What is milgamma injected with in combination for osteochondrosis?

Among the many vitamins there are neurotropic, or B vitamins. They are necessary for the normal functioning of the central and peripheral nervous system. Their prescription as part of complex therapy in our country is the standard for the treatment of neuralgia, radiculitis, sciatica, and acute back pain.

One of the characteristic representatives of combined drugs of group B is Milgamma, which is actively used for protrusions and hernias, for example, of the lumbar spine. How justified is the use of this drug and other vitamins in general? Is there a therapeutic effect from prescribing vitamins? If so, how long should you take this drug to improve your well-being if you have a hernia in the lumbar spine?

Hernia on MRI.

The use of milgamma for osteochondrosis: does it help and what is it prescribed for?

The consequences of progressive osteochondrosis are severe pain in the cervical, thoracic or lumbar spine, and a reduction in the range of motion. Neurological abnormalities appear, brain hypoxia develops, and complications of cardiac pathologies are observed. Milgamma for osteochondrosis is included in the mandatory course of therapy. Its action helps prevent further neurological disorders, moderately reduce pain syndromes and start the process of tissue regeneration.

Composition of the drug

Milgamma is a medicinal complex of B vitamins. It is available in the form of tablets, dragees, and injections. The solution for intramuscular administration includes thiamine (B1), pyridoxine (B6), cyanocobalamin (B12), Lidocaine and additional substances. Tablets and dragees contain benfotiamine, vitamin B6, silicon dioxide and auxiliary components.

• Vitamin B1 plays an important role in carbohydrate metabolism and protects cell membranes from peroxidation.
• Pyridoxine is involved in the synthesis of hemoglobin, controls potassium and sodium metabolism, and normalizes brain function;
• Cyanocobalamin ensures nucleic acid metabolism, promotes the formation of the myelin sheath on nerve fibers, stimulating the normal passage of impulses, and reduces pain in cases of damage to the peripheral nervous system.

Indications

Does Milgamma help with osteochondrosis? In the process of degenerative changes, the intervertebral space decreases, nerve roots and vessels are infringed by the vertebral bodies, causing pain, blood supply deteriorates, and the brain experiences a lack of oxygen. Such pathological changes are characteristic of stages 2 and 3 of osteochondrosis. The action of the drug is aimed at improving blood circulation, metabolic processes and strengthening the body.

• neuralgia;
• neuritis;
• plexopathy (damage to nerve structures);
• radicular pain in osteochondrosis;
• muscle spasms with degenerative-dystrophic changes in the spinal column.

Contraindications

Absolute contraindications include infancy, special sensitivity to the components of the drug, and cardiac pathologies. It is undesirable to use the medicine during pregnancy and breastfeeding, since no research has been conducted in this area.

When using the drug, the following side effects are possible:

• allergic reactions (itching, skin rashes, difficulty breathing);
• in rare cases, tachycardia;
• nausea, vomiting;
• dizziness;
• convulsions.

Dosages and application features

Milgamma injections are often prescribed for acute pain in the cervical and lumbar regions. When administered directly into the muscle, the active substances enter the bloodstream and the desired effect is achieved faster.

How many days can you take injections? Only the attending physician determines the dosage and frequency of use of Milgamma. Injections during an exacerbation are prescribed once a day, 2 mg, for 5-10 days. After an exacerbation, maintenance therapy is carried out, injecting 1 ampoule every 2 or 3 days.

Milgamma Compositum is produced in the form of dragees. The main difference from injections and tablets is the active substance benfotiamine, which is a fat-soluble derivative of thiamine and is absorbed more quickly by the body. For acute relapses of osteochondrosis, the medicine is taken 3 times a day, 1 tablet, then the doctor reduces the dose to a single dose.

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What can you inject together? To achieve maximum therapeutic effect, chondroprotectors are prescribed. For example, Alflutop and Milgamma are compatible and can be taken at the same time.

How to replace Milgamma

An analogue of Milgamma is Kombilipen. The drugs are available in injection solutions and tablets. Each product contains B vitamins. The composition and amount of active substances in intramuscular complexes are identical. Kombilipen solution is a 100 percent analogue of Milgamma. The tablet forms of the drugs differ.

The method of administration and dosage of the drugs are the same. During an exacerbation, 1 injection or 3 tablets per day are prescribed. After eliminating the pain syndrome, they switch to maintenance therapy.

Combilipen is produced in Russia, Milgamma is produced in Germany. The cost of an imported drug is 3 times more expensive than its Russian counterpart. Whether it is better to take Milgamma or Combilipen, everyone decides for themselves, after consulting with their doctor.

Indications for use of Milgamma

The drug is indicated not for separate, independent treatment (monotherapy), but as part of the so-called complex therapy. This means that separate use of Milgamma may be useless. Does this mean that this drug “does not work”? You will find the answer to this question at the end of the article. Naturally, the official indications are neurological pathology.

In addition to neuralgia, neuritis, plexitis and polyneuropathies of various origins, Milgamma is indicated for nocturnal muscle cramps, and especially in old age. Since compression radiculopathy with protrusions and hernias occurs with symptoms of inflammation, the clinic of “lumbago” or lumbago with an aggravated hernia can, to a first approximation, be considered a clinic of neuritis. Therefore, the drug is indicated from this point of view for the relief of pain symptoms, as well as sensory and motor disorders in the presence of a clinically significant hernia, for example, the cervical spine.

The effectiveness of milgamma injections for osteochondrosis

​Treatment for osteochondrosis can take several weeks or a lifetime. And only an experienced doctor and the correct treatment determines how easily and painlessly a patient will move once he or she seeks treatment for back pain.​

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Why is the drug prescribed?

