Compound
The composition of 1 ml of Combilipen solution includes the following active ingredients: thiamine hydrochloride - 50 mg, pyridoxine hydrochloride - 50 mg, cyanocobalamin - 500 mcg, lidocaine hydrochloride - 10 mg.
As excipients: benzyl alcohol, sodium hydroxide, potassium hexacyanoferrate, sodium tripolyphosphate, water for injection. The composition of 1 tablet of the drug includes: pyridoxine hydrochloride - 100 mg, benfotiamine - 100 mg, cyanocobalamin - 2 mcg. As excipients: carmellose sodium, microcrystalline cellulose, povidone K30, calcium stearate, talc, polysorbate, sucrose.
Combilipen®
Thiamine
After intramuscular administration, thiamine is quickly absorbed from the injection site and enters the blood (484 ng/ml after 15 minutes on the first day of administration of a 50 mg dose) and is unevenly distributed in the body with its content in leukocytes 15%, erythrocytes 75% and in blood plasma 10 %. Due to the lack of significant reserves of the vitamin in the body, it must be supplied to the body daily.
Thiamine penetrates the blood-brain and placental barriers and is found in breast milk. Thiamine is excreted by the kidneys in the alpha phase after 0.15 hours, in the beta phase after 1 hour, and in the final (terminal) phase within 2 days. The main metabolites are: thiaminecarboxylic acid, pyramine and some unknown metabolites. Of all the vitamins, thiamine is stored in the body in the smallest quantities. The adult human body contains about 30 mg of thiamine: 80% in the form of thiamine pyrophosphate. 10% in the form of thiamine triphosphate and the rest in the form of thiamine monophosphate.
Pyridoxine
After intramuscular injection, pyridoxine is quickly absorbed from the injection site and distributed in the body, acting as a coenzyme after phosphorylation of the CH2OH group at the 5th position. About 80% of the vitamin binds to blood plasma proteins. Pyridoxine is distributed throughout the body, penetrates the placenta, and is found in breast milk. It accumulates in the liver and is oxidized to 4-pyridoxic acid, which is excreted by the kidneys within a maximum of 2-5 hours after absorption.
The human body contains 40-150 mg of vitamin B6 and its daily elimination rate is about 1.7-3.6 mg with a replacement rate of 2.2-2.4%.
Cyanocobalamin
Cyanocobalamin, after intramuscular administration, binds to transcobalamins I and II and is transported to various tissues of the body. The maximum concentration after intramuscular administration is achieved after 1 hour. Communication with blood plasma proteins - 90%. Penetrates the placental barrier and is found in breast milk. Metabolized primarily in the liver to form adenosylcobalamin, which is the active form of cyanocobalamin. It is deposited in the liver, enters the intestines with bile and is reabsorbed into the blood (the phenomenon of enterohepatic recirculation).
The half-life is long, excreted mainly by the kidneys (7-10%) and through the intestines (50%). With a decrease in renal function, 0-7% is excreted by the kidneys and 70-100% through the intestines.
Lidocaine
When administered intramuscularly, the maximum plasma concentration of lidocaine is observed 5-15 minutes after injection. Depending on the dose, about 60-80% of lidocaine is bound to plasma proteins. Quickly distributed (within 6-9 minutes) in organs and tissues with good perfusion, incl. heart, lungs, liver, kidneys, then in muscle and adipose tissue. Penetrates the blood-brain and placental barriers and is found in breast milk (up to 40% of the concentration in the mother's blood plasma).
Metabolized in the liver with the participation of microsomal enzymes with the formation of active metabolites - monoethylglycine xylide and glycine xylide. having a half-life of 2 and 10 hours, respectively. Metabolic intensity decreases in liver diseases. It is excreted mainly in the form of metabolites by the kidneys and up to 10% unchanged.
pharmachologic effect
The drug is a multivitamin complex, which includes several components.
Thiamine hydrochloride (vitamin B1) provides glucose to the body's nerve cells. Lack of glucose leads to deformation and subsequent enlargement of nerve cells, which ultimately provokes a violation of their immediate functions.
Pyridoxine hydrochloride (vitamin B6) is directly involved in the metabolic processes of the central nervous system. It ensures the normalization of the conduction of nerve impulses, excitation and inhibition, and also takes part in the synthesis of catecholamines ( adrenaline , norepinephrine ) and in the transport of sphingosine (a component of the nerve sheath).
