Peptide bioregulators and their application: from neonatology to gerontology

Cortexin is a medicine that is used for diseases of the nervous system.

The drug is obtained from the cerebral cortex of cattle. For this purpose, the lyophilization method is used. Lyophilization is a method of obtaining peptides by freezing and drying. With this method of drug production, the biological effects of the resulting substances are well preserved. Allergic reactions to the resulting mixtures develop much less frequently than with conventional grinding of the original substrate.

A child is not a small adult. The child's body is much more complex. Many processes in it occur not linearly, but in waves. For example, height accelerates significantly during adolescence and then declines again.

Children's metabolic rate is higher. This is due to the fact that the body needs to constantly create new tissues and improve the structure of internal organs. These processes require a huge amount of energy.

Children need special medications created taking into account their anatomical and physiological characteristics.

Action of Cortexin

Cortexin is a mixture of polypeptides. After entering the body, the product is distributed throughout the body through the bloodstream.

Our body has a special formation - the blood-brain barrier (BBB). This is a set of mechanical and functional devices that regulate the metabolism between blood and brain tissue.

Due to the small size of its components, Cortexin passes through this barrier and can affect nerve structures.

The drug has the following types of effects:

• Nootropic – improves memory, attention and concentration. This occurs due to Cortexin’s ability to positively influence the mechanisms of communication of nerve cells with each other.
• Neuroprotective – increases the resistance of neurons to damaging influences: the effects of infections, toxic substances and lack of oxygen (hypoxia).
• Antioxidant – enhances the ability of nerve cells to survive in hypoxic conditions. This effect is possible by reducing the processes of fat peroxidation, during which free radicals are formed. Excessive amounts of free radicals damage cell membranes, causing them to die.
• Metabolic – improves the supply of nerve structures with nutrients and energy.
• Antiepileptic - reduces the risk of epilepsy attacks. Epileptic seizures develop due to too much stimulation of one or another part of the brain. Cortexin, due to its polypeptide nature, normalizes the ratio between excitatory and inhibitory fractions of the brain's own peptides.

Cortexin price, where to buy

The average price of Cortexin in ampoules of 5 ml of 10 mg each in Russia is 1200-1300 rubles, the average cost of ampoules of 5 mg is 700-900 rubles.

The price of Cortexin 10 mg in Ukraine is 800 UAH, the price of Cortexin injections for children varies within 500 UAH. In Dnepropetrovsk, Zaporozhye and other large cities, you can buy the drug both in a network of retail pharmacies and through online pharmacies with delivery directly to your home.

The drug is not available in tablets.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

ZdravCity

• Cortexin lyof.
  d/prig. solution for intramuscular injection. 10mg vial. No. 10 Geropharm LLC 1364 rub. order
• Cortexin lyof. d/prig. solution for intramuscular injection. 5mg vial. No. 10 (for children) Geropharm LLC

  RUB 847 order

Pharmacy Dialogue

• Cortexin (vial 10 mg No. 10) Geropharm

  RUB 1,358 order

• Cortexin (vial 5 mg No. 10) Geropharm

  RUB 806 order

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Pharmacy24

• Cortexin 5 mg No. 10 powder TOV "Geropharm", Russian Federation
  479 UAH. order

PaniPharmacy

• Cortexin bottle Cortexin lyophilized powder for the preparation of solution 5 mg No. 10 Russia, Geropharm

  471 UAH. order

• Cortexin bottle Cortexin lyophilized powder for the preparation of solution for injection 10 mg No. 10 Russia, Geropharm

  849 UAH. order

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Indications for use

In children, Cortexin is used in the complex treatment of the following diseases:

• Cerebral palsy.
• Developmental disorders of learning skills, speech and language.
• Inflammatory diseases of the brain.
• Perinatal damage to the nervous system.
• Cognitive disorders.
• Attention deficit hyperactivity disorder.
• Encephalopathy.

Due to its universal action, the product can be used in all periods of the disease: from acute to restorative.

To develop a therapeutic effect, you must take Cortexin for at least 2 weeks.

