Citicoline Sodium is indicated in:

• Cerebrovascular disorders such as ischemic stroke, where it helps accelerate recovery of consciousness and improves motor deficits. Early treatment within 24 hours in moderate to severe stroke increases the likelihood of significant recovery within 3 months.
• Cerebral insufficiency (e.g., dizziness, memory loss, poor concentration, and disorientation) caused by head trauma or brain injury.
• Cognitive impairment associated with degenerative conditions such as Alzheimer’s disease.
• Parkinson’s disease, where it may be used as an effective adjunct (co-therapy).

Citicoline is a naturally occurring compound that serves as a key intermediate in the synthesis of structural phospholipids of cell membranes. After oral administration, it is metabolized into choline and cytidine, which enter systemic circulation, cross the blood-brain barrier, and recombine within the central nervous system. Citicoline enhances the synthesis of neuronal membrane phospholipids, supports repair of damaged neuronal cells and mitochondrial membranes, and increases levels of neurotransmitters such as acetylcholine and dopamine. It also provides neuroprotective effects in hypoxic and ischemic conditions and improves learning and memory functions. Additionally, Citicoline inhibits phospholipase A2 activation, helping to prevent apoptotic and necrotic cell death.

Oral:

• Immediate treatment of stroke due to a clot (ischemic stroke): 500–2000 mg of Citicoline per day, start within 24 hours of stroke.
• For decline in thinking skills due to stroke: 1000–2000 mg of Citicoline per day.
• Chronic cerebrovascular disease: 1000 mg daily in divided dose with or between meals for ongoing disease of the blood vessels that serve the brain.

Injection:

• 1 to 2 injections daily.
• Adjust dosage according to the severity.
• Can be administered through intramuscular (IM), or intravenous (IV) [3 to 5 minutes] route.

Geriatric use: No dosage adjustment is required & the usual dose can be administered.

Citicoline may enhance the effects of levodopa, carbidopa, and entacapone. It should not be used with products containing meclophenoxate.

It should not be administered to patients with hypertonia of the parasympathetic nervous system.

Occasionally, Citicoline may stimulate the parasympathetic system and may cause mild and transient hypotension.

There are no adequate and well-controlled studies on the use of Citicoline during pregnancy and lactation. It should be used only if the expected benefits outweigh the potential risks.

Citicoline may cause dizziness or drowsiness; therefore, patients are advised not to operate machinery during treatment. It may also lead to hypotension, which can be managed with corticosteroids or sympathomimetic agents if necessary. In cases of persistent intracranial hemorrhage, very slow intravenous administration (approximately 30 drops per minute) is recommended. High doses may increase cerebral blood flow. Alcohol consumption should be avoided during treatment.

CNS stimulant drugs

Store below 30°C, protected from light and moisture. Keep out of reach of children.