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Use of drugs from other groups in the treatment of back pain
Last reviewed: 08.07.2025
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Nonivamide Vicoboxil (Nonivamide + Nicoboxil)
Ointment for external use
Pharmacological action
Combination drug. Nonivamide is a synthetic analogue of capsaicin (the hot ingredient in hot red pepper); it has an analgesic effect due to the gradual penetration of the substance into peripheral nociceptive C-fibers and A-delta nerve fibers. Nicoboxil has a direct vasodilating effect.
The preparation improves local blood flow in the skin and underlying tissues, has a warming effect. The effect begins a few minutes after application and reaches its maximum after 20-30 minutes.
Indications for use
Diseases of the musculoskeletal system of traumatic and inflammatory genesis: arthritis, arthralgia, bursitis, tendovaginitis, soft tissue contusion, sprains of the muscular-ligamentous apparatus, myalgia (including that caused by excessive physical exertion), osteochondrosis of the spine with radicular syndrome, neuralgia, lumbago, sciatica, sports injuries, peripheral circulatory disorders (as part of complex therapy).
Flupirtine (Flupirtine)
Capsules
Pharmacological action
Non-opioid analgesic of central action, selective activator of neuronal Kr-channels. Due to indirect antagonism in relation to NMDA-receptors, activating descending mechanisms of pain modulation and GABA-ergic processes, it has analgesic, muscle relaxant and neuroprotective effects.
At therapeutic concentrations, it does not bind to alpha1- and alpha2-adrenergic receptors, 5HT1- and 5HT2-serotonin, dopamine, benzodiazepine, opioid, or central cholinergic receptors.
In therapeutic doses, it activates potential-independent K+ channels, which leads to stabilization of the membrane potential of the nerve cell. This inhibits the activity of NMDA receptors (N-methyl-O-aspartate receptors) and, as a consequence, blocks neuronal Ca2+ channels, reduces the intracellular Ca2+ current, and inhibits neuron excitation in response to nociceptive stimuli (analgesia). As a result of these processes, the formation of nociceptive (pain) sensitivity and the "wind up" phenomenon is inhibited, which prevents pain from increasing, becoming chronic, and, in the case of an existing chronic pain syndrome, leads to a decrease in its intensity. It has also been established that flupirtine has a modulating effect on pain perception (sensitivity) via the descending noradrenergic system.
The muscle relaxant effect is associated with blocking the transmission of excitation to motor neurons and intermediate neurons, leading to a decrease in muscle tension.
The neuroprotective properties of the drug ensure protection of nerve structures from the toxic effects of high concentrations of intracellular Ca2+, which is associated with its ability to cause blockade of neuronal Ca2+ channels and reduce the intracellular Ca2+ current.
Indications for use
Pain syndrome (acute and chronic): muscle spasm, malignant neoplasms, algomenorrhea, headache, post-traumatic pain, trauma/orthopedic surgeries and interventions.
Attention!
To simplify the perception of information, this instruction for use of the drug "Use of drugs from other groups in the treatment of back pain" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.