Neurorubin Forte lactab, tablets N20 - Instructions

Pharmacological properties of the drug Neurorubin

B vitamins are components of enzyme systems that regulate protein, lipid and carbohydrate metabolism. Each of the B vitamins plays a specific biological role. Their presence in the body in a balanced amount is necessary for the normal functioning of metabolism. The drug Neurorubin and Neurorubin-Forte are a combination of 3 vitamins in high doses: B1, B6, B12, which play an important role in the functioning of the nervous system. Each of these vitamins is necessary to ensure optimal metabolism in nerve cells. When high doses of vitamins are consumed simultaneously, they exhibit an analgesic effect. Thiamine mononitrate (vitamin B1) is absorbed in the small intestine, duodenum and jejunum. After ingestion, thiamine penetrates the intestinal mucosa and enters the liver through the portal vein system. After administration, some thiamine is absorbed in the liver. The main metabolites that are released when thiamine is taken (with minor amounts of unchanged thiamine) are thiamine carboxylic acid and pyramine (2,5-dimethyl-4-aminopyrimidine). Pyridoxine hydrochloride (vitamin B6) is rapidly absorbed in the intestine. In the body, pyridoxine is oxidized to pyridoxal and aminated to pyridoxamine. The condition for its functioning as a coenzyme is phosphorylation at the CH2OH group in the 5th position, that is, the formation of pyridoxal-5-phosphate (PALP). In the blood, 80% is associated with proteins. Pyridoxine preferentially accumulates in muscles. The main metabolite that is excreted is 4-pyridoxic acid. Cyanocobalamin (vitamin B12). Normally, the absorption of cyanocobalamin is limited and depends on the concentration of intrinsic Castle factor. Some of the vitamin is absorbed in the free state, but the majority is absorbed after binding to intrinsic Castle factor. After absorption from the gastrointestinal tract, vitamin B12 enters the blood serum. The accumulation of vitamin B12 occurs mainly in the liver. The half-life from serum is approximately 5 days, from liver tissue - approximately 1 year.

Neurorubin solution d/in. in amp. 3ml per bl. in pack №5x1

Description

Transparent red solution in brown glass ampoules.

Main active ingredient

Multivitamin

Release form

Solution

Dosage

text

special instructions

Due to the lack of studies regarding drug compatibility, Neurorubin cannot be mixed with other drugs.

Pharmacological properties

Pharmacodynamics

B vitamins are most often part of enzyme systems that regulate the metabolism of proteins, fats and carbohydrates. However, each of the B vitamins performs a specific biological role. Their presence in the body in a balanced amount is necessary for the normal functioning of metabolism. Neurorubin combines high doses of three vitamins: B1, B6, B12, which play an important role in the functioning of the nervous system. Each of these vitamins is necessary to ensure optimal metabolism in nerve cells. In addition, high doses of these vitamins, when used, exhibit an analgesic effect. Neurotropic B vitamins have a beneficial effect on inflammatory and degenerative diseases of the nerves and locomotor system. In large doses, they not only have a substitutive effect, but also have a number of pharmacological effects: analgesic, anti-inflammatory, microcirculatory. Vitamin B1 in the form of thiamine diphosphate and thiamine triphosphate plays a key role in carbohydrate metabolism, being a coenzyme of pyruvate decarboxylase, 2-oxogutarate dehydrogenase and transketolase. In the pentose phosphate cycle, thiamine diphosphate is involved in the transfer of aldehyde groups. Vitamin B6 in its phosphorylated form (pyridoxal-5-phosphate) is a coenzyme of numerous enzymes, primarily involved in the metabolism of amino acids, as well as carbohydrates and fats. Vitamin B12 is essential for cellular metabolism, hematopoiesis and the functioning of the nervous system. It stimulates nucleic metabolism through the activation of folic acid. In large doses, cyanocobalamin has analgesic, anti-inflammatory and microcirculatory effects.

