Calyxin Special Precautions

Film-coated tablet: Large doses of citicoline could aggravate increase in cerebral blood flow in episodes of persistent intracranial hemorrhage.
Solution for injection: General: For patients with acute, severe and progressive disturbance of consciousness resulting from a head injury or brain operation, citicoline injection should be administered in conjunction with hemostatics and an intracranial pressure relieving drug, or a treatment such as hypothermia. For patients with disturbance of consciousness in the acute stage of cerebral infarction, it is recommended to start the administration of citicoline injection within 2 weeks after an apoplectic stroke.
In administering citicoline injection intramuscularly, caution should be exercised so as not to affect the tissues, nerves, etc. Intramuscular injection should be given only when indispensable, and should be restricted to the minimum to be required. Intraparticular, repeated injection at the same site should be avoided. Care should be exercised to avoid injection at sites along the course of the nerves. In case of intense pain or backflow of blood upon insertion of the injection needle, the needle should be withdrawn immediately and injected at a different site. In intravenous administration, inject as slowly as possible. Since shock may occur, a close observation should be maintained. If any such abnormalities such as drop in blood pressure, distressed feeling of the chest or dyspnea are observed, citicoline injection should be discontinued and appropriate measures taken.
Persistent Intracranial Hemorrhage: In case of persistent intracranial hemorrhage, it is recommended not to exceed the dose of 1,000 mg of citicoline daily, given through very slow intravenous administration (30 drops/min).