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Neurovitan instructions for use

Pharmacological action Balanced complex of B vitamins. The effect of the drug is due to the effects of the vitamins that are part of it. Vitamin B1 (thiamine) is an important part of the energy metabolism of nerve fibers in a living organism, as a coenzyme takes part in carbohydrate metabolism, and is necessary for the normal functioning of the nervous system. Octothiamine (a combined substance of vitamin B1 and thioctic acid) has a prolonged action, higher acid resistance, absorption and effectiveness compared to thiamine hydrochloride. Vitamin B2 (riboflavin) is one of the main components of carbohydrate, fat and protein metabolism and is necessary for the synthesis of hemoglobin. Vitamin B6 (pyridoxine) is involved in protein metabolism and the synthesis of neurotransmitters. Improves liver and nerve function. Vitamin B12 (cyanocobalamin) is involved in nucleotide synthesis, blood formation, myelin synthesis, development of epithelial cells and body growth. Neurovitan is absorbed along the entire length of the small intestine, intertwined with plasma proteins, and penetrates all tissues. The half-life is 1.4 hours, it is biotransformable in the body and excreted in the urine. Indications for use Neurovitan as a therapeutic complex of B vitamins is used in the treatment of diseases: - nervous system - neuritis, - neuralgia of various origins, - diabetic neuropathies, - neuralgia of various origins, - diabetic neuropathies, - paresthesias, - peripheral paralysis, - lumbago; - liver - cirrhosis, - hepatitis; - gynecological - gestosis in the early and late trimesters of pregnancy, - with symptomatic therapy in conservative and surgical gynecology, - hypo- and avitaminosis in pregnant women and during lactation in women. Neurovitan is used for diseases of the cardiovascular system, deficiency anemias of various origins, immunodeficiency states, osteochondrosis, arthralgia, radiation sickness, anemia, dermatitis, focal baldness. Neurovitan is indicated for people leading an active lifestyle, with an unbalanced diet, alcohol abuse, and smoking.

Directions for use : Use orally. Adults are prescribed 1 to 4 tablets per day. The course of treatment is 2-4 weeks. Pregnant women are prescribed 1 tablet per day. The course of treatment is 2-4 weeks. In the postpartum period, lactation period - from 1 to 2 tablets per day. The course of treatment is 2-4 weeks. Children 1-3 years old are prescribed 1/4-1/2 tablets once a day. Children 3-7 years old are prescribed 1 tablet per day. The course of treatment is 2-4 weeks. Children 8-14 years old are prescribed 1-3 tablets per day. The course of treatment is 2-4 weeks.

Side effects Allergic reactions in the form of dermatitis are possible if you are allergic to B vitamins.

Contraindications Contraindicated in case of hypersensitivity to the elements of the drug. During treatment with Neurovitan, it is prohibited to drink alcohol. When taking Neurovitan simultaneously with levodopa, the effect of the latter is reduced.

Release form: 10 tablets in blisters, 3 blisters in a cardboard box. Dispensing rules: Without a prescription.

Storage conditions Store at a temperature of 15 - 25 ° C, out of the reach of children. Shelf life 3 years.

Composition One film-coated tablet contains: octothiamine - 25 mg, riboflavin (vitamin B2) - 2.5 mg, pyridoxine hydrochloride - 40 mg, cyanocobalamin (vitamin B12) - 0.25 mg. Excipients: starch, microcrystalline cellulose, colloidal silicon dioxide, magnesium stearate, purified talc, gelatin, titanium dioxide, sucrose, carnauba cream, paraffin paraffin, povidone, shellac, ricin oil, FD&C red No. 3, FD&C yellow No. 6.

Pharmacological group Drugs that primarily affect tissue metabolic processes Vitamins and their analogues

Active ingredients : octothiamine, riboflavin mononucleotide, pyridoxine hydrochloride, cyanocobolamin

Neurovitan tablets N30

Compound

active ingredients
: octothiamine, riboflavin, pyridoxine, cyanocobalamin; 1 tablet contains: octothiamine 25 mg, riboflavin 2.5 mg, pyridoxine (in the form of hydrochloride) 40 mg, cyanocobalamin 0.25 mg;

Excipients

: sucrose, lactose, potato starch, corn starch, microcrystalline cellulose, colloidal silicon dioxide, magnesium stearate, talc, titanium dioxide (E 171), gelatin, shellac, castor oil, purified water, sunset yellow FCF (E 110), erythrosine ( E 127), carnauba wax, paraffin.

