Citicoline: Indication, Dosage, Side Effect, Precaution

Generic Medicine Info Patient Medicine Information

This information is not country-specific. Please refer to the Malaysia prescribing information.

Generic Medicine Info

Indications and Dosage

Intramuscular, Intravenous
Cerebrovascular disorders, Cognitive disorder, Head injury, Ischaemic stroke, Parkinson's disease

Adult: Dosage is individualised according to the severity of the disease: 100-1,000 mg daily given via IM inj, slow IV inj (3-5 minutes), or as IV infusion with a rate of 40-60 drops/min. Dosage recommendations may vary among countries or individual products. Refer to specific product guidelines.

Oral
Cerebrovascular disorders, Cognitive disorder, Head injury, Ischaemic stroke, Parkinson's disease

Adult: Dosage is individualised according to the severity of the disease: As tab: 500 mg 1-2 times daily or 1,000 mg once daily. As solution: 100-200 mg bid or tid; or 500-2,000 mg daily, depending on the severity of the symptoms. Dosage recommendations may vary among countries or individual products. Refer to specific product guidelines.

Administration

May be taken with or without food.

Contraindications

Hypertonia of the parasympathetic nervous system.

Special Precautions

Patient with acute, severe, and progressive disturbances. Avoid giving high dose citicoline (>500 mg) in intracranial bleeding. Pregnancy and lactation.

Adverse Reactions

Cardiac disorders: Bradycardia, tachycardia.
Eye disorders: Diplopia.
Gastrointestinal disorders: Diarrhoea, epigastric distress, nausea, stomach pain.
General disorders and administration site conditions: Fatigue, malaise.
Investigations: Abnormal LFT.
Metabolism and nutrition disorders: Anorexia.
Nervous system disorders: Headache, dizziness, convulsion.
Psychiatric disorders: Insomnia, excitation.
Skin and subcutaneous tissue disorders: Rash.
Vascular disorders: Transient blood pressure changes, flushing.

Drug Interactions

Potentiates the effects of levodopa.

Action

Description:
Mechanism of Action: Citicoline is a complex organic molecule that stimulates the biosynthesis of structural phospholipids of the neuronal membrane. It preserves the neuronal energetic reserve, inhibits apoptosis and stimulates the synthesis of acetylcholine. It is also claimed to increase blood flow and oxygen consumption in the brain.
Synonyms: CDP-choline; cytidine diphosphate choline; cytidine 5'-diphosphocholine.
Pharmacokinetics:
Absorption: Almost completely absorbed (oral); well-absorbed (IM, IV). Bioavailability: >90%. Time to peak plasma concentration: Biphasic (oral): 1 hour and 24 hours.
Distribution: Widely distributed in brain structures. Crosses the blood-brain barrier.
Metabolism: Metabolised in the liver and gut wall via hydrolysis to form choline and cytidine.
Excretion: Mainly via respiratory CO₂ and urine; faeces (<1%). Elimination half-life: 71 hours (urine); 56 hours (respiratory CO₂).

Chemical Structure

Storage

Store below 30°C.

MIMS Class

Nootropics & Neurotonics/Neurotrophics

ATC Classification

N06BX06 - citicoline ; Belongs to the class of other psychostimulants and nootropics.

References

Anon. Citicoline (Natural Products Database). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 04/07/2022.

Buckingham R (ed). Citicoline. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 04/07/2022.

Cholinerv (UNILAB Inc.). MIMS Philippines. http://www.mims.com/philippines. Accessed 04/07/2022.

Cikolin 250 mg/mL (500 mg/2 mL); 250 mg/mL (1 g/4 mL) Solution for Injection [IM/IV] (Huons Co., Ltd.). MIMS Philippines. http://www.mims.com/philippines. Accessed 04/07/2022.

CITXL 500 mg Film-coated Tablet (XL Laboratories Pvt. Ltd.). MIMS Philippines. http://www.mims.com/philippines. Accessed 04/07/2022.

Cyline 1 g Film-coated Tablet (Pharma 3 Co., Inc.). MIMS Philippines. http://www.mims.com/philippines. Accessed 04/07/2022.

Somazina 100 mg/mL Oral Solution (Eisai [Hong Kong] Co Ltd). MIMS Hong Kong. http://www.mims.com/hongkong. Accessed 04/07/2022.

Disclaimer: This information is independently developed by MIMS based on Citicoline from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2024 MIMS. All rights reserved. Powered by MIMS.com