Citicoline

What it is and how it works

Citicoline (CDP-choline) is an endogenous intermediate in the synthesis of phosphatidylcholine, a major component of neuronal membranes. Exogenous citicoline provides cytidine and choline, is proposed to support membrane repair, reduce phospholipid breakdown and free-radical formation after ischaemic or traumatic injury, and to increase acetylcholine and dopamine availability.

Indications

Approved in some European and other countries as adjunctive treatment of acute ischaemic stroke and its neurological sequelae, head injury and its sequelae, and cognitive and behavioural disorders of degenerative or vascular origin; evidence of clinical benefit is limited.

Dosage and administration (summary)

Parenteral (adults): typically 500–2000 mg daily by slow intravenous injection or infusion, or intramuscular injection, depending on the indication and the product label.

Contraindications

Hypersensitivity to citicoline; marked parasympathetic hypertonia (vagotonia).

Warnings and precautions

Generally well tolerated; transient hypotension, headache, gastrointestinal upset, insomnia or agitation may occur. In acute intracranial haemorrhage, high doses and rapid injection should be avoided (product labels recommend slow injection and limited doses). It should not replace established acute stroke treatments.

Pregnancy

Use in pregnancy only if the potential benefit justifies the risk, owing to insufficient data.

Storage and supply

Store below 25 °C, protected from light.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.