Dosage form

Film-coated tablets.

Basic physical and chemical properties

: round tablets with a biconvex surface, sugar-coated from pink to pink-orange in color; patches of pink, orange and white are observed on the break.

Pharmacotherapeutic group

B complex vitamins without additives.

ATX code A11E A.

Pharmacodynamics

The effect of the drug is determined by the vitamins that are included in its composition.

Octothiamine (a combination of vitamin B1 and α-lipoic acid) takes an active part in the metabolism of carbohydrates and fats and is necessary for the synthesis of nucleic acids. Potentiates the effect of acetylcholine, which is involved in the transmission of nerve impulses. Plays an important role in regulating the functions of the muscular and autonomic nervous systems. Strengthens tissue respiration, improves oxygen supply to skin cells.

Riboflavin (vitamin B2) is part of numerous redox enzymes. Participates in tissue respiration and ATP synthesis, synthesis of higher fatty acids and other processes of energy supply to the cell. It has antioxidant properties, participates in hematopoiesis, helping to increase the level of hemoglobin and red blood cells. Improves vision, increases color sensitivity and dark adaptation.

Pyridoxine (vitamin B6) is a component necessary for the metabolism of amino acids, fats and carbohydrates, as well as for the synthesis of physiological regulators such as serotonin and histamine. Participates in the breakdown of cholesterol, synthesis and nutrition of the myelin sheath of the peripheral nerve and axon. Vitamin B6 deficiency leads to the development of neuromuscular dystrophy and litigation. Cyanocobalamin (vitamin B12) is involved in protein, fat and carbohydrate metabolism. Prevents fatty liver degeneration. Helps reduce cholesterol levels in the blood and remove it from blood vessels. By stimulating protein synthesis, it normalizes the processes of growth and development. Regulates hematopoietic processes. By increasing the phagocytic activity of leukocytes and activating the activity of the reticuloendothelial system, it enhances the body’s immunological defense.

Pharmacokinetics

The components of the drug Neurovitan® are absorbed in the small intestine, bind to plasma proteins, and are distributed in all tissues. They undergo biotransformation in the body and are excreted mainly in the urine (both unchanged and in the form of metabolites).

Indications

Treatment of diseases of the nervous system: neuritis, polyneuritis, diabetic neuritis, neuralgia, sciatica, intercostal neuralgia, trigeminal neuralgia, paresthesia, peripheral neuroparalysis, facial paralysis, lumbago, arthralgia and myalgia.

Contraindications

Hypersensitivity to the components of the drug;

vitamin B1 is contraindicated for use in allergic diseases;

vitamin B6 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 B12 is contraindicated for use in cases of erythremia, erythrocytosis, and thromboembolism.

Interaction with other drugs 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.

Antacids reduce the absorption of thiamine. 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 levodopa is contraindicated, since vitamin B6 may reduce the antiparkinsonian effect of levodopa. Pyridoxine may increase the peripheral metabolism of levodopa, reducing the therapeutic effectiveness of the latter. Therefore, patients with Parkinson's disease treated with levodopa itself should not take vitamin B6 in doses significantly higher than the daily requirement. This is not observed when levodopa is combined with peripheral decarboxylase inhibitors.

Concomitant use with pyridoxine antagonists (for example, isoniazid, hydralazine, penicillamine or cycloserine), oral contraceptives may increase the need for vitamin B6. Serum cyanocobalamin levels may be decreased when oral contraceptives are taken concomitantly. This interaction is unlikely to be of clinical significance.

Vitamin B12 absorption may be reduced due to the use of para-aminosalicylic acid, colchicine, biguanides, neomycin, cholestyramine, potassium chloride, methyldopa and cimetidine.

Patients receiving chloramphenicol may have an insufficient response to cyanocobalamin.

