Piracetam stimulates the cerebral cortex by increasing the rate of metabolism and the energy levels of neurons. It facilitates movement of information between the brain's two hemispheres via the corpus callosum, and improves the function of the neurotransmitter acetylcholine via muscarinic cholinergic (ACh) receptors which are implicated in memory processes. Furthermore, Piracetam may have an effect on NMDA glutamate receptors which are involved with learning and memory processes. Piracetam may exert its global effect on brain neurotransmission via modulation of ion channels (i.e. Ca2+, K+). Piracetam exerts its haemorrheological effects on the platelets, red blood cells and vessel walls by increasing erythrocyte deformability and by decreasing platelet aggregation, erythrocyte adhesion to vessel walls and capillary vasospasm.

Piracetam is indicated for- • Cerebral vascular accidents like stroke, head injuries and other acute cases. • Aging disorders such as reduced cerebral functioning evidenced by memory loss, intellectual decay, character disorders, psychomotor disorder etc. • Mental retardation in children.

In cerebro-cortical insufficiency disorders, the usual dose is 800 mg 3 times daily. In myoclonic seizures: Dose of 7.2 g daily, increasing by 4.8 g per day every 3 to 4 days up to maximum of 20 g daily, given in 2 or 3 divided doses. Children: The daily dose depemds on the weigh of the children, 50 mg/kg of body weight in 3 divided doses.

Piracetam is contraindicated in patients with severe renal impairment (renal creatinine clearance of less than 20 ml per minute), hepatic impairment, cerebral hemorrhage and in those with hypersensitivity to Piracetam or any of the excipients.

Abrupt discontinuation of treatment should be avoided as this may induce myoclonic or generalized seizures in some myoclonic patients.

The side effects are vertigo, abdominal pain, diarrhea, nausea, vomiting, insomnia, somnolence, agitation, anxiety, confusion, hallucination, dermatitis and rash.

Use in Pregnancy: Category: C. There is no adequate data from the use of Piracetam in pregnant women. Piracetam should not be used during pregnancy unless clearly necessary. Use in lactation: Piracetam is excreted in human breast milk. Therefore, Piracetam should not be used during breastfeeding or breastfeeding should be discontinued, while receiving treatment with Piracetam.

In a single case, confusion, irritability and sleep disorders were reported in concomitant use with thyroid extract. At present, no interaction has been observed with the following anti-epileptic drugs, clonazepam, carbamazepine, phenyton, phenobarbitone and sodium valporate, based on a small number of studies

Piracetam appears to be devoid of toxicity even at very high doses and, therefore, the need for specific measures to be taken in case of an overdose is avoided. Drug Interactions: In a single case, confusion, irritability and sleep disorders were reported in concomitant use with thyroid extract. At present, no interaction has been observed with the following anti-epileptic drugs, clonazepam, carbamazepine, phenytoin, phenobarbitone and sodium valproate, based on a small number of studies.

Stored in a cool and dry place at a temperature below 30o C. Keep away from light

Neuratam Tablet: Each box contains 30/50/100 tablet in blister packing. Neuratam Solution: Each bottle contains 100 ml solution with a spoon.