Alpha glycerylphosphorylcholine + Ginkgo Biloba + Piracetam

Usage

This combination is prescribed for cognitive enhancement, particularly in conditions like Alzheimer’s disease, dementia, and learning disorders. It aims to improve memory, learning, and other cognitive functions, including attention span, concentration, focus, and mental alertness.

• Pharmacological Classification: Nootropic, cognitive enhancer.

• Mechanism of Action: The combination works synergistically:

  • Alpha-GPC: Elevates acetylcholine levels, a neurotransmitter essential for memory and learning, and supports neuronal membrane health.
  • Piracetam: Modulates acetylcholine receptors, improves interneuronal communication, and enhances brain energy metabolism.
  • Ginkgo Biloba: Improves cerebral blood flow, acts as an antioxidant protecting against neurological damage, and may improve mental function.

Alternate Names

• Alpha-GPC + Ginkgo Biloba + Piracetam
• Moracetam AG Tablet
• Piracetam+alpha Glycerylphosphoryl Choline+ginkgo Biloba

How It Works

• Pharmacodynamics: This combination enhances cognitive function by increasing acetylcholine availability, improving neuronal communication, and protecting neurons from oxidative stress. Piracetam is thought to improve brain cell function by altering the properties of their membranes and enhancing brain energy metabolism and neurotransmission. Ginkgo biloba enhances the tone and elasticity of blood vessels, thus improving blood flow to the brain, and has anti-inflammatory effects. It may inhibit an enzyme that harms brain cells.

• Pharmacokinetics:

  • Alpha-GPC: Readily crosses the blood-brain barrier.
  • Piracetam: Primarily excreted by the kidneys.
  • Ginkgo Biloba: Metabolized by the liver.

• Mode of Action: Alpha-GPC increases acetylcholine levels. Piracetam increases the activity of acetylcholine and enhances communications between nerve cells by altering cell membrane properties. Ginkgo biloba promotes blood circulation and protects the brain by acting as an antioxidant. Specific details on CYP enzyme interactions and elimination pathways for the combination are not fully elucidated.

Dosage

Dosage guidelines for this combination are not definitively established and should be determined by a physician based on individual patient needs and the specific formulation. The following information is compiled from sources describing the individual components and similar combination products.

Standard Dosage

Adults:

A common approach is:

• Alpha-GPC: 400 mg three times daily
• Piracetam: 2.4 g - 4.8 g daily, divided into two or three doses
• Ginkgo Biloba: 120 mg - 240 mg daily, standardized extract

Start with lower doses and titrate upwards based on patient response and tolerance.

Children:

Limited data is available for pediatric use. Consult a pediatrician or specialist before administration. For dyslexia, a dosage of 3.2g of Piracetam daily, divided into two doses, is recommended for children 8 years and older, alongside speech therapy. For sickle cell vaso-occlusive crises, a dosage of 160 mg/kg/day of Piracetam orally for prophylaxis, or 300 mg/kg/day intravenously for remission is recommended.

Special Cases:

• Elderly Patients: Adjust dosage based on renal function.
• Patients with Renal Impairment: Dose reduction is crucial. If creatinine clearance is 50-79 mL/min, use 2/3 the usual dose; if 30-49 mL/min, use 1/3 the usual dose; if <30 mL/min, use 1/6 the usual dose. Piracetam is contraindicated in severe renal impairment (creatinine clearance <20 mL/min).
• Patients with Hepatic Dysfunction: No dose adjustment is needed for solely hepatic impairment. Adjust dose based on renal function if both hepatic and renal impairment are present.
• Patients with Comorbid Conditions: Consider adjustments for conditions such as diabetes, cardiovascular disease, bleeding disorders, pre-existing neurological conditions, or seizure disorders.

Clinical Use Cases

Specific dosage recommendations for clinical settings like intubation, surgical procedures, mechanical ventilation, ICU use, and emergency situations are not well-established for this specific combination. Dosage should be determined by a physician considering the individual patient’s needs and the clinical context.

Dosage Adjustments

Dose adjustments are crucial based on renal function, hepatic function, and other comorbid conditions. Genetic polymorphisms affecting drug metabolism may also necessitate dose modification.

Side Effects

Common Side Effects:

Headache, dizziness, diarrhea, nausea, vomiting, heartburn, nervousness, weight gain, insomnia.

Rare but Serious Side Effects:

Abnormal involuntary movements, increased bleeding risk (especially with Ginkgo Biloba), severe allergic reactions, exacerbation of pre-existing neurological conditions.

Long-Term Effects:

Chronic complications from prolonged use are not well-established. Long-term monitoring is advisable.

