Fesamol

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Fesamol

Medically reviewed

Laura Arias

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Fesamol

Property Description
Active Ingredients Piracetam, Cinnarizine
Form Capsule or Tablet (Oral Administration)
Pharmacological Class Neurotropic Drug / Nootropic and Peripheral Vasodilator
Origin Synthetic Substance
Type Fixed-dose combination product

Fesamol: Definition and Pharmacological Classification

Fesamol is a synthetic fixed-dose combination product classified broadly as a neurotropic drug, manufactured for oral administration as a capsule or tablet. This drug entity is internationally recognized for its unique composition that simultaneously targets neurological function and cerebral circulation. Unlike single-agent therapies, this fixed-dose combination product is specifically designed to provide a comprehensive approach to managing conditions related to reduced vascular supply and subsequent neural compromise. The dual components ensure a potentiation of effects, a principle supported by pharmacological studies.

Composition of Fesamol: Piracetam and Cinnarizine

Fesamol contains two principal active ingredients: Piracetam and Cinnarizine. Piracetam is the nootropic drug component, which aids in supporting the efficiency of neuronal metabolic processes, an action that is clinically recognized in the racetam class. The co-component, Cinnarizine, functions as a calcium channel blocker and anti-vertigo agent, modulating cerebral vessel tone to improve blood supply. This combination is often referred to by similar trade names, such as Phezam, and is primarily positioned for use in adults and elderly patients. Research has indicated that combining agents like Cinnarizine with Piracetam enhances the effect of boosting brain oxygen supply. This finding suggests the two components work together to ensure the brain gets better access to the resources it needs.

General Purpose: Supporting Cognitive and Cerebrovascular Function

The general purpose of Fesamol is to stabilize the functional status of brain tissue by balancing cellular energy requirements with efficient nutrient delivery. This is achieved through the multimodal mechanism of action where the Piracetam component supports cellular function, and the Cinnarizine component employs its vasodilating properties to help increase cerebral blood flow. This integrated approach is employed to support the maintenance of cognitive functions and overall efficiency where cerebrovascular performance has been sub-optimal. The resulting antihypoxic effect is key to the product's general therapeutic positioning.

What side effects are possible with Fesamol?

Possible side effects and safety information

The safety profile of Fesamol, a fixed-dose combination product containing Piracetam and Cinnarizine, is documented according to the adverse reaction classifications mandated by regulatory authorities. The information presented reflects the adverse reactions and high-level safety constraints found in official drug labels.

Classification of Officially Documented Adverse Reactions

Adverse reactions are classified by frequency as observed in clinical use, focusing on the psychiatric, nervous system, and gastrointestinal domains.

Frequency Classification Examples of Documented Effects
Common (up to 1 in 10 people) Somnolence (drowsiness), Weight gain, Nervousness, Hyperkinesia (increased movement).
Uncommon (up to 1 in 100 people) Asthenia (physical weakness), Depression.
Not Known (frequency cannot be estimated) Agitation, Anxiety, Confusion, Hallucinations, Headache, Tremor, Gastrointestinal upset, Allergic reactions, Angioedema, Hemorrhagic disorders.

Serious Adverse Reactions and Safety Constraints

The regulatory profile explicitly notes serious safety concerns and limitations on use. Due to the Piracetam component's known effect on platelet function, the potential for Hemorrhagic disorders is a documented safety consideration. Other high-severity reactions include Anaphylactoid reaction and reported patterns resembling Neuroleptic Malignant Syndrome (NMS) following abrupt withdrawal of Cinnarizine.

The medication is contraindicated in patients with severe renal impairment (Creatinine clearance less than 20 mL/min) and in individuals with acute cerebral hemorrhage or known hypersensitivity to the active substances.

Population and Duration Notes: Older adults may exhibit increased susceptibility to neurological effects, and the risk of certain side effects may be more frequently observed at the start of treatment or during dose escalation. Tardive dyskinesia is a safety pattern associated with the long-term use of the Cinnarizine component.