Antimetabolites and most antibiotics cause false results in the quantitative determination of vitamin B12 by microbiological methods.

Features of application

With the introduction of vitamin B12, the clinical picture, as well as laboratory tests for funicular myelosis or pernicious anemia, may lose their specificity.

The drug contains lactose, so patients with rare hereditary forms of galactose intolerance, lactase deficiency or glucose-galactose malabsorption syndrome should not use this drug.

During treatment with Neurovitan®, you should not drink alcohol. Drinking drinks containing sulfites (such as wine) increases the degradation of thiamine.

Since the drug contains vitamin B6, 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.

Urine may turn yellow, which is completely harmless and is explained by the presence of riboflavin in the drug.

The drug is not recommended to be prescribed together with other multivitamins and microelements, as an overdose is possible. The drug contains sucrose, so it should be used with caution in patients with diabetes mellitus.

The drug Neurovitan®, film-coated tablets, contains dye E 110, which can cause allergic reactions.

The ability to influence reaction speed when driving a vehicle or operating machinery

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.

Use during pregnancy or breastfeeding

Pregnancy

The drug should be used with caution by women during pregnancy, especially in the first trimester.

Lactation

Vitamins B1, B6 and B12 are excreted into breast milk.

High concentrations of vitamin B6 may interfere with the release of prolactin and suppress milk production, so the drug should be used with caution by women during breastfeeding. 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.

Directions for use and doses

Use internally for adults and children over 3 years of age.

For adults and children over 14 years of age, take 1 to 4 tablets per day.

For children aged 3-7 years, take 1 tablet per day, for children aged 8-14 years - from 1 to 3 tablets per day.

The course of treatment is 2-4 weeks.

Children

Use for children aged 3 years and older.

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. Long-term use (more than 6-12 months) in doses of 50 mg of vitamin B6 daily can lead to peripheral sensory neuropathy, nervous agitation, malaise, dizziness, and headache. Excessive use of vitamin B6 at a dose of 1 g per day for several months can lead to neurotoxic effects. Neuropathies with ataxia and sensory disorders, cerebral spasms with EEG changes, and in some cases, hypochromic anemia and seborrheic dermatitis have been described after taking more than 2 g per day.

Vitamin B12:

After parenteral administration (in rare cases, after oral administration) allergic reactions, eczematous skin disorders and benign acne were observed above recommended doses.

With long-term use of high doses of vitamin B12, disturbances in the activity of liver enzymes, pain in the heart, and hypercoagulation are possible.

Adverse reactions

Adverse reactions occur very rarely.

General violations

: weakness, fever, increased sweating.

Cardiac disorders

: tachycardia.

Vascular disorders

: arterial hypotension/hypertension, feeling of heat.

From the immune system

: allergic reactions, anaphylactic shock, angioedema, anaphylaxis, skin manifestations, including itching, rash, urticaria, hyperemia, burning.

Gastrointestinal disorders:

dyspeptic disorders (pain in the epigastric region, increased acidity of gastric juice, heartburn, nausea, vomiting, belching, feeling of fullness in the stomach, bloating, flatulence, diarrhea), dry mouth.

From the side of the organ of vision:

itching and burning in the eyes.

Best before date

3 years.

Storage conditions

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

Package

10 tablets in a blister, 3 blisters in a cardboard box.

Vacation category

Over the counter.

Manufacturer

Hikma Pharmaceuticals Co. Ltd.

Manufacturer's location and address of place of business

Industrial Eria-Bayadera Wadi El Sir, PO Box 182400, Amman 11118, Jordan.

Source: “State register of medicinal facilities of Ukraine”, 2020.

Neurovit solution for intramuscular administration in ampoules 2 ml No. 5x1

Name

Neurovit solution for intramuscular injection in amp. 2 ml in pack No. 5x1

Description

A clear, red solution with virtually no visible particles.

Main active ingredient

Vitamins B?, B? and B?? + lidocaine

Release form

Solution for intramuscular administration.

