Milgamma analogues are cheaper than injections. Milgamma - analogues: instructions for use

Not only cause pain and limit mobility, but also lead to to paralysis and loss of capacity.

Therefore, treatment requires medications and vitamins that stimulate nerve cell growth and restorative conductivity of bundles and fibers.

About the drug

One of these drugs is the drug Milgamma, which produces German company WorwagPharmaGmbH&Co. KG.

This is the medicine prescribed for:

• neuritis and neuralgia of any etiology;
• paresis;
• ganglionitis;
• plexopathies and neuropathies.

Milgamma is , improving many processes occurring in nerve cells. Therefore, it is prescribed as a treatment on initial stages diseases.

For severe lesions nervous system this product is recommended as supportive as part of complex therapy. The active ingredients of this medicine are: lidocaine and B vitamins:

• pyridoxine – 200 mg;
• thiamine – 200 mg;
• cyanocabalamin – 2 mg.

Pyridoxine is a metabolic stimulant that accelerates natural metabolic processes in the affected and healthy cells. It increases delivery to nerve cells glucose and oxygen, due to which they quickly recover and divide, replacing dead cells.

Thiamine– a substance necessary for the metabolism and metabolism of carbohydrates, proteins and fats. Cyanocabalamin increases the number of red blood cells and activates the synthesis of nucleic acids necessary for the restoration of nerve fibers.

In tablets, instead of thiamine and cyanocabalamin, benfotiamine is used, a fat-soluble substance that performs the same functions.

The drug Milgamma is produced in the form of ampoules, tablets and dragees. It is not produced in Russian pharmaceutical factories, so you can only purchase expensive original German medicine.

Price a pack of 10 ampoules costs 450–600 rubles, a jar of dragees (60 pieces) will cost 750–950 rubles, and a pack of tablets (30 pieces) will cost you 600–700 rubles.

This drug has contraindications and side effects.

Here contraindications:

• decompensated heart failure;
• pregnancy;
• lactation period;
• childhood.

Here are the possible side effects:

• acne;
• vomit;
• heavy sweating;
• heart rhythm disturbances;
• dizziness and impaired consciousness;
• convulsions.

Despite its effectiveness, Milgamma is very Expensive, so some buyers are looking for an analogue of this medicine in ampoules or tablets.

There are no complete analogues therefore, you have to choose from those medicines that contain similar active ingredients or perform the same functions. The German drug has structural analogues(foreign, as well as Russian and Ukrainian), that is, medicines containing the same components.

Neuromultivitis

Another German a drug - structural analogue Milgamma in ampoules.

The price of a package (60 tablets) is 700 rubles.

The only difference is thiamine dosage– not 200, but 100 mg.

You can buy a pack of 10 ampoules for 300–350 rubles.

Due to the same composition of active ingredients in both drugs the same list of side effects.

I bought Neuromultivit for my mother, her legs and lower back hurt a lot. Moreover, the pain was such that she rarely left the house, only around the room.

After the first course of treatment, the pain decreased, and now my mother goes for walks and shopping on her own.

Nina Ivanovna, 51 years old

Because of constant stress At work I became irritable and snapped at everyone. It was especially hard on my husband. Milgamma was recommended, but I couldn’t afford the drug. I wanted to find a Milgamma substitute in ampoules, and it would be cheap.

On some website I read about Neuromultivit vitamins and bought two packages. I bought it more out of desperation, what if it helps?

By the end of the first year, my husband noticed that I had become kinder and no longer growled at everyone. And a month later, I suddenly realized that all my stress at work was a figment of my imagination. I stopped worrying about them and the results improved.

Lida, 25 years old

I was preparing for the session and decided to take some vitamins. I bought a pack, ate one tablet and broke out in blisters all over my body. My head was pounding.

In general, thanks to Neuromultivit, I lost two days, then I had to strain as hard as I could, but I passed the session.

Pasha, 19 years old

Combilipen

Analogue of Milgamma in ampoules Russian production, which is produced by the domestic enterprise JSC Pharmstandard-UfaVITA.

The drug is produced in the form of tablets in blister packs of 15 pieces (1–4 blister packs in a pack) and ampoules (volume 2 ml), 5–30 ampoules in a pack.

Despite the fact that Kombilipen is a structural analogue of Milgamma, they have The proportions of vitamins and their total content in the preparation differ:

• pyridoxine – 100 mg;
• thiamine – 100 mg;
• cyanocabalamin – 1 mg.

The tablets contain benfotiamine (100 mg) instead of thiamine, and the dosage of cyanocabalamin is reduced to 2 mcg. Indications for use, contraindications and side effects the same as Milgamma's.