Pharmacokinetics

Water-soluble vitamins are completely absorbed in the body after intramuscular administration. The degree of absorption depends on the location of the bloodstream relative to the injection site. Cyanocobalamin (vitamin B12). After absorption, vitamin B12 binds in serum to specific B12-binding beta (transcobalamin) and B12-binding alpha1 globulin. Vitamin B12 accumulation occurs mainly in the liver. The half-life from serum is approximately 5 days, and from the liver - approximately 1 year. Thiamine hydrochloride (vitamin B1). Part of the absorbed thiamine takes part in the enterohepatic circulation. The main products of thiamine excretion are thiaminecarboxylic acid and pyramine (2,5-dimethyl-4-aminopyrimidine). At the same time, a small amount of thiamine is released unchanged. Pyridoxine hydrochloride (vitamin B6). In the body, pyridoxine is oxidized to pyridoxal or aminated to pyridoxamine. The condition for its functioning as a coenzyme is phosphorylation at the CH2OH group in the 5th position, that is, the formation of pyridoxal-5-phosphate (PALP). In the blood, approximately 80% of PALP is protein bound. Pyridoxine predominantly accumulates in muscles in the form of PALP. The main excretion product is 4-pyridoxic acid. Thiamine is absorbed in the small intestine by active transport. Its absorption is limited to 8-15 mg per day. To prevent vitamin B1 deficiency, its daily replenishment should be 1.3-1.5 mg per day in men, 1.1-1.3 mg in women. Thiamine is excreted in the urine. Pyridoxine, pyridoxal and pyridoxamine are absorbed very quickly and are converted to pyridoxal-5-phosphate. The main metabolite is 4-pyridoxic acid. The required daily amount of vitamin B6 depends on the intensity of protein metabolism; its deficiency is prevented in men with a daily dose of 2.3 mg per day, in women - 2.0 mg. Excreted by the kidneys. Vitamin B12 in the stomach during digestion is released from food and binds to intrinsic factor. The resulting complex is resistant to proteolytic enzymes. Having passed into the distal part of the small intestine, it interacts with specific receptors and then enters the systemic circulation, where it binds to transcobalamin. This complex enters the liver, bone marrow and other proliferating cells, where it is converted into the active form - adenosylcobalamin and methylcobalamin. Vitamin B12 penetrates the placenta. 1.5-3.5 mcg of vitamin B12 is supplied daily with food. If intrinsic factor is deficient, the absorption of vitamin B12 is impaired. The main place of deposition of vitamin B12 is the liver. The half-life is approximately 12 months. It is excreted in bile and, to a lesser extent, in urine.

Indications for use

Neurological disorders caused by a deficiency of vitamins B1, B6, B12, which cannot be eliminated by oral administration of the vitamins included in Neurorubin. Neurorubin is used in adults.

Directions for use and doses

One ampoule is used once a week. The injection is administered deep into the muscle of the upper outer quadrant of the gluteal region, slowly. The duration of treatment depends on the nature and course of the disease and is determined by the doctor. After 4 months of using the drug Neurorubin, the patient should be transferred to oral dosage forms. The drug is administered exclusively intramuscularly. If the drug is accidentally administered intravenously, the patient must be monitored by specialists on an outpatient or inpatient basis, depending on the severity of the symptoms that arise.

Use during pregnancy and lactation

Animal studies of the drug Neurorubin and clinical studies on the use of this drug in women during pregnancy have not been conducted. During pregnancy and breastfeeding, it is recommended to take daily vitamin B1 in a dose of 1.4-1.6 mg per day, vitamin B6 - 2.4-2.6 mg per day. Taking these doses can only be recommended if there is a deficiency of these vitamins. Administration of vitamin B6 in a dose of less than 25 mg per day during pregnancy and breastfeeding is safe. The ampoule contains 100 mg of vitamin B6, so the use of the drug during pregnancy is contraindicated. If it is necessary to use the drug during lactation, breastfeeding should be discontinued. Vitamins B1, B6, and B12 pass from the body into breast milk. High doses of vitamins B6 and B12 can suppress lactation.

Precautionary measures

The drug is administered exclusively intramuscularly. Long-term use of the drug (over 6 months) can cause the development of neuropathy. Intramuscular injections of vitamin B12 may cause anaphylactoid reactions in hypersensitive patients. Children. There is no experience in treating children with this drug, so the drug is not prescribed to children.

Interaction with other drugs

High doses of vitamin B6, such as those contained in Neurorubin, may reduce the therapeutic effect of levodopa on Parkinson's disease. Pyridoxine antagonists, such as isoniazid, cycloserine, penicillamine, hydralazine, may reduce the effectiveness of vitamin B6. Loop diuretics such as furosemide may decrease vitamin B1 concentrations.

