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Instructions for use NEUROBEX

Combined preparation of B vitamins.

The combination of neurotropic B vitamins in Neurobex® is used to influence a number of important processes and functions of the body, mainly inflammatory and degenerative diseases of the nerves and musculoskeletal system. B vitamins are part of enzymes that catalyze metabolic reactions of carbohydrates, fats and proteins.

The physiological functions of vitamin B1 are multifaceted. After absorption in the body, it is converted into thiamine pyrophosphate, which is a cofactor for the enzyme carboxylase, which is involved in the decarboxylation of pyruvic and alpha-ketoglutaric acid. For this reason, vitamin B1 is intensively consumed when consuming carbohydrates. It is related to the activity of the nervous and neuromuscular system, facilitating the biosynthesis of the main mediator acetylcholine and suppressing the activity of the enzyme cholinesterase, which breaks it down. Vitamin B deficiency leads to the accumulation of lactic and pyruvic acid, which may result in the development of polyneuritis, beriberi disease, Wernicke encephalopathy and Korsakoff syndrome, polyneuropathy, cardiac dysfunction, gastrointestinal lesions (ulcerative colitis, chronic diarrhea).

The physiological functions of vitamin B6 as a coenzyme include inclusion in some metabolic transformations of amino acids - decarboxylation, transamination and racemization, as well as enzymatic transformations in the metabolism of sulfate-containing substances and hydroxyamino acids. It takes part in the conversion of tryptophan to 5-hydroxytryptamine in the synthesis of dopamine, norepinephrine, adrenaline, histamine and GABA. The conversion of methionine to cysteine also depends on the vitamin. It takes part in regulating the function of the liver and nervous system, and enhances erythropoiesis in some forms of anemia. Vitamin B6 deficiency is possible due to insufficient intake with food, impaired absorption in the intestine, when taking medications that are its antagonists, or during radiation therapy. Symptoms of deficiency are manifested by the appearance of seborrhea-like lesions around the eyes, nose, glossitis, stomatitis; peripheral neuritis, seizures (due to low concentrations of gamma-aminobutyric acid), very rarely anemia.

The physiological role of the active vitamin B12 coenzymes methylcobalamin and 5-deoxyadenosylcobalamin is essential for cell growth and replication. Methylcobalamin is necessary for the formation of methionine and its derivatives S-adenoylmethionine from homocysteine. It takes part in the processes of transmethylation and transfer of hydrogen cations during the synthesis of choline, methionine, creatinine and nucleic acids. Vitamin B12 plays an important role in hematopoietic processes (especially in the maturation of red blood cells). When the vitamin is deficient, methyltetrahydrofolate absorbs folate and leads to folate deficiency for other intracellular forms of folic acid necessary for red blood cell maturation. It has a beneficial effect on the functions of the liver and nervous system. Vitamin B12 deficiency is manifested by symptoms from the hematopoietic and nervous systems. Hematopoiesis becomes ineffective, and erythropoiesis becomes megaloblastic, and in severe cases pancytopenia develops. Irreversible damage can occur in the nervous system - demyelination, death of neurons in the spinal cord and cerebral cortex, which is manifested by paresthesia of the limbs, instability of gait, disturbance of some reflexes and, in a later stage, mental confusion, hallucinations, rapid mood swings, loss of memory, vision and even psychosis.

Neurobeks p/o tablets in jars No. 90 No. 1

Name

Neurobeks tablet p/o in bank No. 90 in unitary enterprise No. 1

Main active ingredient

Pyridoxine + thiamine + cyanocobalamin.

Release form

Pills.

pharmachologic effect

Neurobex® is a combined preparation containing B vitamins. They are part of enzymes that catalyze metabolic reactions of carbohydrates, fats and proteins. A combination of B vitamins is used to influence a number of important processes and functions in the body and, mainly, inflammatory and degenerative diseases of the nerves and musculoskeletal system.

Indications for use

Indications for use Combined deficiency of vitamins B1, B6, B12. In the complex treatment of neurological and skin diseases and conditions associated with proven clinical or subclinical deficiency of vitamins B1, B6, B12, such as: nonspecific inflammatory and degenerative processes in peripheral nerves - neuritis, polyneuritis (alcoholic, post-infectious, toxic, diabetes); neuralgia, myalgia, paresthesia; dermatitis, eczema, psoriasis, acne vulgaris, atopic dermatitis.

Directions for use and doses

Neurobex® is taken orally during or after meals with water. The usual dose is 1-2 tablets 1-3 times a day for 30 days. The individual dose and duration of treatment are determined by the doctor. Elderly patients Usually no dose adjustment is required for elderly patients. Impaired renal function No dosage adjustment is required in patients with impaired renal function. Impaired liver function No dosage adjustment is required in patients with impaired liver function. If you have the impression that Neurobex® is too weak or too strong, consult your doctor or pharmacist. If you miss one dose of the drug, take it at your next regular dose without increasing the dose.

