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Instructions for use NEUROBEX

Combined preparation of B vitamins.

The combination of neurotropic B vitamins in Neurobex® is used to influence a number of important processes and functions of the body, mainly inflammatory and degenerative diseases of the nerves and musculoskeletal system. B vitamins are part of enzymes that catalyze metabolic reactions of carbohydrates, fats and proteins.

The physiological functions of vitamin B1 are multifaceted. After absorption in the body, it is converted into thiamine pyrophosphate, which is a cofactor for the enzyme carboxylase, which is involved in the decarboxylation of pyruvic and alpha-ketoglutaric acid. For this reason, vitamin B1 is intensively consumed when consuming carbohydrates. It is related to the activity of the nervous and neuromuscular system, facilitating the biosynthesis of the main mediator acetylcholine and suppressing the activity of the enzyme cholinesterase, which breaks it down. Vitamin B deficiency leads to the accumulation of lactic and pyruvic acid, which may result in the development of polyneuritis, beriberi disease, Wernicke encephalopathy and Korsakoff syndrome, polyneuropathy, cardiac dysfunction, gastrointestinal lesions (ulcerative colitis, chronic diarrhea).

The physiological functions of vitamin B6 as a coenzyme include inclusion in some metabolic transformations of amino acids - decarboxylation, transamination and racemization, as well as enzymatic transformations in the metabolism of sulfate-containing substances and hydroxyamino acids. It takes part in the conversion of tryptophan to 5-hydroxytryptamine in the synthesis of dopamine, norepinephrine, adrenaline, histamine and GABA. The conversion of methionine to cysteine also depends on the vitamin. It takes part in regulating the function of the liver and nervous system, and enhances erythropoiesis in some forms of anemia. Vitamin B6 deficiency is possible due to insufficient intake with food, impaired absorption in the intestine, when taking medications that are its antagonists, or during radiation therapy. Symptoms of deficiency are manifested by the appearance of seborrhea-like lesions around the eyes, nose, glossitis, stomatitis; peripheral neuritis, seizures (due to low concentrations of gamma-aminobutyric acid), very rarely anemia.

The physiological role of the active vitamin B12 coenzymes methylcobalamin and 5-deoxyadenosylcobalamin is essential for cell growth and replication. Methylcobalamin is necessary for the formation of methionine and its derivatives S-adenoylmethionine from homocysteine. It takes part in the processes of transmethylation and transfer of hydrogen cations during the synthesis of choline, methionine, creatinine and nucleic acids. Vitamin B12 plays an important role in hematopoietic processes (especially in the maturation of red blood cells). When the vitamin is deficient, methyltetrahydrofolate absorbs folate and leads to folate deficiency for other intracellular forms of folic acid necessary for red blood cell maturation. It has a beneficial effect on the functions of the liver and nervous system. Vitamin B12 deficiency is manifested by symptoms from the hematopoietic and nervous systems. Hematopoiesis becomes ineffective, and erythropoiesis becomes megaloblastic, and in severe cases pancytopenia develops. Irreversible damage can occur in the nervous system - demyelination, death of neurons in the spinal cord and cerebral cortex, which is manifested by paresthesia of the limbs, instability of gait, disturbance of some reflexes and, in a later stage, mental confusion, hallucinations, rapid mood swings, loss of memory, vision and even psychosis.

Neurobex Neo capsules No. 10x10

Name

Neurobex Neo caps. in blister pack No. 10x10

Description

Black/orange gelatin capsules.

Main active ingredient

Pyridoxine+thiamine+cyanocobalamin

Release form

Capsules

Pharmacological properties

The combination of vitamins B, PP and C in Neurobex® Neo is used to influence a number of important processes and functions of the body and mainly on inflammatory and degenerative diseases of the nerves and musculoskeletal system, and provides increased needs of the body during infectious diseases, after chemotherapy and radiotherapy. All active components of the drug are quickly absorbed in the small intestine and distributed throughout the body. They are excreted mainly in urine. Since all the vitamins of Neurobeks Neo are water-soluble, they do not accumulate in the body.

Indications for use

The drug Neurobeks Neo is used in the treatment of neurological disorders caused by vitamin deficiency, which cannot be eliminated by correcting nutrition.

