metabolic processes are improved, local immunity is stimulated, which leads to the restoration of partially lost cognitive functions.

How to take Gliatilin - before or after meals

The drug is prescribed for internal use. The capsule is swallowed whole a quarter of an hour before meals and washed down with a sufficient amount of water.

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Relevance. Due to its high prevalence and severe health consequences, acute cerebrovascular accidents are a major medical and social problem. In addition to high mortality, stroke is the leading cause of disability in the population. About 450 thousand cases of stroke are registered annually in Russia; the ischemic variant of acute cerebrovascular accident occurs predominantly.

One of the most pressing tasks of modern angioneurology is the search for optimal methods for treating cerebral infarction. Insufficiently effective correction of neurological syndromes, which form the core of the clinic of acute circulatory disorders of the brain, leads to a deterioration in the quality of life of patients and a decrease in social and everyday adaptation. Neurometabolic, functional and morphological features of the nervous system, multifactorial pathogenesis, zonality and stages of ischemic damage create extremely difficult conditions for the successful use of neuroprotective drugs. Despite the huge number of works covering the treatment of strokes, there is currently a limited number of drugs with absolutely proven effectiveness in acute cerebral ischemia.

Purpose of the work: to evaluate the effectiveness of the drug "Gliatilin" in patients with primary hemispheric cerebral infarction in the acute period.

Materials and methods. The study was conducted on the basis of the neurological department of the Municipal Clinical Hospital No. 9 in Saratov. We analyzed 122 cases of primary ischemic stroke of hemispheric localization. The criteria for inclusion in the studies were: first-time ischemic stroke of hemispheric localization, duration of the disease - no more than 24 hours, severity of neurological deficit on the NIHSS scale >=2 and <=20, level of consciousness from clear to somnolence (14-15 points on the Glasgow Coma Scale ), age 40-75 years, signed informed consent. Exclusion criteria from the study: ischemic stroke of any other location, recurrent stroke, total aphasia, any other neurological diseases of the central nervous system, somatic diseases in the stage of decompensation, women with childbearing potential, alcohol abuse. By random sampling, the patients were divided into 2 groups: the main group (MG - 62 people) and the comparison group (CG - 60 people). The average age of the subjects was 65.3±8.2 years (67 women, 55 men). Patients with OH , along with the standard treatment regimen for cerebral infarction, were treated with the drug “Gliatilin” according to the regimen of 1000 mg parenterally for 10 days. The study examined the structure of patients' complaints, medical history, indicators of neurological status, and assessed the patients' condition according to the Glasgow Coma Scale, NIHSS, Barthel, Rankin and MMSE. All patients underwent a CT scan of the brain within the first 24 hours from the onset of stroke symptoms. The study design involved conducting neurological and neuropsychological examinations in the first 24-48 hours after an acute vascular accident, as well as on the 5th, 10th and 21st days after the start of gliatilin administration.

Results. Upon admission, all patients had general cerebral symptoms, and a complex of neurological syndromes was determined in accordance with the location of the infarction. Neurological symptoms were represented by sensitivity disorders of the cerebral conduction type and central hemiparesis. When studying the cognitive sphere, all patients had disorders of mnestic function, attention deficit, decreased tempo of mental activity, rapid exhaustion, and anxiety of varying severity was detected. According to computed tomography, 56% of all strokes were assessed as medium in size, 34% as lacunar, and in 10% of cases large infarcts were described. The majority of patients (73.8%) had ischemic stroke in the middle cerebral artery system: 58.9 - right, 41.1 - left; cerebral infarction in the territory of the posterior cerebral artery was registered in 8.2% of patients, in the territory of the anterior cerebral artery - in 18% of patients.

The obtained data from the examination on scales, carried out at different times from the onset of the disease, are shown in Table 1.