More details about these diseases can be found in separate articles.

What side effects may occur in children?

The child’s body is immature in many respects, including the state of the immune system. The development of the following allergic reactions is typical for children:

• Atopic dermatitis (the skin turns red, becomes moist, and cracks may appear);
• Allergic conjunctivitis (inflammation of the mucous membrane of the eyes) and allergic rhinitis (runny nose);
• Food allergies (nausea, vomiting, bloating, belching, bowel problems such as constipation or diarrhea);

Allergic reactions develop faster in children than in adults. The severity of these reactions varies - from minor peeling of the skin to generalized swelling of the entire body. Often, the risk of side effects depends on the child’s pre-existing condition and the presence or absence of diseases.

When Cortexin was administered to children, no adverse reactions were observed.

Instructions for use

Cortexin is a dry whitish-yellow powder. It must be diluted before use. To do this, use saline solution, water for injection or local anesthetic. After receiving the finished mixture, it is drawn into a syringe and injected. The injection is given intramuscularly in the buttock or thigh area.

The procedure should be carried out once a day, preferably in the morning. The course of taking the drug is 10 days. If necessary, can be repeated after 3-6 months.

You can read the instructions for use of the drug in more detail in a separate article.

How to properly administer Cortexin to adults

Cortexin is administered intramuscularly. All manipulations are carried out only with gloves.

First you need to choose the place where the injection will be given.

Injections can be given in the following places:

• Buttock.
• Deltoid.
• Anterior thigh.

In adults, it is preferable to choose the gluteal region for injection. The buttock is mentally divided into four squares. The injection is placed in the upper outer square.

It is better to alternate injection sites: if yesterday you injected in the right buttock, then today - in the left.

Before injection, treat the selected area with a cotton swab soaked in alcohol. Wipe in a circular motion from the center to the periphery.

Before starting the procedure, lightly tap the syringe, lifting it up with the needle. After this, press the plunger until all the air comes out of the syringe.

Stretch the skin at the site of the intended injection with your left hand. Take the syringe in your right hand, lift it a little and sharply insert the needle ¾ of its length. During injection, insert the needle perpendicular to the surface of the body.

The injection should be quick, since if you insert the needle slowly, the pain will be more intense.

Then press the plunger with your right thumb to slowly release the medicine into the muscle. The optimal rate of drug administration is 1 ml in 10 seconds.

After this, quickly remove the needle from the game and put the cap on it. Only in this form can the syringe be thrown away.

It is recommended to massage the injection site so that the drug is better absorbed into the tissue. It is also worth re-treating the area where the injection was made with a cotton swab dipped in an alcohol solution. This is done in order to prevent infection.

The course of taking Cortexin is designed for 10 days. It is better to take the medicine before lunch, like any nootropic drugs. If necessary, the course is repeated after 3-6 months.

For hemispheric ischemic stroke, the Cortexin dosage regimen will be slightly different. Take 1 bottle of medication 2 times a day (morning and evening) for 10 days. 10 days after completion of therapy, the course is repeated.

Cortexin begins to act only a few days after the start of use, so you should not stop injections if you do not see quick results.

The drug is contraindicated during pregnancy and breastfeeding. This is due to insufficient knowledge of the effectiveness and safety of the drug in this category of patients.

Analogues of Cortexin

The closest analogues of Cortexin in structure and origin are Cerebrolysin and Cerebramin.

Cerebrolysin is the closest analogue of Cortexin in origin and action. The drug is interesting because it is the very first peptide nootropic created. During its existence, vast experience has been accumulated about its effects. Compared to Cortexin, older technologies are used to obtain Cerebrolysin. Therefore, after taking it, the risk of developing side effects is higher.

Cerebramin is classified as a dietary supplement (BAA). Dietary supplements are substances that are used as an additional source of components necessary for human life. They are not medicines. This means that this category of products does not undergo the same rigorous testing as drugs, which may make them less safe and effective.