Contraindications

The drug is not recommended for use in patients who are sensitive to one or more components, especially vitamins B1, B6, and B12. Children under 18 years of age. Indication of a history of epileptiform seizures.

Compound

active ingredients: 3 ml of solution (1 ampoule) contains: thiamine hydrochloride (vitamin B1) 100 mg, pyridoxine hydrochloride (vitamin B6) 100 mg, cyanocobalamin (vitamin B12) 1 mg; excipients: potassium cyanide 0.25 mg/3 ml, benzyl alcohol, water for injection.

Overdose

Vitamins B1, B6, and B12 have a wide range of therapeutic effects. The phenomena of overdose with proper use have not been known until now. a) Symptoms of intoxication A very high intravenous dose of vitamin B1 (more than 10 g) has a ganglion blocking effect on people and suppresses the transmission of excitation to nerve cells, similar to the action of curare, since thiamine binds to nicotinic cholinergic receptors. The phenomena of hypervitaminosis after taking large amounts of vitamin B1 for a month have not been described before. Vitamin B6, even in doses of 50 mg per day, with medium-term use, can cause severe irreparable neurotoxicosis. Hypervitaminosis, the phenomena of overdose or poisoning of vitamin B12 in humans were not previously known. b) Therapy for intoxication There are no special countermeasures for intoxication; Treatment should be carried out according to symptoms.

Side effect

Side effects are classified by frequency as follows: very often (? 1/10); often (? 1/100 to

Storage conditions

Store at a temperature of 2-8°C (in the refrigerator). Keep out of the reach of children. Shelf life: 3 years.

Buy Neurorubin solution d/in. in amp. 3ml per bl. in pack No. 5x1 in the pharmacy

Price for Neurorubin solution d/in. in amp. 3ml per bl. in pack №5x1

Instructions for use for Neurorubin solution d/in. in amp. 3ml per bl. in pack №5x1

Indications for use of the drug Neurorubin

Oral use: concomitant therapy for diseases of the nervous system, such as:

• neurotic pain in acute and chronic neuritis and polyneuritis;
• neuralgia, as well as toxic damage to the nervous tissue due to alcoholism, drug intoxication, and diabetic polyneuropathy.

Parenteral use: peripheral neuropathy of alcoholic origin, Wernicke-Korsakoff syndrome, diabetic polyneuropathy, beriberi (dry and wet forms); as an adjuvant for acute or chronic neuritis and polyneuritis, trigeminal neuralgia, cervicobrachial neuralgia, sciatica.

Use of the drug Neurorubin

Orally Take orally, before or during meals, without chewing, with a sufficient amount of water. The usual dose for adults is 1–2 tablets per day. The course of treatment is 4 weeks. Treatment can be continued at the discretion of the doctor. Parenteral In case of severe disease, the dose for adults is: at the beginning of use - 3 ml of solution (contents of 1 ampoule) IM daily or every other day until the severity of pain decreases; in the future - 3 ml of solution 1-2 times a week. For moderate disease, the dose for adults is 3 ml of solution 1–2 times a week. Injected intramuscularly into the outer upper quadrant of the gluteal muscle. The duration of treatment depends on the cause of the deficiency of B vitamins; treatment is continued until clinical recovery and/or normalization of laboratory parameters. During long-term therapy, clinical monitoring is carried out every 6 months.

Neurorubin Forte lactab, tablets N20 - Instructions

DOSAGE FORM

Film-coated tablets, 20 pieces in a package.

COMPOUND

Active ingredients: thiamine nitrate (vitamin B 1), pyridoxine hydrochloride (vitamin B 6), cyanocobalamin (vitamin 12);

1 film-coated tablet contains thiamine nitrate (vitamin B 1) 200 mg, pyridoxine hydrochloride (vitamin B 6) 50 mg, cyanocobalamin (vitamin B 12) 1 mg.

Excipients: mannitol (E 421), powdered cellulose, microcrystalline cellulose, corn starch, magnesium stearate, colloidal silicon dioxide, hypromellose, macrogol 6000, talc, titanium dioxide (E 171), erythrosine (E 127).

PHARMACOLOGICAL GROUP

Vitamin 1 preparations in combination with vitamin B6 and/or vitamin 12.

