Neurobion

Neurobion is a subcategory of multivitamins that do not contain minerals. It is used by people with a noticeable deficiency of B-vitamins - thiamine with pyridoxine and B12-vitamin.

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Indications Neurobion

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

• trigeminal neuralgia;
• thoracalgia;
• sciatica;
• plexopathy affecting the cervicobrachial plexus;
• radicular syndrome, developing due to compression of the roots inside the spinal cord, as a result of degenerative spinal pathologies;
• prosoparesis.

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Release form

The pharmaceutical component is released in the form of tablets, as well as a solution for intramuscular injections, inside ampoules with a capacity of 3 ml.

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Pharmacodynamics

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

The use of these 3 vitamins helps to ensure normal enzyme levels within the body.

When using the drug during various neurological pathologies, the existing deficiency is replenished, as well as the stimulation of natural recovery mechanisms.

Animal test results show that the use of a combination of thiamine with cyanocobalamin and pyridoxine results in the development of an analgesic effect.

It has been found that any B-vitamins can have an analgesic effect of varying intensity. Cyanocobalamin has the greatest effect, followed by pyridoxine, and then thiamine. At the same time, 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 recommended medicinal doses). There is also no information regarding the mutagenic, carcinogenic and teratogenic activity of the drug.

Clinical studies have confirmed that parenteral use of a drug containing pyridoxine with thiamine and cyanocobalamin relieves severe pain, restores sensitivity and stabilizes reflex impulses.

B-vitamins are well tolerated, which distinguishes them from NSAIDs, which cause the development of a large number of negative symptoms (mainly affecting the gastrointestinal tract).

Randomized trials have shown that intramuscular administration of cyanocobalamin to individuals with chronic back pain results in a reduction in pain intensity and an improvement in motor activity.

The introduction of a drug in the form of a substance to eliminate pain of a neuropathic nature in people with neuropathic polyneuropathy leads to a decrease in the intensity of pain, a decrease in the severity of epidermal sensitivity disorders (paresthesia) and a decrease in the sensation of coldness and burning.

Tests of the medicinal effects of pyridoxine have shown that in high concentrations it can cause poisoning. The daily dose that is safe to take is 0.2 g.

Thiamine, when tested for its therapeutic effects in people with polyneuropathy of alcoholic or diabetic origin, showed the following properties when used in high doses:

• short-term relief of pain;
• reduction in the intensity of paresthesia;
• improved sensitivity to temperature and vibration impulses.

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Pharmacokinetics

When thiamine is taken orally, a dosed movement of the substance occurs with active absorption up to a value of 2 μm. At thiamine values above 2 μm, passive diffusion develops.

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

Thiamine does not accumulate inside the human body at doses over 30 mg. Because of this, given the rapid metabolism process and the limited storage capacity, it is consumed in 4-10 days on average.

Pyridoxine is absorbed at high speed when taken orally, mainly in the upper gastrointestinal tract. The component is excreted within 2-5 hours on average. Its levels inside the body fluctuate in the range of 40-150 mg, and 1.7-3.6 mg of the substance is excreted in urine per day.

Absorption of cyanocobalamin within the gastrointestinal tract develops with the participation of the following mechanisms:

• release of the component under the influence of digestive juice, as well as rapid 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 administration of dosages of the substance that exceed 1.5 mcg).

Cyanocobalamin is converted within the liver, at a rate of 2.5 mcg per day (this figure is approximately 0.05% of the volume of the stored substance).

Excretion occurs mainly with bile, and it should also be noted that a significant portion of the substance undergoes reabsorption processes during enterohepatic circulation.

In individuals with megaloblastic anemia, after administration of a dosage equal to or exceeding 100 mcg of the component, only 1% of it is absorbed.

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Dosing and administration

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

When the intensity of clinical symptoms of the disease weakens and in situations where the medication is used at moderate stages of the disease, it should be administered in the amount of 1 ampoule 2-3 times a week.