The cost of the drug is lower analogues - 10 ampoules will cost 200 rubles, however, given the lower concentration existing funds, the difference in price is no longer so noticeable.

A package of 60 tablets will cost 350 rubles, but the content of drugs in the tablet is 2 times lower.

I have been healthy all my life, I almost never got sick, so neuritis facial nerve became for me a serious blow. Frequent pain numb nose and lips, very little pleasant.

The doctor prescribed Kombipilen. However, after 4 injections, I noticed that the sensitivity of my nose and lips was returning. And after the course (10 ampoules) the pain disappeared. So good medicine, inexpensive, I recommend it to everyone.

Jiri, 43 years old

A neighbor boasted about Kombipilen that she injects it when pain in the neck or lower back begins and everything goes away. And then my neck started to hurt so bad, I sent my grandson to the pharmacy to get these vitamins and syringes.

She injected herself and within a minute began to choke. The grandson immediately called an ambulance. The doctors arrived, looked at the packaging of the medicine, gave some kind of injection and everything went away. They said it was an allergy to some component. So these vitamins did not suit me.

Veronika Antonovna, 55 years old

Kombipilen quickly cured the neuralgia, but it’s been two weeks since I finished injecting vitamins, and my whole face is covered in acne. didn't exist before. I went to the doctor, he said the acne would soon disappear on its own. I’m waiting, I’m afraid to look at myself in the mirror and I don’t even go to the store.

Galina, 20 years old

Vitaxon

Ukrainian vitamin complex from PJSC Farmak.

In terms of composition, it is a substitute for Milgamma in ampoules, The only difference is in the dosage of the active ingredients.

The tablets contain 100 mg of benfoatimine and pyridoxine, and the ampoules contain 50 mg of all three active ingredients (pyridoxine, cyanocabalamin and thiamine).

Besides, The injections do not contain lidocaine, which makes the injections somewhat painful.

In terms of indications for use, contraindications and side effects, it is completely identical to Milgamma.

The cost of a package of 30 tablets is 200 rubles, a package of 5 ampoules will cost 150 rubles.

The doctor prescribed Vitaxon to me after a complex hip fracture and surgery. The drug helps, the pain decreases, and the mobility of the leg, as well as the sensitivity of the foot, increases.

One bad thing is that this drug is very painful. But the doctor says that it is better to endure the pain, but not to dilute the vitamins with lidocaion.

Natalya, 22 years old

Six months ago I fell out of a second floor window and was hit hard. left hand along the entire length. There were no fractures, but the arm became less mobile and sensitivity decreased.

In contact with

Group B. Vitamins of this group are used to treat pathologies of nervous tissue and nerve diseases of various origins, in which inflammatory and degenerative changes, combined with impaired nerve conduction. The drug is used in neurological practice, and also partially in orthopedic – for the treatment of pathologies of the musculoskeletal system. B vitamins improve blood circulation and hematopoietic processes, stabilize the functioning of the nervous system, and in large dosages promote pain relief.

pharmachologic effect

The tablet form of the drug, instead of thiamine hydrochloride, contains the substance benfotiamine . This substance also takes part in carbohydrate metabolism.

Pyridoxine – another B vitamin – when metabolized, it participates in amino acid metabolism and the synthesis of active mediators in the body:

• dopamine,
• histamine.

Vitamin B12 (or cyanocobalamin) acts as an antianemic agent; stimulates the synthesis of substances such as:

• choline,
• nucleic acids,
• methionine,
• creatinine

Thiamine excreted along with urine; does not accumulate in body tissues.
Cyanocobalamin actively binds to albumin after entering the blood plasma. Cumulates in bone marrow, easily penetrates the hematoplacental barrier.

Indications for use

• General strengthening effect.
• Neuritis and neuralgia, including retrobulbar neuritis.
• Alcoholic or diabetic polyneuropathy.
• Herpesvirus infections.
• Facial nerve paresis.

• neuropathy;
• brain pathology;

• the functions of organs and blood vessels were normalized,
• improved concentration,
• Deficiency of B vitamins disappeared.

Instructions for use of the drug in the form of tablets and solution for injection (for injections)

The duration of therapy with Milgamma is 1 month.

Dragee Compositum

Side effects

• dyspnea,
• anaphylaxis,
• bradycardia,

Contraindications

• Children and teenagers under 16 years of age.
• Hypersensitivity to B vitamins.
• Disruption of the conduction processes of the heart muscle.