PHARMACOLOGICAL PROPERTIES

Pharmacodynamics.

Neurorubin Forte Lactab combines high doses of three vitamins: B 1, B 6 and B 12, which play a large role in the functioning of the nervous system. Each of these vitamins is necessary to ensure optimal metabolism in nerve cells. In addition, when used in high doses of these vitamins, they exhibit an analgesic effect.

Like all other vitamins, they are essential nutrients that cannot be synthesized directly in the body.

The therapeutic introduction of vitamins B 1, B 6 and B 12 into the body replenishes the insufficient intake of vitamins from food and ensures the presence of the required amount of coenzymes in the body. B vitamins are components of enzyme systems that regulate the metabolism of proteins, fats and carbohydrates. However, each of the B vitamins performs a specific biological role. Their presence in the body in a balanced amount is necessary for the normal functioning of metabolism.

The therapeutic use of these vitamins for various diseases of the nervous system is aimed, on the one hand, at compensating for simultaneously existing deficiency (possibly due to an increase in the body's need caused directly by the disease) and, on the other hand, at stimulating natural recovery mechanisms.

Vitamins B 1, B 6 and B 12 have very low toxicity and have no potential risk to humans. Currently, there is no data regarding the carcinogenic, mutagenic or teratogenic properties of these vitamins.

Pharmacokinetics.

Thiamine (vitamin B1) is absorbed in the small intestine, duodenum and colon through the active transport system. After use, the active substance penetrates the intestinal mucosa and then enters the liver through the portal vein. Some absorbed thiamine participates in enterohepatic recirculation. The main products of thiamine excretion are thiamine carboxylic acid and pyramine (2,5 dimethyl-4-aminopyrimidine), as well as a relatively small amount of thiamine, which is excreted unchanged.

Pyridoxine hydrochloride (vitamin B 6) is rapidly absorbed in the intestine. In the body, pyridoxine is oxidized to pyridoxal or aminated to pyridoxamine. The condition for its functioning as a coenzyme is phosphorylation at CH 2 by the OH group in the fifth position, that is, the formation of pyridoxal-5-phosphate (PALP). In the blood, about 80% of PALP are bound to proteins. Pyridoxine preferentially accumulates in muscles as PALP. The main output product is 4-pyridoxic acid.

Cyanocobalamin (vitamin B 12). In a healthy person, the absorption of cyanocobalamin is limited and depends on the concentration. Some vitamin B 12 is absorbed in a free state, but the bulk is absorbed only after binding to the “intrinsic Castle factor”.

After absorption in the intestine, vitamin B 12 binds in the blood serum to specific proteins B 12-binding beta (transcobalamin) and B 12-binding alpha 1 globulin. The accumulation of vitamin B 12 occurs mainly in the liver. The half-life from plasma is 5 days, from the liver - about a year.

INDICATIONS FOR USE

Concomitant therapy of pain syndromes caused by:

• acute or chronic neuritis, polyneuritis and neuralgia;
• toxic damage to nervous tissue due to alcoholism, diabetic polyneuropathy, drug intoxication.

METHOD OF APPLICATION AND DOSES

Take orally before or during meals, without chewing, with plenty of water. The usual dose for adults is 1-2 tablets per day. The course of treatment is 4 weeks. For further treatment you should consult a doctor.

CONTRAINDICATIONS

Hypersensitivity to the components of the drug.

Vitamin B1 is contraindicated for use in allergic diseases.

Vitamin B 6 is contraindicated for use in cases of gastric and duodenal ulcers in the acute stage (since it is possible to increase the acidity of gastric juice).

Vitamin B 12 is contraindicated for use in cases of erythremia, erythrocytosis, and thromboembolism.

INTERACTIONS WITH OTHER MEDICINES AND OTHER TYPES OF INTERACTIONS

The action of thiamine is inactivated by 5-fluorouracil, since the latter competitively inhibits the phosphorylation of thiamine to thiamine pyrophosphate.

Isoniazid toxicity may increase.

Antacids, alcohol and tea slow down the absorption of vitamin B1.

Loop diuretics, such as furosemide, which inhibit tubular reabsorption, may increase thiamine excretion and thus decrease thiamine levels with long-term therapy.

Concomitant use with pyridoxine antagonists (for example, isoniazid, hydralazine, penicillamine or cycloserine), oral contraceptives may increase the need for vitamin B6.

