Вспомогательные
вещества: калия цианид 0,1 мг, натрия гидроксида раствор 1 М
73,0 мг, вода для инъекций до 3,0 мл.
Описание
Прозрачный раствор
красного цвета.
Фармакотерапевтическая группа
Витамины группы В.
Код
АТХ:
А11DB.
Фармакологические свойства
Фармакодинамика
Препарат содержит
комбинацию нейротропных витаминов группы В.
Содержащиеся витамины:
тиамин (В1), пиридоксин (В6) и цианокобаламин (В12)
играют особую роль в качестве коферментов в промежуточном метаболизме,
протекающем в центральной и периферической нервной системе.
Особую роль в
метаболических процессах нервной системы играет сочетанное действие витаминов В1,
В6 и В12, что обосновывает их совместное применение.
Комбинированное применение витаминов группы В ускоряет процессы регенерации
поврежденных нервных волокон. Доказано, что эффективность комбинации
превосходит эффективность отдельных компонентов.
Подобно другим витаминам,
они являются незаменимыми питательными веществами, которые организм не способен
синтезировать самостоятельно.
Терапевтическое введение
в организм витаминов В1, В6 и В12 восполняет
часто существующее недостаточное поступление витаминов с пищей, что обеспечивает
наличие в организме необходимых количеств коферментов.
Терапевтическое
применение этих витаминов при различных заболеваниях нервной системы направлено
на то, чтобы, с одной стороны, компенсировать существующий дефицит (возможно
из-за повышенной потребности организма, обусловленной непосредственно
заболеванием) и, с другой стороны, чтобы стимулировать естественные механизмы,
направленные на восстановление функции нервных тканей.
Вместе с тем, непрямое
анальгезирующее действие комплекса витаминов группы В оказывает благоприятный
эффект на терапевтический результат.
Фармакокинетика
Тиамин
(витамин B1)
Период полувыведения
составляет около 4 ч.
В организме человека
содержится около 30 мг тиамина. С учетом быстрого метаболизма он выводится через
4-10 дней.
Пиридоксин
(витамин B6)
Биологический период
полувыведения пиридоксальфосфата составляет примерно 15–25 дней. Период
полувыведения составляет приблизительно 3 ч.
В организме человека
содержится около 40-150 мг пиридоксина. В сутки почками выводится 1,7-3,6 мг.
Цианокобаламин
(витамин B12)
Суточная потребность в
витамине составляет 1 мкг.
Скорость метаболизма
цианокобаламина в сутки составляет 2,5 мкг, или 0,05% от количества,
находящегося в печени.
Из печени он выводится с
желчью в кишечник и в значительной степени реабсорбируется при
кишечно-печеночной циркуляции.
Показания к применению
В комплексной терапии
следующих неврологических заболеваний:
Нейропатическая боль,
вызванная полинейропатией (в т.ч. диабетической и алкогольной).
Повышенная чувствительность
к любому из действующих или вспомогательных веществ препарата.
Тяжелые и острые формы декомпенсированной хронической сердечной
недостаточности (ХСН).
Период беременности и грудного вскармливания.
Детский возраст до 18 лет
(вследствие высоких доз действующих веществ).
Беременность
Применение препарата
Нейробион не рекомендовано в связи с отсутствием данных по
применению в период беременности.
Период грудного вскармливания
Витамины
В1, В6 и В12 выводятся с грудным молоком,
однако риск возникновения передозировки у новорожденного не установлен. В
отдельных случаях прием высоких доз витамина В6 (>600 мг в день)
может подавлять секрецию грудного молока.
Применение препарата в период грудного
вскармливания противопоказано.
При
необходимости применения препарата в период лактации грудное вскармливание
следует прекратить.
Применение при беременности и в период грудного вскармливания
Беременность
Применение препарата
Нейробион не рекомендовано в связи с отсутствием данных по
применению в период беременности.
Период грудного вскармливания
Витамины
В1, В6 и В12 выводятся с грудным молоком,
однако риск возникновения передозировки у новорожденного не установлен. В
отдельных случаях прием высоких доз витамина В6 (> 600 мг в день)
может подавлять секрецию грудного молока.
