Neurorubine-Forte Lactab 20 tablets — Made in Switzerland — Free Delivery

Pharmacological properties

Pharmacodynamics. Neurorubine-forte lactab contains high doses of 3 vitamins: B1, B6, B12, which play an important role in the normal functioning of the nervous system. each of them is necessary to ensure optimal metabolism in nerve cells. in addition, when used in high doses, these vitamins have an analgesic effect.

Like all other vitamins, they are essential nutrients that cannot be synthesized directly in the body.

Therapeutic introduction of vitamins B1, B6 and B12 into the body replenishes the insufficient intake of vitamins from food, which ensures the presence of the required amount of coenzymes in the body. B vitamins are components of enzyme systems that regulate protein, lipid and carbohydrate metabolism. Each of the B vitamins plays a specific biological role. Their presence in the body in a balanced amount is necessary for normal metabolism.

The therapeutic use of these vitamins in various diseases of the nervous system is aimed, on the one hand, to compensate for the simultaneously existing deficiency (possibly due to an increase in the body's needs, caused directly by the disease) and, on the other hand, to stimulate the natural mechanisms of recovery.

Vitamins B1, B6 and B12 have very low toxicity and have no potential risk to humans. To date, there is no data on the carcinogenic, mutagenic or teratogenic properties of these vitamins.

Pharmacokinetics.

Thiamine nitrate (vitamin B1) is absorbed in the small intestine, duodenum and colon with the participation of an active transport system. After application, the active substance penetrates the intestinal mucosa, and then enters the liver through the portal vein. Part of the assimilated thiamine takes part in enterohepatic circulation. The main metabolites of thiamine excretion are thiamincarboxylic acid and pyramine (2,5-dimethyl-4-aminopyrimidine).

Pyridoxine hydrochloride (vitamin B6) is rapidly absorbed in the intestines. In the body, pyridoxine is oxidized to pyridoxal and aminated to pyridoxamine. The condition for its functioning as a coenzyme is phosphorylation at the CH2OH group in the 5th position, that is, the formation of pyridoxal-5-phosphate (PALP). In the blood, about 80% of PALP is associated with proteins. Pyridoxine accumulates mainly in muscles in the form of PALP. The main metabolite that is released is 4-pyridoxinic acid.

Cyanocobalamin (vitamin B12). In a healthy person, the absorption of cyanocobalamin is limited and depends on the concentration of "intrinsic Castle factor". A certain amount of vitamin B12 is absorbed in a free state, but the bulk is absorbed only after binding with the "intrinsic Castle factor".

After absorption, vitamin B12 binds in blood plasma with specific B12-binding β (transcobalamin) and B12-binding α1-globulin.

The accumulation of vitamin B12 occurs mainly in the liver. T½ from blood plasma is approximately 5 days, and from liver - about 1 year.

Indications

Concomitant therapy of pain syndromes caused by:

• acute or chronic neuritis, polyneuritis and neuralgia;
• toxic lesions of the nervous tissue in alcoholism, preparation intoxication, diabetic polyneuropathy.

Application

Administered orally before or during meals, without chewing, drinking plenty of water. the usual adult dose is 1-2 tablets per day. the course of treatment is 4 weeks. treatment can be continued at the discretion of the physician.

Contraindications

Hypersensitivity to any component of the preparation.

Vitamin B1 is contraindicated in allergic diseases.

Vitamin B6 is contraindicated in gastric and duodenal ulcers in the acute stage, since the acidity of gastric juice may increase.

Vitamin B12 is contraindicated in erythremia, erythrocytosis, thromboembolism.

Side effects

From the immune system: hypersensitivity reactions, anaphylactic shock, anaphylaxis. allergic reactions are very rare.

From the endocrine system: inhibition of prolactin release.

From the nervous system: anxiety; long-term use (more than 6-12 months) of vitamin B6 in doses of 50 mg daily can lead to peripheral sensory neuropathy, nervous excitement, malaise, headache, and dizziness.

From the side of the cardiovascular system: tachycardia, collapse.

Respiratory, chest and mediastinal disorders: cyanosis, pulmonary edema, respiratory failure.

From the digestive tract: gastrointestinal disorders, including nausea, vomiting, diarrhea, abdominal pain, increased gastric acidity, hemorrhage.

