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Can Aniracetam be used in combination of Piracetam

Last reviewed by Dr. Pooja Chauhan on September 4th, 2018.

What is Aniracetam

Aniracetam is a synthetic pharmaceutical drug that is used to improve or enhance the mental performance such as memory, learning capacity, attention and alertness.

The drug is known as ampakinenootropic drug that is principally used for the treatment of Central Nervous System disorders. The drug Aniracetam is commercially available under generic name Aniracetam and marketed under several brand names such as Ampamet, Aniracetam-Sanhome, Memodrin, Referan, Pergamid, Draganon, Sarpul and many others worldwide.

The drug is useful in the treatment of depression, schizophrenia, social problems, stress and sleep disorder, autism, chronic fatigue syndrome, emotional disturbances, and behavioural problems and urinary incontinence.

The drug Aniracetam is also recommended for the treatment of behavioral and psychological symptoms of dementia, Alzheimer’s disease and Parkinson’s disease. Chemically, Aniracetam is belongs to a class of compound known as benzamides and named as  N-anisoyl-2-pyrrolidinone or 1-(4-methoxybenzoyl) pyrrolidin-2-one.

The Aniracetam is available as tablet or granules and powder form for oral administration through mouth. The tablet is swallowed as a whole and granules mixed in water and then swallowed. The drug is usually recommended two to three times a day and at least 15 minutes after meals.

What is Piracetum

Piracetam is a nootropic drug or smart drug i.e. Substances that primarily acts on the brain or nervous system. The drug is used to improve cognitive functions such as perception, reasoning, attention, learning, memory and intelligence.

Besides this the drug is also used in combination with other medications to treat dementia or cognitive problems, depression , anxiety and movement disorder known as Cortical Myocolonus, a medical condition characterized by jerky muscles movements.

The drug Piracetam is supposed to protect cerebral cortex (area of brain that is responsible for thought, perception, movement and recognition) against a lack of oxygen.

Chemically the drug is belonging to racetams group and known as 2-oxo-1-pyrrolidine acetamide. It is a cyclic derivative of GABA and shares the 2-oxo-pyrrolidone base structure with pyroglutamic acid.

In United States, Piracetam is allowed to be sold for medical purpose only and not as dietary supplements. The drug was originally discovered in 1964 by Belgian pharmaceutical company USB laboratories.

Piracetam is available under generic name Piracetam and various brand names such as Avigilen, Cetam, Cerebrospan,  Cerebroforte, Dinagen, Encetrop, Encefalux, Euvifor, Genogris, Gabacet, Nootrop, Nootron, Nootropil, Norzetam, Normabrain, Psycotron, Pirroxil, and Stimucortex.

The medication is supplied as a tablet or granules/powder form for oral administration. The tablet is swallowed as a whole and granules mixed in water and then swallowed. The drug is usually recommended two to three times a day and at least 15 minutes after meals.

How Aniracetam and Piracetam works

Taking Piracetam vs Aniracetam:

The mode of action of Aniracetam is not fully understood but several theories have been put forth regarding the mechanism of action of the drug. These include glutamatergic, serotonergic, dopaminergic, cholinergic, and indirect adrenergic effects etc.

Nicotinic Cholinergic Receptors: Like other racetams, Aniracetam acts as a positive modulator of Nicotinic receptors involved in interaction with neurotransmitter acetylcholine. The drug also increases the release of acetylcholine from the brain hippocampus resulting in elevating the cholinergic neurotransmission.

AMPA Glutamatergic Receptors: Aniracetam is a positive modulator of AMPA (alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid) receptors responsible for the neurotransmission of glutamate (most common neurotransmitter in the brain). Aniracetam acts by binding to the non-active site of the AMPA receptor and modifies it resulting in reduced rate of desensitization thereby causing enhanced activation in presence of positive stimuli including glutamate. These receptors play important role in memory and are responsible for fast transmission at the synapses in the central nervous system.

GABAergic Receptors: Aniracetam increases the effects of GABAergic inhibition. GABA is responsible for the cognition (thinking) and emotional wellbeing, and improvement in the GABA function may serve in treating anxiety and cognitive disease.