During pregnancy

For children

Interaction

Thiamine is inactivated in the presence of:

• acetates,
• iodides,
• carbonates,
• mercury chloride,
• ferric ammonium citrate,
• riboflavin,
• tannic acid,

Pyridoxine reduces the effectiveness of antiparkinsonian drugs, in particular Levodopa. Their use should not coincide in time. In the presence of certain heavy metal salts, inactivation of cyanocobalamin begins.

Overdose

Release forms - ampoules and tablets

Compound

• cyanocobalamin,
• pyridoxine hydrochloride,
• Thiamine hydrochloride.

• benzyl alcohol,
• potassium hexacyanoferrate,
• lidocaine hydrochloride,
• sodium polyphosphate,
• sodium hydroxide,
• water for injections.

• Benfotiamine,
• pyridoxine hydrochloride.

• povidone,
• talc,
• microcrystalline cellulose,
• colloidal silicon dioxide.

additional information

Analogs

• Neurobion.
• Binavit.
• Combilipen.
• Milgamma Compositum.

Price

• Milgamma, 2 ml ampoules for injection, 5 pieces per package – from 219 to 428 rubles;
• tablets, 30 pieces per package – 300 - 557 rubles.

Reviews

Natalya, 40 years old.
I have diabetic polyneuropathy– the sciatic nerve is affected, and this chronic form, which cannot be treated. The maximum that can be done is to alleviate the condition a little. Well, I’m saving myself with Milgamma, it’s an excellent neurological remedy.

Yana Nikolaevna, 49 years old.
I have myalgia. Because of her I often feel dull pressing pain. Complained to my family doctor, he advised injecting Milgamma intramuscularly. This remedy partially anesthetizes, and for the most part eliminates all sorts of disorders. I tested for myself that the drug is really effective.

Pavel, 38 years old.
My wife and I recently turned to a neurologist - I had neuritis and had to undergo a course of treatment. At first they injected me with Movalis, but it was so painful it was terrible. I asked the doctor to replace Movalis with another drug. He appointed Milgamma. Well, this drug is better, of course, it doesn’t hurt as much. The neuritis went away, but the consequences, unfortunately, remained.

Reviews

My mom works as an accountant. The work is sedentary, and also nervous. When she began to complain to me about pain in her neck, I immediately realized that I needed to advise her. I suffered in the same way until the doctor prescribed Milgamma Compositum to drink. The drug is in tablets, very convenient to use. And he helped my mother too. She took 1 tablet three times a day. Then I took it for another month for prevention.

I had pain in the sternum area, I thought it was my heart, they examined everything, did an ECG several times - everything was clear, no problems. But it hurts! They sent me to a neurologist, and it turned out that thoracic osteochondrosis that's how he showed himself. I had a massage, took Milgamma tablets and everything went away. Well, thank God, at least not the heart.

One day I began to notice pain in my back. Moreover, the pain is such that it radiates to the thigh and even to the toes. Well, in principle, given my office lifestyle, this was to be expected. I work as an operator, I work on the computer all day, entering information. When sitting became unbearable, I went to the doctor. He diagnosed neuralgia sciatic nerve and prescribed Milgamma Compositum. 1 tablet three times a day. I took the course for 4 weeks. The improvement was very noticeable. Since then I always carry pills in my bag. You never know.

If you ask me what I earned in the office, I can honestly answer that osteochondrosis, well, some money))) But seriously, sedentary work at the computer has finished off my spine, the pain is constant. Sometimes I take a course of Milgamma tablets, so their pain-relieving effect lasts for a long time. In general, we need to take up sports, otherwise we’re all sitting and sitting...

For a very long time I wanted to take care of my health, and in particular the treatment of the spine. I work in an office and spend a lot of time at the computer. Because of this, in the evening my back ached and buzzed, and there was a feeling of spiders running between my shoulder blades. It turned out to be osteochondrosis thoracic spine. She was treated with milgamma compositum. I felt improvements somewhere in the middle of the course. Now six months have passed since the treatment, unpleasant

IN Lately There are problems at home with my husband. My face started to itch, then sharp pains began to appear out of the blue. Moreover, my face began to go numb. I was scared, but I understand that everything is on nerves. Because of these scandals. A friend advised me to take pills, Milgamma Compositum. The neurologist prescribed them to her. The symptoms were exactly the same as yours. Well, I started taking 1 tablet a day, and I obviously felt better. Thanks to my friend, I saved it.

My husband came home a month ago with severe pain in the back of the head. And he also complained about pain in his shoulders. He works in an office and decided that there was a draft under the split. They applied a warm compress, but it didn’t help. I sent him to the doctor, who said that it was not a cold, but cervicobrachial radiculitis. Like from sedentary lifestyle life. The doctor prescribed Milgamma Compositum. We've been drinking it for almost a month now, and there are obvious improvements.

