Other psychostimulants and nootropics (local classification)
ATC code: N06BX-CORTEXIN (Cortexin (brain cortex peptides, local code))
A complex of water-soluble low-molecular polypeptides from cattle and pig brain cortex. The manufacturer claims neuroprotective, nootropic, anticonvulsant, and metabolic effects on neurons. The product is not mentioned in the international neurological literature. Manufactured only in Russia and some CIS countries.
Not recommended
AAO 2024 AMD PPP and EURETINA 2021 Guidelines recommend AREDS2 supplementation for dry AMD and intravitreal anti-VEGF (aflibercept, ranibizumab, brolucizumab, faricimab) for wet AMD. Cortexin is not mentioned. Peptide neuroprotection for AMD is not used outside Russia and a few CIS countries.
Not recommended
For ASD, AAP 2020, AACAP, and NICE CG170 international guidelines recommend early behavioural intervention (ABA, ESDM) and management of comorbidities (epilepsy, sleep, anxiety). Peptide preparations and nootropics are not first-line. Massive Cortexin prescribing in Russian ASD practice lacks international support.
Not recommended
Cortexin is not included in international guidelines for cognitive impairment and dementia (NICE NG97, AAN 2018). The drug has no independent multicentre RCTs in international journals.
Not recommended
Russian paediatrics massively prescribes Cortexin for developmental delay, speech delay, and 'perinatal encephalopathy' in young children. AAP 2020 and AACAP international guidelines do not support peptide preparations for developmental delay. The approach relies on early diagnosis of the cause (autism, sensory disorders, metabolic conditions) and early behavioural, speech, and occupational therapy intervention.
Not recommended
AAO 2024 Diabetic Retinopathy PPP and DRCR Retina Network protocols recommend glycaemic, blood pressure, and lipid control; intravitreal anti-VEGF for clinically significant macular edema and proliferative disease; retinal laser photocoagulation. Cortexin and other systemic peptide agents are absent from these documents. RCTs of Cortexin with outcomes on visual acuity, retinal thickness, or progression are not available in international journals.
Not recommended
International guidelines AAO 2020 Glaucoma PPP, EGS 2021, and ICO Guidelines for Glaucoma do not mention the drug. Glaucoma therapy rests on IOP reduction – drops, SLT laser, and surgery. Systemic peptide 'neuroprotection' is not used by the international ophthalmology community. A few Russian publications on peptide neuroprotection in glaucoma entered international databases, but independent multicentre RCTs have not been reproduced.
Not recommended
AHA/ASA 2023 and ESO 2022 ischaemic stroke guidelines do not mention Cortexin. Proven interventions are thrombolysis within eligibility windows, thrombectomy for large-vessel occlusion, and secondary prevention with antiplatelets, statins, and blood-pressure control.
Contraindicated in pregnancy.
Not recommended during breastfeeding.
Cortexin (cattle brain cortex polypeptides) is evaluated for the following indications with varying evidence strength: Ischemic stroke (evidence tier F), Cognitive impairment (evidence tier F), Diabetic retinopathy (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Cortexin (cattle brain cortex polypeptides) (≥ 1 in 100): Allergic reactions, Local injection-site reactions. See the Safety section for uncommon and serious reactions.
Contraindicated in pregnancy.
Not recommended during breastfeeding.
Cortexin (cattle brain cortex polypeptides) is contraindicated in: Hypersensitivity to any component; Pregnancy. Full list in the Safety section.