Effectiveness and safety of Ginkgo biloba, vinpocetine and piracetam as a single agent and fixed dose combination in patients with subjective tinnitus was written by Mathai, Paul;Chandran, Anu;Das, Sourav. And the article was included in Journal of Clinical and Diagnostic Research in 2021.COA of Formula: C22H26N2O2 This article mentions the following:
Owing to the lack of any standard treatment, subjective tinnitus can be debilitating, manifesting a varied population response to tinnitus management. There is, therefore, an unmet need to optimize the existing treatment options and generate data to help physicians provide the best possible care for individual patients. To compare the effectiveness and safety of Ginkgo biloba, vinpocetine, and piracetam as a single agent and their Fixed Dose Combination (FDC) in patients with subjective tinnitus. Patients with complaints of subjective tinnitus were enrolled in this longitudinal cohort, single center study which was conducted at Outpatient Clinic of the ENT Department of Justice KS Hegde Charitable Hospital, Karnataka, India. Patients received one of the five treatments, oral route, three times a day, {group 1: Ginkgo biloba (40 mg); group 2: vinpocetine (5 mg); group 3: piracetam (400 mg); group 4: FDC of Ginkgo biloba (60 mg) and piracetam (400 mg); group 5: FDC of Ginkgo biloba (60 mg), piracetam (800 mg) and vinpocetine (5 mg)} and were followed-up for six weeks using a modified version of Tinnitus Handicap Inventory (THI) and Visual Analog Scale (VAS), before and after the treatment. Data for safety were also recorded. The association between each attribute and the presence of tinnitus was assessed through chi-square tests. A total of 130 out of 149 enrolled patients completed the study. All the groups showed significant improvement in the severity of symptoms at the end of six weeks as assessed by the modified THI and VAS scores. The improvement was found to be better in group 5 than in other groups, which was evident from the percentage improvement at the end of the treatment compared to other groups. No adverse drug reactions were associated with any of the treatment groups. Though all the drugs were found to be effective and safe in reducing the intensity of subjective tinnitus, FDC of Ginkgo biloba-piracetam-vinpocetine may be considered a better alternative than Ginkgo biloba-piracetam combination and Ginkgo biloba, piracetam, or vinpocetine as single agents. In the experiment, the researchers used many compounds, for example, (41S,13aS)-Ethyl 13a-ethyl-2,3,41,5,6,13a-hexahydro-1H-indolo[3,2,1-de]pyrido[3,2,1-ij][1,5]naphthyridine-12-carboxylate (cas: 42971-09-5COA of Formula: C22H26N2O2).
(41S,13aS)-Ethyl 13a-ethyl-2,3,41,5,6,13a-hexahydro-1H-indolo[3,2,1-de]pyrido[3,2,1-ij][1,5]naphthyridine-12-carboxylate (cas: 42971-09-5) belongs to naphthyridine derivatives. The naphthyridines have 10 delocalized π-electrons located in five molecular orbitals, each of which is distorted by the presence of the nitrogen atoms causing an electron drift in that direction. Halogen atoms attached to the naphthyridine moiety can be easily replaced by other nucleophiles such as alkoxides and amines.COA of Formula: C22H26N2O2
Referemce:
1,8-Naphthyridine – Wikipedia,
1,8-Naphthyridine | C8H6N2 – PubChem