Cyanocobalamin (vitamin B12) is involved in the production of choline, the main substrate for the synthesis of acetylcholine (acetylcholine is a neurotransmitter that takes part in the conduction of nerve impulses), hematopoiesis (promotes the maturation of red blood cells and ensures their resistance to hemolysis). Cyanocobalamin is also involved in the synthesis of nucleic acids , folic acid , and myelin . It increases the ability of body tissues to regenerate.
Pharmacology
Several elements act as components.
Vitamin B1 saturates nerve cells with glucose. The lack of this substance causes damage to nerve cells and their subsequent increase. As a result, this negatively affects the nervous system.
Vitamin B6 is involved in metabolic processes in the central nervous system. It normalizes nerve impulses, stabilizes inhibition and agitation.
Vitamin B12 takes part in the production of choline and nucleic acids. This element increases the ability of tissues to recover.
It also contains lidocaine, which has an analgesic effect. The substance promotes vasodilation, which ensures better absorption of vitamins.
There is currently no information on pharmacodynamics and pharmacokinetics.
Indications for use of Kombilipen
Indications for the use of this drug are a number of neurological diseases:
- trigeminal neuralgia;
- inflammation of the facial nerve;
- polyneuropathy , which has different origins: diabetic and alcoholic;
- pain in patients suffering from spinal diseases: intercostal neuralgia , lumbar and cervical syndrome , cervicobrachial syndrome , radicular syndrome , pathological changes in the spine.
The price and reviews of the drug’s effect on the treatment of these diseases indicate its high effectiveness when used in complex therapy.
Combilipen tabs 60 pcs. film-coated tablets
pharmachologic effect
Replenishes the deficiency of B vitamins.
Composition and release form Combilipen tabs 60 pcs. film-coated tablets
Film-coated tablets - 1 tablet:
- active ingredients: benfotiamine - 100 mg; pyridoxine hydrochloride - 100 mg; cyanocobalamin - 2 mcg;
- core: carmellose sodium - 4.533 mg; povidone K30 - 16.233 mg; MCC - 12.673 mg; talc - 4.580 mg; calcium stearate - 4.587 mg; polysorbate 80 - 0.66 mg; sucrose - 206.732 mg;
- film shell: hypromellose - 3.512 mg; macrogol 4000 - 1.411 mg; low molecular weight povidone - 3.713 mg; titanium dioxide - 3.511 mg; talc - 1.353 mg.
Film-coated tablets. In blister pack, 15 pcs. 1, 2, 3 or 4 blister packs in a cardboard pack.
Description of the dosage form
Tablets: round, biconvex, film-coated, white or almost white.
Directions for use and doses
The tablets should be taken after meals, without chewing and with a small amount of liquid.
Adults: 1 tablet 1-3 times a day.
The duration of the course is as recommended by the doctor. Treatment with high doses of the drug for more than 4 weeks is not recommended.
Pharmacodynamics
Combined multivitamin complex. The effect of the drug is determined by the properties of the vitamins included in its composition.
Benfotiamine, a fat-soluble form of thiamine (vitamin B1), is involved in the conduction of nerve impulses.
Pyridoxine hydrochloride (vitamin B6) - participates in the metabolism of proteins, carbohydrates and fats, is necessary for normal hematopoiesis, the functioning of the central nervous system and the peripheral nervous system. Provides synaptic transmission, inhibition processes in the central nervous system, participates in the transport of sphingosine, which is part of the nerve sheath, and participates in the synthesis of catecholamines.
Cyanocobalamin (vitamin B12) - is involved in the synthesis of nucleotides and is an important factor in normal growth, hematopoiesis and development of epithelial cells; necessary for folic acid metabolism and myelin synthesis.
Pharmacokinetics
Pharmacokinetic data not provided.
Indications for use Combilipen tabs 60 pcs. film-coated tablets
It is used in complex therapy of the following neurological diseases:
- trigeminal neuralgia;
- neuritis of the facial nerve;
- pain syndrome caused by diseases of the spine (intercostal neuralgia, lumboischialgia, lumbar syndrome, cervical syndrome, cervicobrachial syndrome, radicular syndrome caused by degenerative changes in the spine);
- polyneuropathy of various etiologies (diabetic, alcoholic).
Contraindications
- hypersensitivity to the components of the drug;
- severe and acute forms of decompensated heart failure;
- childhood.
