Milgamma

Milgamma – a neurotropic complex of vitamins of group B.

Form of release and structure

Dosage forms:

• Solution for intramuscular introduction (in oil): transparent liquid of red color (on 2 ml in glass ampoules of dark color, on 5 pieces in a blister strip packaging, in a cardboard pack of 1, 2 or 5 packagings; in cardboard pallets: on 5 pieces, in a cardboard pack of 1 or 5 pallets, or on 10 pieces, in a cardboard pack 1 pallet);
• Dragee (on 15 pieces in a blister strip packaging, in a cardboard pack 2 or 4 packagings).

Content of active ingredients:

• 1 ml of solution: thiamin a hydrochloride (B1) – 50 mg, a pyridoxine a hydrochloride (B6) – 50 mg, cyanocobalamine (B12) – 0,5 mg, lidocaine a hydrochloride – 10 mg;
• 1 dragees: Benphothiaminum – 100 mg, a pyridoxine a hydrochloride – 100 mg.

Auxiliary components:

• Solution: benzyl alcohol, sodium polyphosphate, potassium hexacyanoferrate, sodium hydroxide, water for injections;
• Dragee: aerosil, calcium carbonate, titanium dioxide, cellulose microcrystallic, sodium carboxymethylcellulose, povidone, shellac, glycerides of fatty acids, sucrose, acacias powder, polyethyleneglycol-6000, starch corn, глицерол, glycolic wax, twin-80, talc.

Indications to use

• Neuritis, neuralgia;
• Polyneuropathy, including alcoholic and diabetic;
• Retrobulbar neuritis;
• Ganglionites, including shingles;
• Neurologic displays of osteochondrosis of a backbone: radiculopathy, lumbar ishialgia, muscular and tonic syndromes;
• Paresis of a facial nerve.

Besides, Milgamma's use is shown:

• Solution: as a part of complex therapy of a plexopathy, a neuropathy, muscular night spasms (is more often at patients of advanced age);
• Dragee: symptomatic therapy of a mialgiya, the general neurologic diseases caused by the confirmed vitamin deficiency of B1 and B6.

Contraindications

• Period of pregnancy and breastfeeding;
• Hypersensitivity to drug components.

Besides, use of drug is contraindicated:

• Solution: existence of dekompensirovanny heart failure, children's age;
• Dragee: heart failure in a decompensation stage.

Route of administration and dosage

• Solution: apply by deep injections in oil. The recommended dosing at the expressed pain syndrome: on 2 ml once a day, a course of treatment – 5-10 days. After removal of an acute pain or at easy forms of a disease drug is appointed by 2-3 times a week for 2-3 weeks. Treatment needs to be carried out under weekly control of the doctor. It is necessary to appoint use of solution to the shortest period with the subsequent transfer of the patient into administration of drug inside;
• Dragee: accept inside, washing down with enough liquid. The recommended dosing: on 1 dragee 1-3 times a day, a course of treatment – 1 month.

Side effects

Allergic reactions are not excluded: seldom – the complicated breath, urticaria, skin rash, a Quincke's edema, an acute anaphylaxis.

Besides, Milgamma's use in the form of solution can cause side effects:

• Cardiovascular system: very seldom – tachycardia; in some cases – arrhythmia, bradycardia;
• Nervous system: in some cases – confusion of consciousness, dizziness;
• Alimentary system: in some cases – vomiting;
• Musculoskeletal system: in some cases – spasms;
• Dermatological reactions: very seldom – an itch, strengthening of sweating, an acne;
• Local and system reactions: in some cases – irritation in the place of an injection; overdose or bystry introduction – strengthening of manifestation of system reactions.

Against the background of treatment of a dragee development of undesirable reactions is possible:

• Cardiovascular system: in some cases – tachycardia;
• Others: in some cases – the increased sweating, acne rash.

Special instructions

At accidental intravenous administration of solution of the patient the doctor has to examine immediately and depending on a condition of the patient to appoint the corresponding therapy or to make the decision on its hospitalization.

The dragee should appoint with care in combination with Cycloserinum, D-Penicillaminum.

Data on Milgamma's influence on ability of the patient to control of vehicles and mechanisms are absent.

Medicinal interaction

Therapeutic doses of Milgamma reduce antiparkinsonichesky effect of a levodopa, it is caused by strengthening of its peripheral decarboxylation under the influence of a pyridoxine. Drug interacts with Penicillaminum, Cycloserinum, an isoniazid.

Medicinal interaction of solution is caused by its combined structure.

Because of the content of thiamin solution cannot be combined with the recovering and oxidizing connections, including carbonates, iodides, acetates, iron ammonium citrate, tannin acid, phenobarbital, benzylpenicillin, Riboflavinum, a dextrose, disulphites. Completely collapsing in solutions of sulfites, decomposition products of thiamin reduce activity of other vitamins. Efficiency of thiamin is lost at рН more than 3, also copper promotes acceleration of processes of its destruction.

At simultaneous use of Epinephrinum and Norepinephrinum existence in composition of solution of lidocaine can cause strengthening of side effects from heart. Interaction with sulfonamides is also noted.

Because of existence in composition of cyanocobalamine solution cannot be combined with salts of heavy metals, Riboflavinum (especially at simultaneous influence of light).

Antioxidants slow down clinical effect of drug, effect of niacinamide accelerates a photolysis.

Terms and storage conditions

To store in the place, unavailable to children, at a temperature:

• Solution: to 15 °C in the place protected from light;
• Dragee: to 25 °C.

Period of validity: solution – 2 years, a dragee – 5 years.