Dosage

2ml

Pharmacodynamics

Neurotropic B vitamins have a beneficial effect on inflammatory and degenerative diseases of the nerves and musculoskeletal system. Thiamine plays a key role in carbohydrate metabolism, 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 each other’s action, manifested 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, and 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 intramuscular administration, thiamine is quickly absorbed from the injection site and enters the blood (484 ng/ml after 15 minutes on the first day of administration of a 50 mg dose) and is distributed unevenly in the body with its content in leukocytes - 15%, erythrocytes - 75% and in plasma - 10%. Due to the lack of significant reserves of the vitamin in the body, it must be supplied to the body daily. Thiamine penetrates the blood-brain and placental barriers and is found in breast 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: thiaminecarboxylic acid, pyramine and some unknown metabolites. Of all the vitamins, thiamine is stored in the body in the smallest quantities. The adult human body 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 quickly absorbed into the bloodstream and distributed in the body, acting as a coenzyme after phosphorylation of the CH2OH group at 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, deposited in the liver and 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 replacement rate of 2.2–2.4%.

Indications for use

Neurological disorders caused by a deficiency of vitamins B1, B6 and B12, which cannot be eliminated by correcting nutrition.

Directions for use and doses

In severe cases and acute pain, one injection (2 ml) is administered deep intramuscularly to quickly increase the level of the drug in the blood. After the disappearance of the acute stage and in milder forms of the disease, 1 injection is given 2-3 times a week. Injections are administered deep intramuscularly. Intravenous administration is contraindicated. In case of accidental intravenous administration, monitoring of patients in the hospital is necessary. The drug contains lidocaine hydrochloride. Before using lidocaine hydrochloride, it is necessary to conduct a skin test for individual sensitivity, which is indicated by swelling and redness at the injection site.

Use during pregnancy and lactation

The use of the drug during pregnancy is contraindicated. If it is necessary to use the drug, breastfeeding should be discontinued.

Impact on the ability to drive vehicles or potentially dangerous mechanisms

After using this medicine, it is not recommended to engage in activities that require rapid psychomotor reactions.

Precautionary measures

Use in patients with psoriasis should be justified, since vitamin B12 may aggravate skin manifestations. With long-term treatment (more than 5 months), sensory neuropathy may develop with an overdose of vitamin B6 (more than 500 mg/day). In rare cases, after repeated administration of a drug containing vitamin B1, anaphylactic shock may develop. Excipients It is recommended to use it with caution in patients with heart and liver failure, since the drug contains lidocaine. The drug is contraindicated for use in newborns, especially premature infants, since the drug contains benzyl alcohol. Before using lidocaine, it is necessary to conduct a skin test for individual sensitivity to the drug, which is indicated by swelling and redness at the injection site. When injecting into vascularized tissues, it is recommended to perform an aspiration test and administer carefully to prevent lidocaine from entering the bloodstream. Before administering lidocaine hydrochloride in high doses, it is recommended to prescribe a barbiturate. When treating the injection site with disinfectant solutions containing heavy metals, the risk of developing a local reaction in the form of pain and swelling increases. When using lidocaine, ECG monitoring is required. In case of disturbances in the activity of the sinus node, prolongation of the PQ interval, widening of the QRS, or the development of a new arrhythmia, the dose should be reduced or the drug discontinued. Use with caution and in smaller doses in patients with heart failure, arterial hypertension, incomplete atrioventricular block, intraventricular conduction disorders, impaired liver and kidney function, epilepsy, after heart surgery, with a genetic predisposition to hyperthermia, and in debilitated patients. Use with caution in elderly patients, as well as in persons with a history of arrhythmia. It is necessary to discontinue MAO inhibitors at least 10 days before therapy.

