Actovegin

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Actovegin is a highly filtered extract obtained from calf blood which enhances aerobic oxidation in mammals.[1] This improves absorption of glucose and oxygen uptake in tissue,[1] which may enhance physical performance and stamina.

Actovegin made headlines from 2009 to 2011 when Canadian sports doctor Anthony Galea was charged with illegally providing professional athletes with a number of performance-enhancing drugs, including Actovegin.[2][3] As revealed by later testimony by drivers, it was also regularly used by Lance Armstrong and the members of his U.S. Postal Service Pro Cycling Team on the 2000 Tour de France to enhance their performance.[4] As of 2012, the substance is currently not banned.

Mechanism of action[edit]

According to Gulevsky, et al., Actovegin "is highly purified hemodialysate extracted from vealer blood by ultrafiltration."[1] There are less than 5 kDa by molecular weight of organic substances in Actovegin.[5]

Actovegin has been shown to improve the transport of glucose over a plasma membrane and the uptake of oxygen by tissues.[1] This can lead to aerobic oxidation, which provides a cell with access to more energy and potentially enhances its function.[1] Actovegin has large amounts of superoxide dismutase enzymes and magnesium.[5]

Uses and side effects[edit]

Nycomed, a Swiss drug company which manufactures Actovegin,[6] claims it can be used for circulation and nutrition disturbances, skin grafting, burns, and wound-healing impairment.[7] Actovegin has also been used as a performance enhancer.[8]

It has been investigated for use in treatment of polyneuropathy in diabetes,[9] and for stroke.[10] One study found that when tissues suffer from hypoxia caused circulation abnormalities, Actovegin helps capillaries improve circulation by enhancing the neogenic mechanism in blood vessels.[5]

Counterindications[edit]

Anaphylactic shock has been observed in at least one patient treated with Actovegin.[11]

Market approvals[edit]

As of July 2011, the drug was not approved for sale, importation, or use in the United States.[12] It is an unapproved drug in Canada as well, and as of March 2011 it was illegal to import or sell it there.[12][13]

References[edit]

  1. ^ a b c d e Gulevsky, Alexander Kirillovich; Abakumova, Yelena Sergeevna; NikolaevnaMoiseyeva, Natalya; and Ivanov, Yevgeniy Gennadievich. "Influence of Cord Blood Fraction (below 5 kDa) on Reparative Processes During Subchronic Ulcerative Gastropathy." Ulcers. 2011, p. 1. Accessed 2011-09-16.
  2. ^ Doheny, Kathleen. "FAQ on Actovegin: An Expert Explains How the Drug May Enhance Athletic Performance." WebMD Health News. December 16, 2009. Accessed 2011-09-16.
  3. ^ Schmidt, Michael S.; Austen, Ian (2009-12-17). "Doctor Under Investigation Is Charged in Canada.". The New York Times. Retrieved 2009-12-17. 
  4. ^ USADA v. Armstrong, Reasoned decision, section IV B 3.e (pp. 42–45) (USADA 10 October 2012). Text
  5. ^ a b c Nordvik, B. "Actovegin. New Aspects of Clinical Application." In Collected Book of Research and Practice Articles. S. A. Rumyantseva, ed. St. Petersburg, Russia: MAPO, 2002, p. 280.
  6. ^ "Nycomed May Invest 35 Million Euros in Ukrainian Production Capacities." The Pharma Letter. 3 May 2011. Accessed 2011-09-16.
  7. ^ "Actovegin." Nycomed. 2011. Accessed 2011-09-16.
  8. ^ Tsitsimpikou C, Tsiokanos A, Tsarouhas K, et al. (January 2009). "Medication use by athletes at the Athens 2004 Summer Olympic Games". Clin J Sport Med 19 (1): 33–8. doi:10.1097/JSM.0b013e31818f169e. PMID 19124981. Retrieved 2009-12-17. 
  9. ^ Ziegler D, Movsesyan L, Mankovsky B, Gurieva I, Abylaiuly Z, Strokov I (August 2009). "Treatment of symptomatic polyneuropathy with actovegin in type 2 diabetic patients". Diabetes Care 32 (8): 1479–84. doi:10.2337/dc09-0545. PMC 2713653. PMID 19470838. Retrieved 2009-12-17. 
  10. ^ Derev'yannykh EA, Bel'skaya GN, Knoll EA, Krylova LG, Popov DV (October 2008). "Experience in the use of Actovegin in the treatment of patients with cognitive disorders in the acute period of stroke". Neurosci. Behav. Physiol. 38 (8): 873–5. doi:10.1007/s11055-008-9051-0. PMID 18802768. 
  11. ^ Maillo L (March 2008). "Anaphylactic shock with multiorgan failure in a cyclist after intravenous administration of Actovegin". Ann. Intern. Med. 148 (5): 407. doi:10.7326/0003-4819-148-5-200803040-00022. PMID 18316765. 
  12. ^ a b Kovaleski, Serge. "Canadian Doctor Tied to Professional Athletes Guilty of Drug Charge." New York Times. July 6, 2011. Accessed 2011-09-16.
  13. ^ "Toronto Sports Doctor Charged." National Post. March 31, 2011.