Pyridoxine, thiamine, cyanocobalamin, lidocaine - a combination of vitamin B1 with B6 and / or B12, supplemented with an anesthetic for painless intramuscular administration. Designed to eliminate the deficiency of vitamins of group B, can be used as adjunctive therapy for many diseases, mainly in neurology. In medical practice, a combination of vitamins is used either by alternately administering thiamine hydrochloride, pyridoxine hydrochloride and cyanocobalamin every other day, or as part of the Milgamma drug complex in which they are already mixed. Appointed by a doctor.
Pharmacological action of thiamine, pyridoxine, cyanocobalamin and lidocaine
Neurotropic drugs have a beneficial effect on the central nervous system and the motor apparatus, therefore, are indispensable assistants in inflammatory and degenerative diseases. The pharmacological effect of the combination is determined by the individual properties of pyridoxine, thiamine and cyanocobalamin. As for lidocaine, its role is limited by the anesthetic effect at the injection site and vasodilation, which contributes to better absorption of vitamins. Lidocaine is necessary to reduce pain, since the introduction of vitamins is quite noticeable.
Thiamine, pyridoxine, cyanocobalamin (and lidocaine) act as coenzymes in the intermediate metabolism, which takes place in the peripheral and central nervous system. They are indispensable components that come exclusively from the outside, since the body cannot synthesize these substances on its own. Due to the fact that the nutrition of a modern person is often unbalanced, this drug combination is used to eliminate vitamin deficiency.
The combined use of thiamine, cyanocobalamin and pyridoxine increases the positive effect of each of them. Taking vitamins separately is inferior in effectiveness to the combination.
Thiamine Effect
Vitamin B1 is actively involved in carbohydrate metabolism and is important for metabolic processes occurring in the nervous tissue. Thiamine is involved in the conduction of a nerve impulse; it is indispensable in the Krebs cycle, since it synthesizes TPF and ATP.
The effect of pyridoxine
Vitamin B6 is vital for the successful metabolism of fats, proteins and carbohydrates. He takes an active part in the process of hematopoiesis, stabilizes the peripheral and central nervous system. Thiamine and pyridoxine successfully complement each other, beneficially affecting the neuromuscular, nervous and cardiovascular systems.
The effect of cyanocobalamin
Vitamin B12 is actively involved in the synthesis of nucleotides, is an important element in the process of normal growth. Cyanocobalamin is needed for the hematopoiesis system, helps to develop epithelial cells, correctly synthesize myelin and produce folic acid metabolism.
Indications for use
The combination of pyridoxine, thiamine, cyanocobalamin and lidocaine is used in medical practice to fill the vitamin deficiency and as an adjunct therapy for diseases of the nervous system of various etiologies:
- Neuritis and neuralgia, including intercostal and trigeminal nerves.
- Ganglionitis, including herpes zoster.
- Paresis of the facial nerve.
- Retrobulbar neuritis.
- Neuropathy.
- Night muscle cramps.
- Polyneuropathy, including alcoholic and diabetic.
- Radiculopathy
- Muscle-tonic syndromes.
- Neurological symptoms in osteochondrosis of the spine.
- Plexopathy.
- Sciatica.
Contraindications
Due to the lack of data on the effect of the combination on the children's body, the use in pediatrics is prohibited (under 18 years). A high content of active components can negatively affect the growing body. Contraindications to the use of thiamine hydrochloride, pyridoxine hydrochloride, cyanocobalamin and lidocaine hydrochloride also serve:
- sensitivity to one or more combination substances;
- decompensated heart failure;
- lactase deficiency;
- hereditary intolerance to fructose or galactose;
- glucose-galactose malabsorption or sucrose-isomaltase deficiency.
Possible side effects
Studies show that unwanted body reactions are very rare. Possible negative manifestations in the form of the following conditions:
- hives;
- vomiting
- itching
- dizziness;
- Quincke's edema;
- confusion of consciousness;
- bradypnea;
- anaphylactic shock;
- tachycardia;
- bradycardia;
- cramps
- increased sweating;
- arrhythmia;
- acne.
With incorrect administration (too fast), as well as a violation of the rules for the injection, irritation at the injection site, systemic reactions of the body (vomiting, confusion, dizziness, and others) may occur. This usually occurs after an unintentional introduction of substances into a vessel or tissue rich in blood supply.
