ACTOVEGIN
Deproteinized calf blood hemodialysate used for muscle injuries, diabetic neuropathy, and neuroprotection with uncertain efficacy.
A 2022 systematic review of Actovegin in ischemic stroke (5 studies, 3879 patients) found no consistent evidence of improved survival, quality of life, or neurologic outcomes, and one study reported higher incidence of recurrent stroke or hemorrhage versus placebo. In sports medicine, a pilot study showed return to play 8 days earlier with Actovegin versus physiotherapy alone, and a 2020 review concluded clinical efficacy for muscle injuries was supported by limited evidence with a safe profile. In vitro studies demonstrate reduced inflammatory cytokine secretion and improved mitochondrial respiration in a diabetic mouse model. Actovegin showed efficacy and safety in randomized trials for diabetic peripheral neuropathy and is authorized for this indication in several countries. The active compound(s) have never been definitively identified, and pharmacokinetic studies are not feasible due to the physiological nature of its components.