The duration of the therapy cycle 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, and also for prevention, to prevent a relapse of the disease, in addition, the intake of medicinal tablets is prescribed.

The tablets should be taken with or after food; they are swallowed whole, without chewing, and washed down with plain water. Adolescents over 15 years of age and adults should take 3 tablets per day (1 piece 3 times per day).

For children under 15 years of age, the appropriate dosage should be selected by the attending physician, individually.

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

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

Use Neurobion during pregnancy

There is insufficient information regarding the safety of administering Neurobion during pregnancy. For this reason, it can only be prescribed during this period after careful assessment of the benefits to the woman and the risk of complications for the fetus.

Pyridoxine with thiamine and cyanocobalamin can be excreted in breast milk, and the use of large doses of pyridoxine causes suppression of lactation.

There is no precise information regarding the volume of the drug excreted in breast milk. Therefore, the decision to continue breastfeeding or to stop breastfeeding is made taking into account the mother's need to take the drug. Therefore, breastfeeding should be discontinued during the treatment cycle.

Contraindications

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

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

Cyanocobalamin is contraindicated in people with thromboembolism, erythrocytosis or polycythemia.

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Side effects Neurobion

After taking the medicine orally, allergy symptoms sometimes appear, often in the form of an epidermal rash.

Injections of the drug may cause local signs in the injection area. In the case of intravenous administration, signs of exanthema and anaphylaxis appear, and problems with the respiratory process develop.

Side effects include:

• Gastrointestinal tract lesions: increased gastric pH, bloating, vomiting, pain in the epigastric region, bowel disturbances and nausea;
• immune disorders: hyperhidrosis, hypersensitivity reactions, anaphylaxis and tachycardia occasionally develop.

Sometimes prolonged use of pyridoxine (at least 6 months) in doses greater than 50 mg per day can cause the patient to experience sensory neuropathy; a general feeling of malaise, severe nervous excitability, dizziness and headaches appear.

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Overdose

In case of significant excess of the recommended medicinal dosage of thiamine (over 10 g), the development of curare-like symptoms is observed and the conductivity of neural impulses is weakened.

Pyridoxine is a substance with a low toxicity index. After daily use in a dose of more than 50 mg for 0.5-1 year, signs of sensory neuropathy of a peripheral nature may develop.

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

When more than 2 g of the substance is administered per day over a long period of time, neuropathy with sensory disturbances and symptoms of ataxia, seborrheic dermatitis, convulsions (with changes in encephalogram readings) and hypochromasia may be observed.

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

Long-term administration of large doses of cyanocobalamin causes a disorder of the enzymatic activity of the liver, the development of pain in the heart and increased blood clotting (hypercoagulation).

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Interactions with other drugs

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

When combined with antacids, the absorption of thiamine is reduced.

Furosemide, as well as similar substances from the subcategory of loop diuretics, slow down the processes of tubular reabsorption, and in the case of prolonged use, increase the excretion of thiamine, due to which its levels in the body decrease.

Neurobion cannot be combined with Levodopa, because pyridoxine weakens its antiparkinsonian activity.

The administration of the drug together with substances that have an antagonistic effect on pyridoxine, as well as with oral contraception, increases the body's need to obtain vitamin B6.

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Storage conditions

Neurobion should be stored in a dark place, out of reach of children. Tablets should be kept at a maximum temperature of 25°C, and the solution should be kept within the range of 2-8°C.

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Shelf life

Neurobion is permitted to be used within a 3-year period from the date of production of the medicinal substance.

Application for children

There is no precise information regarding the medicinal efficacy of Neurobion when administered to children under 15 years of age.

It is prohibited to use in children under 3 years of age, because the drug contains benzyl alcohol, which increases the likelihood of developing diseases that cause a violation of the acid-base balance (or the development of metabolic acidosis).

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Analogues

Analogues of the drug are the drugs Vitaxon, Nerviplex, Complex B1/B6/B12 with Neurobex, and also Neuromultivit, Unigamma and Neurorubin.