Interaction with other drugs

5-fluorouracil is a thiamine antagonist and therefore interferes with the effectiveness of vitamin B1. Vitamin B1 acts as an acetylcholine antagonist and increases the effect of neuromuscular blockers. The simultaneous use of the drug with drugs containing levodopa is not recommended, since vitamin B6 reduces the effectiveness of levodopa. Absorption of vitamin B12 from the gastrointestinal tract may be reduced by certain drugs, such as proton pump inhibitors, aminoglycosides, colchicine, aminosalicylic acid and its salts, phenytoin, potassium salts, primidone and phenobarbital. Chloramphenicol reduces the hematopoietic vitamin B12 response in patients with vitamin B12 deficiency who are receiving concomitant vitamin B12 therapy. Alcohol reduces the effect of vitamins. Vitamin B1 is not very stable in solutions containing sulfites. Other vitamins may become inactive in the presence of thiamine metabolites. Ascorbic acid reduces the effectiveness of cyanocobalamic acid. Thus, the above drugs are not prescribed simultaneously. Interactions caused by the content of lidocaine hydrochloride Lidocaine enhances the inhibitory effect on the respiratory center of anesthetics (hexobarbital, sodium thiopental intravenously), hypnotics and sedatives. When used simultaneously with hypnotics and sedatives, the inhibitory effect on the central nervous system may be enhanced. Ethanol enhances the inhibitory effect of lidocaine on respiratory function. When used simultaneously with beta-adrenergic blockers, a reduction in the dose of lidocaine is necessary. When used simultaneously with polymyxin B, monitoring of respiratory function is necessary. During treatment with MAO inhibitors, lidocaine should not be used parenterally, as this increases the risk of developing arterial hypotension. When used simultaneously with procainamide, hallucinations are possible. Lidocaine may enhance the effect of drugs that block neuromuscular transmission, since the latter reduce the conduction of nerve impulses. In case of intoxication with cardiac glycosides, lidocaine can increase the severity of AV blockade. Lidocaine weakens the cardiotonic effect of cardiac glycosides. Prescribe the drug with caution in combination with:

beta-adrenergic receptor blockers (the metabolism of lidocaine in the liver slows down, the effects of lidocaine increase (including toxic ones) and the risk of developing bradycardia and arterial hypotension increases);
curare-like drugs (possible deepening of muscle relaxation (to the point of paralysis of the respiratory muscles));
norepinephrine, mexiletine (the toxicity of lidocaine increases, the clearance of lidocaine decreases);
isadrine, glucagon (increases lidocaine clearance);
midazolam (increases the concentration of lidocaine in the blood plasma);
barbiturates, including phenobarbital (possibly accelerated metabolism of lidocaine in the liver, decreased concentration in the blood);
antiarrhythmic drugs (amiodarone, verapamil, quinidine, ajmaline, disopyramide, propafenone), hydantoin derivatives (the cardiodepressive effect is enhanced, simultaneous use with amiodarone can lead to the development of seizures);
novocaine, novocainamide (possible stimulation of the central nervous system and the occurrence of hallucinations);
morphine (the analgesic effect of morphine is enhanced);
prenylamine (increases the risk of developing ventricular arrhythmia of the “pirouette” type);
rifampicin (possibly reducing the concentration of lidocaine in the blood);
phenytoin (increases the cardiodepressive effect of lidocaine);
vasoconstrictors (epinephrine, methoxamine, phenylephrine) (help slow down the absorption of lidocaine and prolong its action).

Contraindications

Hypersensitivity to vitamins B1, B6, B12. Hypersensitivity to local anesthetics with an amide structure. Hypersensitivity to the components of the drug, as well as to other amide local anesthetic drugs; indications in the anamnesis of epileptiform seizures associated with the administration of lidocaine hydrochloride; AV blockade of II and III degrees, sick sinus syndrome, Wolff-Parkinson-White syndrome, Adams-Stokes syndrome, severe forms of heart failure (II – III degree), severe arterial hypotension, bradycardia, cardiogenic shock, complete transverse heart block; myasthenia gravis; hypovolemia; porphyria, severe renal and/or liver failure, pregnancy, breastfeeding, age up to 12 years. Malignant tumors.

Compound

One ampoule contains: Active substances: thiamine hydrochloride (vitamin B1) – 100 mg, pyridoxine hydrochloride (vitamin B6) – 100 mg, cyanocobalamin (vitamin B12) – 1 mg. Excipients: lidocaine hydrochloride, benzyl alcohol, potassium hexacyanoferrate (III), sodium hexametaphosphate, 10% sodium hydroxide solution, water for injection.