Применение препарата в период грудного
вскармливания противопоказано.
При
необходимости применения препарата в период лактации грудное вскармливание
следует прекратить.
Способ применения и дозы
Препарат
вводится внутримышечно (глубокие инъекции в ягодичную мышцу).
Лечение
рекомендуется начинать с внутримышечного введения 1 ампулы (3 мл) в сутки до
снятия острых симптомов.
После
улучшения симптомов или в случаях умеренной тяжести заболевания: одна ампула
1-3 раза в неделю в течение 2-3 недель.
Для
поддерживающей терапии, для профилактики рецидива или продолжения проводимого
курса лечения рекомендуется препарат Нейробион в другой
лекарственной форме (таблетки, покрытые оболочкой).
Продолжительность лечения определяется
врачом.
Не рекомендовано лечение более 4-х недель.
Побочное действие
Поскольку информация о большинстве нежелательных эффектов основана на
спонтанных сообщениях, полученных в пострегистрационный период, точная оценка
частоты их развития невозможна.
Частота
побочных эффектов препарата расценивается следующим образом:
очень
часто: ≥ 1/10;
часто:
≥ 1/100, < 1/10;
нечасто:
≥ 1/1000, < 1/100;
редко:
≥ 1/10 000, < 1/1 000;
очень
редко: < 1/10 000, включая отдельные сообщения;
частота
неизвестна: по имеющимся данным определить частоту не представляется возможным.
Нарушения со стороны иммунной системы
Очень
редко: анафилактический шок.
Частота
неизвестна: реакции повышенной чувствительности, такие как потливость,
тахикардия, кожные реакции (зуд, крапивница).
Нарушения со стороны желудочно-кишечного тракта
Частота неизвестна: жалобы со стороны
желудочно-кишечного тракта, такие как тошнота, рвота, диарея,
боль в животе.
Нарушения со стороны кожи и подкожных
тканей
Частота
неизвестна: описаны отдельные случаи появления угревой сыпи или экземы после
парентерального применения высоких доз витамина В12.
Нарушения со стороны почек и
мочевыводящих путей
Частота
неизвестна: хроматурия (окрашивание мочи в красноватый цвет, было отмечено в
первые 8 ч после применения препарата; обычно описанное явление исчезает в течение
48 ч).
Общие расстройства и нарушения в
месте введения
Частота
неизвестна: реакции в месте введения.
Передозировка
Симптомы
Витамины
В1, В6 и В12 имеют широкий терапевтический
диапазон.
Симптомы
передозировки не наблюдаются при применении препарата в рекомендуемых дозах и
режиме.
При
внутривенном введении высоких доз витаминов в течение длительного времени
(более 2 месяцев) могут наблюдаться симптомы интоксикации.
Витамин В1:
после введения дозы, превышающей рекомендованную более чем в 100 раз (>10
г), наблюдались курареподобные ганглиоблокирующие эффекты, вызывающие нарушение
проведения нервных импульсов.
Витамин В6:
длительное применение (>6-12 месяцев) витамина В6 в суточной дозе
>50 мг может вызывать периферическую сенсорную нейропатию. Симптомы
нейропатии постепенно исчезают при отмене препарата.
Продолжительное
применение витамина В6 в суточной дозе свыше 1 г в течение более чем
2 месяцев может вызывать нейротоксические эффекты.
После
введения более 2 г в сутки были описаны случаи гипохромной анемии и себорейного
дерматита, нейропатии с атаксией, расстройства чувствительности,
эпилептиформные припадки с изменениями на электроэнцефалограмме.
Витамин В12:
после парентерального введения высокой дозы наблюдались экзематозные кожные
нарушения и доброкачественная форма акне.
Лечение
В
случае появления вышеуказанных симптомов передозировки лечение препаратом
следует отменить. При необходимости назначается симптоматическая терапия, в том
числе десенсибилизирующая.
Взаимодействие с другими лекарственными средствами
При
одновременном применении витамин В6 (пиридоксин) может уменьшать
противопаркинсоническое действие леводопы.
Одновременное
применение антагонистов пиридоксина (таких как изониазид, циклосерин,
пеницилламин или гидралазин) может снижать эффективность витамина В6
(пиридоксина).
