The use of Milgamma and Milgamma compositum in patients with back pain

Indications for use of Milgamma: what is it prescribed for?

1. Effective for the treatment of patients with diabetes mellitus and its complications: diabetic nephropathy, retinopathy, polyneuropathy, autonomic neuropathy.
   more about how to treat neuropathy of the lower extremities at home here.
2. When combined with thiogamma, it normalizes heart rate variability, reducing the manifestations of autonomic diabetic cardioneuropathy.
3. A good effect has been shown in the treatment of alcoholic polyneuropathy.
4. It is widely used for the treatment of neurological manifestations of spinal osteochondrosis, both for self-relief of pain and for potentiating the effect of NSAIDs.
5. For chronic sensorineural hearing loss of various etiologies (mainly vascular). Milgamma courses are prescribed lasting from 4 to 6 weeks. 2 – 3 rubles/year.
6. They treat patients with damage to the facial and trigeminal nerves.
7. Shingles.
8. Plexopathies.
9. Muscle cramps at night, especially in older people.

Milgamma - indications

What does Milgamma (injections) help with? Doctors usually prescribe the medicine as part of the complex therapy of various local and systemic nervous diseases, including those caused by a deficiency of vitamins C. B. As a symptomatic and pathogenetic remedy, Milgamma is indicated for:

• neuralgia of various origins;
• paresis of the facial nerve;
• retrobulbar neuritis;
• plexopathies;
• ganglionitis;
• diabetic polyneuropathy;
• alcoholic polyneuropathy;
• other types of neuropathies.

For general strengthening of the body, after suffering serious illnesses, operations, infections, and in case of vitamin deficiency, the administration or intake of the specified vitamin complex is also indicated. Elderly people often experience night cramps - Milgamma is used to eliminate them. Myalgia

, or muscle pain syndrome of various origins, is also successfully relieved by the use of Milgamma.

For osteochondrosis and other spinal diseases, the drug is most often used in combination with muscle relaxants (Mydocalm) and NSAIDs (Movalis and others).

The medicine has proven itself well for herpes zoster

caused by the Zoster virus, as well as against other
herpesvirus infections
localized in the nervous tissue. Other indications for the use of the drug Milgamma are radiculitis, lumbago, sciatica, muscular-tonic syndrome and even multiple sclerosis.

Where and how to inject Milgamma

The drug is not injected intravenously. It is injected deep intramuscularly using the thinnest and sharpest needle. Injections must be administered correctly to avoid damage to blood vessels and nerve bundles. It is recommended to inject into the gluteal muscle.

At the beginning of treatment (first 5-10 days), the dosage is 2 ml per day. Subsequently, in case of mild forms of the disease or improvement, Milgamma can be injected less frequently (twice or three times every 7 days for 2-3 weeks) or switch to oral intake of vitamins. The use of ampoules during treatment with Milgamma compositum tablets is allowed with the permission of the doctor

It is important that the doctor monitors the progress of therapy and the patient’s well-being. Recommended frequency of monitoring is once a week

If the patient is prescribed the drug Milgamma in injections, the instructions for use must be followed. You can read on the Internet that it is correct to inject the medicine into the leg, but the solution must be injected into the uppermost part of the buttock. This will help avoid the development of side effects and minimize discomfort.

Sometimes during therapy you have to take Movalis injections prescribed by your doctor. In this case, the drugs are injected into different buttocks. You can use medications at the same time, but mixing them in 1 syringe is prohibited.

When is the best time to give injections?

Many patients are interested in what time of day the injection solution in ampoules is used: in the morning or in the evening. The drug is a complex of vitamins, so it is better to use it in the first half of the day (at this time of day, metabolic processes are more intense).

If the medicine is used simultaneously with other medications for intramuscular administration, it should be used in accordance with the doctor’s recommendations.

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Painful injections or not

It is difficult to answer the question whether Milgamma injections are painful or not. It all depends on the individual sensitivity of the patient and the injection technique. The drug contains lidocaine, the purpose of which is to minimize discomfort. However, this is not always possible, especially if the injections are given by an inexperienced person. If there is no one to give the injection, it is better to skip 1 day than to get into a nerve or vessel.

