Piracetam, cinnarizine

Combitropil is a combination drug with a pronounced antihypoxic, nootropic and vasodilating effect.
Both components mutually potentiate their own anti-hypoxic effect and have a vasodilator effect. The combined drug also contributes to a significant increase in blood flow in the brain. The toxicity of the combination does not exceed the toxicity of the individual components of the drug.

Piracetam is a nootropic agent. It has a positive effect on the metabolic processes of the brain: it increases ATP concentration in brain tissue, enhances the synthesis of RNA and phospholipids, stimulates glycolytic processes, and enhances glucose utilization.
It improves the integrative activity of the brain, contributes to the consolidation of memory, facilitates the learning process.
Changes the speed of propagation of excitation in the brain, improves microcirculation, without exerting a vasodilator action, suppresses the aggregation of activated platelets. It has a protective effect in brain damage caused by hypoxia, intoxication, electroshock; enhances alpha and beta activity, reduces delta activity on EEG, reduces the severity of vestibular nystagmus.
It improves interneuronal transmission and synaptic conduction in neocortical structures, improves mental performance, and improves cerebral blood flow. The effect develops gradually.

Practically does not have a sedative and psychostimulating effect.
Cinnarizine is a selective blocker of slow calcium channels, reduces the entry of Ca2 + into cells and reduces its content in the plasmootremus depot, reduces the tone of arteriole smooth muscle, reduces their response to biogenic vasoconstrictor substances (epinephrine, norepinephrine, dopamine, angiotensin, vasopressin, synephrine, norepinephrine, dopamine, angiotensin, vasopressin, epinephrine, norepinephrine, dopamine, angiotensin, and vasopressin).
It has a vasodilating effect (especially in relation to the vessels of the brain, enhancing the antihypoxic effect of piracetam), without having a significant effect on blood pressure. It shows moderate antihistamine activity, reduces the excitability of the vestibular apparatus, lowers the tone of the sympathetic nervous system. In patients with impaired peripheral blood circulation, it improves the blood supply to organs and tissues (including myocardium), increases post-ischemic vasodilation. Increases the elasticity of erythrocyte membranes, their ability to deform, reduces blood viscosity.

Pharmacokinetics
The combined drug is rapidly and completely absorbed in the gastrointestinal tract. Bioavailability of piracetam - 95%. The therapeutic effect appears after 1-6 hours. The maximum level of cinnarizine in plasma is noted after 1-4 hours, piracetam - after 2-6 hours. Cinnarizine metabolism proceeds completely in the liver (by dealkylation). 60% of cinnarizine in an unchanged form is excreted in the feces, the rest of the amount in the urine as metabolites in about 5 hours. The maximum level of cinnarizine after 1-4 hours is noted not only in the blood, but also in the liver, kidneys, heart, lungs, spleen and in the brain. Associated with 91% of plasma proteins.

Piracetam penetrates the blood-brain barrier, accumulates in the brain tissue within 1-4 hours after ingestion. From the cerebral spinal fluid is displayed much slower than from other tissues. Practically not metabolized. The half-life is 4.5 hours (7.7 hours from the brain). Excreted by the kidneys - 2/3 unchanged for 30 hours.