There are a number of other drugs that sometimes replace Cortexin: Mexidol, Fezam, Cavinton, Ceraxon, Pantogam. However, they have different mechanisms of action, so calling them analogues is not entirely correct. Indications for their use may differ from each other, and the combined use of drugs usually gives a more pronounced effect.

You can learn more about the differences between Cortexin and other common medications used for neurological diseases from separate articles (Links to articles).

How to properly administer Cortexin to children

A child’s body has its own characteristics, so Cortexin treatment of patients under 18 years of age has a number of features:

• Dosage calculation: for children weighing up to 20 kg, the dose is calculated at 0.5 mg per kg of body weight. That is, if a child weighs 14 kg, then the volume of the drug he needs will be 14 * 0.5 = 7 mg of the active substance. This means that you need to draw 5 ml of Cortexin from one ampoule (the entire solution) and 2 ml from the other, guided by the graduation scale on the syringe. For children weighing more than 20 kg, the dose per dose will be equal to an adult - 10 mg

Cortexin is an effective and safe remedy. If possible, it is better to entrust the administration of the drug to specially trained medical professionals. If you administer the injections yourself, follow all instructions so that the medicine has the desired effect.

Peptide bioregulators and their application: from neonatology to gerontology

The peptide drug Cortexin, which is a complex of natural low-molecular compounds from the brain of animals (a highly purified extract of nuclear proteins), continues to be one of the most widely discussed pharmacological agents in periodical medical press. At the same time, two aspects attract attention: firstly, the use of Cortexin by representatives of various medical specialties (multidisciplinary in the intended use of the drug), and secondly, the absence of age restrictions on its use. In the modern pharmacopoeia there are not too many similar drugs that do not have age-related contraindications and restrictions on use. Therefore, Cortexin, rightly called the “drug of the 21st century,” deserves more detailed consideration [1].

Categorization and composition of Cortexin

As you know, Cortexin belongs to the pharmacological group 9.7 (“Nootropics (neurometabolic stimulants)”). According to the ATC system (anatomical-therapeutic-chemical) classification, the drug belongs to the heading N06BX (“Other psychostimulants and nootropic drugs”). Among the x-class peptide drugs (cytogens, cytamins, cytomedins), Cortexin belongs to the cytomedins, which are a highly purified extract of nuclear proteins (fractions 1–10 kDa) and are characterized by a proven property of regulating immunological reactivity [2]. Cortexin is an innovative peptide drug; its substance and dosage forms are protected by patents of the Russian Federation (RF No. 2104702, 2275924, 2195297) and other countries.

Cortexin is a multicomponent drug, the composition of which is not limited to neuropeptide substances. In addition to neuropeptides, Cortexin ingredients are represented by no less than three groups of substances: amino acids, vitamins and minerals. There is reason to believe that the positive effects of the drug are explained not only by the action of amino acids and polypeptides, but also by the neurochemical activity of macro- and microelements and vitamins [3, 4].

In particular, Cortexin peptides contain at least two stimulating amino acids - aspartic acid (446 nmol/mg) and glycine (298 nmol/mg). In addition to the above-mentioned aspartic acid and glycine, Cortexin contains the following amino acids:

• threonine (212 nmol/mg);
• serine (268 nmol/mg);
• glutamic acid (581 nmol/mg);
• proline (187 nmol/mg);
• alanine (346 nmol/mg);
• valine (240 nmol/mg);
• isoleucine (356 nmol/mg);
• tyrosine (109 nmol/mg);
• phenylalanine (162 nmol/mg);
• histidine (116 nmol/mg);
• lysine (253 nmol/mg);
• arginine and other amino acids (202 nmol/mg).

From the information presented it follows that aspartic acid accounts for up to 12%, and glutamic acid - about 15% of the total amino acid content in Cortexin peptides. The drug does not contain methionine. In addition, the stabilizer of the drug is the free amino acid glycine (12 mg), the role of which in normalizing the functions of the cerebral cortex has been proven many times.

