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.
Not recommended
International 2019 and 2021 stroke guidelines do not mention Cytoflavin or other «metabolic neuroprotectors» in acute ischemic stroke. Proven therapies are tPA thrombolysis within 4.5 hours and mechanical thrombectomy within 6–24 hours in selected patients.
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.
Not recommended
— Chronic cerebral ischaemia / dyscirculatory encephalopathy: «Dyscirculatory encephalopathy» is absent from international neurology and ICD-11. Cytoflavin for cognitive impairment or chronic cerebrovascular disease is not mentioned in or guidelines. Evidence-based management of vascular cognitive impairment relies on cardiovascular risk factor control, physical activity, and cognitive training. — Asthenic syndrome: «Asthenic syndrome», «nervous exhaustion», and «post-infectious asthenia» as clinical indications do not exist in international guidelines. Cytoflavin is not mentioned for these uses. Chronic fatigue requires differential workup: anemia, B12 deficiency, hypothyroidism, depression, obstructive sleep apnea, chronic infections.
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 evaluated for the following indications with varying evidence strength: Ischemic stroke (evidence tier F), Post-stroke recovery (evidence tier F), Stress, anxiety, memory, and behavior (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.
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.