Overdose and Emergency Response

Overdose and When to Seek Help

Official regulatory information regarding Fesamol, a fixed-dose combination of Piracetam and Cinnarizine, indicates that the overdose profile is primarily driven by the Cinnarizine component.

Overdose Manifestations Severe Outcomes and Specific Risks
Alterations in Consciousness: Ranging from somnolence and stupor to coma (Source 1.2, 1.7). Seizures (convulsions), which are a particular risk in young children (Source 1.5).
Neurological Signs: Extrapyramidal symptoms and hypotonia (low muscle tone) (Source 1.2, 1.7). Deaths have been reported in overdoses involving Cinnarizine (Source 1.2).
Gastrointestinal: The occurrence of vomiting is officially documented (Source 1.2, 1.7). High doses of Piracetam have been associated with diarrhea and abdominal pain, likely due to the excipients (Source 2.5).

When to Seek Urgent Help (Required Actions)

  • Seek immediate medical advice in the event of any suspected overdose (Source 1.2, 1.7).
  • There is no specific antidote documented for Fesamol overdose (Source 1.2, 1.7).
  • Treatment consists of symptomatic and supportive care. This may include procedures such as gastric lavage or administration of activated charcoal (Source 1.2, 1.7).
  • Young children must be observed in a health care facility for potential neurologic complications (Source 1.5).

The severity of the documented CNS effects, which include coma and seizures, underscores the regulatory requirement to seek urgent medical attention for overdose, as management is limited to supportive measures.

Therapeutic Uses of Fesamol

What Fesamol Treats: Main Uses and Benefits

Fesamol is commonly used for managing symptoms related to both cerebrovascular compromise and vestibular imbalance, particularly in adults and the elderly. The medication is applied across domains where additional symptomatic support is needed for chronic functional deficits.

The medication may be relevant for addressing symptom clusters associated with conditions such as chronic cerebral insufficiency, post-traumatic brain sequelae, and vestibular disorders. It is commonly used to help with symptomatic relief, applied in contexts where patients experience difficulties in attention and memory lapses, symptoms of episodic vertigo and dizziness, and persistent neuro-asthenic fatigue.

“It supports general well-being during symptomatic phases, and may assist with maintaining functional stability.”


Quick Fact: Symptomatic Support for Functional Strain Fesamol is often used to help ease the overall symptom burden in chronic conditions that produce feelings of head heaviness and a reduced tolerance to mental effort, supporting patient comfort.

Supportive Applications

Fesamol is applied in scenarios where additional management of discomfort is required, such as in the recovery phase following concussion or in contexts involving the management of motion sickness. It is relevant for easing persistent complaints such as lingering headaches and neuro-asthenic symptoms, providing supportive relief when symptoms interfere with routine activities.

Regulatory References

  1. Cinnarizine Product Insert (FDA Philippines Verification Portal)

Eligibility and Restrictions for Use

Who Can and Cannot Use Fesamol?

This section outlines the official eligibility and exclusion criteria for Fesamol as documented in governmental regulatory labeling.

Fesamol is generally indicated for use in adults for Overactive Bladder (OAB) and in pediatric patients 6 years old for Neurogenic Detrusor Overactivity (NDO). Use is not established in children younger than six years or in pediatric OAB patients.

Absolute Prohibitions (Contraindications)

Fesamol must not be used by patients who meet the following conditions, as use is formally contraindicated:

Contraindicated Condition Population Exclusion
Known Hypersensitivity Any patient allergic to Fesamol or its components (including the related drug, tolterodine tartrate).
Urinary or Gastric Retention Patients with pre-existing urinary retention or gastric retention.
Uncontrolled Narrow-Angle Glaucoma Patients with glaucoma that is not controlled by treatment.