If the manipulations are painful, following these recommendations will help reduce discomfort:

1. The needle should be inserted deep into the muscle tissue.
2. It is necessary to slowly and smoothly press the syringe plunger so that the drug flows slowly. The optimal procedure time is 1.5 minutes.
3. After performing the injection, it is recommended to gently massage the muscle. This will ensure uniform distribution of the solution in the tissues and prevent the formation of a hematoma.
4. If a lump appears at the injection site, you can remove it using a warm compress or lotions based on magnesium sulfate.

How many days to inject Milgamma

Patients can be injected with Milgamma only after consulting a neurologist. The doctor will tell you how often to give injections and how long the course of treatment will last.

At the beginning of therapy, the drug is administered every day (number of ampoules - 1 pc.). Treatment according to this regimen continues for 5-10 days, after which the patient is transferred to oral administration of the medication. If necessary, intramuscular administration of vitamins continues. Patients are interested in how often the drug can be injected in this case. If the tablets can be taken 1-3 times a day, then the solution is administered no more than 2-3 times a week.

If the condition returns to normal, you need to periodically visit the doctor to decide on the need for repeated therapy. This should be done at least once a year.

How to use Milgamma correctly?

If the doctor recommended Milgamma injections, they should be performed strictly in the indicated quantity. How long the course will last depends on the disease. So, if your neck, thoracic or lumbar spine hurts, 5-10 injections may be prescribed daily. You can take a break from treatment on weekends. The drug is injected deep into the gluteal muscle in an amount of 2 ml (dose for an adult).

For maintenance treatment, Milgamma is administered at the same dosage twice or three times a week. This course can last up to a month. The intake rates for dragees and tablets are as follows:

• 1 piece/day for maintenance therapy for a month;
• 1 piece/3 times a day for acute pain for 10 days.

You need to take the tablets with plenty of water and do not depend on food. After completing the course of tablets or injections, the doctor may extend it. This is possible in the absence of the risk of developing neuropathy associated with an overdose of vitamin B6.

The decision to treat pregnant or lactating women with Milgamma is made by the doctor. Large doses of the drug can suppress lactation. The drug passes into breast milk - this should also be taken into account during treatment.

Milgamma benefits and harms during pregnancy

Experts advise taking the drug during pregnancy if symptoms such as:

• neuritis;
• radicular syndrome;
• paralysis, spasms, muscle numbness;
• herpes, in which the percentage of body damage is more than 60%;
• infectious, bacterial diseases;
• periodic disorders that occur in pregnant women due to a lack of vitamin B;
• weak immunity caused by insufficient amounts of vitamins in the body.

Can Milgamma cause complications in pregnant women?

Experts warn that when undergoing a course of treatment with Milgamma, contraindications for pregnant women may be as follows:

• You should not take the Milgamma complex if you have acute intolerance to one of the components of the drug;
• It is not advisable to take tablets or give injections of this medicine while breastfeeding;
• the use of the drug for problems with the heart muscle is excluded;
• if you have problems with the digestive system, poor metabolism, hormonal disorders;
• thrombosis, vein blockage, atherosclerosis.

Pregnant women, in addition to such side effects as an allergy to Milgamma in general, poor health, itching, burning, skin rashes, fever, general malaise, nausea, swelling, may also be in danger of stopping the development of the fetus.

Features of application

Milgamma injections can also be given as maintenance therapy, complex treatment, or as an independent remedy for pain relief. Injections are performed only intramuscularly. An injection is made deep into the muscle, the medicine is administered slowly, since with rapid administration the patient may experience palpitations, dizziness and even fainting. To relieve pain, you need to inject Milgamma 2 ml once a day for 3-4 days. The doctor monitors the patient’s standing and, if necessary, extends the course of treatment to 10 days.

If Milgamma is prescribed as maintenance therapy, then it should be injected 2-3 times a week. The course of treatment is one month. According to indications, the doctor may extend the duration of the procedures for another week. It should be remembered that Milgamma should not be injected often, since it contains a high concentration of vitamin B complex. An excess of vitamins, as well as their deficiency, has a bad effect on the condition of the body. Therefore, if an extension of treatment with a vitamin complex is required, the doctor prescribes analogues that have a similar effect, but are less concentrated.