Similar symptoms are possible with an overdose. In this case, the drug is stopped, the patient is given symptomatic treatment.
Use during pregnancy and lactation
It is allowed only with a confirmed deficiency of B vitamins. If the deficiency is not diagnosed, the use is prohibited, since the safety of doses exceeding the daily requirement for pregnant women has not been established. During lactation, the use is prohibited due to the penetration of vitamins into breast milk.
Important notes
Drugs are available in the form of solutions. Pyridoxine, thiamine, cyanocobalamin and lidocaine are administered exclusively intramuscularly. In case of accidental introduction into the bloodstream, the patient should be under the supervision of a doctor. The dosage is selected individually by the attending physician, depending on the person’s history, physical condition and severity of the disease. Performing intramuscular injection, avoid getting drugs into the vascular bed. After deep injection of the needle into the muscle, but before administering the medicine, it is necessary to pull the plunger of the syringe to make sure that there is no blood. Only in this case can the medicine be administered. If there is blood, it is necessary to change the injection site.
It is strictly forbidden to collect individual drugs in one syringe and inject into muscle tissue. Thiamine is incompatible with pyridoxine, since the second inhibits the action of the first and delays its excretion from the body. Vitamin B6 can be combined with cyanocobalamin. With thiamine, they are administered alternately every other day. However, given the fact that maximum effectiveness can be achieved only by combination, a unique dosage formula has been created. The trade name of the drug is Milgamma.
The trade name for pyridoxine, thiamine, cyanocobalamin and lidocaine is Milgamma.
The drug has the same indications, contraindications, pharmacological properties, overdose symptoms and adverse reactions, like pyridoxine, thiamine, cyanocobalamin and lidocaine. "Milgamma" is a solution for intramuscular injection of red or raspberry color. One ampoule contains 2 ml of active substances:
- pyridoxine hydrochloride - 100 mg;
- cyanocobalamin - 1 mg;
- thiamine hydrochloride - 100 mg;
- lidocaine hydrochloride - 20 mg.
Milgamma injections contain various auxiliary components. These are such substances:
- benzyl alcohol - 40 mg;
- potassium hexacyanoferrate - 0.2 mg;
- sodium polyphosphate - 20 mg;
- sodium hydroxide - 12 mg;
- water for injection - up to 2 ml.
The drug is available in cardboard packs with pallets of 5 or 10 ampoules of dark glass. There are packages with contour cells. In one box 10 ampoules of dark glass.
This is the form of release and composition of the Milgamma in ampoules. As for the dosage regimen, it is selected by the doctor individually. For example, with severe pain, 2 ml per day is prescribed for 5-10 days. When the patient feels better, he is transferred either to more rare drug injections (2-3 times in 7 days for 2-3 weeks), or to a tablet form of the drug. During therapy, the patient is under the supervision of a doctor.
A condition analysis is carried out weekly to obtain data on the level of B vitamins in the body.
The drug is also in the form of tablets. The drug is called "Milgamma Composite". The composition of the tablets is different from injection. It includes 100 mg of benfotiamine and pyridoxine. If everything is clear with the second substance, then what is the first? Benfotiamine is a fat-soluble analogue of vitamin B1, that is, it has the same properties as thiamine.
The tablet form of the drug has similar positive and negative properties that Milgamma has in ampoules. The dosage regimen is determined individually by the doctor. The standard dosage involves taking 1 tablet per day. If necessary, the doctor can increase the rate to three times a day, but subject to treatment with a short course. Tablets are taken after meals with a large amount of water, which avoids undesirable reactions from the gastrointestinal tract. And although the composition of the Milgamma tablets is different, they are not inferior in effectiveness to the solution in ampoules.
Drugs are dispensed from a pharmacy without a prescription. However, you should not self-medicate and prescribe them yourself, which is often done by people who decide that they have a lack of B vitamins in their bodies. To take the medicine, the deficiency must be confirmed by diagnostic methods of research. This will avoid an overdose, which in some cases is more harmful to the body than a deficiency. It is necessary to treat your health with caution, because any thoughtless action will entail negative consequences that are dangerous both for the functioning of organs and for life.