Composition
1 coated tablet contains: The core: Active ingredients: Thiamine disulfide-100,00 mg, Pyridoxine hydrochloride-200,00 mg, Cyanocobalamin-200,00 * MCGM Auxiliary substances: magnesium stearate 2.14 mg, methylcellulose 4.00 mg, corn starch 20.00 mg, gelatin 23.76 mg, lactose monohydrate 40.00 mg, talc 49.86 mg. Shell:  wax mountain glycol 300 mcg, mcg 920 gelatin, methylcellulose 1.08 mg, acacia Arab 1.96 mg glycerol 85% to 4.32 mg, povidone-25 thousand 4,32 mg, calcium carbonate to 8.64 mg, silicon dioxide colloid of 8.64 mg, kaolin 21,50 mg, titanium dioxide of 28.00 mg, talc 47,10 mg, sucrose 133,22 mg * number of cyanocobalamin, including an excess of 20%, is 240 µg
Description
Pharmacological properties
Pharmacotherapeutic group gruppovaya In ATX: A11DBPharmacological properties. Neurotropic contains a combination of active substances of a complex of b vitamins Contained vitamins: thiamin (b 1), pyridoxine (6) and cyanocobalamin (B12) play a special role as coenzymes in the intermediary metabolism occurring in the Central and peripheral nervous system. Like other vitamins, they are essential food components that the body is not able to synthesize on its own. Therapeutic introduction of vitamins B1, B6 and B12 into the body makes up for the often existing insufficient intake of vitamins from food, which ensures the presence of the necessary amounts of coenzymes in the body. The combined use of B vitamins increases their therapeutic effectiveness, since the effectiveness of the combination exceeds the effectiveness of individual components. The therapeutic use of these vitamins in various diseases of the nervous system is aimed, on the one hand, to compensate for the existing deficiency (possibly due to the increased need of the body caused directly by the disease) and, on the other hand, to stimulate natural mechanisms aimed at recovery. At the same time, the indirect analgesic effect of the B vitamin complex has a favorable effect on the therapeutic result. Pharmacokinetication of Thiamine After oral use, thiamine undergoes dose-dependent transport, the mechanism of which is twofold: active absorption at concentrations up to 2 mmol/l and passive diffusion at concentrations above 2 mmol/l. Phosphorylation of thiamine occurs in the liver. The elimination half-life is about 4 hours. The human body contains about 30 mg of thiamine. Taking into account the rapid metabolism, it is excreted in 4-10 days. Pyridoxine Pyridoxine is absorbed very quickly, mainly in the upper intestine, and is eliminated in a maximum of 2-5 hours. The coenzyme function requires phosphorylation of pyridoxine. Pyridoxine in phosphorylated form (pyridoxal phosphate) binds to plasma proteins by almost 80%. The human body contains about 40-150 mg of pyridoxine. 1.7-3.6 mg is excreted by the kidneys per day. Cyanocobalamin Cyanocobalamin is absorbed from the gastrointestinal tract through 2 mechanisms:  – release under the action of gastric juice and rapid binding to the internal factor, – passive diffusion through the intestinal epithelium, regardless of the internal factor. At doses above 1.5 micrograms, the latter mechanism plays a significant role. In patients with B12-deficient anemia, reabsorption after oral use is approximately 1% of 100 mcg or more. Excess cyanocobalamin mainly accumulates in the liver. From the liver, it is excreted with bile into the intestines and is largely reabsorbed during the intestinal-hepatic circulation. The metabolic rate of cyanocobalamin per day is 2.5 mcg.
Indications
In the complex therapy of the following neurological diseases: Neuritis and neuralgia:
- trigeminal neuralgia,
- facial neuritis,
- intercostal neuralgia,
- pain syndrome caused by diseases of the spine (lumboishialgia, plexopathy, radicular syndrome caused by degenerative changes of the spine).