Pyridoxine may reduce the effectiveness of altretamine.

Concomitant use with levodopa is contraindicated, since vitamin B6 may reduce the antiparkinsonian effect of levodopa. Concomitant use with pyridoxine antagonists (for example, isoniazid, hydralazine, penicillamine or cycloserine), oral contraceptives may increase the need for vitamin B6.

APPLICATION FEATURES

As a result of hypersensitivity to vitamins B 1, B 6 and B 12, reactions from the skin and subcutaneous tissue may occur during therapy.

Pyridoxine can provoke the appearance of acne or acne skin rashes or intensify the manifestations of existing ones.

With the introduction of vitamin B 12, the clinical picture, as well as laboratory tests for funicular myelosis or pernicious anemia, may lose their specificity.

Drinking alcohol and black tea reduces the absorption of thiamine.

Drinking drinks containing sulfites (such as wine) increases the degradation of thiamine.

Since the drug contains vitamin B 6, it should be used with caution in patients with a history of gastric and duodenal ulcers, severe renal and liver dysfunction.

Patients with neoplasms, with the exception of cases accompanied by megaloblastic anemia and vitamin B12 deficiency, should not use the drug.

The drug should not be used in severe or acute forms of cardiac decompensation and angina.

USE DURING PREGNANCY OR BREAST-FEEDING

The drug can be prescribed only after a thorough assessment of the benefit/risk ratio, since there is insufficient data on the safety of the drug during pregnancy.

Vitamins B1, B6 and B12 are excreted into breast milk. High concentrations of vitamin B6 may suppress milk production. Studies on the degree of secretion of vitamins into breast milk have not been conducted. The decision to discontinue breastfeeding or use of the drug must be made taking into account the importance of taking the drug for the mother. If it is necessary to use the drug, you should stop breastfeeding for this period.

ABILITY TO INFLUENCE REACTION SPEED WHEN DRIVING VEHICLES OR OTHER MECHANISMS

Does not affect.

If dizziness occurs during treatment, you should refrain from driving vehicles or operating machinery.

CHILDREN

The drug should not be prescribed to children, since there is no experience of use in pediatric practice.

OVERDOSE

Vitamin B1: has a wide therapeutic range. Very high doses (more than 10 g) exhibit a curare-like effect, suppressing the conduction of nerve impulses.

Vitamin B6: has very low toxicity.

With long-term use (more than 6-12 months) of daily doses exceeding 50 mg of vitamin B6, as well as with short-term use (more than 2 months) of more than 1 g of vitamin B6 per day, neuropathies were observed.

Neuropathies with ataxia and sensory disturbances, cerebral seizures with EEG changes, and in isolated cases hypochromic anemia and seborrheic dermatitis have been described after administration of >2 g per day. In this regard, constant monitoring is recommended during long-term use.

Vitamin B12: after parenteral administration (in rare cases, after oral administration) of the drug in doses exceeding the recommended, allergic reactions, eczematous skin disorders and a benign form of acne were observed.

With long-term use in high doses, disturbances in the activity of liver enzymes, pain in the heart, and hypercoagulation are possible.

Therapy for oral intoxication: removal of the toxic substance (induce vomiting, rinse the stomach), measures to reduce absorption (use of activated carbon).

ADVERSE REACTIONS

From the immune system: hypersensitivity reactions, anaphylactic shock. Allergic reactions occur quite rarely.

From the endocrine system: the release of prolactin is inhibited.

From the nervous system: anxiety; Long-term use (more than 6-12 months) of vitamin 6 in doses >50 mg daily can lead to peripheral sensory neuropathy, nervous agitation, malaise, dizziness, headache.

From the cardiovascular system: tachycardia, collapse.

From the respiratory system, chest and mediastinum: cyanosis, pulmonary edema, respiratory disorders.

From the gastrointestinal tract: gastrointestinal disorders, including nausea, vomiting, diarrhea, abdominal pain, increased acidity of gastric juice, hemorrhage.

From the liver and gallbladder: when used in high doses, an increase in the level of glutamine-oxal transaminase (SGOT) in the blood serum.

From the skin and subcutaneous tissue: rash, skin reactions, including itching, urticaria, common pimples, acne, erythema multiforme.