Cortexin contains a number of vitamins, in particular water-soluble ones: thiamine (vitamin B1) - 0.08 mcg/10 mg, riboflavin (vitamin B2) - 0.03 mcg/10 mg, niacin (vitamin B3, vitamin PP, nicotinic acid) - 0.05 mcg/10 mg; as well as fat-soluble: retinol (vitamin A) - 0.011 mcg/10 mg, alpha-tocopherol (vitamin E) - 0.007 mcg/10 mg. We must admit frankly that this vitamin composition is optimal for the neurons of the brain, as it is perfectly balanced by nature!

In addition to the five essential vitamins, Cortexin contains many minerals (macro- and microelements):

• copper (Cu): 0.2129 µg/10 mg;
• iron (Fe): 2.26 µg/10 mg;
• Calcium (Ca): 22.93 µg/10 mg;
• magnesium (Mg): 8.5 µg/10 mg;
• potassium (K): 19.83 µg/10 mg;
• sodium (Na): 643.2 µg/10 mg;
• sulfur (S): 152.65 µg/10 mg;
• phosphorus (P): 91.95 µg/10 mg;
• zinc (Zn): 4.73 µg/10 mg;
• molybdenum (Mb): 0.0203 µg/10 mg;
• cobalt (Co): 0.0044 µg/10 mg;
• manganese (Mn): 0.0061 µg/10 mg;
• selenium (Se): 0.0745 µg/10 mg;
• aluminum (Al): 0.3104 µg/10 mg;
• lithium (Li): 0.0340 µg/10 mg [4].

Almost all of the listed mineral substances that make up the Cortexin drug have neuromodulatory and other functions.

Traditional and new areas of application of Cortexin

Cortexin is used not only in the Russian Federation. It is registered and used in countries such as Ukraine, Belarus, Armenia, Uzbekistan, Kazakhstan, Azerbaijan, Kyrgyzstan, Tajikistan and Moldova (the use of Cortexin in all cases was preceded by preclinical and clinical examination).

The most important property of Cortexin, which determines the areas of its use, is considered to be the correction of cognitive functions, but the cognitive-modulating effect of the drug is far from the only one. The nootropic, neurotrophic, anticonvulsant, immunomodulatory (immunoregulatory) and neuroprotective effects of the drug, as well as its anti-stress, antioxidant and metabolic effects are described. In connection with the latter, I would like to especially note Cortexin’s ability to normalize the metabolism of neurotransmitters and regulate the balance of activating/inhibitory amino acids.

Therefore, over the past 10 years, Cortexin has been actively used by Russian doctors in various fields of clinical medicine (neurology, pediatrics, ophthalmology, gerontology, etc.): for traumatic brain injuries, neuroinfections, cerebral palsy (CP), perinatal nerve damage systems, disorders (delay) of psychomotor and speech development, thinking disorders, reduced learning ability, neurotic disorders, attention deficit hyperactivity disorder (ADHD), burnout syndrome, autonomic dysfunction, hypertensive angioretinopathy, glaucoma, diabetic neuropathy, amblyopia, etc. d. [1–6].

It should be noted that new areas of application are being discovered for the drug Cortexin. Thus, Bochkova L. G. and Nosova O. M. (2008) report on the experience of using Cortexin in the treatment of natal cervical injury in newborns, Kamenskikh T. G. et al. (2006) - in the treatment of partial optic nerve atrophy (PANA), Utaganova G. Kh. (2010) - in the correction of cervical spondylogenic lesions in young children [7–9].

Cortexin is actively used in gerontology (cerebrovascular accidents, asthenic conditions, encephalopathy of various origins, etc.) [10]. Suffice it to recall that the drug was first introduced into clinical practice by employees of the Military Medical Academy (on the battlefields in Afghanistan [16, 17]), and then by employees of the St. Petersburg Institute of Bioregulation and Gerontology of the Northwestern Branch of the Russian Academy of Medical Sciences. According to Corresponding Member of the Russian Academy of Medical Sciences, Prof. Khavinson V.Kh., who is the vice-president of the Gerontological Society of the Russian Academy of Sciences, “the use of peptide drugs makes it possible to effectively prevent premature aging, as well as treat diseases associated with age...”.