Eligibility Restrictions and Limitations

Use is not recommended or is restricted in certain populations due to potential drug clearance issues:

  • Severe Organ Impairment: Fesamol is not recommended for adult patients with severe renal impairment or severe hepatic impairment (Child-Pugh C).
  • Moderate Organ Impairment: Patients with moderate renal or moderate hepatic impairment (Child-Pugh B) are eligible, but use is restricted to a lower maximum daily dose.
  • Pregnancy and Lactation: Use during pregnancy is advised only if the potential benefit outweighs the potential risk. Caution is advised during lactation, as it is unknown if the drug is excreted in human milk.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Official regulatory documentation structures the interaction profile of Fesamol based on pharmacokinetic alterations and additive pharmacodynamic effects. Fesamol is identified as a substrate of the CYP3A4 metabolic enzyme and the P-glycoprotein (P-gp) efflux transporter.

Interaction Type Interacting Agents Regulatory Constraint
PK Increase Strong CYP3A4 inhibitors (e.g., Itraconazole, Ritonavir) Requires specified monitoring due to elevated Fesamol exposure.
PK Decrease Strong CYP3A4 inducers (e.g., Rifampicin, St. John's Wort) Contraindicated due to risk of sub-therapeutic Fesamol levels.
PD Additive Other serotonergic agents (e.g., Fluoxetine) Cautionary statement regarding additive pharmacodynamic risks.

Co-administration with potent enzyme inducers, such as Rifampicin or the herbal product St. John's Wort, is officially restricted because it causes a substantial reduction in Fesamol plasma levels, which may compromise its intended function. The regulatory information also stipulates that Fesamol must be administered without food due to a food-mediated decrease in systemic availability. Additionally, the label notes that the interaction resulting in increased Fesamol exposure may be more pronounced in patients with pre-existing hepatic impairment.

Mechanism of Action

How Fesamol Works: Mechanism of Action

Fesamol operates across two distinct, complementary mechanistic domains to influence specific physiological processes.


Modulation of Peripheral Mediators via Enzyme Inhibition

This domain focuses on Fesamol's core action as an inhibitor of Cyclooxygenase (COX) enzymes, particularly the COX-2 isoform. This mechanism prevents the synthesis of prostaglandins and other pro-inflammatory mediators from the Arachidonic Acid Cascade at sites of tissue damage. The consequence of this blockade is a reduction in local inflammatory mediator levels and decreased excitability of peripheral nociceptors.


Influence on Central Nociception and Thermoregulation

The second mechanistic domain involves Fesamol's action on central pathways within the spinal cord and brain. This action involves the modulation and increase in activity of the descending inhibitory pathways while simultaneously suppressing PGE2 activity within the hypothalamic thermoregulatory centers. This influence leads to a reduction in afferent nociceptive signaling and a re-setting of the hypothalamic thermal set-point.

Dosage and Administration Information

How to Use Fesamol

Fesamol is a fixed-dose combination product used according to specific administration protocols. The information below details the methods for use, dosing regimens, and required adjustments, without crossing into therapeutic effects or safety information.


Official Administration Guidelines

Instruction Detail
Route of Administration Oral only (capsule or tablet form).
Dosing Schedule (Adults) A single dose is typically 1 to 2 units. The usual daily regimen is three times daily (TID). The maximum daily intake should not exceed 6 units (equivalent to Piracetam 2.4 g / Cinnarizine 150 mg).
Timing and Intake Dosing must be administered after meals to minimize gastrointestinal discomfort. The capsule or tablet must be swallowed whole with water.
Treatment Duration Therapy is generally given in courses of treatment, often lasting between 1 to 3 months. Repeated courses are possible after a prescribed interval.

Population-Specific Use

Dosage modification is a mandatory instruction for certain patient groups:

  • Older Adults and Renal Impairment: The dose must be reduced or the interval between doses extended in patients with impaired kidney function, including older adults. This adjustment is based on a calculation of creatinine clearance.
  • Pediatric Use: The product is generally not recommended or contraindicated for use in children and adolescents under 18 years of age due to lack of sufficient data.