Directions for use and doses

The drug is taken 1 capsule 1 time per day during or after meals, without chewing, with a sufficient amount of liquid. The duration of treatment is determined by the doctor. If symptoms persist for 4 weeks during treatment, you should consult a doctor. If you forget to take Neurobex® Neo, take the capsule as soon as possible before it is time for your next dose. If it is time for your next dose of medication, do not take the missed dose. Do not double the dosage of the drug to compensate for the missed one! Next, the drug is used according to the recommended dosage regimen.

Use during pregnancy and lactation

During pregnancy and lactation, the recommended daily dose for vitamin B1 is 1.4-1.6 mg and vitamin B6 is 2.4-2.6 mg. During pregnancy, these doses can only be exceeded after a careful assessment of the benefit/risk ratio, since the safety of using vitamins B1 and B6 above the recommended daily dose has not yet been proven. Vitamin B1, B6 and B12 pass into breast milk. Taking high doses of vitamin B6 may inhibit milk production. The use of this drug during pregnancy and lactation is possible only after a careful assessment of the risk-benefit ratio.

Impact on the ability to drive vehicles and operate equipment

The drug does not affect the ability to drive a car or use equipment.

Precautionary measures

It should be used with extreme caution in patients with severe and acute forms of decompensated heart failure and angina. The drug is not recommended to be prescribed together with other medications that contain vitamins, since an overdose of the latter in the body is possible. Patients prone to hyperoxaluria, due to the possible increase in oxalate excretion, are not recommended to take ascorbic acid in a dose of more than 1 g. Increased intake of ascorbic acid over a long period may lead to an increase in the renal clearance of ascorbic acid with subsequent development of deficiency with a decrease in intake or quick cancellation. When conducting tests (determination of glucose, creatinine, uric acid in urine), it is necessary to take into account the possibility of the influence of ascorbic acid on obtaining distorted test results. The use of high doses of ascorbic acid can lead to false-negative results when determining occult blood in the stool. The use of Neurobex Neo is not recommended for children (it is recommended to use Neurobex tablets).

Interaction with other drugs

Ethyl alcohol sharply reduces the absorption of thiamine. Thiamine is inactivated by 5-fluorouracil as a result of the latter's competitive inhibition of thiamine phosphorylation. Long-term treatment with furosemide may increase renal excretion of thiamine. Vitamin B6 affects the metabolism of certain medications. High doses of vitamin B6 reduce the antiparkinsonian effect of levodopa. This vitamin enhances the peripheral decarboxylation of levodopa and thus reduces its effectiveness in the treatment of Parkinson's disease. It is an antagonist of isoniazid and thiosemicarbazones, correcting sideroblastic anemia caused by these anti-tuberculosis drugs. Long-term use of penicillamine can lead to the development of vitamin B6 deficiency. Hydralazine and cycloserine are also its antagonists, and the simultaneous use of the vitamin with them reduces the adverse neurological reactions caused by these drugs. The amount of vitamin B6 decreases when taken simultaneously with oral contraceptives. Colchicine, ethyl alcohol and neomycin inhibit the absorption of vitamin B12. Oral antidiabetic drugs of the biguanidine type, p-aminosalicylic acid, as well as chloramphenicol and vitamin C interfere with the absorption of the vitamin. Vitamin C increases the half-life of paracetamol, increases the rate of iron absorption and increases the renal excretion of amphetamine. Plasma ascorbate concentrations decrease with smoking and oral contraceptives. In renal failure, oral vitamin C increases the absorption of aluminum, the concentration of which can reach toxic levels. The simultaneous use of aluminum hydroxide and ascorbic acid may provoke an increase in aluminum absorption in patients with normal renal function. Concomitant use of ascorbic acid with amygdalin (alternative medicine) may result in cyanide toxicity. Ascorbic acid can be used in conjunction with deferoxamine to increase iron excretion. However, in the early stages of treatment, when there is excess iron in the tissues, there is some evidence that ascorbic acid may increase iron toxicity, especially in the heart. Therefore, ascorbic acid should not be prescribed within the first month after starting deferoxamine treatment.

Contraindications

Hypersensitivity to the active substances or to any of the excipients in the drug.
Acute thromboembolism.
Erythrosis and erythremia.
Hyperoxaluria.
Glucose-6-phosphate dehydrogenase deficiency.
Malignant tumors.