Длительное
применение «петлевых» диуретиков, например, фуросемида, может усиливать
экскрецию тиамина, что приводит к снижению содержания витамина В1
(тиамина) в крови.
Длительное
применение препаратов, снижающих кислотность желудка, может привести к дефициту
витамина В12.
Не
рекомендуется смешивать препарат с другими лекарственными средствами в одном
шприце.
Витамин
В1 полностью разрушается при взаимодействии с растворами,
содержащими сульфиты.
Особые указания
В литературе описаны случаи нейропатии после
длительного (6-12 месяцев) применения витамина В6 в дозе, в среднем
превышающей 50 мг в сутки. Поэтому при длительной терапии рекомендуется
регулярное наблюдение за пациентом.
Клиническая картина, а также лабораторные
анализы при фуникулярном миелозе или пернициозной анемии могут терять свою
специфичность при введении витамина В12.
Цианокобаламин может маскировать симптомы
дефицита фолиевой кислоты.
Препарат следует вводить исключительно
внутримышечно и не допускать попадания в сосудистое русло.
Препарат
не следует вводить внутривенно!
Не используйте повторно
шприцы и иглы. Шприцы и иглы должны быть утилизированы сразу после
использования.
Использованные шприцы и
иглы нельзя выбрасывать в мусорные баки или канализационную систему, они должны
быть утилизированы в специальные контейнеры.
Влияние на способность управлять автомобилем и движущимися механизмами
Прием препарата не влияет на способность управлять
транспортными средствами и занятия другими потенциально опасными видами
деятельности, требующими повышенной концентрации внимания и быстроты
психомоторных реакций.
Форма выпуска
Раствор
для внутримышечного введения, 100 мг+100 мг+1 мг.
По
3 мл препарата в ампулу из темного стекла типа I. На ампулу нанесена точка
разлома и маркирующая полоска.
По
3 ампулы или по 10 ампул в контурной ячейковой упаковке вместе с инструкцией по
применению в пачку картонную.
Условия хранения
При
температуре от 2 до 8 °С.
Хранить
в недоступном для детей месте.
Срок годности
3
года.
Не применять после
истечения срока годности
Условия отпуска
Отпускают
по рецепту.
Производитель
СЕНЕКСИ
ЭйчЭсСи, Франция
CENEXI HSC, France
Рю
Луи Пастер, 2, ЭРУВИЛЬ-СЕН-КЛЕР, 14200, Франция.
Организация, принимающая претензии потребителей
Пи
энд Джи Хелс Джермани ГмбХ, Германия
P&G Health Germany GmbH, Germany
Зульцбахер
Штрассе 40, 65824 Швальбах ам Таунус, Германия.
Для описания товара использована информация от партнера 36.6
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Доказано, что эффективность комбинации\nпревосходит эффективность отдельных компонентов."}},{"type":"paragraph","data":{"text":"Подобно другим витаминам,\nони являются незаменимыми питательными веществами, которые организм не способен\nсинтезировать самостоятельно."}},{"type":"paragraph","data":{"text":"Терапевтическое введение\nв организм витаминов В\u003csub\u003e1\u003c/sub\u003e, В\u003csub\u003e6\u003c/sub\u003e и В\u003csub\u003e12\u003c/sub\u003e восполняет\nчасто существующее недостаточное поступление витаминов с пищей, что обеспечивает\nналичие в организме необходимых количеств коферментов."}},{"type":"paragraph","data":{"text":"Терапевтическое\nприменение этих витаминов при различных заболеваниях нервной системы направлено\nна то, чтобы, с одной стороны, компенсировать существующий дефицит (возможно\nиз-за повышенной потребности организма, обусловленной непосредственно\nзаболеванием) и, с другой стороны, чтобы стимулировать естественные механизмы,\nнаправленные на восстановление функции нервных тканей."}},{"type":"paragraph","data":{"text":"Вместе с тем, непрямое\nанальгезирующее действие комплекса витаминов группы В оказывает благоприятный\nэффект на терапевтический результат."}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eФармакокинетика\u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eТиамин\n(витамин \u003c/i\u003e\u003ci\u003eB\u003c/i\u003e\u003ci\u003e\u003csub\u003e1\u003c/sub\u003e\u003c/i\u003e\u003ci\u003e)\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Период полувыведения\nсоставляет около 4 ч. "}},{"type":"paragraph","data":{"text":"В организме человека\nсодержится около 30 мг тиамина. С учетом быстрого метаболизма он выводится через\n4-10 дней."