Milgamma compositum 100 mg + 100 mg, 60 pcs.

Active ingredients:

benfotiamine 100 mg;

pyridoxine hydrochloride 100 mg;

Excipients:

 microcrystalline cellulose,

aerosil,

sodium carboxymethyl cellulose,

talc,

povidone,

fatty acid glycerides,

shellac,

sucrose,

calcium carbonate,

acacia powder,

corn starch,

titanium dioxide,

polyethylene glycol-6000,

glycerol,

twin-80,

glycolic wax.

Milgamma - metabolic, neuroprotective, analgesic.

Pharmacodynamics

The neurotropic B vitamins have a beneficial effect on inflammatory and degenerative diseases of the nerves and locomotor system. Thiamine plays a key role in the metabolism of carbohydrates, as well as in the Krebs cycle with subsequent participation in the synthesis of thiamine pyrophosphate and ATP. Pyridoxine is involved in protein metabolism and partially in the metabolism of carbohydrates and fats. 

The physiological function of both vitamins is to potentiate the action of each other, which manifests itself in a positive effect on the nervous and neuromuscular systems. Cyanocobalamin is involved in the synthesis of the myelin sheath, reduces pain associated with damage to the peripheral nervous system, stimulates nucleic acid metabolism through the activation of folic acid. Lidocaine is a local anesthetic that causes all types of local anesthesia: terminal, infiltration, conduction.

Pharmacokinetics

After i / m administration, thiamine is rapidly absorbed from the injection site and enters the bloodstream (484 ng / ml after 15 minutes on the first day of a 50 mg dose) and is unevenly distributed in the body when it is contained in leukocytes - 15%, erythrocytes - 75% and in plasma - 10%. Due to the lack of significant reserves of vitamin in the body, it must be ingested daily. 

Thiamine crosses the blood-brain and placental barriers and is found in human milk. Thiamine is excreted in the urine in the alpha phase after 0.15 hours, in the beta phase after 1 hour and in the terminal phase within 2 days. The main metabolites are: thiamincarboxylic acid, pyramine and some unknown metabolites. Of all the vitamins, thiamine is stored in the body in the smallest amount. The body of an adult contains about 30 mg of thiamine in the form of thiamine pyrophosphate (80%), thiamine triphosphate (10%) and the rest in the form of thiamine monophosphate.

After intramuscular injection, pyridoxine is rapidly absorbed into the bloodstream and distributed in the body, acting as a coenzyme after phosphorylation of the CH2OH group in the 5th position. About 80% of the vitamin binds to blood plasma proteins. 

Pyridoxine is distributed throughout the body, crosses the placenta and is found in breast milk, is deposited in the liver and is oxidized to 4-pyridoxine acid, which is excreted in the urine a maximum of 2–5 hours after absorption. The human body contains 40–150 mg of vitamin B6 and its daily elimination rate is about 1.7–3.6 mg with a replenishment rate of 2.2–2.4%.

As a pathogenetic and symptomatic agent in the complex therapy of diseases and syndromes of the nervous system of various origins:

• neuralgia;
• neuritis;
• paresis of the facial nerve;
• retrobulbar neuritis;
• ganglionitis (including shingles);
• plexopathy;
• neuropathy;
• polyneuropathy (including diabetic, alcoholic);
• nocturnal muscle cramps, especially in older age groups;
• neurological manifestations of spinal osteochondrosis: radiculopathy, lumboishalgia, muscular-tonic syndromes.

• increased individual sensitivity to drug components;
• decompensated heart failure;
• the period of pregnancy and breastfeeding;
• childhood.

Allergic reactions: rarely - skin rash, urticaria, shortness of breath, Quincke's edema, anaphylactic shock.

From the side of the cardiovascular system: in some cases - tachycardia.

Others: in some cases - increased sweating, acne.

In case of an overdose of local anesthetics, adrenaline and norepinephrine should not be additionally used. Thiamine decomposes completely in solutions containing sulfites. Other vitamins are inactivated in the presence of decay products of vitamin B. Levodopa removes the effect of therapeutic doses of vitamin B6., And interaction with D-penicillamine, norepinephrine, cycloserine, adrenaline, sulfonamides can also occur. 

With parenteral use of lidocaine, in the case of additional use of norepinephrine and norepinephrine, an increase in side effects on the heart is possible. Thiamine is incompatible with oxidizing and reducing substances such as riboflavin chloride, benzylpenicillin, iodide, carbonate, acetate, tannin acid, mercury, iron-ammonium citrate, as well as sodium phenobarbital, glucose and metabisulfite. 

Copper accelerates the breakdown of thiamine; in addition, thiamine loses its effect with increasing pH values ​​(above pH 3). Vitamin B12 is incompatible with heavy metal salts. In solutions containing vitamin B12, thiamine, like other B vitamins, is quickly degraded by the breakdown products of thiamine - low concentrations of iron ions can prevent this. It is also destructive, especially when exposed to light at the same time; accelerates photolysis, nicotinamide, while antioxidants have an inhibitory effect.

Assign 1 tablet up to 3 times a day for 1 month.

The drug should be taken with a sufficient amount of liquid.