Application of Combilipen tabs 60 pcs. film-coated tablets during pregnancy and breastfeeding
Combilipen® tabs contains 100 mg of vitamin B6, and therefore the drug is not recommended for use in these cases.
The use of the drug in childhood is contraindicated.
special instructions
While using the drug, it is not recommended to take multivitamin complexes that include B vitamins.
Overdose
Symptoms: increased symptoms of side effects of the drug.
Treatment: gastric lavage, activated carbon, symptomatic therapy.
Side effects of Combilipen tabs 60 pcs. film-coated tablets
Allergic reactions (itching, urticarial rash), in some cases increased sweating, nausea, tachycardia.
Drug interactions
Levodopa reduces the effect of therapeutic doses of vitamin B6.
Vitamin B12 is incompatible with heavy metal salts.
Ethanol sharply reduces the absorption of thiamine.
While using the drug, it is not recommended to take multivitamin complexes that include B vitamins.
Instructions for use of Kombilipen (Method and dosage)
When using a solution of the drug, injections are given intramuscularly.
If the symptoms of the disease are pronounced, injections are carried out for 5-7 days, 2 ml daily, after which the administration of Combilipen continues 2-3 times a week for another two weeks.
For mild forms of the disease, injections are carried out 2-3 times a week for no more than 10 days. Treatment with Kombilipen solution is carried out for no more than two weeks, the dosage is adjusted by the attending physician.
Instructions for use of Combilipen Tabs tablets
The drug should be taken after meals, washed down with a small amount of water, and not chewed. Adult patients take 1-3 tablets daily. The course of treatment is prescribed by a specialist. High doses of the drug should not be taken for longer than four weeks.
Combilipen PPO tablets No. 30
Compound
Active ingredients: benfotiamine - 100 mg, pyridoxine hydrochloride - 100 mg, cyanocobalamin - 2 mcg. Excipients: carmellose sodium - 4.533 mg, povidone (polyvinylpyrrolidone, povidone K-30) - 16.233 mg, microcrystalline cellulose - 12.673 mg, talc - 4.58 mg, calcium stearate - 4.587 mg, polysorbate 80 (Tween 80) - 0.66 mg, sucrose (white sugar) - 206.732 mg.
Pharmacokinetics
Pharmacokinetic data not provided.
Indications for use
As part of complex therapy for the following neurological diseases:
- trigeminal neuralgia;
- neuritis of the facial nerve;
- pain syndrome caused by diseases of the spine (intercostal neuralgia, lumboischialgia, lumbar syndrome, cervical syndrome, cervicobrachial syndrome, radicular syndrome caused by degenerative changes in the spine);
- polyneuropathy of various etiologies (diabetic, alcoholic).
Contraindications
- hypersensitivity to the components of the drug;
- severe and acute forms of decompensated heart failure;
- childhood.
Directions for use and doses
The tablets should be taken after meals, without chewing and with a small amount of liquid.
Prescribe 1 tablet. 1-3 times/day.
The duration of the course of treatment is as recommended by the doctor. Treatment with high doses of the drug (3 tablets/day) for more than 4 weeks is not recommended. After 4 weeks of treatment, the doctor decides on the need to continue taking the drug at a high dose and considers reducing the dose to 1 tablet per day.
Storage conditions
The drug should be stored out of the reach of children at a temperature not exceeding 25°C.
Best before date
2 years. Do not use after the expiration date stated on the package.
special instructions
While using the drug, it is not recommended to take multivitamin complexes that include B vitamins.
The drug contains 100 mg of vitamin B6, therefore, when used for more than 6 months, the development of sensory peripheral neuropathy is possible. During long-term therapy, it is recommended to monitor the patient's condition. If signs of peripheral sensory neuropathy appear, it is necessary to adjust the dose and, if necessary, stop taking the drug.
Taking cyanocobalamin may mask the symptoms of folic acid deficiency.
Description
Vitamin B complex.
Dosage form
White or almost white, film-coated tablets, round, biconvex; On a cross section, the core is almost white.
Use in children
The use of the drug in childhood is contraindicated.
Action
Combined multivitamin preparation.
The pharmacological action is determined by the properties of the vitamins included in its composition. Benfotiamine is a fat-soluble form of thiamine (vitamin B1). Participates in the conduction of nerve impulses.