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПиридоксин\n(витамин \u003c/i\u003e\u003ci\u003eB\u003c/i\u003e\u003ci\u003e\u003csub\u003e6\u003c/sub\u003e\u003c/i\u003e\u003ci\u003e)\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Биологический период\nполувыведения пиридоксальфосфата составляет примерно 15–25 дней. Период\nполувыведения составляет приблизительно 3 ч."}},{"type":"paragraph","data":{"text":"В организме человека\nсодержится около 40-150 мг пиридоксина. В сутки почками выводится 1,7-3,6 мг."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЦианокобаламин\n(витамин \u003c/i\u003e\u003ci\u003eB\u003c/i\u003e\u003ci\u003e\u003csub\u003e12\u003c/sub\u003e\u003c/i\u003e\u003ci\u003e)\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Суточная потребность в\nвитамине составляет 1 мкг."}},{"type":"paragraph","data":{"text":"Скорость метаболизма\nцианокобаламина в сутки составляет 2,5 мкг, или 0,05% от количества,\nнаходящегося в печени."}},{"type":"paragraph","data":{"text":"Из печени он выводится с\nжелчью в кишечник и в значительной степени реабсорбируется при\nкишечно-печеночной циркуляции."}}]},{"id":1,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"В комплексной терапии\nследующих неврологических заболеваний:"}},{"type":"paragraph","data":{"text":"Нейропатическая боль,\nвызванная полинейропатией (в т.ч. диабетической и алкогольной)."}},{"type":"paragraph","data":{"text":"Невриты и невралгии:"}},{"type":"paragraph","data":{"text":"- невралгия тройничного\nнерва;"}},{"type":"paragraph","data":{"text":"- неврит лицевого нерва;"}},{"type":"paragraph","data":{"text":"- межреберная невралгия;"}},{"type":"paragraph","data":{"text":"- болевой синдром,\nвызванный заболеваниями позвоночника (люмбоишиалгия, плексопатия, корешковый\nсиндром, вызванный дегенеративными изменениями позвоночника);"}},{"type":"paragraph","data":{"text":"- опоясывающий герпес."}}]},{"id":2,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность\nк любому из действующих или вспомогательных веществ препарата."}},{"type":"paragraph","data":{"text":"Тяжелые и острые формы декомпенсированной хронической сердечной\nнедостаточности (ХСН)."}},{"type":"paragraph","data":{"text":"Период беременности и грудного вскармливания."}},{"type":"paragraph","data":{"text":"Детский возраст до 18 лет\n(вследствие высоких доз действующих веществ)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eБеременность\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Применение препарата\nНейробион не рекомендовано в связи с отсутствием данных по\nприменению в период беременности."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПериод грудного вскармливания\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Витамины\nВ\u003csub\u003e1\u003c/sub\u003e, В\u003csub\u003e6\u003c/sub\u003e и В\u003csub\u003e12\u003c/sub\u003e выводятся с грудным молоком,\nоднако риск возникновения передозировки у новорожденного не установлен. В\nотдельных случаях прием высоких доз витамина В\u003csub\u003e6\u003c/sub\u003e (>600 мг в день)\nможет подавлять секрецию грудного молока."}},{"type":"paragraph","data":{"text":"Применение препарата в период грудного\nвскармливания противопоказано."}},{"type":"paragraph","data":{"text":"При\nнеобходимости применения препарата в период лактации грудное вскармливание\nследует прекратить. "}}]},{"id":12,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eБеременность\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Применение препарата\nНейробион не рекомендовано в связи с отсутствием данных по\nприменению в период беременности."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПериод грудного вскармливания\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Витамины\nВ\u003csub\u003e1\u003c/sub\u003e, В\u003csub\u003e6\u003c/sub\u003e и В\u003csub\u003e12\u003c/sub\u003e выводятся с грудным молоком,\nоднако риск возникновения передозировки у новорожденного не установлен. В\nотдельных случаях прием высоких доз витамина В\u003csub\u003e6\u003c/sub\u003e (> 600 мг в день)\nможет подавлять секрецию грудного молока."