I have been taking Milgamma Compositum for a month now, my neurologist prescribed it to me from lumbar osteochondrosis. I am satisfied with the drug, it helps well. The pain in my spine went away, but before that I couldn’t turn or bend over, the shooting was terrible. An effective remedy!

Milagamma Compositum helped me very well. I had terrible pain in my back, I couldn’t turn around. My daughter-in-law works as a nurse and came to see me. I thought I would have to give injections, but I really didn’t want it. As a result, she advised me to buy Milgamma tablets. I took one tablet a day, and it helped very well. A few days later the pain went away. But I finished the course anyway, as expected.

I regularly buy Milgamma for my father. No matter how much I say, it’s useless not to strain yourself in the garden. And then he suffers with his osteochondrosis. Of course, he applies ointments, but without pills, the pain goes away after Milgamma.

My husband was prescribed milgamma. One day he broke his back at work. Either he pulled a muscle, or something happened to the nerve endings, but his lower back hurt badly. After I took Milgamma Compositum tablets, everything became fine. I also bought it for myself, my spine also bothers me. I think they won’t make things worse; after all, they contain a vitamin complex.

Lately I've been saving myself only with Milgamma. I’m tired of applying ointments and creams to my lower back, their effect is temporary and the pain returns again. On the advice of a neurologist, I bought a package of Milgamma compositum, and after taking the tablets the pain went away.

When the muscles in my back were pinched, I ran to the pharmacy, bought Nise, began to rub it on myself, of course there was a result, but it was very short-lived, and then it started to hurt again. I went to the doctor so that he prescribed me treatment. He recommended taking Milgamma Compositum. It helped me a lot, after taking it I started to improve, and then completely discomfort gone. I am satisfied with the effect of the drug.

I’m 33 years old... he mocked me, it means I had a mini-stroke... after undergoing treatment in the hospital, they prescribed milgamma... I wish I could have taken it 🤢 just a waste of money... not only is my head like a house of advice, but I’m also itching in my throat ... vision in one eye dropped to - 7 ...

I have with early years there is a curvature of the spine. Previously, this did not interfere with my life, but lately, due to permanent job at the computer, I began to constantly feel discomfort. By evening, my back was especially sore. I decided to go to the doctor. In addition to gymnastics, the doctor prescribed Milgamma compositum for a course of 4 weeks. By the middle of the treatment I began to notice improvements. Now I'm finishing the course - nothing bothers me.

25 years old, athlete, injured his hand. After the first injection, the pain subsided. The effect is felt very quickly.

Milgamma Compositum helped me a lot. For coursework monthly intake The pain and discomfort disappeared and never returned. The most important advantage of milgamma is that it restores nerve endings, and not just relieves pain, it gives a lasting and long-lasting result.

I took Milgamma tablets. For a month, one tablet per day. The pain - aching and sharp - gradually disappeared completely. Thanks to my neurologist for the competent choice of medication. Treatment with Milgamma really helped.

I cannot judge which is better - tablets or injections, since I only drank Milgamma Compositum. I was pleased with them, the back pain that I had been fighting with for almost a year (I used warming ointments, gels, and took analgesics) has subsided for good, but previously it only temporarily relieved the attacks. The tablets gave me results even greater than I expected, so I recommend them from the bottom of my heart.

I was tormented by pain in the lumbar region - my back is generally weakness and often makes itself felt in the bad sense of the word. I took Milgamma compositum for a month, one tablet a day. The course is not very long and only one tablet per day - I was surprised that it helps. I thought that the pain would simply not be so severe. But painful sensations completely gone. After a month's course, nothing bothers me yet. I am planning to go to see a doctor, do I need to clarify whether and when, if necessary, to take Milgamma again?

Analogues of the drug Milgamma are medicines that have similar pharmacological properties, and also combine the same active ingredients.

This group of drugs is prescribed for neurological disorders caused by a lack of vitamins B12, B6, B1; For symptomatic treatment for pathologies of the central nervous system of various etiologies: polyneuritis and neuritis with pain syndrome, paresis peripheral nerves, polyneuropathy (alcoholic, diabetic), neuralgia, osteochondrosis and other diseases.

Let's consider the most popular analogues of this drug: Vitagamma, Binavit, Compligam B, Combilipen, Milgamma Compositum, Neuromultivit, Binavit, Neurobion and many others.

Vitagamma

Vitagamma – is a complex vitamin preparation. Produced in ampoules for intramuscular injection medicine. One ampoule contains:

• 100 mg thiamine hydrochloride;
• 100 mg pyridoxine hydrochloride;
• 10 mg lidocaine hydrochloride;
• 1 mg cyanocobalamin.