The most revealing data were obtained already on the 5th day of the study: in 42 patients with OH, signs of hemiparesis and sensory disturbances in the extremities regressed; in 11 patients with OH, similar dynamics were observed at a later date - by days 10-21. The number of patients with mild neurological disorders (NIHSS < 8 points) by the 5th day of observation was 48% of the total number included in the OG. According to scales that determine the ability to self-care, the number of patients in the MG with moderate dependence in daily activities (total score on the Barthel scale > 75) was 34% by day 5 and 73% by day 10 from the onset of the disease. A similar picture can be seen according to the criteria of patients’ mobility, their ability to self-care, and household activity (Rankin scale). On day 10, patients in the GS had moderately pronounced signs of disability, while in the OG, patients receiving the drug “Gliatilin” noted mild signs of disability and were able to take care of themselves without outside help. Positive changes also occurred in the GS, but they were less pronounced.

In all subjects, the MMSE scale revealed cognitive deficits of varying severity. In the first 48 hours, the average values ​​on the MMSE scale in the MG were 24.1±5.3 points, in the GS - 24.3±5.3 points, which corresponds to the presence of cognitive impairment. On the 5th day in the MG after gliatilin therapy, the MMSE score increased by an average of 3.2 points, in the GS by 1.3. Subsequently, the regression of cognitive deficit was less pronounced: in the OG the average score increased by 0.8 points on the 10th day and by 0.6 points on the 21st day, in the GS by the 10th day the scores increased by 0.5 points, by the 21st day by 0.2 points.

Table 2 shows the dynamics of recovery of neurological deficit depending on the duration of drug administration in MG patients.

The analysis showed that in MG patients who were prescribed gliatilin on the 1st day from the onset of the disease, there was a statistically significant advance in the recovery of neurological functions by the 10th day of the disease compared to patients who received the drug later than 24 hours after the first symptoms of stroke.

Conclusions. An overall assessment of the treatment effect revealed a clear prevalence of positive results in the group where the drug “Gliatilin” was used compared to the group that received only basic therapy.

The use of the drug "Gliatilin" in the treatment of ischemic stroke of hemispheric localization in the acute period contributes to the regression of neurological symptoms and an increase in the patient's functional activity, which is determined already on the 5th day from the moment of the disease. The most significant positive dynamics in the patient’s condition can be seen in the acute period of cerebral ischemia. Prescribing the drug "Gliatilin" allows you to achieve the best therapeutic result and generally helps to increase the effectiveness of medical rehabilitation for this category of patients.

Analogues of Gliatilin

The domestic and foreign pharmaceutical industry produces a sufficient number of Gliatilin analogues in capsules and other dosage forms that are similar in various characteristics and indications. These drugs are sold by the pharmacy chain in the form of synonyms, generics, and combination drugs.

Table of Gliatilin analogues with price and country of origin

What else can replace Gliatilin, what effective analogues? The list can be supplemented with the following medications:

• Memantine;
• Recognan;
• Cytoflavin;
• Pantogam;
• Vasobral;
• Cogitum;
• Citicoline;
• Cerebrolysin;
• Phenibut;
• Noopept.

Among the large number of medicines presented on the pharmaceutical market, there are analogues of Gliatilin for children and adults, which are distinguished by a high therapeutic effect.

Belarusian generics

Effective synonyms of gliatilin produced in Belarus occupy a strong place in the pharmaceutical market among the main analogues of the drug. Several close substitutes are discussed in the table below.

Gliatilin or Cerepro

Manufacturer: VEROPHARM OJSC (Russia)
Release form: capsules, solution for intramuscular and intravenous administration

Active ingredient: glycerylphosphorylcholine hydrate

Both medications belong to nootropic drugs and have equivalent indications for various diseases of the central nervous system. Gliatilin is an original drug, the active substance of which is choline alfoscerate, and in Cerepro it is glycerylphosphorylcholine hydrate.