Pyridoxine hydrochloride (vitamin B6) is involved in the metabolism of proteins, carbohydrates and fats, and is necessary for normal hematopoiesis and the functioning of the central and peripheral nervous systems. Provides synaptic transmission, inhibition processes in the central nervous system, participates in the transport of sphingosine, which is part of the nerve sheath, and participates in the synthesis of catecholamines.
Cyanocobalamin (vitamin B12) is involved in the synthesis of nucleotides and is an important factor in normal growth, hematopoiesis and development of epithelial cells; necessary for folic acid metabolism and myelin synthesis.
Side effects
According to WHO, undesirable effects are classified according to their frequency of development as follows: very often (≥1/10), often (≥1/100, <1/10), infrequently (≥1/1000, <1/100), rare (≥1/10000, <1/1000) and very rare (<1/10000); frequency unknown (the frequency of events cannot be determined from the available data).
From the gastrointestinal tract: very rarely - nausea.
From the immune system: very rarely - hypersensitivity reactions (itching, urticaria, Quincke's edema).
From the skin and subcutaneous tissues: frequency unknown - increased sweating.
From the cardiovascular system: frequency unknown - tachycardia.
When using pyridoxine (vitamin B6) at a dose of 100 mg/day for 6 months, neuropathy may develop.
If the side effects indicated in the instructions are aggravated or any other side effects not specified in the instructions are noted, the patient should inform the doctor.
Use during pregnancy and breastfeeding
The use of Combilipen® Tabs during pregnancy and breastfeeding is not recommended.
Interaction
Levodopa reduces the effect of therapeutic doses of vitamin B6.
Vitamin B12 is incompatible with heavy metal salts.
Ethanol sharply reduces the absorption of thiamine.
Overdose
Taking high doses of pyridoxine (vitamin B6) at a dose of more than 1 g/day can lead to short-term neurotoxic effects.
Given the wide therapeutic range, overdose of benfotiamine when taken orally is unlikely.
Treatment: gastric lavage, taking activated charcoal, prescribing symptomatic therapy.
Impact on the ability to drive vehicles and operate machinery
There is no information on warnings regarding the use of Combilipen® tabs for vehicle drivers and persons working with potentially dangerous mechanisms.
Interaction
If Kombilipen injections or oral administration of the drug are combined with treatment with Levodopa, the effect of vitamin B6 .
You cannot inject medications with substances that have a redox effect, as they are incompatible with vitamin B1 . These are mercuric chloride , carbonate , iodide , acetate , tannic acid .
In addition, thiamine intake cannot be combined with sodium phenobarbital , riboflavin , metabisulfite , benzylpenylene , dextrose .
Thiamine is destroyed very quickly when in contact with copper. Thiamine inactivation also occurs when the pH exceeds 3.
Vitamin B12 is not compatible with heavy metal compounds.
Analogs
Level 4 ATX code matches:
Neurobex Forte
Neurobex
Milgamma compositum
Milgamma
Neurorubin
Neurobion
Pharmacies sell analogues of Kombilipen, which contain similar active ingredients. There are a large number of multivitamin preparations that contain vitamins. The price of analogues varies widely. When choosing an analogue, you should take into account what Combilipen is and what vitamins are included in its composition.
Which is better: Milgamma or Combilipen?
The drugs Milgamma and Kombilipen are analogs and are manufactured by different manufacturers. Both drugs have a similar effect on the human body. However, the cost in Milgamma pharmacies is higher.
Reviews
Reviews for Combilipen are mostly positive. Patients note its beneficial effects in the complex treatment of various neurological diseases. Leaving reviews of injections and reviews on Combilipen Tabs, people note its affordable price.
Due to the presence of lidocaine in the composition, the injections are less painful than the injection of analogues containing B vitamins. Reviews of doctors about the tablets and solution of this drug indicate that it has a pronounced positive effect in the treatment of osteochondrosis . As adverse reactions, reviews mention the appearance of slight itching of the skin and urticaria.
Price, where to buy
The average price for Combilipen in ampoules is about 350 rubles. (ampoules 2 ml, 10 pcs/). Price for ampoules in a package of 5 pcs. averages 150 rubles. In some pharmacy chains the price of Combilipen injections may be lower.
The medicine in tablet form is sold for an average of 300 rubles. (price of Combilipen Tabs tablets, 30 pieces per package). The drug in tablets (pack of 60 pieces) can be purchased at a price of 450 rubles.
- Online pharmacies in RussiaRussia
- Online pharmacies in KazakhstanKazakhstan
ZdravCity
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