Other metabolic agents (local classification)
ATC code: A16AX-CYTOFLAVIN (Cytoflavin (succinic acid, nicotinamide, riboflavin, inosine complex) – local code)
The manufacturer claims metabolic, anti-hypoxic, and antioxidant effects from a four-component composition — succinic acid, nicotinamide, riboflavin, and inosine. Claimed indications include ischemic brain or myocardial injury, post-hypoxic states, asthenia, and prolonged intoxications. International , , and recommendations do not mention the product as a therapeutic agent. Independent multicenter RCTs by current standards are absent. The manufacturer and the related clinical research base are located in Russia.
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
Cytoflavin combines succinic acid, nicotinamide, riboflavin and inosine, and is promoted as a metabolic and neuroprotective remedy for ischemic stroke. Convincing benefit for this use has not been shown: there is no solid evidence that it changes stroke outcomes. What actually helps in ischemic stroke is calling emergency services early, thrombolysis or thrombectomy within the first hours, and supervised rehabilitation. Cytoflavin should not be used instead of treatments with proven benefit, or you risk losing the time when real help works.
Sources
Not recommended
Cytoflavin is a Russian combination of succinic acid, nicotinamide, riboflavin, and inosine. It is not included in international clinical guidelines, and the , , and AEMPS have not approved it. Cytoflavin is prescribed for the Soviet-era diagnoses asthenic syndrome, nervous-system exhaustion, post-infectious asthenia, and dyscirculatory encephalopathy, none of which exist in ICD-11 or international neurology. There are no independent international clinical studies with endpoints on validated fatigue or cognitive scales. For chronic-fatigue complaints, the workup should include anemia, B12 deficiency, hypothyroidism, depression, obstructive sleep apnea, and chronic infections: the cause is often one of these. For dizziness attributed to blood pressure, check blood pressure, hemoglobin, and rule out cardiac arrhythmia. If cytoflavin was prescribed for asthenia or after an acute respiratory infection, consider seeking a second opinion.
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Not recommended
In post-stroke rehabilitation, Cytoflavin is not mentioned in Stroke Rehabilitation Guidelines 2016 or . Effective approaches: early mobilization, physical and occupational therapy, speech therapy, psychological support. CIMT helps hemiparesis; intensive speech therapy helps dysphasia. Pharmacotherapy is largely limited to antidepressants for post-stroke depression.
Sources
Opens the checker prefilled with this drug. Pick the second one from your regimen.
Parenteral forms are contraindicated in pregnancy per manufacturer label. No international recommendations.
Contraindicated during breastfeeding per manufacturer label.
Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.
Cytoflavin (succinic acid, nicotinamide, riboflavin, inosine complex) is evaluated for the following indications with varying evidence strength: Ischemic stroke (evidence tier D), Post-stroke recovery (evidence tier F), Chronic fatigue (evidence tier F). See the full indication matrix with dosing and citations above on this page.
Common side effects of Cytoflavin (succinic acid, nicotinamide, riboflavin, inosine complex) (≥ 1 in 100): Facial flushing, warmth sensation, Nausea, Injection site pain, Allergic reactions. See the Safety section for uncommon and serious reactions.
FDA category N. Parenteral forms are contraindicated in pregnancy per manufacturer label. No international recommendations.
Contraindicated during breastfeeding per manufacturer label.
Cytoflavin (succinic acid, nicotinamide, riboflavin, inosine complex) is contraindicated in: Hypersensitivity; Pregnancy (parenteral forms); Breastfeeding; Gout, hyperuricemic nephrolithiasis (inosine component). Full list in the Safety section.
international guidelines do not support these regimens. Evidence-based rehabilitation includes early mobilization, physical and occupational therapy, speech therapy, and psychotherapy or antidepressants when needed.
mixing nutrients in a pharmaceutical form does not make the combination therapeutically effective. Evidence comes from clinical RCTs, not composition. Independent international RCTs of Cytoflavin do not exist.