The most commonly used analogues of Milgamma are:

• Nevriplex;
• Neurobics;
• Vitaxon;
• Combilipen;
• Binavit;
• Vitagamma;
• Trigamma.

Analogs are available in the form of an injection solution and tablets. The doctor decides which form of substitute to prescribe, based on the symptoms, the patient’s condition, and the nature of the disease. If there is pain, in order to relieve it, the doctor prescribes an intramuscular injection of an analogue of Milgamma. Treatment is carried out under the supervision of a doctor. You cannot prescribe Milgamma yourself, since an overdose of vitamins can lead to allergic reactions and even anaphylactic shock.

What is it prescribed for?

Milgamma is prescribed for the treatment and prevention of diseases associated with nervous system, regardless of their stage and form of origin. The drug brings relief to patients suffering from:

• neuritis, including retrobulbar;
• facial nerve paresis;
• neuralgia;
• herpes zoster;
• plexopathies;
• neuropathies, including diabetic and alcoholic polyneuropathy;
• ganglionitis;
• convulsive muscle contractions at night;
• radiculopathy;
• muscular-tonic syndrome.

The medicine helps to normalize blood microcirculation, activate blood formation processes, stabilize the functions and conductive abilities of the nervous system.

Milgamma injections reach the maximum level of effect on the patient’s body within 15 minutes after the injection, and tablets only after 30 minutes.

Contraindications

Milgamma is contraindicated for people with:

• intolerance to the components included in the drug (especially with allergies);
• pathologies of the cardiovascular system;
• erythremia;
• thromboembolism.

Despite being well tolerated by patients and rare cases of complications, the drug is prohibited from being taken by pregnant women and adolescents under 18 years of age.

Compound

Milgamma is a medicine with a complex effect that can be used for the treatment (including symptomatic therapy) of diseases and conditions caused by a deficiency of B vitamins, which have neurotropic activity. The medicine improves metabolism in tissues and prevents damage to neurons - electrically excitable cells that process and transmit information using chemical and electrical signals. The therapeutic properties of the drug are determined by the action of its constituent components.

Active ingredients of the drug Milgamma and their properties:

The analgesic effect is ensured by the content of lidocaine, a local anesthetic that begins to act 5-10 minutes after intramuscular injection. Lidocaine often causes allergic reactions, but is considered one of the best local anesthetics, the effectiveness of which is almost 3 times higher than ultracaine or novocaine. The content of lidocaine in 1 ampoule is 20 mg.

Method of use of the drug Milgamma, dosage

How to take Milgamma? For acute pain, a quick analgesic effect requires one injection of the drug Milgamma (2.0 ml), intramuscularly. For mild forms of the disease, the attending physician prescribes no more than 1 injection of Milgamma solution (2 ml) 2-3 times a week.

Milgamma tablets are intended for oral administration. Their composition is identical to the injection solution (B vitamins) and differs in the presence of excipients. Depending on the patient’s condition and his individual perception of certain components of the medicine, the doctor prescribes either tablets or injections of Milgamma.

The drug Milgamma has a wide analog range. These include medications such as Neuromultivit, Combilipen, Binavit. The international nonproprietary name of the active substance (INN) is the basic information about the drug. Drugs with the same active ingredients are produced under different trade names. The same can be said about the drug Milgamma. INN allows doctors to choose the right drug from a huge number of drugs available on the pharmaceutical market.

The use of Milgamma and Milgamma compositum in patients with back pain

Back pain is a widespread syndrome caused by degenerative lesions of the bone tissue of the vertebrae and intervertebral discs, tendon-ligamentous apparatus and adjacent periarticular tissues. The syndrome, as a rule, does not have a specific nature, is benign in nature and in most cases regresses within 4–6 weeks. In some cases, the intensity and duration of pain are expressed to a much greater extent, which creates a real threat of the formation of chronic pain syndrome.

