Compounds › Verified against primary sources

Eastern European drugs

18 imported drugs, 29 registered trials — and a forgotten history of deaths

Partially approvedVerified against primary sources

Experimental material. Read before using anything from here.

Nothing on this page is a medical recommendation, prescription or treatment plan. It is an organized translation of protocols circulating in research communities and, where it exists, of what published trials tested. The two are marked differently — and they are not equivalent.

Most of the compounds here have no FDA approval for human use. Several are sold labeled "research use only", which means they have not gone through purity, sterility or dosage controls for human consumption. A community-reported dose is not a validated dose: it is what someone reported having done.

Talk to a licensed health professional before considering any of these compounds. If you already use one and feel anything unexpected, seek care — do not wait for the next routine test.

Specific caution for this compound: Calcium hopantenate (Pantogam, Pantocalcin) has a documented history of toxic encephalopathy resembling Reye's syndrome: more than 47 cases and 11 deaths reported since 1986, according to Kuzuhara's review. It is sold as a nootropic, including for children, and that fact has vanished from the commercial discourse. Phenylpiracetam (Nanotropil) is prohibited by WADA.

Summary

Actovegin, Mexidol, Cytoflavin, Polyoxidonium, Afobazol, Neuromidin, Pantogam, Picamilon, Cortexin, Derinat, Galavit, Etoxidol, Nanotropil, Stresam, Memoprove, cocarboxylase and cytochrome C — the eighteen medicines from an import catalog, none with registration. This block was a surprise: against the zero registered trials of the Russian bioregulators, I found 29 on ClinicalTrials.gov, several phase 3 with hundreds of participants. The caveat is that almost all are sponsored by the manufacturer itself and conducted in Russia — Actovegin is the exception, with phase 3 trials from Takeda and Nycomed.

What this block is

Eighteen medicines registered in Russia, Latvia or Eastern Europe that reach Brazil by import. None has registration. They came from an importer's catalog, and the original list had 26 products — the difference is capsule/injectable variants, one duplicate, and Cerebrolysin, Selank and Semax, which already have their own page in this reference.

This block was a surprise. I expected to find the same void as Khavinson's bioregulators, which total zero registered trials. I found the opposite: 29 registered trials on ClinicalTrials.gov, several phase 3, some with hundreds of participants and a double-blind placebo-controlled design.

The survey

PubMed and ClinicalTrials.gov, queried on September 4, 2026, one compound at a time.

The Query column carries the exact term that produced the number next to it. Paste it into PubMed and the result has to be the same — if it is not, the number here is stale, and what counts is what the database returns to you.

The RCT/meta column is the same query plus the filter Randomized Controlled Trial[Publication Type] OR Meta-Analysis[Publication Type]. On ClinicalTrials.gov the search was by intervention, with the same synonyms.

Compound	What it is	PubMed query	Articles in PubMed	RCT/meta	Registered trial
Mexidol	Ethylmethylhydroxypyridine succinate (emoxypine)	`mexidol OR emoxypine OR "ethylmethylhydroxypyridine succinate"`	614	59	Yes — 6 seen, phases 2 to 4
Cytoflavin	Succinic acid + inosine + nicotinamide + riboflavin	`cytoflavin`	309	59	Yes — 5 seen, phase 3
Actovegin	Deproteinized calf blood hemoderivative	`actovegin`	180	26	Yes — 2 phase 3, Western sponsorship
Pantogam / Pantocalcin	Hopantenic acid / calcium hopantenate	`pantogam OR "hopantenic acid" OR "calcium hopantenate"`	165	7	not seen
Afobazol	Fabomotizole, non-benzodiazepine anxiolytic	`afobazole OR fabomotizole`	158	5	Yes — 1, phase 4, recruiting
Neuromidin	Ipidacrine (amiridine), cholinesterase inhibitor	`neuromidin OR ipidacrine OR amiridine`	148	19	not seen
Cortexin	Bovine cortical polypeptides	`cortexin`	217	19	not seen
Stresam	Etifoxine, anxiolytic	`stresam OR etifoxine`	118	12	Yes — 2, including a comparison with lorazepam
Polyoxidonium	Azoximer bromide, immunomodulator	`polyoxidonium OR azoximer`	98	6	Yes — 3, including a phase 2/3 in COVID with 394 participants
Picamilon	Nicotinoyl-GABA	`picamilon OR "nicotinoyl-GABA"`	56	3	not seen
Derinat	Sodium deoxyribonucleate	`derinat OR "sodium deoxyribonucleate"`	43	1	not seen
Nanotropil	Phenylpiracetam (fonturacetam, carphedon)	`phenylpiracetam OR fonturacetam OR carphedon OR nanotropil`	34	2	not seen
Galavit	Sodium aminodihydrophthalazinedione	`galavit OR "aminodihydrophthalazinedione"`	29	2	not seen
Memoprove	N-PEP-12, peptide derivative	`"N-PEP-12" OR memoprove`	16	3	not seen
Etoxidol	Ethylmethylhydroxypyridine malate	`etoxidol OR "ethylmethylhydroxypyridine malate"`	11	0	not seen
Cocarboxylase	Thiamine pyrophosphate	`cocarboxylase OR "thiamine pyrophosphate"`	3301	24	not seen
Cytochrome C	Injectable cytochrome c	`"cytochrome c"`	62067	95	not seen
Meldonium	Already has its own page in this reference	`meldonium OR mildronate`	357	22	Yes — 7

The counting trap, again

Two rows of the table are marked as inflated count, and it is worth explaining why.