}},{"type":"paragraph","data":{"text":"Применение препарата в период грудного\nвскармливания противопоказано."}},{"type":"paragraph","data":{"text":"При\nнеобходимости применения препарата в период лактации грудное вскармливание\nследует прекратить. "}}]},{"id":3,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат\nвводится внутримышечно (глубокие инъекции в ягодичную мышцу)."}},{"type":"paragraph","data":{"text":"Лечение\nрекомендуется начинать с внутримышечного введения 1 ампулы (3 мл) в сутки до\nснятия острых симптомов."}},{"type":"paragraph","data":{"text":"После\nулучшения симптомов или в случаях умеренной тяжести заболевания: одна ампула\n1-3 раза в неделю в течение 2-3 недель."}},{"type":"paragraph","data":{"text":"Для\nподдерживающей терапии, для профилактики рецидива или продолжения проводимого\nкурса лечения рекомендуется препарат Нейробион в другой\nлекарственной форме (таблетки, покрытые оболочкой)."}},{"type":"paragraph","data":{"text":"Продолжительность лечения определяется\nврачом."}},{"type":"paragraph","data":{"text":"Не рекомендовано лечение более 4-х недель."}}]},{"id":4,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Поскольку информация о большинстве нежелательных эффектов основана на\nспонтанных сообщениях, полученных в пострегистрационный период, точная оценка\nчастоты их развития невозможна."}},{"type":"paragraph","data":{"text":"Частота\nпобочных эффектов препарата расценивается следующим образом:"}},{"type":"paragraph","data":{"text":"очень\nчасто: ≥ 1/10;"}},{"type":"paragraph","data":{"text":"часто:\n≥ 1/100, < 1/10;"}},{"type":"paragraph","data":{"text":"нечасто:\n≥ 1/1000, < 1/100;"}},{"type":"paragraph","data":{"text":"редко:\n≥ 1/10 000, < 1/1 000;"}},{"type":"paragraph","data":{"text":"очень\nредко: < 1/10 000, включая отдельные сообщения;"}},{"type":"paragraph","data":{"text":"частота\nнеизвестна: по имеющимся данным определить частоту не представляется возможным."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны иммунной системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Очень\nредко: анафилактический шок."}},{"type":"paragraph","data":{"text":"Частота\nнеизвестна: реакции повышенной чувствительности, такие как потливость,\nтахикардия, кожные реакции (зуд, крапивница)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны желудочно-кишечного тракта\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Частота неизвестна: жалобы со стороны\nжелудочно-кишечного тракта, такие как тошнота, рвота, диарея,\nболь в животе."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны кожи и подкожных\nтканей\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Частота\nнеизвестна: описаны отдельные случаи появления угревой сыпи или экземы после\nпарентерального применения высоких доз витамина В\u003csub\u003e12\u003c/sub\u003e."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны почек и\nмочевыводящих путей\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Частота\nнеизвестна: хроматурия (окрашивание мочи в красноватый цвет, было отмечено в\nпервые 8 ч после применения препарата; обычно описанное явление исчезает в течение\n48 ч)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eОбщие расстройства и нарушения в\nместе введения\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Частота\nнеизвестна: реакции в месте введения."}}]},{"id":13,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Витамины\nВ\u003csub\u003e1\u003c/sub\u003e, В\u003csub\u003e6\u003c/sub\u003e и В\u003csub\u003e12\u003c/sub\u003e имеют широкий терапевтический\nдиапазон."}},{"type":"paragraph","data":{"text":"Симптомы\nпередозировки не наблюдаются при применении препарата в рекомендуемых дозах и\nрежиме."}},{"type":"paragraph","data":{"text":"При\nвнутривенном введении высоких доз витаминов в течение длительного времени\n(более 2 месяцев) могут наблюдаться симптомы интоксикации."