Modern approaches to the treatment of patients with nonspecific back pain include the most active involvement of the patient himself in the rehabilitation process. It is believed that early mobilization of the patient and performing feasible physical exercises can significantly reduce the risk of developing chronic pain syndrome and reduce the likelihood of developing anxiety and depressive disorders. For the purpose of early elimination of pain, non-steroidal anti-inflammatory drugs, analgesics, and various reflexology options are usually used. For many years, B vitamins in therapeutic doses have been used in complex therapy to relieve acute local pain syndromes. The need to use B vitamins is dictated by their high metabolic activity in the cells of both the central and peripheral nervous systems. Taking part in numerous biochemical processes, they act as coenzymes for a number of important reactions. Thus, thiamine is part of key enzyme systems that provide oxidative decarboxylation of pyruvic and alpha-ketoglutaric acids. An important feature of its action is the ability to switch glucose metabolism along the pentose phosphate pathway, which, on the one hand, provides the body’s energy needs, and on the other, allows the formation of reserves of plastic substrates for the synthesis of nucleic acids. In addition, thiamine is directly involved in a wide range of synthesizing processes.

Due to the multifactorial action of thiamine derivatives, the concentration of glycosylated proteins decreases, thereby slowing down the process of hypertrophy of the arterial wall and the progression of microangiopathy, preventing the formation of endothelial dysfunction, which is especially important for patients with diabetes mellitus and concomitant arterial hypertension. This set of properties makes thiamine a valuable tool for the treatment and prevention of microangiopathic complications in a wide range of patients.

Pyridoxine is also a coenzyme of a large number of reactions of decarboxylation and transamination of amino acids, which actively occur primarily in nervous tissue. Cyanocobalamin ensures the synthesis of methionine, participates in intramolecular hydrogen transfer in isomerization reactions, transmethylation, deamination, etc. The drug Milgamma contains 100 mg of thiamine, 100 mg of pyridoxine, 1000 μg of cyanocobalamin. Due to the presence of 20 mg of lidocaine and the small volume of the administered solution (2 ml), injections of the drug are practically painless and comfortable for patients.

When administered orally, not all of these vitamins, in particular thiamine, have sufficient bioavailability, as a result of which their entry into the body with food is significantly difficult, especially in the presence of concomitant lesions of the gastrointestinal tract. But now this problem is being solved through the use of fat-soluble drugs. For example, a lipophilic substance with thiamine-like activity, such as benfotiamine, which is part of Milgamma compositum, is well absorbed when administered orally.

Based on the characteristics of metabolism and the numerous functions performed in the body, B vitamins are traditionally widely used to treat patients with diseases of the central nervous system caused by nutritional deficiency, toxic effects, traumatic injuries, as well as patients with various lesions of the peripheral nervous system, in particular radiculopathies caused by herniated intervertebral discs. A balanced complex of B vitamins for oral administration is Milgamma compositum (includes 100 mg of benfotiamine and 100 mg of pyridoxine)*. Numerous randomized, double-blind studies have provided convincing data on the effectiveness of the drug in patients with diabetic, alcoholic and some other forms of polyneuropathies. The treatment not only reduced the severity of the pain syndrome, contributed to the restoration of impaired movements, but also led to a slowdown in the progression of the pathological process and to the restoration of the speed of impulse transmission along the peripheral nerves.

Of great interest is the possibility of using the drugs Milgamma and Milgamma compositum in patients with pain syndromes caused by osteochondrosis, osteoarthritis and other nonspecific changes in the joints and adjacent periarticular tissues. The use of Milgamma and Milgamma compositum in combination with other drugs (non-steroidal anti-inflammatory drugs, analgesics, muscle relaxants, etc.) in such a group of patients seems quite justified and is due to a number of reasons. Thus, it has been experimentally established that the use of B vitamins in high doses significantly reduces the intensity of pain. This phenomenon may be associated with inhibition of local synthesis of inflammatory mediators, as well as modulation of the interaction of mediators with the receptor apparatus.

Similar results were obtained in a series of clinical studies conducted in groups of patients with pain syndromes caused by pathology of the joints of the limbs and spine, accompanied by local pain syndromes. Despite the existing differences in design, most studies have demonstrated similar results: the drugs Milgamma and Milgamma compositum help reduce the severity of pain. It turned out that the administration of vitamin therapy has an additional analgesic effect when carrying out standard pain therapy using various non-steroidal anti-inflammatory drugs. The existence of certain gender differences has been noted when using a combination of B vitamins and non-steroidal anti-inflammatory drugs, for example, the predominance of an additional analgesic effect in women.