Contraindications for the use of Vitagamma include: pregnancy, lactation in women; erythrocytosis and erythremia ( a large number of erythrocytes in the blood); decompensated degree of heart failure; thromboembolism, thrombosis; childhood; shock; arterial hypotension(low pressure); individual intolerance to the components of the drug.

Use caution when:

• menopause and premenopausal period;
• neoplasms of benign and malignant nature (especially in cases of vitamin B12 deficiency and megaloblastic anemia);
• over 65 years of age;
• increased thrombus formation.

Side effects can manifest themselves in the form of acne, tachycardia, and increased sweating. Allergic reactions of a skin and systemic nature are also possible.

The price for Vitagamma may vary, but on average it is about 150 rubles.

Combilipen

Combilipen is another effective Russian analogue Milgamma. Produced in the form of injection solutions in ampoules. This drug contains:

• 50 mg thiamine hydrochloride (vitamin B1);
• 50 mg pyridoxine hydrochloride (vit. B6);
• 500 mcg cyanocobalamin (vitamin B12);
• 10 mg lidocaine hydrochloride.

Combilipen is indicated for diseases of a neurological nature: polyneuropathy, neuralgia trigeminal nerve, pain syndrome for pathologies of the spine, inflammation of the facial nerve.

The use of Combilipen is contraindicated during pregnancy and lactation, in children, and in cases of decompensated heart failure.

The cost of this drug averages about 250 rubles for 10 ampoules and about 400 rubles for 60 tablets.

Binavit

Binavit is a combination drug.

• 50 mg pyridoxine hydrochloride;
• 50 mg thiamine hydrochloride;
• 500 mcg cyanocobalamin;
• 10 mg lidocaine hydrochloride.

Contraindications to treatment with this medication include:

Side effects may also include allergic reactions, tachycardia, increased sweating, and difficulty breathing.

With rapid introduction of this medication Systemic reactions may occur in the form of arrhythmia, headache, dizziness, and convulsions.

Neurobion

Neurobion is a complex vitamin preparation that is available in the form of tablets and solution for injection. The composition of the drug is represented by the following components:

• 100 mg thiamine disulfide;
• 200 mg pyridoxine hydrochloride;
• 240 mcg cyanocobalamin.

The administration of this drug to children under 18 years of age and to persons with hypersensitivity to the components of the medication is contraindicated. It should also not be used in the treatment of patients with hereditary fructose and galactose intolerance, glucose-galactose malabsorption, lactase deficiency, sucrose and isomaltase deficiency.

Side effects may include tachycardia, sweating, allergic manifestations, nausea, vomiting, abdominal pain, diarrhea.

average cost The drug costs about 300-350 rubles for 3 ampoules or 20 tablets.

Neurorubin

Neurorubin is another analogue of Milgamma. It is produced in the form of tablets or injection solution. One ampoule contains:

• 100 mg thiamine hydrochloride (vitamin B1);
• 100 mg pyridoxine hydrochloride (vitamin B6);
• 1 mg cyanocobalamin (vitamin B12).

The drug is contraindicated for persons sensitive to the components of the drug, as well as for children. The use of B12-containing medications is not recommended for patients with psoriasis, as an exacerbation may develop.

Side effects may occur in the form of allergic reactions, tachycardia, circulatory collapse, urticaria.

average price Neurorubin costs about 100 rubles for 20 tablets or 5 ampoules.

Neuromultivitis

Neuromultivit is an Austrian complex B-vitamin preparation.

Produced in tablet form. Includes:

• 100 mg thiamine hydrochloride (vit. B 1);
• 200 mg pyridoxine hydrochloride (vit. B 6);
• 200 mcg cyanocobalamin (vit. B 12).

The drug is contraindicated for use in children, pregnant and breastfeeding women, as well as in people with hypersensitivity to the components of the drug.

The drug is well tolerated, but in some cases tachycardia, nausea, and possible urticaria and itching may occur.

Research has proven that taking a complex of vitamins B1, B6, B12 has positive action on nerve tissue for diseases such as neuritis, radiculitis and various kinds neuralgia. For an analgesic effect and restoration of nerve structure, it is recommended to use Neuromultivit - medicine, containing a combination of vitamins B1 (100 mg), B6 ​​(200 mg) and B12 (200 mcg) in dosages that are higher than in standard multivitamin preparations.

Application complex means more efficient use analgesics: the drug not only relieves unpleasant symptoms, but also eliminates the cause of the pain. The drug is available in the form of tablets, which is especially convenient for use at home and at work, and a package of 60 tablets is enough for full course treatment.