For more severe lesions of the central nervous system (brain contusion, ischemic stroke) with severe neurological symptoms, Gliatilin quickly and effectively reduces the negative manifestations of the disease. Milder lesions of the nervous system are well treated with the Cerepro analogue, which copes well with transient cerebrovascular accident, concussion, and cognitive disorders due to stress.

In what cases is Gliatilin prescribed?

Indications for taking this drug are functional disorders of the central nervous system caused by injuries or various diseases. Gliatilin is actively used in the treatment of the following pathologies:

1. Encephalopathy;
2. Senile, Alzheimer's, mixed dementia;
3. Huntington's chorea;
4. Senile pseudomelancholia.

In addition, Gliatilin is prescribed for the occurrence of the following cognitive disorders:

1. Confusion;
2. Memory impairment;
3. Reduced motivation and lack of concentration;
4. Disorientation in space and time.

The drug has proven itself well in recovery from traumatic brain injury (TBI) with damage at the brain stem level. Gliatilin is also used in therapy after an ischemic stroke.

Gliatilin or Cereton

Manufacturer: SOTEK FARMFIRMA (Russia)
Release form: capsules, solution for intravenous and intramuscular administration

Active ingredient: choline alfoscerate

Cereton is a domestic analogue of Gliatilin in tablets and solution, having the same active substance as the original drug and indications, but different excipients.

The Cereton analogue is more suitable for adults, as it copes well with various pathologies of the central nervous system, including brain injury, cognitive disorders and vascular lesions. Gliatilin gives a greater effect in the treatment of diseases of a central nature. This occurs due to the high degree of purification of the source material.

Russian-made analogues

Cheap, domestically produced analogues of the drug gliatilin contain almost identical active ingredients.

Table of close substitutes for the main original:

Gliatilin or Mexidol

Manufacturer: Moscow Endocrine Plant Federal State Unitary Enterprise (Russia)
Release form: tablets, solution for intravenous and intramuscular administration

Active ingredient: ethylmethylhydroxypyridine succinate

Both drugs have equivalent indications, but different active substances and mechanisms of action. The Mexidol analogue exhibits a broader pharmacological effect, possessing antihypoxic, antioxidant, and nootropic properties.

According to reviews from doctors and relatives of older patients, the effect of Mexidol therapy is fully manifested. The medication reduces anxiety, improves the emotional background of patients, memory, increases resistance to stress, and reduces blood viscosity. Mexidol will be more effective for transient cerebrovascular accidents, ischemic stroke, and vegetative-vascular dystonia.

Gliatilin or Ceraxon

Manufacturer: FERRER INTERNATIONAL A.O.
(Spain) Release form: solution for oral administration, intramuscular and intravenous administration

Active ingredient: citicoline

Both medications have similar indications and have a beneficial effect on the functions of the central nervous system, but act through different mechanisms. Ceraxon has a direct effect on the regeneration of cellular structures of brain tissue, stimulates the formation of adenosine triphosphate, which is an energy source for biochemical processes.

Having broader indications, this Gliatilin analogue will be effective for vascular lesions of the brain in elderly patients, since the medication acts directly on the morphological structure of the cell and cognitive disorders. The use of the original drug will be a priority in the acute period of stroke due to a possible transition from intravenous administration of the drug to taking Gliatilin 400 mg capsules.

Ukrainian substitutes

Gliatilin substitutes presented by Ukrainian manufacturers are distinguished by their low pricing policy and the active composition of the drug.

