A 1970s synthetic memory compound, prescribed for decades where brain blood vessels are damaged. It does something in brains already impaired and nothing measurable in brains that are not, and has never been tested in healthy adults over a meaningful period. Safety is the least contentious part; the greater hazard is the supply, where most labels have proved inaccurate. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Estimated glomerular filtration rate (eGFR) | > 90 mL/min/1.73 m² | Sets oxiracetam exposure; ~84% of the dose leaves unchanged in urine |
| Cystatin C | 0.60–0.90 mg/L | Confirms filtration independently of muscle mass, which distorts creatinine-based estimates |
| Serum creatinine | 0.7–1.1 mg/dL (men), 0.6–0.9 mg/dL (women) | The direct input to filtration estimates and to the published clearance correlation |
| Blood urea nitrogen | 10–16 mg/dL | Cross-checks renal clearance and detects dehydration that transiently reduces filtration |
| High-sensitivity C-reactive protein (hs-CRP) | < 0.8 mg/L | Tracks the vascular inflammation that drives the cerebrovascular substrate this compound targets |
| Apolipoprotein B (ApoB) | < 80 mg/dL, or < 60 mg/dL with existing cerebrovascular disease | Counts atherogenic particles, the primary modifiable driver of small-vessel brain disease |
| Homocysteine | < 8 µmol/L | Elevated levels independently predict white-matter disease and cognitive decline, and are correctable |
| Vitamin B12 | 500–1,000 pg/mL | Deficiency causes reversible cognitive impairment that mimics what oxiracetam is being used for |
| Haemoglobin A1c (HbA1c) | 4.8–5.4% | Glycaemic control drives small-vessel disease and is a major determinant of cognitive trajectory |
| Alanine and aspartate aminotransferase (ALT, AST) | ALT < 25 U/L (men), < 20 U/L (women); AST < 25 U/L | Baseline safety reference, and detects the metabolic liver disease that clusters with vascular risk |
Cadence: Baseline before the first dose; tolerability and sleep rechecked at 2 weeks; kidney markers and the identical baseline cognitive assessment repeated at 12 weeks; kidney function and cognition every 6–12 months thereafter. A 3-month kidney-marker interval applies to adults over 65, to a filtration rate below 75 mL/min/1.73 m², and to anyone starting or stopping a non-steroidal anti-inflammatory drug.