Overdose

In case of overdose, systemic reactions may occur. Adverse reactions such as dizziness, bradycardia, vomiting or shock may occur. When vitamin B6 is taken in high doses (500 mg/day) for a long period (more than 5 months), peripheral sensory neuropathy may occur. Treatment is symptomatic and supportive. There is no specific antidote. Lidocaine overdose The main symptoms associated with depression of the central nervous system and cardiovascular system: general weakness, dizziness, disorientation, tonic-clonic convulsions, coma, tremor, blurred vision, atrioventricular block, asphyxia, nausea, vomiting, euphoria, psychomotor agitation, asthenia, apnea, bradycardia, decreased blood pressure, collapse. The first symptoms of overdose in healthy people occur when the concentration of lidocaine hydrochloride in the blood is more than 0.006 mg/kg, convulsions - at 0.01 mg/kg. Treatment: discontinuation of drug administration, oxygen therapy, vasoconstrictors (norepinephrine, mezaton), anticholinergics. The patient should be in a horizontal position; it is necessary to provide access to fresh air, oxygen supply and/or artificial respiration. Symptoms from the central nervous system are corrected by the use of benzodiazepines or short-acting barbiturates. To correct bradycardia and conduction disturbances, atropine (0.5 – 1.0 mg) is used; for arterial hypotension, sympathomimetics are used in combination with beta-adrenergic receptor agonists. In case of cardiac arrest, immediate resuscitation measures are indicated. It is possible to use intubation and artificial ventilation. In the acute phase of lidocaine overdose, dialysis is not effective. There is no specific antidote.

Side effect

Adverse reactions are classified depending on the frequency of occurrence: Very often (? 1/10) Often (? 1/100 to

Storage conditions

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

Products from this group

Tradename:

Neurovit
Neurovit

Compound:

Each tablet contains:

Thiamine hydrochloride (B1) 250 mg

Pyroxine hydrochloride (B6) 100 mg

Cyanocobalamin (B12) 250 mg

Auxiliary components:

Povidone, lactose anhydrous, magnesium stearate, croscarmellose sodium, microcrystalline cellulose, gelatin, lactose monohydrate, ethanol, sugar.

Properties:

Vitamin B complex. Thiamine (B1), pyridoxine (B6) and cyanocobalamin (B12) are neurotropic substances and play a special role as coenzymes in intermediate metabolism occurring in the central and peripheral nervous system.

The therapeutic use of vitamins B1, B6 and B12 replenishes the often existing insufficient intake of vitamins from food, which ensures the presence of the required amount of coenzymes in the body. The use of B vitamins in the form of a complex increases their therapeutic effectiveness, since the effectiveness of the combination exceeds the effectiveness of the individual components.

Indications:

As part of complex therapy for the following neurological diseases: - various anemias

-neuritis and neuralgia - trigeminal neuralgia;

- facial nerve paresis;

-intercostal neuralgia;

-pain syndrome caused by diseases of the spine (lumbar ischialgia, plexopathy, radicular syndrome caused by degenerative changes in the spine);

-herpes zoster;

-neuropathic pain caused by polyneuropathy, incl. diabetic and alcoholic).

Directions for use and dosage:

Doses are prescribed by a doctor.

Recommended dose:

1 tablet 3 times/day.

After eating, drink a small amount of liquid.

Contraindications:

- increased sensitivity to the active substances of the combination.

Precautionary measures:

If signs of peripheral sensory neuropathy (paresthesia) appear, it is necessary to adjust the dose and, if necessary, stop using the drug.

With the introduction of vitamin B12, the clinical picture, as well as laboratory parameters for funicular myelosis or pernicious anemia, may lose their specificity.

The drug contains lactose; patients with lactose intolerance should be careful.

Side effects:

From the immune system:

- very rarely - hypersensitivity reactions such as sweating, tachycardia.

Allergic reactions:

- very rarely - itching, urticaria, anaphylactic shock.

From the digestive system:

frequency not established - nausea, vomiting, diarrhea, abdominal pain.

Storage method:

In a cool, dry place at a temperature not exceeding 25 degrees.

Package:

The cardboard box contains 2 or 3 blisters of 10 tablets, paper instructions.