Kombilipen NEO solution 2ml, No. 10

As part of the complex therapy of the following neurological diseases:

neuritis and neuralgia - trigeminal neuralgia; paresis of the facial nerve;

intercostal neuralgia;

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

herpes zoster;

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

IM is administered 1 single dose 1 time / day until acute symptoms are relieved. After a decrease in symptoms or in case of moderate severity of the disease, 1 single dose is administered 1-3 times a week for 2-3 weeks.

thiamine hydrochloride, pyridoxine hydrochloride, cyanocobalamin

• Children under the age of 18;

• hypersensitivity to the active substances of the combination.

pharmachologic effect

Complex of B vitamins Thiamine (B1), pyridoxine (B6) and cyanocobalamin (B12) are neurotropic substances and play a special role as coenzymes in intermediate metabolism in the central and peripheral nervous system. Like other vitamins, they are essential food components that the body cannot synthesize on its own. The therapeutic use of vitamins B1, B6 and B12 compensates for 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 individual components.The therapeutic use of these vitamins for various diseases of the nervous system is aimed, on the one hand, to compensate for the existing deficiency (possibly due to an increased body demand caused by the disease itself) and, on the other hand, to stimulate natural mechanisms aimed at recovery. At the same time, the indirect analgesic effect of the complex of B vitamins has a beneficial effect on the therapeutic result.the indirect analgesic effect of the B complex vitamins has a beneficial effect on the therapeutic result.the indirect analgesic effect of the B complex vitamins has a beneficial effect on the therapeutic result.

Pharmacokinetics

ѕосле приема внутрь тиамин подвергаетс¤ дозозависимому транспорту, механизм которого носит двойственную природу: активное всасывание при концентрации до 2 мкмоль/л и пассивна¤ диффузи¤ при концентраци¤х свыше 2 мкмоль/л. ¬ печени происходит фосфорилирование тиамина. T1/2 составл¤ет около 4 ч. ¬ организме человека содержитс¤ около 30 мг тиамина. — учетом быстрого метаболизма он выводитс¤ через 4-10 дней. ѕиридоксин всасываетс¤ очень быстро, в основном, в верхнем отделе кишечника и выводитс¤ максимум через 2-5 ч. ¬ыполнение функции кофермента требует фосфорилировани¤ пиридоксина. ѕиридоксин в фосфорилированной форме (пиридоксальфосфат) почти на 80% св¤зываетс¤ с белками плазмы крови. ¬ организме человека содержитс¤ около 40-150 мг. «а сутки с мочой выводитс¤ 1.7-3.6 мг. ?ианокобаламин всасываетс¤ из ? “ посредством 2 механизмов: 1) высвобождение под действием желудочного сока и быстрое св¤зывание с внутренним фактором; 2) пассивна¤ диффузи¤ через эпителий кишечника независимо от внутреннего фактора. ѕри дозах более 1.5 мкг последний механизм играет значительную роль. ” больных ¬12-дефицитной анемией реабсорбци¤ после приема внутрь составл¤ет приблизительно 1% из 100 мкг и более. »збыток цианокобаламина накапливаетс¤ в печени. »з печени цианокобаламин выводитс¤ с желчью в кишечник и в значительной степени реабсорбируетс¤ при кишечно-печеночной циркул¤ции. —корость метаболизма цианокобаламин в сутки составл¤ет 2.5 мкг.

Side effect

From the immune system: very rarely - hypersensitivity reactions such as sweating, tachycardia. Allergic reactions: very rarely - itching, urticaria, anaphylactic shock. From the digestive system: the frequency has not been established - nausea, vomiting, diarrhea, abdominal pain. From the side of the nervous system: the frequency has not been established - long-term use (> 6-12 months) of vitamin B6 in a daily dose of> 50 mg can cause peripheral sensory neuropathy.

Application during pregnancy and lactation

Application during pregnancy and lactation (breastfeeding) is not recommended due to the high content of vitamins.

Application in children

The drug is contraindicated for use in children and adolescents under the age of 18 years.

special instructions

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

Drug interactions

When used simultaneously with levodopa, pyridoxine can reduce the antiparkinsonian effect of levodopa. Concomitant use of pyridoxine antagonists (eg, isoniazid, hydralazine, penicillamine, or cycloserine) may increase the need for pyridoxine. Thiamine is inactivated by fluorouracil. Fluorouracil competitively inhibits the phosphorylation of thiamine to thiamine pyrophosphate. Antacids reduce the absorption of thiamine. Loop diuretics, such as furosemide, can block tubular reabsorption, thus increasing thiamine excretion with prolonged use, leading to a decrease in blood thiamine levels. Drinking alcohol and black tea leads to a decrease in the absorption of thiamine. Sulfite-containing beverages (such as wine) increase thiamine degradation.