IN high dosages Neuromultivit can be used for up to 4 weeks. During treatment with Neuromultivit, it is not recommended to take multivitamin complexes containing B vitamins.

The cost of the drug is about 550 rubles for 20 tablets.

Neurobex

Neurobex is a Bulgarian analogue of the drug Milgamma. Available in tablet form. 1 tablet contains: pyridoxine hydrochloride, thiamine nitrate, cyanocobalamin.

Contraindicated in persons with hypersensitivity to the components of this medication, as well as with erythremia, erythrocytosis and acute thromboembolism. It is not recommended for use in patients with lactase deficiency, malabsorption or galactosemia.

Neurobeks is generally well tolerated. However, sometimes tachycardia, sweating, and urticaria may occur. Rarely develop anaphylactic shock, choking, rash.

Today on the pharmaceutical market you can find great amount analogues of Milgamma. Each of them has its own characteristics, advantages and disadvantages. Any of the analogues should be prescribed exclusively by a doctor, since only a specialist can select the most optimal drug for the patient individually.

The average cost of this drug is 65 rubles for 30 tablets.

So, analogues of Milgamma can be much cheaper than this drug. The cost of Milgamma on average is about 600-800 rubles for 10 ampoules, Milgamma Compositum dragees are about 1200 rubles for 60 pieces. Due to the presence of such a variety of analogues, a doctor can prescribe best option at price and composition for each patient.

pharmachologic effect

Vitamin preparation of combined composition.

Benfotiamine, a fat-soluble derivative of thiamine (vitamin B1), is phosphorylated in the body to the biologically active coenzymes thiamine diphosphate and thiamine triphosphate. Thiamine diphosphate is a coenzyme of pyruvate decarboxylase, 2-oxyglutarate dehydrogenase and transketolase, thus participating in the pentose phosphate cycle of glucose oxidation (aldehyde group transfer).

Phosphorylated form pyridoxine (vitamin B 6)- pyridoxal phosphate - is a coenzyme of a number of enzymes that affect all stages of non-oxidative metabolism of amino acids. Pyridoxal phosphate is involved in the process of decarboxylation of amino acids, and, consequently, in the formation of physiologically active amines (for example, adrenaline, serotonin, dopamine, tyramine). By participating in the transamination of amino acids, pyridoxal phosphate is involved in anabolic and catabolic processes (for example, being a coenzyme of transaminases such as glutamate-oxalocetate transaminase, glutamate-pyruvate transaminase, gamma-aminobutyric acid (GABA), α-ketoglutarate transaminase), as well as V various reactions breakdown and synthesis of amino acids. Vitamin B 6 is involved in 4 different stages tryptophan metabolism.

Pharmacokinetics

Suction and p distribution

When taken orally, most of benfotiamine is absorbed into the duodenum, smaller - in the upper and middle sections small intestine. Benfotiamine is absorbed by active resorption at concentrations ≤2 µmol and by passive diffusion at concentrations ≥2 µmol. Being a fat-soluble derivative of thiamine (vitamin B1), benfotiamine is absorbed faster and more completely than water-soluble thiamine hydrochloride. In the intestine, benfotiamine is converted to S-benzoylthiamine as a result of dephosphorylation by phosphatases. S-benzoylthiamine is fat-soluble, highly penetrating, and is absorbed largely without being converted to thiamine. Due to enzymatic debenzoylation after absorption, thiamine and the biologically active coenzymes thiamine diphosphate and thiamine triphosphate are formed. Especially high levels These coenzymes are observed in the blood, liver, kidneys, muscles and brain.

Pyridoxine (vitamin B 6) and its derivatives are absorbed primarily into upper sections Gastrointestinal tract during passive diffusion. In blood serum, pyridoxal phosphate and pyridoxal are bound to albumin. Before penetration through the cell membrane, pyridoxal phosphate bound to albumin is hydrolyzed alkaline phosphatase with the formation of pyridoxal.

Metabolism and excretion

Both vitamins are excreted primarily in the urine. Approximately 50% of thiamine is excreted unchanged or as sulfate. The remainder consists of several metabolites, among which are thiamine acid, methylthiazoacetic acid and pyramine. The average half-life of benfotiamine in the blood is 3.6 hours.

T1/2 of pyridoxine when taken orally is approximately 2-5 hours. Biological T1/2 of thiamine and pyridoxine is approximately 2 weeks.

Indications

- neurological diseases with confirmed deficiency of vitamins B1 and B6.

Dosage regimen

Dragee should be taken orally and washed down big amount liquids.

Adults are prescribed 1 tablet/day.

IN acute cases after consulting a doctor, the dose can be increased to 1 tablet 3 times a day.