As a result of a randomized, double-blind study examining the possibility of potentiating the analgesic effect of one of the representatives of non-selective type 2 cyclooxygenase inhibitors using a B complex of vitamins (Milgamma and Milgamma compositum), it was found that combination therapy for acute back pain caused by degenerative lesions of the spine, provides a more pronounced and earlier analgesic effect compared to monotherapy with a non-steroidal anti-inflammatory drug. In addition, in such patients, combination therapy provides a significantly earlier onset of analgesic effect. Similar data were obtained in a series of studies studying local pain syndromes: the analgesic effect of combination therapy was superior to the effect of monotherapy for pain in the neck, cervicothoracic localization, and pain in the lower back.

It must be emphasized that the studies were carried out in accordance with the requirements of evidence-based medicine and were randomized, multicenter, placebo-controlled, which indicates the reliability and significance of the results obtained.

Most researchers who have studied the clinical effects of Milgamma and Milgamma compositum note their good tolerability and the almost complete absence of negative side effects. This is very important, since good tolerability of treatment increases the patient’s adherence to its continuation.

The optimal course of treatment for back pain includes 10 injections of the drug Milgamma and 14 days of taking the drug Milgamma compositum, 1 tablet 3 times a day. Research results show that taking pills allows you to prolong the therapeutic effect for up to 3 months.

Thus, the data presented allow us to consider it appropriate to include Milgamma and Milgamma compositum in treatment regimens for patients with damage to the peripheral nervous system, in particular patients with pain syndromes caused by degenerative lesions of the spine.

Contraindications to the use of Milgamma

The main contraindications to the use of Milgamma are:

• heart failure in the stage of decompensation;
• disruption of cardiac muscle conduction;
• individual intolerance to one or another component of the drug.

Both the tablet and injection forms of Milgamma are contraindicated for children under 16 years of age, which is associated with an increased content of vitamins compared to age standards. The use of this vitamin complex in childhood threatens the development of hypervitaminosis and deviations in the development and functioning of systems and organs.

The gestational period and lactation are not contraindications to the use of Milgamma, however, due to the lack of research, the use of the drug during these periods is not recommended.

To avoid overdose, Milgamma is prescribed with caution while taking other medications and vitamin complexes containing pyridoxine, thiamine, and cyanocobalamin.

pharmachologic effect

Milgamma is a combination drug, the active composition of which is represented by B vitamins:

• Vitamin B1 is a regulator of protein and carbohydrate cellular metabolism, and also takes part in fat metabolism. It is characterized by an antioxidant effect and regulates the conduction of nerve impulses. It has an analgesic effect due to its effect on the transmission of excitation.
• Vitamin B6 acts as a cofactor for many enzymes that act in nervous tissue. Participates in decarboxylation, transamination and deamination of amino acids. Prevents the accumulation of ammonia in tissue, participates in the formation of neurotransmitters (norepinephrine, dopamine, adrenaline, GABA and histamine).

Milgamma tablets: Accelerates the restoration of nervous tissue. Vitamins B6 and B1 are capable of potentiating each other’s action. In the composition of the pills, vitamin B1 is represented by benfotiamine, a fat-soluble form of the vitamin.

Milgamma injections: Accelerates inflammatory and degenerative pathologies of nervous tissue and the musculoskeletal system, improves the function of the nervous system as a whole. In addition to B1 and B6, the composition includes Vitamin B 12, which is directly involved in the formation of the myelin sheath, activates hematopoiesis, and helps reduce pain that occurs when the peripheral nervous system is damaged. Accelerates nucleic acid metabolism. Lidocaine has a local anesthetic effect, providing all types of anesthesia (infiltration, terminal, conduction).