From the hepatobiliary system: high doses can lead to an increase in the level of AST in the blood plasma.

On the part of the skin and subcutaneous tissue: rash, skin reactions, including itching, urticaria, acne, acne.

On the part of the kidneys and urinary system: chromaturia.

Other violations:

• increased sweating, feeling of weakness, dizziness, malaise, feeling of constriction in the throat.

Special instructions

As a result of hypersensitivity to vitamins B1, B6 and B12 during treatment, reactions from the skin and subcutaneous tissue may occur.

Pyridoxine can cause acne or acne or increase the severity of existing ones.

With the introduction of vitamin B12, the clinical picture, as well as laboratory tests for funicular myelosis or pernicious anemia, may lose their specificity.

Drinking alcohol and black tea decreases the absorption of thiamine.

Drinking beverages containing sulfites (such as wine) increases the degradation of thiamine.

Since the preparation contains vitamin B6, it should be used with caution in patients with a history of gastric ulcer and duodenal ulcer, severe renal and liver dysfunction.

In patients with neoplasms, with the exception of cases accompanied by megaloblastic anemia and vitamin B12 deficiency, the preparation should not be used.

The preparation should not be taken in case of severe or acute decompensation of cardiac activity and angina pectoris.

Use during pregnancy and lactation.

The preparation can be prescribed only after a careful assessment of the balance of benefits and risks, since there is insufficient data on the safety of using the preparation during pregnancy.

Vitamins B1, B6 and B12 are excreted in breast milk. High concentrations of vitamin B6 can suppress milk production.

Studies of the degree of excretion of vitamins in breast milk have not been conducted. The decision to stop breastfeeding or to stop using the preparation should be made taking into account the need for the mother to take the preparation. If necessary, the use of the preparation should stop breastfeeding for this period.

Children. Do not prescribe the preparation to children, since there is no experience of use in pediatric practice.

The ability to influence the reaction rate when driving or working with other mechanisms.

The preparation does not affect the ability to drive vehicles or operate complex mechanisms.

If dizziness is observed during treatment, you should refrain from driving and working with mechanisms.

Interactions

The action of thiamine is inactivated by 5-fluorouracil, since the latter competitively inhibits the phosphorylation of thiamine into thiamine pyrophosphate.

Isoniazid toxicity may increase.

Antacids, alcohol and tea slow down the absorption of vitamin B1.

Loop diuretics, such as furosemide, which inhibit tubular reabsorption, may increase thiamine excretion with prolonged therapy and therefore decrease thiamine levels.

Concomitant use with pyridoxine antagonists (for example, isoniazid, hydralazine, penicillamine or cycloserine), oral contraceptives may increase the need for vitamin B6.

Pyridoxine may decrease the effectiveness of altretamine.

Simultaneous use with levodopa is contraindicated, since vitamin B6 can reduce the antiparkinsonian effect of levodopa. Concomitant use with pyridoxine antagonists (for example, isoniazid, hydralazine, penicillamine or cycloserine), oral contraceptives may increase the need for vitamin B6.

Overdose

Vitamin B1: has a wide therapeutic range. very high doses (more than 10 g) have a curariform effect, suppressing the conduction of nerve impulses.

Vitamin B6: very low in toxicity.

With prolonged intake (more than 6-12 months) daily doses exceeding 50 mg of vitamin B6, as well as with short-term intake (more than 2 months) more than 1 g of vitamin B6 per day, neuropathies were observed.

Neuropathies with ataxia and sensory disturbances, cerebral convulsions with changes in the EEG, as well as, in some cases, hypochromic anemia and seborrheic dermatitis have been described after administration of more than 2 g / day.

Vitamin B12: after parenteral administration (in rare cases, after oral administration) of the preparation in doses exceeding the recommended ones, allergic reactions, eczematous skin disorders and a benign form of acne were observed.

With prolonged use in high doses, a violation of the activity of liver enzymes, pain in the region of the heart, hypercoagulation are possible.

Therapy for oral intoxication: elimination of a toxic substance (induce vomiting, rinse the stomach), measures to reduce absorption (use of activated carbon).

Storage conditions

At temperatures up to 25 ° C.