After 4 weeks of treatment, the doctor must decide on the need to continue taking the drug at an increased dose and consider reducing the dose of vitamins B 6 and B 1 to 1 tablet/day. If possible, the dose should be reduced to 1 tablet/day in order to reduce the risk of developing neuropathy associated with the use of vitamin B6.

Side effect

The frequency of side effects is distributed in the following order: very often (more than 10% of cases), often (in 1%-10% of cases), infrequently (in 0.1%-1% of cases), rarely (in 0.01%-0.1% of cases), very rare (less than 0.01% of cases), as well as side effects, the frequency of which is unknown.

Allergic reactions: very rarely - skin reactions, itching, urticaria, skin rash, difficulty breathing, Quincke's edema, anaphylactic shock.

From the nervous system: V in some cases- headache; frequency unknown (single spontaneous reports) - peripheral sensory neuropathy at long-term use drug (more than 6 months).

From the digestive system: very rarely - nausea.

For the skin and subcutaneous fat: frequency unknown (single spontaneous reports) - acne, increased sweating.

From the cardiovascular system: frequency unknown (single spontaneous messages) - tachycardia.

Contraindications for use

- decompensated heart failure;

- children's age (due to lack of data);

- pregnancy;

- period of breastfeeding;

- hypersensitivity to thiamine, benfotiamine, pyridoxine or other components of the drug.

Each dragee contains 92.4 mg of sucrose. Therefore, the drug should not be used when congenital intolerance fructose, glucose/galactose malabsorption syndrome or glucose-isomaltase deficiency.

Use during pregnancy and breastfeeding

The use of the drug is contraindicated during pregnancy and lactation (breastfeeding).

Use in children

Contraindicated in childhood(due to lack of data).

Overdose

Overdose symptoms

Given the wide therapeutic range, overdose of benfotiamine when taken orally is unlikely.

Taking high doses of pyridoxine (vitamin B 6) for a short period of time (at a dose of more than 1 g / day) can lead to short-term neurotoxic effects. When using the drug at a dose of 100 mg/day for more than 6 months, the development of neuropathies is also possible. Overdose, as a rule, manifests itself in the development of sensory polyneuropathy, which may be accompanied by ataxia. Taking the drug in extremely high doses can lead to seizures. The drug may have a strong effect on newborns and infants. sedative effect, cause hypotension and breathing disorders (dyspnea, apnea).

Treatment of overdose

When taking pyridoxine in a dose exceeding 150 mg/kg body weight, it is recommended to induce vomiting and take Activated carbon. Provocation of vomiting is most effective during the first 30 minutes after taking the drug. Emergency symptomatic therapy may be required.

Drug interactions

In therapeutic doses, pyridoxine (vitamin B 6) can reduce the effect of levodopa.

Concomitant use of pyridoxine antagonists (for example, hydralazine, isoniazid, penicillamine, cycloserine), alcohol consumption and long-term use estrogen-containing oral contraceptives can lead to vitamin B6 deficiency in the body.

When taken simultaneously with fluorouracil, deactivation of thiamine (vitamin B1) is observed, since fluorouracil competitively inhibits the phosphorylation of thiamine to thiamine diphosphate.

Conditions for dispensing from pharmacies

The drug is approved for use as a means of OTC.

Storage conditions and periods

The drug should be stored out of the reach of children at a temperature not exceeding 25°C. Shelf life - 5 years.

special instructions

When using the drug at a dose of 100 mg/day for more than 6 months, sensory peripheral neuropathy may develop.

Impact on the ability to drive vehicles and operate machinery

There are no warnings regarding the use of the drug by drivers Vehicle and persons working with potentially dangerous mechanisms.

The drug, known among Russians as Milgamma, is produced in Germany by the pharmaceutical company Verwag Pharma. Therefore, the cost of these tablets is not small - for a package containing 30 tablets, the average price in Russian pharmacies is 550 rubles. Whether there is a domestic analogues of this medicine? Read about it in our article.

The drug Milgamma and its composition

Milgamma is a medicine combined type, containing B vitamins and lidocaine. Let's look at the composition of this combination medicine in more detail:

1. B vitamins:
   • B1 or thiamine (100 mg per 2 ml of solution) - differs in that during metabolization it can be transformed into cocarboxylase, which is necessary for normal stable carbohydrate metabolism;
   • B6 or pyridoxine (100 mg per 2 ml of solution) – participates in amino acid metabolism and the synthesis of active mediators, which include adrenaline, histamine, serotonin and dopamine;
   • B12 or cyanocobalamine (1000 microns per 2 ml of solution) - stimulates the synthesis of choline, creatinine, methionine and nucleic acid, is considered an antianemic agent, and can act as an analgesic.
2. Lidocaine (20 mg per 2 ml solution) – anesthetic local action(that is, it has the ability to cause anesthesia) and at the same time a cardiac depressant, due to these properties it is used as an antiarrhythmic drug.
3. Auxiliary components:
   • benzyl alcohol;
   • potassium hexacyanoferarrate;
   • sodium polyphosphate;
   • sodium hydroxide;
   • water for injections.