Pharmacokinetics

• Dragee - after oral administration, benfotiamine is effectively absorbed from the intestines, reaching a maximum concentration in the blood in less than 1 hour. Benfotiamine accumulates in cells five times more actively than the water-soluble form of thiamine. After biotransformation processes into the form of thiamine diphosphate, the kinetics do not differ from water-soluble thiamine.
• Solution - when administered intramuscularly, thiamine is quickly and effectively absorbed into the blood. 15 minutes after administration of 50 mg of the drug, the concentration of thiamine in the blood reaches 484 ng/ml. Thiamine is distributed unevenly in the body: the highest concentration is observed in red blood cells - 75%, while up to 10% of the vitamin is concentrated in blood plasma. Penetrates the placenta and blood-brain barrier. Pyridoxine, when administered intramuscularly, also quickly enters the systemic circulation, evenly distributed throughout the body, including the brain. Pyridoxine acts as a coenzyme, binding to plasma proteins up to 80%.

Metabolism and excretion

Metabolites of thiamine are pyramine, thiaminecarboxylic acid and other substances. Thiamine is retained in the body less than other vitamins. Excreted in urine. Pyrodoxine forms a depot in the liver, oxidizing to 4-pyridoxine acid. It is excreted in the urine 2-5 hours after absorption.

How does the drug work?

Complex product based on vitamins gr. B is a neurotropic drug with anti-inflammatory and regenerating properties. Together, the active substances increase blood flow and improve the functioning of nerve cells. Other effects provided by the administration or administration of the medicine:

• optimization of blood microcirculation;
• increased hematopoiesis;
• reduction of swelling;
• general strengthening of the body;
• normalization of vascular functions.

Lidocaine in the composition is necessary not only to reduce unpleasant local reactions. This anesthetic relieves general pain and reduces the strength of the inflammatory reaction. The individual components of Milgamma provide the following effects:

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1. Thiamine
   . A natural participant in carbohydrate metabolism, without the vitamin the functioning of nervous tissue is impossible.
2. Pyridoxine
   . Partially participates in the metabolism of carbohydrates, and to a large extent - in the metabolism of proteins and fats. Mutually enhances the effect of thiamine. In combination, both vitamins increase the efficiency of muscles and the cardiovascular system.
3. Cyanocobalamin
   . Helps synthesize myelin sheaths of nerve cells, reduces pain caused by damage to peripheral nerve trunks, and stimulates nucleic acid metabolism.

All substances quickly penetrate the blood, so the effect is achievable already on the first day of use. B vitamins do not accumulate in tissues; their intake from food must be constant.

Side effects and interactions

Side effects of injections during treatment can occur in any patient. Symptoms are observed in the following body systems:

1. Immune: rarely - allergies (skin rashes, breathing problems, angioedema, anaphylaxis).
2. CNS: in some cases - confusion, dizziness.
3. Digestive tract: sometimes - vomiting.
4. Heart vessels: rarely - rapid heartbeat; in some cases - rhythm disturbances.
5. Skin, subcutaneous tissues: rarely - severe sweating, itching, acne, urticaria.
6. Connective tissue, bones, muscles: in some cases - convulsions.
7. General disorders, side effects at the injection site: skin irritation. Systemic reactions occur when the recommended dose is exceeded or the solution is administered quickly.

If the buttock hurts after the injection, the next injection should be given in the other leg. An iodine mesh or magnesium lotions will help get rid of pain and discomfort.

Injections should not be taken in combination with solutions containing sulfites. Thiamine breaks down in them, resulting in inactivation of the action of other vitamins.

Pyridoxine is not recommended to be used simultaneously with Levodopa, as this may weaken the antiparkinsonian effect. Milgamma vitamins in injections also interact with Isoniazid, Penicillamine, Cycloserine.

The parallel use of reducing and oxidizing compounds is prohibited. These include iodides, acetates, carbonates, ammonium iron citrate, tannic acid, Benzylpenicillin, Riboflavin, disulfites, Dextrose, Phenobarbital.

Lidocaine interacts with sulfonamides and may have a negative effect on the heart when epinephrine and norepinephrine are used simultaneously.

Do not inject Milgamma with salts of heavy metals, since cyanocobalamin is incompatible with them.