Serotonergic Receptors: Aniracetam acts on serotonin receptors thereby inhibiting the breakdown of serotonin (involved in mood and behaviour regulation) and restoring its optimum level. Increased serotonin levels results in mood improvement, boosting energy, and decreasing anxiety.

Dopaminergic Receptors: Aniracetam causes reduction in anxiety and enhances socialization via interaction with dopamine receptors. The drug results in an increase in the release of dopamine and acts to improve mood and judgement.

Adrenergic Receptors: Binding of Aniracetam to AMPA receptors causes enhanced release of noradrenaline from neurons. This brings about slight stimulatory effect on the central nervous system.

Similar to Aniracetam, the mode of action of Piracetam is still under investigation/debate. Several theories have been put forward regarding the mode of Piracetam action.

However, among the proposed mechanisms of action Piracetam is thought to exert its effect on central nervous system efficiency of cholinergic neurotransmission.

Piracetam acts as a positive allosteric modulator of the AMPA receptor. Piracetam primarily act through muscarinic cholinergic (ACh) receptors (implicated in memory processes), NMDA glutamate receptors (implicated in learning and memory processes), but did not act on GABA receptors.

It is suggested that Piracetam activate neuronal and vascular functions and influences cognitive function. Besides this it is also suggested that Piracetam also act on ion channels or ion carriers; therefore potentiate the neuron excitability. Piracetam has been observed to increase blood flow and oxygen consumption and increased brain activity.


Can both Aniracetam and Piracetam be taken together in combination

Mixing Piracetam and Aniracetam: Yes, both the drugs can be taken together in combination. Aniracetam and Piracetam are routinely used to treat medical conditions related to  dementia, Alzheimer’s, and other trauma to the brain with great efficacy.

Aniracetam Piracetam can be taken as stack that provides additional benefits as compared to taking Aniracetam Piracetam individually. Literature studies with racetam class of drugs have suggested that these drugs were routinely used in combination to increase their impact on cognitive enhancement.

In clinical studies, it has been observed that Aniracetam Piracetam combination increase the potent ability of each other. However, combination therapy required professional supervision and dose adjustment for better and desired results.

Both Aniracetam and Piracetam acts on brain and improve memory, perception, reasoning, attention, learning and intelligence. Despite this, when comparing Aniracetam vs. Piracetam, it has been observed that Aniracetam is more potent then Piracetam in improving concentration, anxiety, fear, depression and attentiveness. The recommended dose of Aniracetam (750-4500 mg) is usually less then Piracetam (1.5 – 6.5 gm).

Safety and precautions while taking Aniractam: Piracetam combination

  • It is generally recommended to continue with the normal diet unless and until asked by your doctor.
  • Aniracetam should be taken with a fat source (fish oil or fat rich food such as almonds, yogurt, eggs white/yolk, whole milk, salmon, etc.) due to its fat soluble nature. While Piracetam is highly soluble in water then fat or oil, therefore it is recommended to take with a glass of water.
  • Aniracetam must be taken in combination with a choline source including eggs, butter, beef.
  • Aniracetam and Piracetam should never be taken as a self-medication practice for treatment of physiological problems.
  • Consult your physician prior to use of Aniracetam Piracetam and never self prescribe the drug.
  • Aniracetam and Piracetam both are generally not recommended to be taken in case of pregnancy and breastfeeding.
  • Aniracetam should be used with caution in patients suffering from mild to moderate renal impairment (dose adjustment may be needed).
  • Dosage adjustments (reduction of the daily dosage by half) are necessary in case of patients with serious renal failure (creatinine clearance < 10 mL/min).
  • Sudden withdrawal of Aniracetam and Piracetam should be avoided. Aniracetam and Piracetam combination should not be taken very late in the day as it may cause sleep delay.
  • Do not use the medicine if you are hypersensitive or allergic to racetam class of drug or any of its ingredients. Before taking Aniracetam, tell your doctor about your medical history.
  • Consult with your doctor and pharmacist if you are taking any prescription and nonprescription medications, nutritional supplements, vitamins and herbal products.
  • Do not share this medication with other persons having the similar kind of problems. Consult your doctor for more details.
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