Compound

Active ingredients in one capsule, mg: Thiamine nitrate 50 Riboflavin 25 Pyridoxine hydrochloride 10 Cyanocobalamin 0.005 Nicotinamide 100 Calcium pantothenate 25 Folic acid 0.5 Ascorbic acid 175 Excipients potato starch, aerosil, talc, magnesium stearate, anhydrous calcium hydrogen phosphate and gelatin new capsule ( gelatin, ponzo 4P (E124), quinoline yellow (E104), sunset yellow (E110), titanium dioxide (E171), brilliant black (E151))

Overdose

A single dose of vitamin B6 less than 500 mg is safe. Overdose may lead to a decrease in serum folate concentrations. With long-term use, at a dose of 200 mg per day, sensory neuropathy is possible. Acute overdose of nicotinamide is not accompanied by serious side effects, but transient liver dysfunction may occur. Large doses of vitamin C can cause diarrhea and the formation of oxalate stones in the kidneys. In case of an overdose, the symptoms of side effects of the drug increase. Nervous excitement, tachycardia, and pain in the heart area may occur. Treatment includes gastric lavage, administration of activated carbon, and the use of symptomatic agents.

Side effect

Neurobex® Neo is generally well tolerated. In rare cases, increased sweating, tachycardia, itching, urticaria are possible; in isolated cases, allergic reactions, rashes, suffocation and the development of anaphylactic shock are possible. Significant doses of vitamins included in the drug can change the color of urine and change some laboratory parameters during urine analysis. The development of photosensitivity has been reported when using high daily doses of B vitamins. From the digestive system: nausea, vomiting, discomfort in the stomach. High doses of ascorbic acid can cause diarrhea and hyperoxalaturia. Ascrbic acid may cause the development of hemolytic anemia in some patients with glucose-6-phosphate dehydrogenase deficiency. If side effects occur, tell your doctor. This applies to all possible side effects, including those not described in this leaflet.

Storage conditions

At a temperature of 15-25°C in a place protected from light and moisture. Keep out of reach of children. The drug should not be used after the expiration date indicated on the package. Shelf life – 3 years from the date of issue.

Neurobeks p/o tablets in jars No. 90 No. 1

Name

Neurobeks tablet p/o in bank No. 90 in unitary enterprise No. 1

Main active ingredient

Pyridoxine + thiamine + cyanocobalamin.

Release form

Pills.

pharmachologic effect

Neurobex® is a combined preparation containing B vitamins. They are part of enzymes that catalyze metabolic reactions of carbohydrates, fats and proteins. A combination of B vitamins is used to influence a number of important processes and functions in the body and, mainly, inflammatory and degenerative diseases of the nerves and musculoskeletal system.

Indications for use

Indications for use Combined deficiency of vitamins B1, B6, B12. In the complex treatment of neurological and skin diseases and conditions associated with proven clinical or subclinical deficiency of vitamins B1, B6, B12, such as: nonspecific inflammatory and degenerative processes in peripheral nerves - neuritis, polyneuritis (alcoholic, post-infectious, toxic, diabetes); neuralgia, myalgia, paresthesia; dermatitis, eczema, psoriasis, acne vulgaris, atopic dermatitis.

Directions for use and doses

Neurobex® is taken orally during or after meals with water. The usual dose is 1-2 tablets 1-3 times a day for 30 days. The individual dose and duration of treatment are determined by the doctor. Elderly patients Usually no dose adjustment is required for elderly patients. Impaired renal function No dosage adjustment is required in patients with impaired renal function. Impaired liver function No dosage adjustment is required in patients with impaired liver function. If you have the impression that Neurobex® is too weak or too strong, consult your doctor or pharmacist. If you miss one dose of the drug, take it at your next regular dose without increasing the dose.

Use during pregnancy and lactation

There is no data on the negative effects of Neurobex on the fetus and child during pregnancy and lactation. Vitamins penetrate the placental barrier and are excreted from the body through breast milk. Due to the lack of sufficient information, the use of the drug is possible only if absolutely necessary, in recommended doses, as prescribed and under the supervision of a physician, after assessing the benefit/risk ratio, if the benefit outweighs the risk. It should be taken into account that in high doses, pyridoxine may interfere with the secretion of prolactin and should be used with caution in nursing mothers. Use in large quantities during pregnancy may lead to pyridoxine dependence syndrome in newborns.