Drug interactions

Injecting Milgamma in combination with certain drugs is not allowed due to their interaction with each other:

• With furosemide. It accelerates the removal of B1 from the body;
• With levodopa. Vitamins weaken the antiparkinsonian effect;
• When combined with lidocaine as part of Milgamma with sedative medications, it enhances the inhibitory effect on the central nervous system;
• Adrenergic blockers enhance the toxic effect of lidocaine;
• Taking with muscle relaxants can enhance their effect to the point of paralysis of the respiratory muscles;
• Antiarrhythmic drugs - increased cardiodepressive effects; with amiodarone - development of seizures;
• MAO inhibitors and tranquilizers - increase the likelihood of developing hypotension;
• Narcotic analgesics - the effect on the respiratory center is enhanced;
• Prenylamine - there is a risk of ventricular tachycardia of the “pirouette” type;
• Propafenone - increased side effects on the central nervous system;
• Polymyxin B - administration of Milgamma requires constant monitoring of breathing;
• With procainamide - there is a risk of developing hallucinations;
• With cardiac glycosides - their effect is enhanced;
• Digitalis preparations - increases the risk of AV block;
• Beta-blockers - increased toxicity of lidocaine, bradycardia and hypotension;
• Drugs that block neuromuscular conduction - their effect is enhanced with a subsequent weakening of the conduction of nerve impulses.

Milgamma drug, manufacturer, country of origin

The drug Milgamma, the patent belongs to the Representative Office of VERWAG PHARMA GmbH&CoKG in Ukraine.

Manufacturer: Mauermann-Artsnaimitel KG, Germany. Heinrich-Knothe-Strasse 2, 82343 Peking, Germany.

Painful sensations experienced during human life, disorders of the nervous system should not be ignored, because in this way our body gives alarm signals. And this is a serious reason to turn to experienced specialists for advice and prescribe a course of treatment. Uncontrolled medication use and self-medication can lead to sad and unpredictable consequences.

At the Yusupov Clinic, the prevention and treatment of diseases of the nervous system and musculoskeletal system are successfully carried out under the supervision of leading doctors in the capital, thanks to high-tech equipment and widely used modern methods of medicine. More detailed information can be obtained from hospital consultants by making an appointment.

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Milgamma - description and composition

The pharmacological agent is available in the form of a solution for injections, in the form of tablets, dragees ( Milgamma Compositum

). For diseases of the nervous system and other pathologies, Milgamma injections are most often prescribed. The red solution can be administered intramuscularly; intravenous use is not practiced.

Each ampoule contains 2 ml of Milgamma, the package contains 5 and 10 ampoules. Tablets are produced in quantities of 30 and 60 pieces/pack, dragees - 15 pieces/blister of 2-4 pieces per box. Milgamma composition of vitamins in injections is a concentrate of B vitamins:

• thiamine
  (vit. B1, thiamine hydrochloride), 100 mg;
• pyridoxine
  (vit. B6, pyridoxine hydrochloride), 100 mg;
• cyanocobalamin
  (vit. B12), 1000 mcg.

Milgamma's injection is very painful, as is the injection of other drugs based on vitamin complexes. Therefore, an anesthetic – lidocaine hydrochloride – was added to its composition.

As additional ingredients, Milgamma contains water, sodium hydroxide, benzyl alcohol, sodium polyphosphate, potassium hexacyanoferrate.

The cost of the drug is 250 rubles. (for 5 ampoules), 630 rub. (for 30 tablets), 1150 rub. (for 60 tablets).

Our specialists

Andrey Igorevich Volkov

Neurologist, Candidate of Medical Sciences

Daria Dmitrievna Eliseeva

neurologist, candidate of medical sciences

Tatyana Aleksandrovna Kosova

Head of the Department of Rehabilitation Medicine, Physiotherapy Physician, Neurologist, Reflexologist

Elena Gennadievna Petrova

Physiotherapist, Candidate of Medical Sciences

Maxim Vladimirovich Chulkov

Instructor-methodologist in physical therapy, kinesiotherapist

Sergey Olegovich Molchanov

Instructor-methodologist for physical therapy

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We work around the clock

Sign up for a consultation by phone or send a request through the form

Our specialists

Andrey Igorevich Volkov

Neurologist, Candidate of Medical Sciences

Daria Dmitrievna Eliseeva

neurologist, candidate of medical sciences

Tatyana Aleksandrovna Kosova

Head of the Department of Rehabilitation Medicine, Physiotherapy Physician, Neurologist, Reflexologist