List of main analogues:

• Alzmerath . A high-quality synonym for the original made in Ukraine. The effectiveness of the analogue lies in the content of the active substance. Intended for the treatment of acute brain injuries, disorders associated with circulatory disorders, and memory loss in old age. Prohibited during pregnancy, breastfeeding, and high sensitivity. The maximum cost is 550–600 rubles.
• Gliaton . A relatively inexpensive analogue of gliatilin, presented as capsules and solution for injection. It has the following indications for use: degenerative-involutional disorders of the brain, memory loss in the elderly, acute periods of inflammation after traumatic brain injury. Use during pregnancy, breastfeeding, and allergies should be avoided. The maximum cost is 650–700 rubles.
• Neurotilin . A similar composition to gliatilin in the form of an injection solution. The action of the main components provides the restorative properties of the drug, which have a positive effect on the functioning of the central nervous system. Used for the preventive treatment of brain disorders of various etiologies. Use is prohibited during pregnancy, allergies, lactation, excessive psychotic syndrome. The maximum cost is 580–620 rubles.
• Reneiro . Centrally acting parasymptomimetic. Gliatilin substitute in the form of a solution for injection. The drug is effective in various acute courses of post-traumatic traumatic brain disorders, memory loss, and ischemic strokes. Contraindications: high sensitivity to the active substance, pregnancy, lactation. The maximum cost is 500–560 rubles.

Gliatilin or Holitylin

Manufacturer: ARTLAYF LLC (Russia)
Release form: capsules, solution for intramuscular and intravenous administration

Active ingredient: choline alfoscerate

Cholitilin, an analogue of Gliatilin in injections and capsules, is a generic version of the original drug, since both drugs have equivalent active substances and mechanism of action. A more effective medication for vascular lesions of the central nervous system would be Gliatilin. The ingredients included in the structure of the product have a higher chemical purity, which increases its therapeutic result.

Alpha GPC by Mr.Lt.Nootropics

This supplement is an analogue of Gliatilin, but with a reduced concentration of choline alfoscerate. It belongs to the category of nootropic drugs and cholineergics (helps the body produce choline necessary for normal functioning).

Indications for taking Alpha GPC are the following symptoms:

1. Decreased concentration;
2. Memory impairment;
3. Frequent dizziness;
4. Disturbances in brain function caused by oxygen starvation;
5. Mental disorders arising from prolonged use of alcohol;
6. Psychoorganic syndrome.

The result of taking Alpha GPC is an improvement in mood and general well-being, elimination of apathy, chronic fatigue syndrome, irritability, and anxiety. Concentration improves significantly, the level of stress resistance and the speed of memorizing information increases.

Alpha GPC

1999 rub.

Alpha GPC is available in powder or capsule form for oral administration. Before use, consultation with a medical specialist is required.

Gliatilin or Cortexin

Manufacturer: GEROPHARM LLC (Russia)
Release form: lyophilisate for preparing a solution for intramuscular administration

Active ingredient: polypeptides of the cerebral cortex of cattle

Cortexin and Gliatilin are classified as nootropics, but they act differently due to different active substances. In the treatment of stroke, traumatic lesions of the central nervous system, accompanied by memory disorders, analysis, it is more effective to use Gliatilin, and its analogue Cortexin - in pediatric practice for cerebral palsy, other neurological diseases, inflammatory processes of the central nervous system, and intoxications.

Actovegin

Manufacturer: CJSC FARMFIRMA SOTEX (Russia)
Release form: solution for injection

Active ingredient: deproteinized hemoderivative of calf blood

An analogue of the drug Gliatilin in ampoules is an activator of interstitial metabolism, stimulating trophism and regeneration of cellular structures. Actovegin, improving microcirculation, provides the energy needs of cells in the nervous tissue, reduces the clinical manifestations of arterial angiopathy and hypoxia.

Cavinton

Manufacturer: JSC GEDEON RICHTER (Hungary)
Release form: tablets

Active ingredient: vinpocetine

The medication, once inside the body, exhibits a neuroprotective effect. Cavinton is a cheaper analogue of Gliatilin, increases the brain's resistance to hypoxia and ischemia, has a beneficial effect on the rheological properties of blood, reducing its viscosity and increasing fluidity.

By stimulating cerebral blood flow, the drug increases cardiac output, reduces cerebral vascular resistance, while having no effect on blood pressure and heart rate.