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВитамин В\u003csub\u003e1\u003c/sub\u003e\u003c/i\u003e:\nпосле введения дозы, превышающей рекомендованную более чем в 100 раз (>10\nг), наблюдались курареподобные ганглиоблокирующие эффекты, вызывающие нарушение\nпроведения нервных импульсов."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВитамин В\u003csub\u003e6\u003c/sub\u003e\u003c/i\u003e:\nдлительное применение (>6-12 месяцев) витамина В\u003csub\u003e6\u003c/sub\u003e в суточной дозе\n>50 мг может вызывать периферическую сенсорную нейропатию. Симптомы\nнейропатии постепенно исчезают при отмене препарата. "}},{"type":"paragraph","data":{"text":"Продолжительное\nприменение витамина В\u003csub\u003e6\u003c/sub\u003e в суточной дозе свыше 1 г в течение более чем\n2 месяцев может вызывать нейротоксические эффекты."}},{"type":"paragraph","data":{"text":"После\nвведения более 2 г в сутки были описаны случаи гипохромной анемии и себорейного\nдерматита, нейропатии с атаксией, расстройства чувствительности,\nэпилептиформные припадки с изменениями на электроэнцефалограмме."}},{"type":"paragraph","data":{"text":"\u003ci\u003eВитамин В\u003csub\u003e12\u003c/sub\u003e\u003c/i\u003e:\nпосле парентерального введения высокой дозы наблюдались экзематозные кожные\nнарушения и доброкачественная форма акне."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"В\nслучае появления вышеуказанных симптомов передозировки лечение препаратом\nследует отменить. При необходимости назначается симптоматическая терапия, в том\nчисле десенсибилизирующая."}}]},{"id":14,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"При\nодновременном применении витамин В\u003csub\u003e6\u003c/sub\u003e (пиридоксин) может уменьшать\nпротивопаркинсоническое действие леводопы."}},{"type":"paragraph","data":{"text":"Одновременное\nприменение антагонистов пиридоксина (таких как изониазид, циклосерин,\nпеницилламин или гидралазин) может снижать эффективность витамина В\u003csub\u003e6\u003c/sub\u003e\n(пиридоксина)."}},{"type":"paragraph","data":{"text":"Длительное\nприменение «петлевых» диуретиков, например, фуросемида, может усиливать\nэкскрецию тиамина, что приводит к снижению содержания витамина В\u003csub\u003e1\u003c/sub\u003e\n(тиамина) в крови."}},{"type":"paragraph","data":{"text":"Длительное\nприменение препаратов, снижающих кислотность желудка, может привести к дефициту\nвитамина В\u003csub\u003e12\u003c/sub\u003e."}},{"type":"paragraph","data":{"text":"Не\nрекомендуется смешивать препарат с другими лекарственными средствами в одном\nшприце."}},{"type":"paragraph","data":{"text":"Витамин\nВ\u003csub\u003e1\u003c/sub\u003e полностью разрушается при взаимодействии с растворами,\nсодержащими сульфиты."}}]},{"id":15,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"В литературе описаны случаи нейропатии после\nдлительного (6-12 месяцев) применения витамина В\u003csub\u003e6\u003c/sub\u003e в дозе, в среднем\nпревышающей 50 мг в сутки. Поэтому при длительной терапии рекомендуется\nрегулярное наблюдение за пациентом."}},{"type":"paragraph","data":{"text":"Клиническая картина, а также лабораторные\nанализы при фуникулярном миелозе или пернициозной анемии могут терять свою\nспецифичность при введении витамина В\u003csub\u003e12\u003c/sub\u003e."}},{"type":"paragraph","data":{"text":"Цианокобаламин может маскировать симптомы\nдефицита фолиевой кислоты. "}},{"type":"paragraph","data":{"text":"Препарат следует вводить исключительно\nвнутримышечно и не допускать попадания в сосудистое русло. "}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eПрепарат\nне следует вводить внутривенно!\u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"Не используйте повторно\nшприцы и иглы. Шприцы и иглы должны быть утилизированы сразу после\nиспользования. "}},{"type":"paragraph","data":{"text":"Использованные шприцы и\nиглы нельзя выбрасывать в мусорные баки или канализационную систему, они должны\nбыть утилизированы в специальные контейнеры."