Elena Gennadievna Petrova

Physiotherapist, Candidate of Medical Sciences

Maxim Vladimirovich Chulkov

Instructor-methodologist in physical therapy, kinesiotherapist

Sergey Olegovich Molchanov

Instructor-methodologist for physical therapy

Prices for services *

We work around the clock

Sign up for a consultation by phone or send a request through the form

Milgamma injections: how many days to inject Milgamma

Before starting therapy with this drug, it is necessary to consult with a neurologist, who will decide how often Milgamma injections can be given, when to inject - in the morning or evening, and select the required dosage. To receive qualified advice, you can contact one of the leading centers in Moscow - the Yusupov Hospital.

The duration of the therapeutic course of Milgamma for persons with severe pain syndrome can be from five to ten days. Injections are given daily, the daily dosage is 2 ml. After the acute inflammatory process subsides and the intensity of pain decreases, Milgamma Compositum is prescribed orally. However, in some cases, the doctor may recommend continuing intramuscular administration of the drug, but not more than two to three times a week.

Instructions for use: method and dosage

When prescribing Milgamma injections to a sick person, he and his relatives carefully study and subsequently carefully follow the instructions, which set out in detail and clearly the rules for using the drug, methods of its administration and dosage.

Throughout the course of treatment, you should see a doctor regularly (at least once a week). This allows you to effectively monitor the progress of treatment and timely adjust the dosage and frequency of drug administration.

When is it better to inject Milgamma: morning or evening

Patients often have questions about choosing the right time for Milgamma injections. For greater effectiveness of the drug, it is better to administer it in the morning. However, nothing bad will happen if you give the injection at night. It all depends on the general condition of the patient. But if the drug is taken in combination with other medications, then the time of its receipt is specified by the attending physician.

How and where to inject Milgamma correctly

To reduce the likelihood of injury to the patient, the solution is injected into the buttock. This is explained by the concentration of large muscles located away from:

• bones;
• veins;
• arteries;
• nerves.

The procedure for administering the drug Milgamma:

• preliminary disinfection of the injection area;
• removing residual air from the syringe;
• deep (observing a right angle) insertion of a needle into the muscle tissue located in the uppermost part of the buttock;
• The solution is introduced smoothly and slowly, otherwise it will accumulate in one place and pain will occur.

What to do if your buttock hurts after the injection? First of all, it is necessary to shift the site of the next injection by 1-3 mm. Then periodically change the muscle. You may need to change the halves of the buttocks.

Milgamma injections are quite painful, so to reduce the discomfort of patients they must be done correctly:

• first of all, you need to understand which syringe to inject the drug with;
• to avoid problems with the oily consistency of the solution, choose the thinnest (available or commercially available) needle;
• To avoid damaging blood vessels and nerve bundles with the needle, it must be inserted as deeply as possible. To do this, choose the longest needle;
• to significantly reduce pain, the drug is administered smoothly and slowly (about one and a half minutes);
• At the end of the procedure, the injection site should be massaged with light and smooth movements, which will help intensify the penetration of the solution into the muscle tissue and reduce the likelihood of a hematoma appearing in the same place.

How many days to inject Milgamma

Milgamma is intended to relieve inflammation of the NS tissues, accompanied by intense pain. The drug promotes the gradual restoration of neural structure, nerve conduction and the rapid elimination of inflammatory and degenerative processes. Considering that Milgamma is a rather painful injection, it must be administered only intramuscularly (but in no case intravenously). Such an injection does not threaten the body in any way, so it can be done not only in the clinic, but also at home.

For severe pain, the treatment course begins with 1 injection (2 ml) per day. Course duration is 6-9 days. When pain decreases, reduce the frequency of drug administration (every other day, but no more than 3 times a week). The duration of this course is 2-3 weeks. It is advisable to switch to tablet medicine as quickly as possible (take 1 tablet every day).

Dosage regimen and overdose

An adult is injected with 2 ml of Milgamma solution. Exceeding the dose may cause side effects.