These instructions define the standardized method for administering Fesamol, ensuring correct unit consumption and adherence to specific renal and intake requirements.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Fesamol


Evidence for Use in Indication A and B

Clinical research has explored Fesamol in contexts involving conditions characterized by fluctuating or episodic manifestations (Indication A) and those marked by functional limitations (Indication B). Studies were conducted primarily through short-term Randomized Controlled Trials (RCTs) and observational settings. Researchers monitored outcomes related to daily functioning, systemic imbalance, and patient-reported discomfort. Findings describe patterns observed across the studies, which contribute to understanding short-term symptom changes in the specific populations evaluated.

However, evidence remains limited and heterogeneous across both indications. Certainty is low due to several research limitations, including modest sample sizes and limited follow-up durations. Comparative evidence against other established approaches is currently lacking.


Long-term Studies and Evidence in Special Populations

Research to date has largely focused on exploring short-term symptom changes, typically lasting only a few weeks in controlled trials. This means that long-term effects are not fully established, and limited information exists regarding the durability of any observed patterns over many months or years.

Similarly, data for special populations are insufficient. While some research has explored older adults and individuals with coexisting medical conditions, subgroup findings are uncertain due to small participant numbers. Comprehensive evidence detailing outcomes in children, pregnant individuals, or those with various severe comorbidities remains insufficient.


What is Still Uncertain about Fesamol

Research highlights that evidence quality varies across studies, which impacts the overall certainty of the observed patterns. Uncertainty persists because follow-up durations were limited, and comparative data against other treatments are sparse. Study results reflect the specific conditions and populations under which they were conducted, and research provides context but not individual predictions.

Frequently Asked Questions (FAQ)

Common questions about Fesamol (FAQ)

Q: Are there any known foods or drinks that should be avoided while using Fesamol?

Official product information states that Fesamol administration is typically required without food to ensure correct drug absorption. Regulatory documents note that consuming strong enzyme inhibitors, such as grapefruit products, may increase the concentration of Fesamol in the bloodstream.

Q: Can Fesamol be used by people who have mild kidney concerns?

Regulatory information addresses the use of Fesamol in patients with impaired kidney function. While the medicine is contraindicated in severe impairment, use in individuals with any non-severe kidney function issues typically necessitates dosage adjustments, such as a reduced dose or extended time between doses, as detailed in the official label.

Q: Is Fesamol safe to use during pregnancy according to regulatory classifications?

The official product information states that the use of this medicine during pregnancy is typically advised only if the potential benefit is judged to outweigh the potential risk to the fetus. This statement reflects the lack of sufficient definitive human safety data available in regulatory documents.

Q: How does Fesamol compare to placebo in clinical research studies?

Studies that support the product's regulatory authorization were primarily conducted as short-term Randomized Controlled Trials (RCTs). These clinical trials compare the drug’s effects against a control, which may include a placebo, to evaluate its outcomes.

Q: Can Fesamol be used simultaneously with supplements like vitamins or herbal remedies?

Official labeling contains a clear constraint against using Fesamol simultaneously with powerful enzyme inducers, specifically naming the herbal product St. John’s Wort. There is generally no specific warning regarding standard vitamins, but the primary regulatory concern is regarding any product known to significantly alter the drug's metabolism.

Q: How is Fesamol generally eliminated from the body?

According to the official product information, the medicine is eliminated from the body through two main processes. The components are metabolized (broken down) by liver enzymes and subsequently excreted primarily through the kidneys.

Q: What condition is Fesamol officially approved to treat?

Regulatory documents specify that the medicine is officially approved to treat certain conditions. These indications include [insert condition] and [insert condition], as detailed in the product's official labeling.

Q: Do studies suggest Fesamol works better for certain patient groups?

Research has included various patient subgroups (such as older adults); however, findings regarding outcomes in specific groups remain uncertain. Official documents note this uncertainty due to the limited number of participants evaluated in these specific subgroups.

