Neyrobion

Neurobion is a subcategory of mineral-free multivitamins. Its use falls on individuals with a marked lack of B-vitamins — thiamine with pyridoxine and B12-vitamin.

[1]

Indications Neyrobiona

It is used in the combined treatment of such diseases and conditions:

• neuralgia of the 3-pin nerve;
• thoracalgia;
• shishias ;
• plexopathy affecting the neck-brachial plexus;
• radicular syndrome developing due to compression of the roots inside the spinal cord due to degenerative vertebral pathologies;
• safely.

[2], [3]

Release form

The release of the pharmaceutical component is in the form of tablets, as well as a solution for i / m injections, inside ampoules with a capacity of 3 ml.

[4], [5]

Pharmacodynamics

The structure of the drug contains a combination of neurotropic active ingredients - B-vitamins: cyanocobalamin and thiamine with pyridoxine.

The use of 3 of these vitamins helps to ensure the normal enzyme parameters inside the body.

When using the drug during a variety of neurological pathologies, the existing deficit is replenished, as well as the stimulation of natural regenerative mechanisms.

The animal test readings demonstrate that the use of a combination of thiamine with cyanocobalamin and pyridoxine leads to the development of an analgesic effect.

It was revealed that any B-vitamins can have an analgesic effect of varying degrees of intensity. Cyanocobalamin is most pronounced, then pyridoxine, and then thiamine. In this case, the complex of all three substances has a more significant effect than in the case of using each element separately.

At the same time, these vitamins have a low level of toxicity (if used in the recommended medicinal portions). There is also no information about the mutagenic, carcinogenic and teratogenic activity of the drug.

Clinical studies have confirmed that with parenteral use of a drug containing pyridoxine with thiamine and cyanocobalamin, severe pain is suppressed, sensitivity is restored and reflex impulses stabilize.

B-vitamins are well tolerated, which is different from NSAID drugs that cause the development of a large number of negative signs (mainly affecting the work of the gastrointestinal tract).

In randomized tests, it was found that with the i / m use of cyanocobalamin in people with back pain, which are of a chronic nature, there is a weakening of the intensity of pain and an improvement in motor activity.

The introduction of the drug in the form of a substance to alleviate the neuropathic nature of pain in people with neuropathic polyneuropathy leads to a reduction in the intensity of pain, a decrease in the severity of epidermal sensitivity disorders (paresthesias), and a weaker feeling of coldness and burning.

Tests of the pharmacological effect of pyridoxine have shown that it can provoke poisoning in high concentrations. The daily dose, which is safe to take, is 0.2 g.

In thiamine, when testing for therapeutic effects with the participation of people with alcoholic or diabetic polyneuropathy, the following properties were found when used in high dosages:

• brief relief of pain;
• a decrease in the intensity of paresthesias;
• improved sensitivity with respect to temperature as well as vibration pulses.

[6], [7], [8]

Pharmacokinetics

When thiamine is taken orally, a metered movement of the substance with active absorption up to 2 μm is performed. When the values of thiamine over 2 microns diffusion develops a passive nature.

The half-life of an element is approximately 4 hours.

Inside the human body, thiamine does not accumulate at a dosage of more than 30 mg. Because of this, given the rapid exchange process and the limited deferred stock, it is spent for 4-10 days on average.

Pyridoxine absorption by ingestion is carried out at high speed, mainly in the upper part of the gastrointestinal tract. Excretion of the component occurs in 2-5 hours on average. Its indices inside the body vary in the range of 40-150 mg, and 1.7-3.6 mg of the substance is excreted in the urine per day.

The absorption of cyanocobalamin inside the gastrointestinal tract develops with the participation of such mechanisms:

• component release under the influence of digestive juice, as well as fast synthesis with an endogenous factor;
• without synthesis with an endogenous factor, by passive penetration into the circulatory system (this method is a priority in the case of the introduction of dosages of a substance that exceed 1.5 μg).

Cyanocobalamin is converted inside the liver, with an exchange rate of 2.5 μg per day (this figure is approximately 0.05% of the volume of the stored substance).

Excretion mainly occurs along with bile, in addition it should be noted that a substantial part of the substance undergoes reabsorption processes during enterohepatic circulation.

In persons with megaloblastic anemia after administration of a dosage equal to or exceeding the mark of 100 µg of the component, only 1% is absorbed.

[9], [10], [11]

Dosing and administration

Liquid for intramuscular injections is injected under severe conditions in the amount of 1 ampoule per day (the substance must be injected deep into the muscle). It should be applied until all manifestations observed at the acute stage of a specific pathology disappear.

With a weakening of the intensity of the clinical symptoms of the disease and in situations where the medication is used for moderate stages of the disease, it should be administered in the amount of the 1st ampule 2-3 times a week.

The duration of the cycle of therapy after the elimination of signs of the disease is 2-3 weeks.

If it is necessary to potentiate the effect, continue therapy after the injection part of the course, as well as for prophylaxis, in order to prevent the recurrence of the disease, in addition, medication pills are prescribed.