From the kidneys and urinary system: chromaturia.

Other disorders: increased sweating, feeling of weakness, dizziness, malaise, feeling of constriction in the throat.

BEST BEFORE DATE

2 years.

STORAGE CONDITIONS

Store at a temperature not exceeding 25 ° C out of the reach of children.

VACATION CATEGORY

Over the counter.

Side effects of the drug Neurorubin

Hypersensitivity. In patients with hypersensitivity, angioedema may occur. Allergic reactions are observed quite rarely. In isolated cases and under certain conditions, repeated intramuscular injections of preparations containing vitamin B1 can cause anaphylactic shock in patients with hypersensitivity. In these cases, corticosteroids and antihistamines can be used for treatment. Endocrine system. When taking the drug, the release of prolactin is inhibited. Nervous system. In some cases, a feeling of anxiety arose (in patients with hypersensitivity). When taking high doses of pyridoxine hydrochloride (500 mg/day) over a long period of time, isolated cases of reversible peripheral sensory neuropathy have been reported. The cardiovascular system. Isolated cases of tachycardia, circulatory collapse (in patients with hypersensitivity). Respiratory system. Isolated cases of cyanosis, pulmonary edema (in patients with hypersensitivity). Gastrointestinal organs. Nausea, bleeding from the gastrointestinal tract (in patients with hypersensitivity). Liver and gall bladder. High doses of the drug may lead to increased levels of glutamic oxaloacetic transaminase (SGOT) in the blood plasma. Leather. Reactions with itching and urticaria (in patients with hypersensitivity). High doses of the drug may cause acne. Pyridoxine hydrochloride may cause acne. General symptoms. Sudden sweating, feeling of weakness, dizziness.

Neurorubin injection solution 3 ml No. 5

Contraindications

Hypersensitivity to the components of the drug.

Vitamin B1 is contraindicated for use in allergic diseases.

Vitamin B 6 is contraindicated for use in case of peptic ulcer of the stomach and duodenum in the acute stage since it is possible to increase the acidity of gastric juice).

Vitamin B 12 is contraindicated for use in cases of erythremia, erythrocytosis, and thromboembolism.

Interaction with other drugs and other types of interactions

High doses of vitamin B6, such as those contained in Neurorubin™, may reduce the therapeutic effect of levodopa for Parkinson's disease.

Isoniazid toxicity may increase.

Vitamin B6 may reduce the effectiveness of altretamine.

Concomitant use with pyridoxine antagonists (for example, isoniazid, hydralazine, penicillamine or cycloserine), oral contraceptives may increase the need for vitamin B6.

The action of thiamine is inactivated by 5-fluorouracil, since the latter competitively inhibits the phosphorylation of thiamine to thiamine pyrophosphate.

Antacids slow down the absorption of vitamin B1.

Loop diuretics, such as furosemide, which inhibit tubular reabsorption, with long-term therapy can cause an increase in thiamine excretion and, thus, reduce its level.

Consumption of drinks containing sulfites (for example, wine) increases the degradation of thiamine.

Features of application

The drug should not be administered intravenously.

Intramuscular injections of vitamin B 12 may cause anaphylactoid reactions in patients with hypersensitivity.

Parenteral administration of vitamin B 12 may temporarily interfere with the diagnosis of funicular myelosis or pernicious anemia.

Long-term use of vitamin 6 (more than 6-12 months) in doses greater than 50 mg daily or in doses greater than 1000 mg per day (more than 2 months) can lead to reversible peripheral sensory neuropathy. If symptoms of peripheral sensory neuropathy (paresthesia) occur, the dose of the drug must be adjusted and, if necessary, discontinued.

Since Neurorubin TM contains vitamin 6, it should be used with caution in patients with a history of gastric and duodenal ulcers, with severe impaired renal and liver function.

Patients with neoplasms, with the exception of cases accompanied by megaloblastic anemia and vitamin B12 deficiency, should not use the drug.

The drug is used for severe or acute forms of cardiac decompensation and angina.

Use during pregnancy or breastfeeding.

There are no clinical studies of Neurorubin™ treatment in animals or women during pregnancy.

The drug is prescribed only after a careful assessment of the benefit-risk ratio, since there is insufficient data on the safety of the drug during pregnancy.