Adverse Drug Reactions (ADR):

Clinically significant ADRs requiring immediate intervention are rare but can include severe allergic reactions and exacerbations of pre-existing neurological conditions.

Contraindications

• Hypersensitivity to any of the components
• Severe renal impairment (creatinine clearance <20 mL/min)
• Brain hemorrhage
• Huntington’s disease
• Bleeding disorders
• Seizure disorders
• Pregnancy

Relative contraindications include epilepsy, liver impairment.

Drug Interactions

• Antiretroviral drugs (e.g., efavirenz)
• Antimuscarinic drugs (e.g., scopolamine)
• Thyroid hormone (thyroxine)
• Anticoagulants (e.g., warfarin)
• Antiplatelet drugs (e.g., clopidogrel, aspirin)
• Calcium channel blockers (e.g., nifedipine)
• Alcohol (potential increased side effects)
• Blood pressure-lowering medicines (e.g., amlodipine, lisinopril)
• Hypoglycemic medicines (e.g., insulin, metformin)
• Nootropic medicines (e.g., donepezil, memantine)
• Medications affecting liver enzymes

Pregnancy and Breastfeeding

The safety of this combination during pregnancy and breastfeeding is not established. Avoid use.

Drug Profile Summary

• Mechanism of Action: Enhances cognitive function by increasing acetylcholine, improving interneuronal communication, and protecting neurons.
• Side Effects: Headache, dizziness, gastrointestinal issues, nervousness, weight gain, insomnia. Rarely, involuntary movements, bleeding risk.
• Contraindications: Hypersensitivity, severe renal impairment, brain hemorrhage, Huntington’s disease, bleeding disorders, seizure disorders, pregnancy.
• Drug Interactions: Antimuscarinics, thyroid hormone, anticoagulants, antiplatelets.
• Pregnancy & Breastfeeding: Avoid use.
• Dosage: Varies; commonly 400 mg Alpha-GPC, 2.4-4.8 g Piracetam, 120-240 mg Ginkgo Biloba daily for adults. Adjust for renal/hepatic impairment.
• Monitoring Parameters: Cognitive function, renal function, liver enzymes, weight, blood pressure.

Popular Combinations

This combination itself is a popular combination used in clinical practice for its potential synergistic effects on cognitive enhancement. Combining piracetam with choline sources like Alpha-GPC can mitigate potential side effects like headaches.

Precautions

• General Precautions: Pre-screening for allergies, metabolic disorders, organ dysfunction.
• Specific Populations:
  • Pregnant Women: Avoid use.
  • Breastfeeding Mothers: Avoid use.
  • Children & Elderly: Use with caution; adjust dosage as needed.
• Lifestyle Considerations: Limit alcohol; monitor for side effects affecting driving ability.

FAQs (Frequently Asked Questions)

Q1: What is the recommended dosage for Alpha glycerylphosphorylcholine + Ginkgo Biloba + Piracetam?

A: Dosage varies depending on individual patient needs and the specific formulation. A common adult dosage is 400 mg Alpha-GPC three times daily, 2.4 g - 4.8 g Piracetam daily divided into two or three doses, and 120 mg - 240 mg Ginkgo Biloba daily. Pediatric and special population dosing should be determined by a physician.

Q2: What are the primary uses of this combination?

A: It is primarily used to enhance cognitive function, particularly in conditions like Alzheimer’s disease, dementia, and learning disorders.

Q3: What are the common side effects?

A: Common side effects include headache, dizziness, diarrhea, nausea, vomiting, heartburn, nervousness, and insomnia.

Q4: Are there any serious side effects?

A: While rare, serious side effects may include involuntary muscle movements and increased bleeding risk. Severe allergic reactions can also occur.

Q5: What are the contraindications for this combination?

A: Contraindications include hypersensitivity to any component, severe renal impairment, brain hemorrhage, Huntington’s disease, bleeding disorders, seizure disorders, and pregnancy.

Q6: What drug interactions should I be aware of?

A: Potential interactions exist with antiretrovirals, antimuscarinics, thyroid hormone, anticoagulants, antiplatelets, calcium channel blockers, alcohol, blood pressure medications, and drugs affecting liver enzymes.

Q7: Can this combination be used during pregnancy or breastfeeding?

A: No, it is contraindicated during pregnancy and breastfeeding due to a lack of established safety data.

Q8: Is there a risk of weight gain with this combination?

A: Yes, weight gain has been reported as a potential side effect. Patients should be advised to follow a healthy diet and exercise regularly.

Q9: How should I monitor patients on this combination?

A: Monitor cognitive function, renal function, liver enzymes, weight, and blood pressure.

Q10: Are there any special considerations for elderly patients?

A: Yes, elderly patients may require dosage adjustments based on their renal function. Start with a lower dose and titrate cautiously.