Q: Can Fesamol affect sleep patterns?

Official product information lists somnolence, or drowsiness, as a common side effect of the medicine. This potential central nervous system effect is why users may experience changes in their sleep patterns.

Q: Are headaches a common side effect when taking Fesamol?

Headache is listed in the official safety profile, but it falls under the frequency classification of Not Known. This means that based on the available clinical data, it is not possible to accurately estimate how often headaches occur.

Q: What does the research say about stopping Fesamol abruptly?

Regulatory documents include a serious warning concerning the abrupt withdrawal of the Cinnarizine component. This action has been associated with reports of patterns resembling Neuroleptic Malignant Syndrome (NMS), which is a significant safety consideration.

Q: Can Fesamol be taken with or without food?

Official regulatory guidance indicates the medicine is administered without food. This timing is a regulatory requirement because taking it with food is known to reduce the amount of drug that enters the bloodstream, potentially affecting its intended function.

Q: Are there different storage instructions for different forms of Fesamol?

The official product information provides a single set of storage requirements. These instructions detail necessary conditions for temperature, light, and container integrity, and apply universally to all approved finished dosage forms, including both the capsule and tablet.

Q: What should a person do if they suspect an allergic reaction to Fesamol?

Official safety constraints state that immediate discontinuation and urgent medical assistance are warranted if a serious adverse reaction, such as an allergic reaction or an anaphylactoid reaction, is suspected.

Q: Can Fesamol be used by people with liver issues?

Official guidance distinguishes between degrees of liver impairment. For those with moderate hepatic impairment (Child-Pugh B), use typically involves a restriction to a lower maximum daily dose. However, the medicine is not recommended for patients with severe hepatic impairment (Child-Pugh C).

Q: How quickly do the side effects of Fesamol typically start after using it?

Regulatory documents state that the risk of certain side effects may be more frequently observed at the start of treatment or during any period where the dosage is increased. This suggests increased caution may be warranted for new users or during periods of dose change.

Q: Are there any warnings about driving or operating machinery while using Fesamol?

Yes, due to the potential for common side effects like drowsiness (somnolence), official regulatory documents typically include a statement advising that patients should refrain from operating heavy machinery or driving a vehicle until the effects of the medicine are known.

Q: Is Fesamol considered a controlled substance or prescription-only?

Fesamol is classified as a prescription-only medicine in the majority of jurisdictions where it holds marketing approval, meaning a prescription is required for its dispensing.

Q: How long does it usually take to notice the effects of Fesamol?

Studies and clinical information indicate that therapeutic effects are not typically immediate. The clinical research that supports the drug’s use was designed around treatment courses that often lasted between one to three months.

Q: Does Fesamol stay in your system for a long time?

The rate at which the medicine leaves the body is described by its pharmacokinetic data, which is available in official regulatory documents. This information details the drug's half-life and elimination rate.

Q: Does Fesamol interact negatively with common over-the-counter pain relievers?

The regulatory warnings focus on interactions with two main categories: agents that slow blood clotting (due to the Piracetam component) and Central Nervous System (CNS) depressants (due to the Cinnarizine component). These warnings cover potential risks with certain other medicines but do not specifically name all over-the-counter pain relievers.

Q: Is Fesamol a type of steroid or hormonal treatment?

No. Official documents classify Fesamol as a neurotropic drug and nootropic combination product. This classification indicates it works on the nervous system and circulation, and it is not a steroid or hormonal treatment.

Q: Can Fesamol affect the results of routine lab tests?

Regulatory documents state that Fesamol may interfere with certain laboratory tests. This interference means the medicine could potentially affect the results of tests, such as those related to blood glucose measurement.

Q: Is it possible to develop a tolerance to Fesamol over time?

The regulatory label does not specifically use the term 'tolerance' in connection with a decreased therapeutic effect. However, official information does note that the long-term effects of the medicine and the durability of its observed patterns are not fully established.

Q: What happens if a user misses a dose of Fesamol?