The use of Cortexin for migraine, recommended by Pak L.A. et al. (2005, 2006, 2008), Izzati-Zadeh K. F. et al. (2006), etc., has already become firmly established in the practice of Russian neurologists dealing with this group of primary cephalgia [11–14]. It is indicated that during a migraine attack, Cortexin stabilizes platelet membranes, inhibits the development of the “serotonin cascade,” suppresses neuronal cortical depression of Leo, reduces neurogenic inflammation of the vessels of the dura mater of the brain, suppresses the release of neuropeptides of pain and inflammation from perivascular afferent fibers of the trigeminal nerve [14].

Preliminary studies by the staff of the Scientific Center for Children's Diseases of the Russian Academy of Medical Sciences suggest that in the near future Cortexin will be used as a means for correcting various forms of neurological deficits accompanying certain types of food intolerance (celiac disease, lactase deficiency, etc.) in childhood, and subsequently in adult patients. But perhaps most impressive is the drug's potential use in the treatment of epilepsy.

Cortexin and epilepsy

Epilepsy therapy is a relatively recent indication for the use of Cortexin. The use of Cortexin in the complex treatment of various forms of epilepsy is reported in the works of Guzeva V. I. and Trubacheva A. N. (2003), Golovkin V. I. (2005, 2006) and Zvonkova N. G. (2006) [15–18 ]. Khorshev S.K. et al. (2002, 2008) consider Cortexin as a corrector of the neuroimmune component of epileptogenesis and, based on data from their own biochemical and neuroimmunophysiological studies, recommend this neuropeptide drug for the preventive treatment of epilepsy [19, 20]. The effectiveness of Cortexin in the treatment of epilepsy in children and adults is discussed in the publications of Tsygan V.N. et al. (2008) and Fedunova G.V. et al. (2008) [21, 22]. The need for correction of cognitive impairment with nootropic drugs for epilepsy is indicated by S. V. Balkanskaya et al. (2007, 2008) and Kalinin V.V. et al. (2009) [23–25]. It is Cortexin that plays an important role in this regard.

Finally, in April 2010, at the XVII Russian National Congress “Man and Medicine”, with the support, a symposium “Neuroprotection in the treatment of epilepsy” was held (chaired by Prof. A. B. Gekht). During the work of this symposium, the speakers (Kalinin V.V., Kalacheva I.O., Odintsova G.V.) reflected both theoretical aspects and their own experience of using the drug Cortexin in the treatment of epilepsy in children and adult patients.

In particular, at the Brain Institute of the Russian Academy of Sciences (N. Yu. Koroleva and G. V. Odintsova) there is a positive experience of using Cortexin in 8,000 patients, and, as A. B. Gekht noted, this institution receives “far from the mildest patients "

It is possible that in the future Cortexin will find wide use in the preventive treatment of febrile seizures (FS), which is the most common chronic disorder of cerebral functions in children.

Cortexin for children - a new form of neuropeptide drug

A new form of the drug called “Cortexin for Children” was registered in the Russian Federation on April 27, 2009 [26].

Cortexin for children is a lyophilisate for preparing a solution for intramuscular administration. 1 bottle (3 ml capacity) contains 5 mg of Cortexin (a complex of water-soluble polypeptide fractions with a molecular weight of not more than 10,000 Da) instead of 10 mg present in the standard form of the drug Cortexin, as well as 6 mg of glycine as a stabilizer.

In fact, Cortexin for children is almost the only example where a nootropic drug is targeted specifically for pediatric patients. It is expected that the new form of the peptide drug (Cortexin for children) will be in demand and will find wide application both in Russia and abroad.

What the “Formular System” is silent about

Previously, we have repeatedly pointed out that in the “Formular System” of Russia there is not even a mention of Cortexin [2, 4, 6]. We have to admit that in the XI issue (2010) of this annually updated publication there is no information about Cortexin again [27]. This is all the more strange when even the Internet encyclopedia Wikipedia provides data on this “pharmacopoeial polypeptide bioregulator with biological activity.”