Use during pregnancy and lactation
During pregnancy and lactation, the use of Neurobion® is not recommended due to its high vitamin content. Vitamins B1, B6 and B12 are excreted in breast milk, however, the risk of overdose in a newborn has not been established. In some cases, taking high doses of vitamin B6 (> 600 mg per day) may inhibit the secretion of breast milk. If it is necessary to take the drug during lactation, breastfeeding should be discontinued.
Contraindications
Hypersensitivity to any component of the drug. Age up to 18 years (due to the high content of active ingredients). The drug contains lactose and sucrose, so its use is contraindicated in patients with hereditary galactose or fructose intolerance, lactase deficiency, glucose-galactose malabsorption or sucrose-isomaltase deficiency.
Side effects
The frequency of side effects of the drug is estimated as follows: Very frequent: ≥ 1/10 Frequent: ≥ 1/100, < 1/10 Uncommon: ≥ 1/1000, < 1/100 Rare: ≥ 1/10 000, < 1/1000 Very rare: From the immune system: Very rare: Hypersensitivity reactions, such as sweating, tachycardia and skin reactions-pruritus, urticaria. From the digestive system: Frequency not established: nausea, vomiting, diarrhea, abdominal pain.
Interaction
When used concomitantly with levodopa, pyridoxine may reduce the antiparkinsonian effect of levodopa. Concomitant use of pyridoxine antagonists (e. g., isoniazid, hydralazine, penicillamine, or cycloserine) may increase the need for pyridoxine. Thiamine is inactivated by fluorouracil. Fluorouracil competitively inhibits phosphorylation of thiamine to thiamine pyrophosphate. Antacids reduce the absorption of thiamine. “Loop” diuretics, such as furosemide, can block tubular resorption, thus increasing the excretion of thiamine with prolonged use, which leads to a decrease in the content of thiamine in the blood. Taking alcohol and black tea leads to a decrease in the absorption of thiamine. Drinks containing sulfites (such as wine) increase thiamine degradation.
How to take, course of use and dosage
Tablets are taken orally, without chewing, with a small amount of water, during or after a meal. Take 1 tablet 3 times a day or as directed by your doctor. The duration of treatment is determined by the doctor and averages 1-1.5 months. It is recommended to adjust the dose of the drug during therapy for more than 4 weeks.
Overdose
Vitamin B-1. Thiamine has a wide therapeutic range. Very high doses (>10 g) have a ganglioblocking effect and inhibit the transmission of nerve impulses, i. e. they have a muscle-relaxing effect.
Vitamin B6. Pyridoxine has very low toxicity. The use of pyridoxine for 2 months or more at a dose of more than 1 g per day can cause neurotoxic effects.
In case of overdose after ingestion of more than 2 g per day, the following effects were noted: neuropathies with ataxia, impaired sensitivity, cerebral convulsions with changes in the ECG, as well as, in some cases, hypochromic anemia and seborrheic dermatitis.
Vitamin B12. After parenteral use of a high dose (and also in rare cases after oral use), eczematous skin changes and a benign form of acne were observed.
Treatment: Â therapeutic measures for overdose include washing the gastrointestinal tract, taking activated charcoal, and prescribing symptomatic therapy.
Description
Round biconvex tablets, coated almost white in color, shiny.
Special instructions
With prolonged use (more than 6-12 months) of vitamin B6 in a daily dose of 50 mg, peripheral sensory neuropathy may occur. Therefore, with long-term therapy, it is recommended to regularly monitor the patient’s condition. If signs of peripheral sensory neuropathy (paresthesia) appear, the dose should be adjusted and, if necessary, the drug should be discontinued. When taking vitamin B12, the clinical picture, as well as laboratory parameters for funicular myelosis or pernicious anemia, may lose their specificity. Neurobion® does not affect the ability to drive vehicles and to control mechanisms.
Composition
Tablet Form of production
Storage conditions
At a temperature not exceeding 25°C. Keep out of reach of children.
Shelf life
3 years
Active ingredient
Pyridoxine, Thiamine, Cyanocobalamin
Conditions of release from pharmacies
By prescription
Dosage form
Tablets
Indications
Lumbago, Polyneuropathy, Sciatica, Sciatica, Trigeminal Neuralgia
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