Universal reference book for medicines
Name of the preparation: NEUROMULTIVIT ® (NEUROMULTIVIT)

Active substance: cyanocobalamin, pyridoxine, thiamine

Type: Complex of B vitamins

Manufacturer: VALEANT (Russia) manufactured by GLPHARMA (Austria)
Composition, form of production and packaging
The tablets covered with a film membrane of
white or almost white color, round, biconcave;
on a cross-section - from white to light pink color with impregnations from light pink to dark pink color.
1 tab.

thiamine hydrochloride (Vit B 1 ) 100 mg

pyridoxine hydrochloride (Vit B 6 ) 200 mg

cyanocobalamin (Vit B 12 ) 200 μg

Excipients: microcrystalline cellulose - 80 mg, magnesium stearate - 4.8 mg, povidone - 15 mg.

Sheath composition: Macrogol 6000-9 mg, titanium dioxide 11.25 mg, talc 30 mg, hypromellose 7.5 mg, methyl methacrylate and ethyl acrylate copolymer (1: 2) (dispersion 30%) 2.25 mg.

20 pcs.
- blisters (1) - packs of cardboard.
INSTRUCTION FOR THE SPECIALIST.

Description of the drug approved by the manufacturer for the printed edition of 2014.

PHARMACHOLOGIC EFFECT

Combined preparation of vitamins of group B.

Thiamine (vitamin B 1 ) in the human body as a result of phosphorylation processes is converted into cocarboxylase, which is the coenzyme of many enzyme reactions.
Thiamine plays an important role in the carbohydrate, protein and fat metabolism. Actively involved in the processes of conduction of nervous excitation in the synapses.
Pyridoxine (vitamin B 6 ) is necessary for the normal functioning of the central and peripheral nervous system.
In phosphorylated form it is a coenzyme in the metabolism of amino acids (including decarboxylation, transamination). Acts as a coenzyme of the most important enzymes that act in the nerve tissues. Participates in the biosynthesis of neurotransmitters, such as dopamine, norepinephrine, epinephrine, histamine and GABA.
Cyanocobalamin (vitamin B 12 ) is necessary for normal blood formation and erythrocyte maturation, and also participates in a number of biochemical reactions that ensure the vital activity of the organism (in the transfer of methyl groups, in the synthesis of nucleic acids, protein, in the exchange of amino acids, carbohydrates, lipids).
It influences the processes in the nervous system (the synthesis of RNA, DNA) and the lipid composition of cerebrosides and phospholipids. Coenzyme forms of cyanocobalamin - methylcobalamin and adenosylcobalamin - are necessary for replication and cell growth.
PHARMACOKINETICS

The components of the drug are water-soluble vitamins, which excludes the possibility of their cumulation in the body.

Suction and distribution

Thiamin and pyridoxine are absorbed in the upper intestine, the degree of absorption depends on the dose.

The absorption of cyanocobalamin is largely determined by the presence of an internal factor in the stomach and upper intestinal tract, then the delivery of cyanocobalamin to the tissue is carried out by transport protein transcobalamin II.

Metabolism

Thiamin, pyridoxine and cyanocobalamin are metabolized in the liver.

Excretion

Thiamine and pyridoxine are excreted by the kidneys (about 8-10% in unchanged form).
When an overdose is significantly increased the excretion of thiamine and pyridoxine through the intestine.
Cyanocobalamin is excreted mainly with bile, the degree of excretion by the kidneys is variable - from 6 to 30%.

INDICATIONS

In the complex therapy of the following neurological diseases:

- polyneuropathy of various etiologies (including diabetic, alcoholic);

- intercostal neuralgia;

- trigeminal neuralgia;

- radicular syndrome caused by degenerative changes in the spine;

cervical syndrome;

- Shoulder-scapular syndrome;

- lumbar syndrome;

- Lumboeishalgia.

DOSING MODE

Assign inside 1 tab.
1-3 times / day. The duration of the course is determined individually.
Tablets should be taken after meals, without chewing and washing down with a small amount of liquid.

SIDE EFFECT

In isolated cases: nausea, tachycardia, skin reactions in the form of itching and urticaria.

The drug is well tolerated.

CONTRAINDICATIONS

- Children's age (effectiveness and safety of the drug are not investigated);

- Hypersensitivity to the components of the drug.

PREGNANCY AND LACTATION

Do not recommend Neuromultiv ® in pregnancy and lactation (breastfeeding) due to the lack of reliable clinical data confirming the safety of the drug during these periods.

APPLICATION FOR CHILDREN

Contraindicated in childhood.

SPECIAL INSTRUCTIONS

Do not recommend using the drug in high doses for more than 4 weeks.

Cyanocobalamin can mask the symptoms of folic acid deficiency.

OVERDOSE

Symptoms: The clinical symptoms of an overdose of vitamins contained in Neuromultivit ® can be expected only after taking exceptionally high doses for a very long time.

Vitamin B 1 - no symptoms of an overdose after oral administration.

Vitamin B 6 - after taking more than 2 g / day described neuropathy with ataxia and sensitivity disorders, seizures with EEG changes and, in some cases, hypochromic anemia and seborrheic dermatitis.

Vitamin B 12 - after parenteral administration (in rare cases and after ingestion), eczematous skin and acne changes were observed.

Treatment: symptomatic therapy.

DRUG INTERACTION

With the simultaneous use of Neuromultivit ® and levodopa, there is a decrease in the antiparkinsonian efficacy of levodopa.

When combined with Neuromultiv® and ethanol, the absorption of thiamine, which is part of the drug, drops sharply (the blood level may drop by 30%).

During treatment with the drug Neuromultivit ® is not recommended the use of multivitamin complexes, which include vitamins of group B.

TERMS OF RELEASE FROM PHARMACY

The drug is released by prescription.

TERMS AND CONDITIONS OF STORAGE

The drug should be stored out of reach of children, dry, protected from light at a temperature of no higher than 25 ° C.
Shelf life - 3 years.
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