Vinpocetine

Other psychostimulants and nootropics (local classification)

ATC code: N06BX-VINPOCETINE (Vinpocetine (local code))

Mechanism of action

A derivative of vincamine, an alkaloid from lesser periwinkle. The manufacturer claims cerebral vasodilation via phosphodiesterase-1 inhibition and sodium channel blockade. Registered in some European and CIS countries but has no medicinal registration in the United States or United Kingdom. In 2019 the FDA stated that vinpocetine is not considered an acceptable dietary ingredient for supplements.

Indications

Chronic cerebral ischaemia / dyscirculatory encephalopathy (marketed indication)

Not recommended

'Chronic cerebral ischaemia', 'dyscirculatory encephalopathy', and 'vegetative-vascular dystonia' are not nosologies in ICD-11 or international neurology. Vinpocetine is prescribed in Russia specifically under these labels. AAN, ESO, AHA/ASA, and NICE do not mention the drug.

Post-stroke recovery

Not recommended

A 2018 Cochrane Review of vinpocetine in acute stroke concluded that there was insufficient evidence of efficacy. The drug is not included in AHA/ASA 2023 or ESO 2022 guidelines.

Subjective age-related memory complaints (marketed indication)

Not recommended

For subjective age-related memory complaints without objective cognitive impairment, international guidelines do not support vinpocetine. The foundation is correction of reversible causes and cognitive training.

Tinnitus

Not recommended

For tinnitus, AAO-HNS 2014 and NICE NG214 note the absence of evidence-based pharmacotherapy. Sound therapy, CBT, and hearing correction are recommended. Vinpocetine is not mentioned. Russian practice of prescribing Cavinton for tinnitus is not considered clinically substantiated.

Vertigo

Not recommended

AAN 2024 and Barany Society recommend diagnosing the cause of vertigo: benign positional vertigo (Epley manoeuvre), Meniere's disease, vestibular neuritis, vestibular migraine. Vinpocetine as 'vascular therapy' is not part of these recommendations.

Practical notes

Russian practice note

Cavinton has been used in Russian neurology for decades to 'improve cerebral circulation'. It is produced in tablet and infusion forms. Absent from international sources. For symptoms traditionally treated with Cavinton (dizziness, tinnitus, memory decline), workup for a specific diagnosis is needed: BPPV, depression, sleep apnoea, migraine.

safety_concerns

The FDA warns that vinpocetine may cause miscarriage in pregnant women. In 2019 the regulator prohibited sale as a supplement in the United States. The drug remains available by prescription in CIS countries.

Safety

Contraindications

Hypersensitivity to any component
Pregnancy and breastfeeding
Acute haemorrhagic stroke
Severe coronary heart disease, severe arrhythmias

Serious adverse effects

QT prolongation with parenteral administration
Increased bleeding with concomitant anticoagulants

Common adverse effects

Decreased blood pressure, tachycardia
Headache, dizziness
Dry mouth
Nausea

Pregnancy

Contraindicated. The FDA warns of miscarriage risk.

Breastfeeding

Contraindicated during breastfeeding.

Frequently asked

What is Vinpocetine used for?

Vinpocetine is evaluated for the following indications with varying evidence strength: Tinnitus (evidence tier F), Vertigo (evidence tier F), Post-stroke recovery (evidence tier F). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Vinpocetine?

Common side effects of Vinpocetine (≥ 1 in 100): Decreased blood pressure, tachycardia, Headache, dizziness, Dry mouth, Nausea. See the Safety section for uncommon and serious reactions.

Is Vinpocetine safe during pregnancy?

Contraindicated. The FDA warns of miscarriage risk.

Is Vinpocetine compatible with breastfeeding?

Contraindicated during breastfeeding.

Who should not take Vinpocetine?

Vinpocetine is contraindicated in: Hypersensitivity to any component; Pregnancy and breastfeeding; Acute haemorrhagic stroke; Severe coronary heart disease, severe arrhythmias. Full list in the Safety section.