The composition of Cortexin in the “Register of Medicines” (2010) is presented as follows: “in 1 bottle Cortexin - 10 mg, glycine - 12 mg” (glycine present in the drug simultaneously acts as a stabilizer) [28]. In the Vidal Reference (2010), the composition of Cortexin is described even more succinctly: “a complex of polypeptide fractions isolated from the cerebral cortex of cattle and pigs - 10 mg” [29]. In fact, as stated above, the ingredients are much more numerous.

We will try to present information about Cortexin using a form similar to that typically used in the Federal Drug Administration Guidelines.

Cortexin. A peptide preparation representing a complex of low molecular weight peptides isolated from the cerebral cortex of cattle (calves) and pigs under 12 months of age. To isolate the drug, the acetic acid extraction method is used. In order to obtain a fraction of polypeptides with a molecular weight not exceeding 10,000 Da (10 kDa), the resulting extract is subjected to multi-stage purification and repeated filtration on special filters. Purification of the active substance of Cortexin ensures the infectious and antigenic safety of the drug (the absence of infectious agents, nucleic acids, amyloids, functionally active pro-oncogenes and other undesirable impurities).

Cortexin has pronounced metabolic activity: normalization of neurotransmitter metabolism; regulation of the balance of inhibitory/activating amino acids and levels of serotonin and dopamine; GABAergic action; antioxidant effect; normalization of bioelectrical activity (BEA) of the brain. Possessing a pronounced tissue-specific effect on the cells of the cerebral cortex, this neuropeptide drug has cerebroprotective, nootropic, neurotrophic), neurometabolic, stimulating, anti-stress, antioxidant, anticonvulsant and immunoregulatory effects.

Indications. Traumatic brain injury (TBI), cerebrovascular accidents (CVA - acute and chronic), neuroinfections (viral and bacterial), asthenic conditions, encephalopathies of various origins, encephalitis (acute and chronic) and encephalomyelitis, epilepsy, various forms of cerebral palsy, critical conditions newborns with perinatal damage to the nervous system (PPNS), disturbances of psychomotor and speech development, disturbances (decrease) in memory and thinking; disorders of other cognitive functions (CF), headaches of various origins, etc.

Contraindications. Individual intolerance to the drug, pregnancy, lactation.

Side effects. When used according to indications, no side effects of Cortexin were identified.

Interaction. Drug interactions between Cortexin and other drugs have not been described.

Doses and application. The drug is prescribed intramuscularly for children weighing up to 20 kg at a dose of 0.5 mg/kg, and for children weighing more than 20 kg at a dose of 10 mg. The duration of treatment with Cortexin is usually 10 days. If necessary, a repeat course is provided after 1–6 (usually 3–6) months.

The contents of 1 bottle are dissolved in 1–2 ml of 0.5% novocaine solution, water for injection or 0.9% isotonic NaCl solution.

Cortexin. Lyophilized powder (lyophilisate) or porous mass of white/white color with a yellowish tint - for the preparation of a solution for intramuscular administration (vial), 1 ml (1 ml = 10 mg).

Cortexin for children. Lyophilisate for the preparation of solution for intramuscular administration (vial), 3 ml (5 mg).

* * *

In the new English-language scientific journal The Open Neuropsychopharmacology Journal, published since 2008 in the Netherlands, at the end of 2009 a joint publication of Russian and Italian scientists appeared (Moscow State University named after M.V. Lomonosov, L'Istituto Superiore di Sanita, Rome), dedicated to the use of the drug Cortexin and its effect on cognitive functions and behavioral reactions (under experimental conditions).

In particular, Adriani W. et al. (2009) report a confirmed anxiolytic effect of Cortexin, while emphasizing the activity of the drug when used in small doses and the absence of adverse reactions when used for medicinal purposes [30]. Such publications indicate not only the effectiveness of the neuropeptide bioregulator Cortexin from the standpoint of evidence-based medicine, but also the international recognition of this Russian drug.

