Piracetam

What it is and how it works

Piracetam is a cyclic GABA derivative whose mechanism is not fully established; it is thought to modulate neurotransmission, improve neuronal membrane fluidity and have rheological effects, including reduced platelet aggregation and erythrocyte adhesion. It does not act as a sedative or stimulant.

Indications

Adjunctive treatment of myoclonus of cortical origin, irrespective of aetiology; in some countries also used for cognitive impairment and vertigo, although evidence for these uses is limited.

Dosage and administration (summary)

Oral: for cortical myoclonus, initially 7.2 g daily in 2–3 divided doses, increased by 4.8 g daily every 3–4 days up to a maximum of 24 g daily; dose reduced in renal impairment.

Contraindications

End-stage renal disease (creatinine clearance below 20 mL/min), cerebral haemorrhage, Huntington’s chorea and hypersensitivity to piracetam or pyrrolidone derivatives.

Warnings and precautions

Because of its effect on platelet aggregation, use with caution in patients with haemostatic disorders, major surgery, severe haemorrhage or those taking anticoagulants or antiplatelet drugs. Abrupt withdrawal may precipitate recurrence of myoclonus or seizures in myoclonic patients. Dose must be adjusted to renal function, especially in the elderly.

Pregnancy

Should not be used in pregnancy unless clearly necessary; it crosses the placenta.

Storage and supply

Store below 25–30 °C.

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