Vitamins B1, B6 and B12 are excreted into breast milk. High concentrations of vitamin B6 may suppress milk production. Studies on the degree of secretion of vitamins into breast milk have not been conducted. The decision to discontinue breastfeeding or use of the drug must be made taking into account the need for the drug for the mother. If it is necessary to use the drug, you should stop breastfeeding for this period.

The ability to influence the reaction rate when driving vehicles or other mechanisms.

The drug does not affect the ability to drive vehicles or operate machinery.

If dizziness occurs during treatment, you should refrain from driving vehicles and operating machinery.

Directions for use and doses

For intramuscular administration.

In severe (acute) cases, 1 ampoule per day until acute symptoms subside.

After easing symptoms or in cases of moderate severity, 1 ampoule 1-3 times a week.

To maintain or continue the course of injection therapy or to prevent relapse, it is recommended to use the drug Neurorubin ™ for Laktab, film-coated tablets.

Do not exceed the recommended daily dose.

The duration of treatment depends on the nature and course of the disease and is determined by the doctor.

Application technique.

To open the ampoule:

• hold the ampoule up with the marking in the form of a dot;
• shake the ampoule until the liquid reaches the bottom;
• break off the ampoule head above the marking.

Children

There is no experience in treating children with this drug, so it should not be prescribed to children.

Overdose

In case of overdose, the symptoms of side effects increase.

Vitamin B1: has a wide therapeutic range. Very high doses (more than 10 g) exhibit a curare-like effect, suppressing the conduction of nerve impulses.

Vitamin B6: has very low toxicity.

Excessive use of vitamin 6 in doses greater than 1 g per day for several months can lead to neurotoxic effects.

Neuropathies with ataxia and sensory disorders, cerebral spasms with EEG changes, as well as in some cases hypochromic anemia and seborrheic dermatitis have been described after administration of more than 2 g per day.

Vitamin B12: after parenteral administration (in rare cases, after oral administration) of the drug in doses exceeding the recommended ones, allergic reactions, eczematous skin disorders and a benign form of acne were observed. With long-term use in high doses, disturbances in the activity of liver enzymes, pain in the heart, and hypercoagulation are possible.

Adverse reactions

From the immune system: hypersensitivity reactions, including angioedema, anaphylactoid reactions, anaphylactic shock, mainly in patients with hypersensitivity.

From the endocrine system: inhibition of prolactin release.

From the nervous system: anxiety; long-term use (more than 6-12 months) of pyridoxine hydrochloride (vitamin B 6) in doses of more than 50 mg daily can lead to peripheral sensory neuropathy, nervous agitation, malaise, headache, dizziness.

From the cardiovascular system: tachycardia, circulatory collapse, mainly in patients with hypersensitivity.

From the respiratory system: cyanosis, pulmonary edema, mainly in patients with hypersensitivity.

From the gastrointestinal tract: gastrointestinal disorders, including vomiting, diarrhea, abdominal pain, increased acidity of gastric juice, nausea, bleeding from the digestive tract, mainly in patients with hypersensitivity.

From the digestive system: high doses may lead to increased levels of glutamine aspartate aminotransferase (AST) in the blood serum.

From the skin and subcutaneous tissue: itching, urticaria, mainly in patients with hypersensitivity.

High doses of the drug can lead to acne. Pyridoxine hydrochloride may cause worsening of acne vulgaris or the appearance of acne.

General reactions: reactions at the injection site, increased sweating, weakness, feeling of a “lump” in the throat.

Best before date

3 years.

Storage conditions

Store at a temperature of 2 to 8 ° C (in the refrigerator). Keep out of the reach of children.

Incompatibility

Due to the lack of drug compatibility studies, Neurorubin™ cannot be mixed with other drugs.

Package

3 ml per ampoule; 5 ampoules per box.

Vacation category

On prescription.

Drug interactions Neurorubin

Because pyridoxine hydrochloride stimulates the decarboxylation of L-dopamine (levodopa) and may reduce the therapeutic effect of this drug in the treatment of patients with Parkinson's disease, the simultaneous use of these drugs should be avoided. The toxicity of isoniazid may increase when used in combination. Thiosemicarbazone and fluorouracil reduce the effectiveness of vitamin B1, being its antagonists. Antacids slow down the absorption of vitamin B1. Vitamin B6 may reduce the effectiveness of altretamine.