The tissue specificity and high bioavailability of Cortexin determine an ever-increasing range of possibilities for the use of this drug in the treatment of patients, from the neonatal period to old age.

The reality of today's pharmacology is that there is actually a very meager list of drugs approved for use in children, and in this regard, the high therapeutic properties of Cortexin make it the drug of choice.

Literature

1. Dyakonov M. M. Cortexin is a drug of the 21st century. Treatment and prevention of brain diseases // Aqua Vitae. 2001. No. 3. P. 22–23.
2. Studenikin V. M. Use of the drug Cortexin in neuropediatrics // Med. messenger 2006. No. 37 (380). P. 14.
3. Shabalov N. P., Platonova T. N., Skoromets A. P. Cortexin in neuropediatrics. Method. rec. St. Petersburg 2006. 64 p.
4. Studenikin V.M., Pak L.A., Shelkovsky V.I. et al. The use of cortexin in pediatric neurology: experience and prospects // Pharmateka. 2008. No. 14. pp. 23–29.
5. Granstrem O.K., Sorokina E.G., Storozhevykh T.P. et al. Latest news about cortexin (neuroprotection at the molecular level) // Terra Medica Nova. 2008. No. 5. P. 1–4.
6. Studenikin V.M., Pak L.A., Shelkovsky V.I. et al. About the experience and prospects of using a domestic neuropeptide drug in pediatric neurology // Lech. Doctor. 2009. No. 5. pp. 42–45.
7. Bochkova L. G., Nosova O. M. Nootropic and neuroprotective therapy for newborns with natal cervical trauma // Perinatology and Pediatrics. 2008. No. 1. P. 32–34.
8. Kamenskikh T. G., Bashkatov A. N., Tuchin V. V. et al. Clinical and experimental rationale for the use of the drug “Cortexin” in the treatment of partial optic nerve atrophy // Russian Med. and. 2006. No. 4. pp. 147–150.
9. Utaganova G. Kh. Natal cervical spondylogenic lesions in young children (clinic, diagnosis, treatment). Author's abstract. dis. ...cand. honey. Sci. M., 2010. 28 p.
10. Morozov V. G., Khavinson V. Kh. Prospects for the use of cytomedins in clinical medicine and gerontology // Klin. gerontology. 2000. T. 78. No. 2. P. 42–45.
11. Pak L. A., Goryunova A. V., Studenikin V. M. et al. Evaluation of the effectiveness of treatment of primary headaches in children with the peptide bioregulator Cortexin // Pediatrician. pharmacology. 2005. App. P. 121.
12. Pak L. A., Goryunova A. V., Studenikin V. M. et al. Experience of clinical use of the drugs topiramate and cortexin in the preventive therapy of migraine in children // Issues. modern pediatrics. 2006. T. 5. No. 1. P. 441.
13. Pak L. A., Goryunova A. V., Studenikin V. M. et al. Experience in the treatment of primary headaches in children // Doctor.ru. 2008. No. 4. pp. 28–30.
14. Izzatizade K.F., Lodochnikova L.N., Shutov A.A. Migraine is another target for treatment with cortexin // Neuroimmunology. 2006. T. 4. No. 3–4. pp. 63–70.
15. Guzeva V.I., Trubacheva A.N. Use of cortexin in the complex treatment of epilepsy in children // Terra Medica. 2003. No. 2. P. 19–21.
16. Golovkin V.I. Cortexin in the treatment of epilepsy. In the book: Cortexin - five years of experience in domestic neurology / Ed. Skoromtsa A. A., Dyakonova M. M. St. Petersburg: Science. 2005. pp. 107–113.
17. Golovkin V.I. Cortexin in the treatment of epilepsy // Medico-pharmacist. Vestn. Tatarstan. 2006. No. 6 (234). P. 15.
18. Zvonkova N. G. Immunological parameters in children with epilepsy using traditional and alternative methods of therapy. Author's abstract. dis. ... Ph.D. M., 2006. 26 p.
19. Khorshev S.K., Polyakov Yu.I., Bessmeltsev S.S. Cortexin as a corrector of the neuroimmune component of epileptogenesis. Mat. XI All-Russian. conf. "Neuroimmunology". St. Petersburg 2002. pp. 301–302.
20. Khorshev S. L., Korsakova E. A., Stolyarov I. D. et al. Preventive treatment of epilepsy: the possibilities of cortexin (neuroimmunophysiological and biochemical study) // Neuroimmunology. 2008. T. VI. No. 1. pp. 22–26.
21. Tsygan V.N., Mirolyubov A.V., Bogoslovsky M.M. et al. Efficacy of Cortexin in the treatment of epilepsy // Terra Medica Nova. 2008. No. 4. pp. 20–24.
22. Fedunova G.V., Sysoeva E.N. Experience of using cortexin for symptomatic epilepsy in children // Chapter. doctor. 2008. No. 4 (16). P. 32.
23. Balkanskaya S.V., Studenikin V.M., Kuzenkova L.M. et al. Nootropic drugs in the correction of cognitive functions in children with epilepsy // Issues. modern pediatrics. 2007. T. 6. No. 2. P. 92–96.
24. Balkanskaya S.V., Studenikin V.M., Kuzenkova L.M. et al. Cognitive impairments and their correction in children with epilepsy // Pediatric Practice. 2008. No. 3. pp. 24–27.
25. Studenikin V.M. Cortexin for children - a new form of a popular neuropeptide drug // Med. messenger 2009. No. 24. P. 13.
26. Kalinin V.V., Zheleznova E.V., Sokolova L.V. et al. Cognitive and psychotropic effects of the drug Cortexin in the treatment of patients with epilepsy // Psychiatry and psychopharmacotherapy. 2009. T. 11. No. 3. P. 50–54.
27. Federal guidelines for the use of medicines (formulary system). Vol. XI. M.: Echo. 2010.
28. Register of Medicines of Russia "Encyclopedia of Medicines". 18th edition, revised. and additional M.: RLS-2010.
29. Vidal Directory. Medicines in Russia: Directory. Ed. 16th, revised, corrected. and additional M.: AstraPharmService. 2010.
30. Adriani W., Granstrem O., Romano E. et al. Modulatory effects of cortex and cortagen on locomotor activity and anxiety-related behavior in mice // Open Neuropsychopharmacology Journal. 2009. Vol. 2. P. 22–29.