Precautionary measures

Neurobex® should be used with extreme caution in patients with severe and acute forms of decompensated heart failure and angina. During treatment with this drug, you should not drink alcohol, since the ethanol it contains reduces the amount of vitamin B1 absorbed in the intestines. If the signs of the disease do not begin to subside, or, on the contrary, your health condition worsens, or if undesirable effects appear, consult your doctor for advice regarding further use of the drug! The tablets are not intended for use in children under 6 years of age, as this group of patients may have difficulty swallowing medications in the form of tablets and capsules.

Interaction with other drugs

If you are taking any other medications, be sure to inform your doctor about this, and if you are treating yourself, consult your doctor or pharmacist about the possibility of using the drug! Ethyl alcohol sharply reduces the absorption of vitamin B1. Vitamin B6 affects the metabolism of certain medications. Concomitant use of chloramphenicol, cycloserine, ethionamide, hydralazine, isoniazid, penicillamine, or immunosuppressants with pyridoxine may result in anemia or peripheral neuritis as these agents may act as pyridoxine antagonists or increase renal excretion of pyridoxine. Patients receiving these drugs may have increased requirements for pyridoxine. Concomitant use of estrogens may increase pyridoxine requirements. Concomitant use of levodopa with pyridoxine is not recommended because the antiparkinsonian effects of levodopa are reduced by oral pyridoxine in doses exceeding daily requirements. This problem does not arise if levodopa is combined with the peripheral decarboxylase inhibitor carbidopa. Serum levels of cyanocobalamin may be reduced by oral contraceptives. These interactions are unlikely to be of clinical significance. Antimetabolites and most antibiotics distort the results of vitamin B12 blood tests using microbiological methods. Para-aminosalicylic acid, colchicine, biguanides, neomycin, cholestyramine, potassium chloride, methyldopa and cimetidine may reduce the absorption of vitamin B12. Patients treated with chloramphenicol may respond poorly to cyanocobalamin.

Contraindications

Neurobex® is not used for: allergies to the active substances or any of the excipients in the composition of the drug; acute thromboembolism (blockage of a vessel by a blood clot); erythrocytosis and erythremia (blood diseases caused by an increase in the number of red blood cells).

Compound

Active ingredients in one coated tablet: Thiamine nitrate (vitamin B1) 15 mg, Pyridoxine hydrochloride (vitamin B6) 10 mg, Cyanocobalamin (vitamin B12) 0.02 mg. Excipients: lactose monohydrate, wheat starch, talc, magnesium stearate, colloidal silicon dioxide, povidone. Shell composition: collicoate protect (copolymer of polyvinyl alcohol and polyethylene glycol, polyvinyl alcohol, silicon dioxide), titanium dioxide, talc, cochineal red varnish E124. Information on excipients This medicinal product contains lactose as an excipient and should not be used in patients with lactase deficiency, galactose intolerance or glucose-galactose malabsorption syndrome. Due to the presence of wheat starch in the drug, it should not be taken by patients with an allergy to wheat (different from celiac disease). The medicine is suitable for patients with celiac disease (celiac disease). Dye E124, which is part of the drug, can cause allergic reactions.

Overdose

Symptoms: In case of overdose, the symptoms of side effects of the drug increase. Nervous excitement, tachycardia, and pain in the heart area may occur. Treatment: Treatment includes gastric lavage, administration of activated carbon, and the use of symptomatic agents. Isoniazid is an antidote to vitamin B6.

Side effect

Neurobex® is generally well tolerated. In rare cases, increased sweating, tachycardia, itching, and urticaria are possible. In isolated cases, allergic reactions may occur: rash, suffocation and anaphylactic shock. Severe sensory neuropathy has been described in patients taking high doses of pyridoxine (2 g to 6 g per day) for 2 to 40 months. Sensory peripheral neuropathy is also possible with prolonged use of daily doses of 200 mg or lower. If the listed adverse reactions occur, as well as reactions not listed in the instructions, you should consult a doctor.

Storage conditions

At a temperature not exceeding 25°C. Keep out of the reach of children!