Other metabolic agents (local classification)
ATC code: V03AX-ACTOVEGIN (Deproteinized hemoderivative (local code))
The biologically active component is a low-molecular-weight fraction of a deproteinized calf blood extract. The manufacturer claims improved tissue glucose and oxygen utilization. The mechanism is not described in international pharmacological literature. The product is not registered in the United States or Canada and was withdrawn from the market in Switzerland. It is not available in most Western European countries.
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
Not recommended
A single published RCT (Ziegler 2009) showed a modest improvement in subjective diabetic polyneuropathy symptoms with intravenous administration. The study has not been replicated in independent multicenter work since. International guidelines from 2024 and 2022 on painful diabetic neuropathy do not mention Actovegin; first-line options are , , , and .
Not recommended
For cognitive impairment and 'chronic cerebral ischemia', the product is not mentioned in international guidelines (, ).
Not recommended
International guidelines for acute ischemic stroke management ( 2019, 2021) do not mention the product. Proven acute therapies are reperfusion (thrombolysis, thrombectomy) and standard secondary prevention.
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Use in pregnancy only under strict indication and supervision. International recommendations are unavailable.
There are no data on the transfer of deproteinised calf-blood haemodialysate into human milk. The product is a mixture of low-molecular peptides, amino acids, nucleosides and electrolytes derived from calf blood, and its pharmacokinetics as a medicinal substance are not characterised. Cochrane reviews and EMA have not confirmed efficacy claims. Routine use during breastfeeding is not supported.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Deproteinized hemoderivative from calf blood is evaluated for the following indications with varying evidence strength: Diabetic polyneuropathy (evidence tier D), Ischemic stroke (evidence tier F), Cognitive impairment (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Deproteinized hemoderivative from calf blood (≥ 1 in 100): Allergic reactions, Injection site redness and pain. See the Safety section for uncommon and serious reactions.
FDA category N. Use in pregnancy only under strict indication and supervision. International recommendations are unavailable.
There are no data on the transfer of deproteinised calf-blood haemodialysate into human milk. The product is a mixture of low-molecular peptides, amino acids, nucleosides and electrolytes derived from calf blood, and its pharmacokinetics as a medicinal substance are not characterised. Cochrane reviews and EMA have not confirmed efficacy claims. Routine use during breastfeeding is not supported.
Deproteinized hemoderivative from calf blood is contraindicated in: Decompensated heart failure; Pulmonary edema; Oliguria, anuria; Fluid retention; Hypersensitivity. Full list in the Safety section.