V. M. Studenikin , Doctor of Medical Sciences, Professor L. A. Pak , Candidate of Medical Sciences S. Sh. Tursunkhuzhaeva V. I. Shelkovsky , Candidate of Medical Sciences S. V. Balkanskaya , Candidate of Medical Sciences

SCCD RAMS, Moscow

Contact information for authors for correspondence

Compatibility

An integrated approach is usually used in the treatment of neurological diseases. This means that several drugs are used at the same time.

In some cases, the combined use of medications gives a more pronounced effect, since the drugs act from different sides. Sometimes the opposite happens, when one remedy weakens the effect of another. In addition, the drugs may not affect each other's effects in any way.

Cortexin is often used together with the following drugs:

• Mexidol.
• Phezam (piracetam + cinnarizine).
• Cavinton.
• Ceraxon or Recognan.
• Pantogam.

Read more about the compatibility of Cortexin with other drugs in a separate article.

What side effects can occur in pregnant women?

Pregnancy is the greatest physiological stress for a woman's body. Inside the mother's body, the development of the fetus occurs, which has a different set of antigens. Normally, when something foreign enters the internal environment of a person, the immune system makes active attempts to expel the foreign object. However, during pregnancy, the fetus must remain inside the mother's body for about 9 months. To prevent the immune system from interfering with this process, during pregnancy the amount of hormones and substances that suppress the immune system (progesterone, estrogen, cortisol, human chorionic gonadotropin, etc.) increases.

Thanks to this mechanism, allergic reactions in pregnant women occur less frequently.

There is no information about the occurrence of side effects of Cortexin when administered to pregnant women. However, due to the small number of clinical studies on the effect of Cortexin during pregnancy, this drug is contraindicated during pregnancy.