This is the classic composition of Milgamma, which is designed for parenteral administration using injections. But this drug also has another form of release - tablets, the composition of which is slightly different:

1. Benfotiamine (100 mg in one tablet) is an analogue of thiamine (B1), but of a synthetic type, has a vitamin and metabolic effect on the human body, normalizes the functions of the nervous system and adjusts carbohydrate metabolism.
2. Pyridoxine hydrochloride (100 mg per tablet) is one of the forms of B6 that regulates protein metabolism.
3. Auxiliary components:
   • povidone is an enterosorbent that is used in the insoluble form of polyvinylpyrrolidone;
   • talc is a mineral, used in tablets as powder;
   • microcrystalline cellulose is one of the modifications of natural cellulose (a natural polymer that affects the elastic properties of plant tissues), used in powder form;
   • colloidal silicon dioxide is another enterosorbent that binds and removes toxins, antigens, and salt allergens from the human body heavy metals etc.

Doctors prescribe these Milgamma tablets in combination with other medications for treatment various diseases nervous system, which include:

• neuralgia and neuritis;
• ganglionitis;
• neuropathy and polyneuropathy;
• muscle cramps;
• osteochondrosis of the spine, including muscular-tonic syndrome.

It is not recommended to use these tablets if hypersensitivity of an individual nature, during pregnancy and during breastfeeding, with decompensated heart failure.

Milgamma analogues (in tablets)

There are a number of analogues of Milgamma, which also come in the form of tablets. By analogues, experts mean drugs that have similar (identical) pharmacological properties due to their composition - the main active ingredient is the same. In Russia you can buy in pharmacies the following drugs, which are official analogues German Milgamma:

1. Neuromultivit is a multivitamin that contains: the following vitamins group B (per tablet), which are contained in Milgamma injection solution:
   • cyanocobalamine – 200 microns;
   • thiamine hydrochloride – 100 mg.

Neuromultivit is used to eliminate hypovitaminosis and improve the performance of the patient’s nervous system. The manufacturer of this medicine is Austria, Lannacher Heilmittel GmbH.” In Russian pharmacies the average price is 150 rubles.

1. Neurobion is considered one of the vitamin products, which affects digestive system, metabolism. It contains the following main active ingredients(dosage per tablet):
   • thiamine disulfide – 100 mg;
   • pyridoxine hydrochloride – 200 mg;
   • cyanocobalamin – 240 microns.

The indications indicate neuritis and neuralgia, including sciatica, lumbago, plexitis and radicular neuritis. The manufacturer of this drug is Germany, Merck KGaA. The average cost in Russian pharmacies is 320 rubles.

1. Combilipen is a domestic multivitamin preparation in combination with other medicinal substances, it contains the following active substances(contents indicated per tablet):
   • benfotiamine – 100 mg;
   • pyridoxine hydrochloride – 100 mg;
   • cyanocobalamin – 2 mcg.

Used in complex therapies for treatment neurological diseases of various origins. Manufacturer - Russia, JSC Pharmstandard-UfaVITA, average price - 220 rubles.

1. Neurobex Forte is multivitamin complex, which contains B vitamins (per tablet):
   • thiamine nitrate – 100 mg;
   • pyridoxine hydrochloride – 200 mg;
   • cyanocobalamin – 300 mcg.

Supports stable activity of the patient's nervous system, cell replication and growth. Manufacturer – Bulgaria, Balkanfarma-Dupnitsa AD. The average cost of a package is 157 rubles.

1. NeuroMax forte is intended for the treatment of a deficiency of B vitamins in the body; it contains (per tablet):
   • thiamine hydrochloride - 100 mg;
   • pyridoxine hydrochloride – 200 mg;
   • cyanocobalamin – 200 mcg.

It does not contain sugar or lactose among the additional components. Manufacturer – Finland, Vitabalance. The average price of a package (30 tablets) is 560 rubles.

Also close composition The following drug has components - Vitaxon - a Ukrainian drug with neurotropic action. Its composition is quite close to tablet Milgamma (content of active active substance per tablet):

• benfotiamine – 100 mg;
• pyridoxine hydrochloride – 100 mg.