Use during pregnancy and lactation

There is no data on the negative effects of Neurobex on the fetus and child during pregnancy and lactation. Vitamins penetrate the placental barrier and are excreted from the body through breast milk. Due to the lack of sufficient information, the use of the drug is possible only if absolutely necessary, in recommended doses, as prescribed and under the supervision of a physician, after assessing the benefit/risk ratio, if the benefit outweighs the risk. It should be taken into account that in high doses, pyridoxine may interfere with the secretion of prolactin and should be used with caution in nursing mothers. Use in large quantities during pregnancy may lead to pyridoxine dependence syndrome in newborns.

Precautionary measures

Neurobex® should be used with extreme caution in patients with severe and acute forms of decompensated heart failure and angina. During treatment with this drug, you should not drink alcohol, since the ethanol it contains reduces the amount of vitamin B1 absorbed in the intestines. If the signs of the disease do not begin to subside, or, on the contrary, your health condition worsens, or if undesirable effects appear, consult your doctor for advice regarding further use of the drug! The tablets are not intended for use in children under 6 years of age, as this group of patients may have difficulty swallowing medications in the form of tablets and capsules.

Interaction with other drugs

If you are taking any other medications, be sure to inform your doctor about this, and if you are treating yourself, consult your doctor or pharmacist about the possibility of using the drug! Ethyl alcohol sharply reduces the absorption of vitamin B1. Vitamin B6 affects the metabolism of certain medications. Concomitant use of chloramphenicol, cycloserine, ethionamide, hydralazine, isoniazid, penicillamine, or immunosuppressants with pyridoxine may result in anemia or peripheral neuritis as these agents may act as pyridoxine antagonists or increase renal excretion of pyridoxine. Patients receiving these drugs may have increased requirements for pyridoxine. Concomitant use of estrogens may increase pyridoxine requirements. Concomitant use of levodopa with pyridoxine is not recommended because the antiparkinsonian effects of levodopa are reduced by oral pyridoxine in doses exceeding daily requirements. This problem does not arise if levodopa is combined with the peripheral decarboxylase inhibitor carbidopa. Serum levels of cyanocobalamin may be reduced by oral contraceptives. These interactions are unlikely to be of clinical significance. Antimetabolites and most antibiotics distort the results of vitamin B12 blood tests using microbiological methods. Para-aminosalicylic acid, colchicine, biguanides, neomycin, cholestyramine, potassium chloride, methyldopa and cimetidine may reduce the absorption of vitamin B12. Patients treated with chloramphenicol may respond poorly to cyanocobalamin.

Contraindications

Neurobex® is not used for: allergies to the active substances or any of the excipients in the composition of the drug; acute thromboembolism (blockage of a vessel by a blood clot); erythrocytosis and erythremia (blood diseases caused by an increase in the number of red blood cells).

Compound

Active ingredients in one coated tablet: Thiamine nitrate (vitamin B1) 15 mg, Pyridoxine hydrochloride (vitamin B6) 10 mg, Cyanocobalamin (vitamin B12) 0.02 mg. Excipients: lactose monohydrate, wheat starch, talc, magnesium stearate, colloidal silicon dioxide, povidone. Shell composition: collicoate protect (copolymer of polyvinyl alcohol and polyethylene glycol, polyvinyl alcohol, silicon dioxide), titanium dioxide, talc, cochineal red varnish E124. Information on excipients This medicinal product contains lactose as an excipient and should not be used in patients with lactase deficiency, galactose intolerance or glucose-galactose malabsorption syndrome. Due to the presence of wheat starch in the drug, it should not be taken by patients with an allergy to wheat (different from celiac disease). The medicine is suitable for patients with celiac disease (celiac disease). Dye E124, which is part of the drug, can cause allergic reactions.

Overdose

Symptoms: In case of overdose, the symptoms of side effects of the drug increase. Nervous excitement, tachycardia, and pain in the heart area may occur. Treatment: Treatment includes gastric lavage, administration of activated carbon, and the use of symptomatic agents. Isoniazid is an antidote to vitamin B6.

Side effect

Neurobex® is generally well tolerated. In rare cases, increased sweating, tachycardia, itching, and urticaria are possible. In isolated cases, allergic reactions may occur: rash, suffocation and anaphylactic shock. Severe sensory neuropathy has been described in patients taking high doses of pyridoxine (2 g to 6 g per day) for 2 to 40 months. Sensory peripheral neuropathy is also possible with prolonged use of daily doses of 200 mg or lower. If the listed adverse reactions occur, as well as reactions not listed in the instructions, you should consult a doctor.

Storage conditions

At a temperature not exceeding 25°C. Keep out of the reach of children!