MILЬGAMMA

Active material: The complex B vitamins
When ATH: A11DB
CCF: The complex B vitamins
ICD-10 codes (testimony): B02.2, G50.0, G51, G60, G61, G62.1, G63.2, H46, M54.1, M54.3, M54.4, M79.2, R25.2
At KFU: 02.11.01
Manufacturer: WÖRWAG PHARMA GmbH & Co. KG (Germany)

Pharmaceutical form, composition and packaging

The solution for the / m clear, of red color.

Excipients: benzyl alcohol, sodium polyphosphate, potassium ferrocyanide, Sodium hydroxide, water d / and.

2 ml – vials of dark glass (5) – packings Valium planimetric (1) – packs cardboard.
2 ml – vials of dark glass (5) – packings Valium planimetric (2) – packs cardboard.
2 ml – vials of dark glass (5) – packings Valium planimetric (5) – packs cardboard.
2 ml – vials of dark glass (5) – Cardboard trays (1) – packs cardboard.
2 ml – vials of dark glass (5) – Cardboard trays (5) – packs cardboard.
2 ml – vials of dark glass (10) – Cardboard trays (1) – packs cardboard.

Pharmacological action

The complex B vitamins. Neurotropic B vitamins have a beneficial effect on inflammatory and degenerative diseases of the nerves and musculoskeletal system. Contribute to increased blood flow, and improve the functioning of the nervous system.

Thiamin (vitamin B₁) It plays a key role in the metabolism of carbohydrates, and in the Krebs cycle, followed in the synthesis TPF (thiamine pyrophosphate) and ATP (adenosine triphosphate).

Pyridoxine (vitamin B₆) involved in the metabolism of protein and, partially, in the metabolism of carbohydrates and fats.

The physiological function of both vitamins is potentiation of each other, It manifests itself in a positive impact on the neuromuscular and cardiovascular systems. At deficiency of vitamin B₆ widespread state deficit quickly cease after the introduction of these vitamins.

Цianokoʙalamin (vitamin B₁₂) involved in the synthesis of myelin, stimulate hematopoiesis, reduces pain, associated with lesions of the peripheral nervous system, It encourages the exchange of nucleic acid through the activation of folic acid.

Lidokain – local anesthetic, causing all kinds of local anesthesia (terminal, infiltration, provodnikovuju).

Pharmacokinetics

Absorption

After the / m of thiamine is rapidly absorbed and enters the blood. The concentration of thiamine 484 ng / mL in 15 min after drug administration in a dose of 50 mg (1 day administration).

After the / m of pyridoxine is rapidly absorbed into the systemic circulation and is distributed in the body, acting as a coenzyme after phosphorylation group CH₂OH 5-position.

Distribution

Thiamine is unevenly distributed in the body. The content of thiamine in leukocytes 15%, in erythrocytes – 75% in plasma – 10%. In the absence of substantial reserves of the vitamin in the body, it must be ingested daily. Thiamine passes through the blood-brain barrier and the placental barrier and is found in breast milk.

Pyridoxine is distributed throughout the body, It crosses the placental barrier and is found in breast milk. The body contains 40-150 mg of vitamin B_6, his daily rate of elimination is about 1.7-3.6 mg fill at a rate 2.2-2.4%.

Metabolism and excretion

The major metabolites of thiamine are tiaminkarbonovaya acid, Pyramin and some unknown metabolites. Of all the vitamins thiamine stored in the body in the least amount. The body of an adult contains about 30 mg as thiamine 80% thiamine pyrophosphate, 10% thiamine triphosphate and the remaining amount as thiamine monophosphate. Thiamine is excreted in the urine, T_1/2 a-фазы – 0.15 no, b-фазы – 1 h and terminal phases – during 2 days.

Pyridoxine deponiruetsя in baked and okislяetsя to 4 piridoksinovoй kislotы, which is excreted in the urine, a maximum of 2-5 h after absorption.

Testimony

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

- Neuralgia, neuritis;

- Paresis of the facial nerve;

- Optic neuritis;

- Ganglionitis (including herpes zoster);

- Plexopathy;

- Neuropathy;

- Polyneuropathy (Diabetic, Alcoholic);

- Nocturnal muscle cramps, particularly in older age groups;

- Neurological manifestations of osteochondrosis;

- Radikulopatiya;

- Ljumʙoişialgija;

- Muscular-tonic syndromes.

Dosage regimen

In cases severe pain syndrome treatment it is advisable to start with the / m injection at a dose of 2 ml daily for 5-10 days later transition either ingestion, or at a rare introduction (2-3 once a week for 2-3 weeks) with the possible continuation of the therapy dosage form for oral administration.

The drug is injected deep into the / m.

Side effect

Allergic reactions: itch, hives, labored breathing, angioedema, anaphylactic shock.

Other: in some cases – increased perspiration, tachycardia, acne.

Contraindications

- Decompensated heart failure;

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

- Individual hypersensitivity to the drug.

Pregnancy and lactation

During pregnancy and lactation is not recommended to use the drug.

Cautions

–

Overdose

In cases of very rapid injection may be dizziness, arrhythmia, convulsions, they may also be symptoms of overdose.

Treatment: symptomatic therapy.

Drug Interactions

Thiamine is completely destroyed in solutions, containing sulfites.

Other vitamins are inactivated in the presence of decay products of B vitamins.

Levodopa reduces the effect of pyridoxine.

Perhaps the interaction of the drug with cycloserine, D-penïcïllamïnom, epinephrine, norepinephrine, sulьfonamidami, which reduces the effect of pyridoxine.

Thiamine is incompatible with oxidizing substances, mercuric chloride, iodide, karʙonatom, acetate, tannic acid, hardware-ammonium citrate, and takzhe fenobarbitalom, riʙoflavinom, benzilpenicillinom, dextrose and sodium metabisulphite.

Copper accelerates the destruction of thiamine.

Thiamine loses its effect by increasing the pH (more 3).

Conditions of supply of pharmacies

The drug is released under the prescription.

Conditions and terms

The drug should be stored in the dark, inaccessible to children at temperature not above 15 ° C. Shelf life – 2 year.