Before using any medicine, many questions arise in our mind like:
How we get benefit, Side Effects, Contra indications & so many
We at DM PHARMA, trying to explain in scientific way so we know that , Citicoline is a supplement use to improve thinking, learning and memory in elderly people, citicoline has also been investigated as a therapy in stroke patients, perkinson's disease, ADHD, and head trauma(in which person suffer from injury).
Citicoline has neuroprotective properties, So it is composed of choline and cytidine, Citicoline is instrumental in the synthesis of cell membrane phospholips that aid in neuronal membrane repair, and provide a choline source needed for acetylcholine and phosphatidylcholine synthesis.

Citicoline is used for :
Alzheimer's Disease: (Alzheimer's disease is one form of dementia that gradually gets worse over time. It affects memory, thinking, and behavior).
Head Trauma: (Head trauma is an injury that affects the scalp, skull, or brain The injuries can range from a minor bump on the skull to serious brain injury).
Cerebrovascular Disease such as stroke: (strokes are usually acute events and are mainly caused by a blockage that prevents blood from flowing to the heart or brain).
Parkinson's Disease: (Parkinson's disease is a disorder of the brain that leads to shaking (tremors) and difficulty with walking, movement, and coordination).
Attention deficit-hyperactive disorder (ADHD) : ( is one of the most common childhood disorders. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity).
It has been demonstrated by recent studies concomitant administration of an Citicoline tablet shows better symptoms relief compared with the modest improvement of cerebrovascular disease such as stroke and Alzheimer's disease.

Indications and Usage:
●It is use for the treatment of patients with serious cerebrai injuries of vascular or traumatic nature with or without loss of consciousness.
●It is also indicated for treatment of degenerative damages and chronic cerebral vascular injuries in senile dementia.

Mechanism of Action:
From above discussion we come to know that it is useful against cerebrovascular disease such as stroke, so it is necessary to know that how citicoline work in body.
We know that the extensive damage caused by stroke requires repair and regeneration of axons and synapses of neurons, so new membrane production is essential. The primary mechanism by which citicoline is believed to have a therapeutic effect in stroke is its ability to increase the synthesis of phosphatidylcholine, the primary neuronal membrane component.
It also enhances acetylcholine synthesis, and might thus ameliorate symptoms caused by the stroke induced los of cholinergic neurons. Another mechanism by which citicoline may have a more acute effect on the outcome of stroke patients relates to its ability to reduce free fatty acid accumulation at the site of injury, and thus to prevent further damage.
Citicoline avoids, reduces of reverses the effects of ischemia and/or hypoxia in major part of animals and cellular models studied and acts in the cranial traumatic forms, reduces and limits the injuries to the membranes of the nerve cells, re – establishes the sensitivity and the functions of the regulatory intracellular enzymes and accelerates the re- absorption of the cerebral edema.
Thus considerable evidence accumulated supports the use of citicoline for increasing and maintaining and repairing the membranes and the neuronal function in situations such as ischemia and traumatic injuries. In patients with senile dementia, citicoline reduces the evolution of damages.

Citicoline Uses:
Age-related memory problems. Citicoline seems to help memory loss in people aged 50 to 85 years. Stroke recovery.

How does it work?
Citicoline seems to increase a brain chemical called phosphatidylcholine. This brain chemical is important for brain function. Citicoline might also decrease brain tissue damage when the brain is injured.

Clinical Pharmacology:
Citicoline is a pyrimidine 5' – nucleotide which serves as an essential precursor in the synthesis of lecithin (phosphatidylcholine) and other phospholipids.

Citicoline is well absorbed after oral administration, has an absolute bioavailability of approximately 99%. Citicoline is metabolized in the liver to free choline. The liver is capable of synthesizing lecithin from choline, and resynthesizing citicoline from cytidine and choline.
Due to difficulties in detecting plasma levels of citicoline itself, assays have been performed for free choline or total plasma radioactivity in terms of citicoline equivalents. Plasma choline levels are elevated significantly after oral administration. Two peaks of plasma citicoline equivalents have been reported after oral doses of radiolaberled citicoline (300mg). An initial peak is observed in approximately 1 hour (1.5 mcg.mL), presumably related to mixture of unchanged citicoline and its metabolites (choline and cytidine diphosphate). A second peak of approximately 3 mcg/mL is seen 24 hours postdose, and may be due to delayed absorption of the drug or continued metabolite accumulation over this time period. Choline derived from citicoline crosses the blood brain barrier, presumably serving as a source for acetylcholine and phosphatidylcholine (lecithin) synthesis. The major portion of a dose of citicoline appears to be incorporated into tissues and/or used in biosynthetic/ biodegradation pathways. Including lecithin/lipid membrane synthesis. Small amounts of a dose are recovered in urine (2% to 3%) and in feces (less than 1%). Approximately 12% of a dose is eliminated as respiratory carbon dioxide. Elimination half life of citicoline is 3.5 hours (first peak concentration), 125 hours (second peak concentration).

Drug Interactions:
Usually drug interactions occur when it is taken with another drug or with food. Before you take a medication for a particular ailment, you should inform the health expert about intake of any other medications including non-prescription medications. Citicoline must not be use with medicines containing meclophenoxate (or centrophenoxine). Citicoline increases the effects of L – dopa.

Hypersensitivity to citicoline or any other component of the formulation.

Warning and Precautions:
Citicoline may cause hypotension and in case necessary the hypotensive effect can be treated with corticosteroids or sympathomimetics.

Pregancy and Lactation:
There are no adequate and well controlled studies of citicoline during pregnancy and lactation citicoline should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Caution should be exercised during breast feeding because it is not known whether citicoline is excreted in human breast milk.

Side Effects:
Citicoline is generally well tolerated. Few adverse effects that are reported with oral citicoline include gastrointestinal disturbances, dizziness, and fatigue.

From the above discussion, it can be concluded that this Citicoline tablet used to treat many diseases like Parkinson's disease, Alzheimer's disease, head trauma, memory loss and stroke. This citicoline has neuroprotective properties, So it is composed of choline and cytidine, Citicoline is instrumental in the synthesis of cell membrane phospholipase that aid in neuronal membrane repair, and provide a choline source needed for acetylcholine and phosphatidylcholine synthesis and this brain chemical is important for brain function. Citicoline might also decrease brain tissue damage when the brain is injured.
We also conclude that :
● Citicoline help to protect nerve cells in conditions where there is low oxygen availability.
● After research on citicoline drug, in 2003 Mc Daniel conclude that this drug also help to improves learning and memory.
● Citicoline helps recovery from post-traumatic coma and neurological deficits and in those who have had an ischemic cerebral vascular disease such as stroke.
● It also improves cognitive function in Alzheimer's and Parkinson's disease, exerting cholinergic effects, reducing endogenous histamine levels and improving cerebrovascular blood flow.
● It help to Improve vision and nourishing the optic nerve in those with glaucoma.
● In 2002 Zweifler also conclude that it also act as stabilizer of cell membranes and reduces the presence of free radicals.

Store in a cool, dry place, protected from light, keep out of reach of children.