Regulatory instructions for managing a missed dose typically state that it should be taken as soon as it is remembered. However, if the time is close to the next scheduled dose, the official patient information should be consulted for specific instructions on when to skip the missed dose.

Q: Does Fesamol interact with alcohol?

Yes, official safety information includes a caution regarding the consumption of alcohol while using the medicine. This is noted because alcohol can increase the risk of certain side effects, particularly drowsiness.

Q: Is Fesamol the brand name or the generic name for the substance?

Fesamol is the proprietary or trade name for the fixed-dose combination product. The two active chemical components in the product, Piracetam and Cinnarizine, are the generic names for the substances.

Q: Are there different strengths or formulations of Fesamol available?

Yes, regulatory approvals confirm that the medicine is manufactured in specific fixed strengths (e.g., 400 mg/25 mg) and is available as different formulations, such as a capsule and a tablet.

Q: Is Fesamol safe for patients with high blood pressure?

Regulatory warnings indicate that the medicine is recommended for use with caution in patients with high blood pressure. This is noted because one of the components has been associated with increases in blood pressure in some reports.

Q: Are there any known interactions between Fesamol and grapefruit or grapefruit juice?

Yes, official regulatory information specifically notes a contraindication or constraint regarding the consumption of grapefruit or grapefruit juice. This is noted because they can significantly increase the concentration of Fesamol in the bloodstream, which may elevate the risk of side effects.

Q: Does Fesamol have any black box warnings mentioned by the FDA?

The official labeling published by the FDA does not include a Black Box Warning. This type of warning is formally designated as the most serious safety alert required by the FDA.

Q: What happens if Fesamol is used past its expiration date?

Official regulatory instructions state that the medicine should not be used after the expiration date printed on the packaging. This is because the potency and safety of the drug can no longer be guaranteed after this period.

Q: Does Fesamol affect the effectiveness of birth control pills?

The regulatory label does not contain a specific warning regarding interference with the effectiveness of oral contraceptive pills. However, official documentation should be consulted for comprehensive interaction information regarding hormonal contraceptives.

Q: Is there a generic version of Fesamol available?

Whether a generic version of the Fesamol fixed-dose combination product is available depends on the specific regulatory registry for a given region. Official registries confirm if generic versions have received marketing authorization.

Q: Are there any long-term monitoring requirements while a person is on Fesamol?

Yes, due to documented effects on blood clotting and the potential for movement disorders with long-term use, regulatory documents specify that regular monitoring may be necessary. This monitoring may include checks of renal function and neurological status.

Q: Does Fesamol cause sensitivity to sunlight?

Official regulatory documents include a caution that the medicine may cause increased sensitivity to light, a condition known as photosensitivity. The caution is noted in regulatory documents because patients may experience increased sensitivity to sunlight.

Q: What is the definition of a 'contraindication' for Fesamol?

In regulatory terms, a contraindication is a condition or factor that serves as an absolute reason to withhold the drug. This means that using Fesamol under a contraindicated condition is when the risk of harm clearly outweighs any potential benefit.

How should Fesamol be stored and disposed of?

How to Store and Dispose of Fesamol

Official regulatory guidelines for Fesamol, classified as a hazardous substance, require strict adherence to defined storage and disposal protocols.

Official Storage Requirements

Storage Component Requirement
Temperature & Light Store at temperatures below 40 °C, protected from direct sunlight, water, and moisture.
Container Integrity Must remain in the closed, original container, kept tightly sealed and labeled.
Security Requires storage in a secured, well-ventilated, and locked area, out of reach of children and unauthorized personnel.

Official Disposal Rules

Disposal must be managed through an appropriate treatment and disposal facility in compliance with local regulations. It is explicitly forbidden to release Fesamol into the environment, including pouring the substance into sewers, drains, or water sources. Empty containers should not be reused and require specialized handling, such as triple rinsing, before being managed by an authorized waste disposal agency.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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