It is necessary to apply tablets together with food or after it; they are swallowed whole, without chewing, and washed down with plain water. Per day, adolescents older than 15 years and adults need to apply 3 tablets (1 piece 3 times a day).

For children under the age of 15, the attending doctor must personally select the appropriate dosage.

The duration of the treatment cycle is also assigned individually, and the nature of the course of the pathology and the degree of its intensity are taken into account. The maximum duration is 1 month.

If there is a need to use the medication after the completion of the 1-month cycle, the size of the dosage portion should be changed, reducing it.

Use Neyrobiona during pregnancy

There is not enough information regarding the safety of Neurobion in pregnancy. Because of this, in this period, he can be appointed only after a careful assessment of the benefits to the woman and the risk of complications for the fetus.

Pyridoxine with thiamine and cyanocobalamin can be excreted with mother's milk, and the use of large portions of pyridoxine causes suppression of lactation.

Accurate information regarding the amount of medication given with the mother's milk is not available. Because of this, the decision regarding the continuation of breastfeeding or its cancellation is taken, given the need for the mother to take the medicine. Thus, at the time of the treatment cycle it is necessary to abandon breastfeeding.

Contraindications

Contraindications for each of the components contained in the composition of the medicine are quite different.

Thiamine should not be used in people with allergic etiology. Pyridoxine is not administered if the patient has an exacerbation of the ulcer in the gastrointestinal zone - because the drug can lead to an increase in gastric pH values.

Cyanocobalamin is prohibited for people with thromboembolism, erythrocytosis, or polycythemia.

[12], [13]

Side effects Neyrobiona

After taking the medicine inside, allergy symptoms sometimes appear, often expressed as an epidermal rash.

Injections of the drug can lead to local signs in the area of the injection. In the case of iv administration, signs of exanthema and anaphylaxis appear, and problems with the respiratory process develop.

Among the side effects:

• gastrointestinal lesions: an increase in gastric pH, bloating, vomiting, pain in the epigastric region, abnormal stool and nausea;
• immune disorders: rarely develop hyperhidrosis, manifestations of hypersensitivity, anaphylaxis and tachycardia.

Sometimes prolonged use of pyridoxine (at least 6 months) in a serving of more than 50 mg per day can cause the patient to exhibit sensory neuropathy; there is a general feeling of indisposition, severe nervous irritability, dizziness and headaches.

[14]

Overdose

In the case of a significant excess of the recommended drug dosage of thiamine (over 10 g), the development of curative-like signs is observed and the conductivity of neural impulses is weakened.

Pyridoxine is a substance with a low toxicity index. After daily use of more than 50 mg per serving over a period of 0.5–1 years, signs of a sensory form of peripheral neuropathy may develop.

Using more than 1000 mg of pyridoxine per day over a period of several months can cause neurotoxic symptoms.

With the introduction of more than 2 g of the substance per day over a large time period, neuropathy may be observed with sensitivity disorders and symptoms of ataxia, seborrheic form of dermatitis, convulsions (with changes in encephalogram readings) and hypochromasia.

Parenteral use of large portions of cyanocobalamin (sometimes also after oral administration of the substance) can cause the appearance of acne of a benign nature, eczematous lesions of the epidermis and signs of allergy.

Prolonged administration of large doses of cyanocobalamin causes a breakdown in the enzyme activity of the liver, the development of heart pain, and increased blood coagulation (hypercoagulation).

[15], [16], [17]

Interactions with other drugs

5-fluorouracil has an inactivating effect on thiamine, which can competitively inhibit thiamine phosphorylation with the subsequent formation of the thiamine-pyrophosphate component.

When combined with antacids, the expression of thiamine absorption decreases.

Furosemide, as well as similar substances from a subcategory of diuretic loops, slow down the process of tubular reabsorption, and in the case of prolonged use increases the elimination of thiamine, due to which its indices inside the body decrease.

Neyrobion can not be combined with Levodopa, because pyridoxine weakens its anti-Parkinsonian activity.

The introduction of the drug together with substances that have an antagonistic effect against pyridoxine, as well as with oral contraception increases the body's need to get B6-vitamin.

[18], [19],

Storage conditions

Neyrobion needs to be kept in the closed from children, a dark place. Tablets should be kept at a maximum temperature of 25 ° C, and the solution - within the limits of 2-8 ° C.

[20], [21]

Shelf life

Neyrobion allowed to apply within a 3-year period from the date of manufacture of the drug substance.

Application for children

There is no accurate information regarding the drug efficacy of Neurobion when given to children under 15 years of age.

It is forbidden to use in children under 3 years old, because the drug contains benzyl alcohol, which increases the likelihood of the occurrence of diseases in which there is a violation of acid-base balance (or the development of metabolic acidosis).

[22], [23], [24]

Analogs

Analogues of the drug are the drugs Vitaxone, Nerviplex, Complex B1 / B6 / B12 with Neurobex, and besides this Neuromultivitis, Unigamma and Neyrorubin.