}}]},{"id":16,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Прием препарата не влияет на способность управлять\nтранспортными средствами и занятия другими потенциально опасными видами\nдеятельности, требующими повышенной концентрации внимания и быстроты\nпсихомоторных реакций. "}}]},{"id":17,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Раствор\nдля внутримышечного введения, 100 мг+100 мг+1 мг."}},{"type":"paragraph","data":{"text":"По\n3 мл препарата в ампулу из темного стекла типа I. На ампулу нанесена точка\nразлома и маркирующая полоска."}},{"type":"paragraph","data":{"text":"По\n3 ампулы или по 10 ампул в контурной ячейковой упаковке вместе с инструкцией по\nприменению в пачку картонную."}}]},{"id":18,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"При\nтемпературе от 2 до 8 \u003csup\u003e°\u003c/sup\u003eС."}},{"type":"paragraph","data":{"text":"Хранить\nв недоступном для детей месте."}}]},{"id":19,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3\nгода."}},{"type":"paragraph","data":{"text":"Не применять после\nистечения срока годности"}}]},{"id":20,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Отпускают\nпо рецепту."}}]},{"id":21,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"СЕНЕКСИ\nЭйчЭсСи, Франция"}},{"type":"paragraph","data":{"text":"CENEXI HSC, France"}},{"type":"paragraph","data":{"text":"Рю\nЛуи Пастер, 2, ЭРУВИЛЬ-СЕН-КЛЕР, 14200, Франция."}}]},{"id":22,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"Пи\nэнд Джи Хелс Джермани ГмбХ, Германия "}},{"type":"paragraph","data":{"text":"P&G Health Germany GmbH, Germany"}},{"type":"paragraph","data":{"text":"Зульцбахер\nШтрассе 40, 65824 Швальбах ам Таунус, Германия.\u003cb\u003e\u003c/b\u003e"}}]}],"source":{"title":"36.6","url":"https://366.ru"}},"description_toggle":false,"short_description":"ФармакодинамикаПрепарат содержит комбинацию нейротропных витаминов группы В. Содержащиеся витамины: тиамин (В1), пиридоксин (В6) и цианокобаламин (В12) играют особую роль в качестве коферментов в промежуточном метаболизме, протекающем в центральной и периферической нервной системе. Особую роль в метаболических процессах нервной системы играет сочетанное действие витаминов В1, В6и В12, что обосновывает их совместное применение. Комбинированное применение витаминов группы В ускоряет процессы регенерации поврежденных нервных волокон. Доказано, что эффективность комбинации превосходит эффективность отдельных компонентов. Подобно другим витаминам, они являются незаменимыми питательными веществами, которые организм не способен синтезировать самостоятельно. Терапевтическое введение в организм витаминов В1, В6и В12восполняет часто существующее недостаточное поступление витаминов с пищей, что обеспечивает наличие в организме необходимых количеств коферментов. Терапевтическое применение этих витаминов при различных заболеваниях нервной системы направлено на то, чтобы, с одной стороны, компенсировать существующий дефицит (возможно из-за повышенной потребности организма, обусловленной непосредственно заболеванием) и, с другой стороны, чтобы стимулировать естественные механизмы, направленные на восстановление функции нервных тканей. Вместе с тем, непрямое анальгезирующее действие комплекса витаминов группы В оказывает благоприятный эффект на терапевтический результат.ФармакокинетикаТиамин (витаминB1)Период полувыведения составляет около 4 ч. В организме человека содержится около 30 мг тиамина. С учетом быстрого метаболизма он выводится через 4-10 дней.Пиридоксин (витаминB6)Биологический период полувыведения пиридоксальфосфата составляет примерно 15–25 дней. Период полувыведения составляет приблизительно 3 ч. В организме человека содержится около 40-150 мг пиридоксина. В сутки почками выводится 1,7-3,6 мг.Цианокобаламин (витаминB12)Суточная потребность в витамине составляет 1 мкг. Скорость метаболизма цианокобаламина в сутки составляет 2,5 мкг, или 0,05% от количества, находящегося в печени. 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