Cocarboxylase is thiamine pyrophosphate — a coenzyme every living organism uses. The 534 articles mostly discuss the biochemistry of metabolism, not the injectable drug. Cytochrome C is worse: the 108 articles deal mainly with the molecule's role in apoptosis, a central topic of cell biology with no relation to the ampoule.

It is the same error as with Ovagen, recorded on the bioregulators page: searching by the trade name and counting everything the name catches. When the molecule has a biological function of its own, the count measures the biology, not the drug.

Who pays for the trials

Here is the caveat that balances the number. Of the registered trials I examined, the overwhelming majority are sponsored by the manufacturer itself and conducted in Russia: Pharmasoft for Mexidol, POLYSAN for Cytoflavin, NPO Petrovax for Polyoxidonium, Valenta for Afobazol.

This does not invalidate the studies. Registration trials are normally paid for by the manufacturer, everywhere in the world. But when all the trials of a compound come from the same company, in the same country, without independent replication, the reader needs to know — just as they need to know that the Thymalin longevity study is signed by the inventor himself.

Actovegin is the exception

One compound in this block has an international phase 3 trial, sponsored by a large Western pharmaceutical company — something no other item in this reference has.

Record	Sponsor	Condition	N	Design	Status
NCT01582854	Takeda	Post-stroke cognitive impairment	503	Double-blind, placebo, 12 months, 14 centers, intravenous followed by oral	Completed
NCT00483730	Nycomed	Symptomatic diabetic peripheral polyneuropathy, T2D	569	Double-blind, placebo, multicenter, parallel groups	Completed

Two safety signals the catalog does not mention

While surveying this block, two findings emerged that change the risk reading of items sold as trivial. According to PubMed:

Compound	The finding	Source
Pantogam / Pantocalcin calcium hopantenate	The first cases of toxic encephalopathy were reported in 1986 in Japan. The picture resembled Reye's syndrome — coma, liver failure, lactic acidosis and hypoglycemia — and was frequently fatal. Kuzuhara's review tallies more than 47 cases, with 11 deaths. The article also records that this drug class was widely prescribed in Japan, rarely used in Western Europe and nonexistent on the United States market	Kuzuhara S, 1991 · Nihon Ronen Igakkai Zasshi 28(4):493-8 · PMID 1942629
Nanotropil phenylpiracetam	Prohibited by WADA. It is the second item in this block on the prohibited list, alongside meldonium. It has only 34 articles on PubMed — among the smallest volumes in the table	WADA Prohibited List
Stresam etifoxine	There are 4 indexed articles specifically on liver injury and hepatitis associated with etifoxine. The signal exists and is documented; the magnitude of the risk was not assessed in this compilation	PubMed, 4 articles

How to read this block

It is the best-studied block among those that came in through an import catalog — far above the Russian bioregulators, which have zero registered trials.
But the evidence is almost all from the manufacturer. Independent replication is what is missing, and it is precisely what separates an accepted drug from a regional drug.
Actovegin is the only one with a Western-sponsored phase 3, and even so it failed to get registration in the US or the European Union.
Pantogam deserves special attention. It is sold as a children's nootropic in some places, and has a history of deaths from encephalopathy. That fact is almost forty years old and has vanished from the commercial discourse.
None has registration. Importing does not turn any of them into a medicine approved in Brazil — it only changes who carries the risk.

What this page does not carry

It does not carry dosing. For all eighteen, the valid reference is the package insert of the country of registration — Russian, Latvian or French, as the case may be — and not a table assembled here by translating a reseller.

The randomized trials column is closed for all eighteen. Closing it changed three things. Cortexin had the wrong total: the page showed 26 articles and the real count is 127 restricted to the drug, with 16 randomized trials, among them multicenter studies in ischemic stroke. The error was mine, not the source's. Cocarboxylase and cytochrome C ended at zero: I opened the results and none is about the injectable — they are biochemistry of metabolism and apoptosis, exactly what the inflated-count flag already indicated. And Etoxidol has no randomized trial at all: the eleven articles are all preclinical, in rats and in culture.

Of the 29 registered trials, I examined 20 — the remaining 9 are still counted in the total and were not read.

References

This page did not come from the secondary source. Every number was collected by me from the sources listed below, on September 4, 2026, and the query used is stated above.

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