​With exacerbations of osteochondrosis, especially in the cervical and lumbar region, the pain is so severe that no pills or ointments can help. In such cases, doctors recommend giving injections to get rid of unbearable pain.​

​Blockades can be carried out with one drug, for example, an anesthetic (novocaine, lidocaine, etc.), or several - for example, in combination with hydrocortisone (a hormonal agent), non-steroidal drugs, antispasmodics and others.​

• ​Ketonal and Ketorolac are effective non-steroidal anti-inflammatory drugs that quickly relieve pain, swelling and inflammation.​
• There are several reasons why the injection form of introducing drugs into the body is preferable to others. Why?​

​Blockades in neurology are called manipulations, the essence of which boils down to the following. The drug is injected directly into the source of pain. That is, for cervical osteochondrosis, the medicine is injected into the neck area, for lumbar osteochondrosis - into the lumbar region. This method of administering the substance is called paravertebral. Sometimes it can be injected directly into the intervertebral disc or epidural canal.​

1. A drug such as milgamma is widely used. This is a multivitamin complex containing large quantities of B vitamins. It has an analgesic effect and normalizes blood supply to nerves and muscles. It is actively used in the treatment of neck chondrosis, intervertebral hernia, and neurological pathology associated with diabetes mellitus.​
2. ​Chondrosis of the cervical or lumbar spine is accompanied by severe pain at the time of exacerbation of the disease.​
3. Chondrosis is what people call the symptoms of osteochondrosis. Prolonged and debilitating pain in the neck and lumbar back is most often his fault.​

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The drug is best used for neurological disorders with severe pain. By accelerating metabolic processes in such a situation, it is possible to achieve a significant improvement in the patient’s condition.​

​Milgamma for cervical osteochondrosis is used to increase the trophic properties of the soft tissues of the spinal column. The drug consists of a group of B vitamins, which are valuable suppliers of energy for cells. Against the backdrop of increased energy metabolism, the supply of nutritional compounds to the vertebrae and discs of the spinal segment increases.

Indications for use

​The speed of the body's reaction to the drug. With the help of injections, the result comes many times faster than with other dosage forms.​

• Self-medication, as with any other disease, is not recommended, so any medications for osteochondrosis - injections, tablets, ointments, massage or warming - should only be prescribed by an experienced doctor. The first thing that comes to mind is to give an anesthetic injection and forget about the discomfort. But it is worth remembering that any pain relief, including even a therapeutic blockade given by a doctor, will not solve the problem. This is just a temporary solution that can help you get to the hospital or home.​
• To improve the outcome of treatment, local anesthetic injections for cervical osteochondrosis are combined with immobilization of the cervical spine with a Shants collar (an orthopedic device that eliminates the ability to move the head) for several days.
• Mydocalm is a drug that relieves muscle spasms. Helps quickly relax stiff muscles around the site of the disease, reducing pain and increasing mobility.​
• ​Fast action of the drug. The medicine entering directly into the blood immediately reaches the “target” - the nerve endings, and the swallowed tablet takes time to dissolve in the stomach, pass through the digestive tract, be absorbed into the blood and only after half an hour - an hour begin to act.

​Often the injection contains a small dose of the hormone to prolong the analgesic effect.​

Milgamma is administered only intramuscularly.

In addition, pain may be accompanied by symptoms such as dizziness, especially with cervical osteochondrosis, or the sensation of “goosebumps” running across the skin - paresthesia. There are medicines in injections that can cope with this.​

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Pharmacological group of vitamin Milgamma

Agents that affect tissue metabolic processes. B vitamins (Milgamma) do not contain mineral complexes.

The active ingredients of the drug are B vitamins: B1 (thiamine), vitamin B6 (pyridoxine) and vitamin B12 (cyanocobalamin).

The choice of the form of administration of this medication into the body depends on the individual characteristics of the patient, whether ampoules with a solution or tablets

The active ingredients of Milgamma injections are B vitamins: B1 (thiamine), vitamin B6 (pyridoxine) and vitamin B12 (cyanocobalamin), as well as lidocaine, which has local anesthetic properties.

Milgamma tablets are intended for oral administration. Their composition is identical to the injection solution (B vitamins - active substances benfotiamine 100 mg, pyridoxine hydrochloride 1) and differs in the absence of lidocaine hydrochloride and the presence of excipients.

Contraindications for use

No matter how good the drug is, it cannot suit everyone - some of the side effects of Milgamma can seriously harm groups of patients vulnerable to them. For example, for patients under 15 years of age, especially with a diagnosis of VSD (and it occurs very often, sometimes without the knowledge of the patient himself, who confuses dystonia with other diseases or poor health for no reason), it is better to choose another drug with an anesthetic effect instead of Milgamma.

It is worth paying close attention to individual intolerance to the constituent components of the drug. There are quite a lot of allergy sufferers whose bodies react negatively to lidocaine. A person who has at least once been offered serious painkillers should have already had an allergy test for basic anesthetics, which includes lidocaine, but for those who have not encountered it, it is better to play it safe.

Important! Cancer patients are prohibited from taking Milgamma and most other drugs with vitamin complexes - this can accelerate the growth of malignant tumors. Milgamma is not recommended for people with heart failure, as well as for those undergoing a recovery period after major surgery.

The consequences of negligence usually do not go beyond the following:

Milgamma is not recommended for people with heart failure, as well as for those undergoing a recovery period after major surgery.

The consequences of negligence usually do not go beyond the following:

• dizziness and nausea;
• convulsions;
• arrhythmia;
• increased sweating;
• allergic reactions (rash, redness of the skin).

Such side effects during one of the attacks of pain, which are not uncommon with cervical osteochondrosis, will significantly worsen the patient’s condition.

Heart failure is one of the contraindications for taking milgamma.

Milgamma is contraindicated for pregnant and lactating women in almost all cases (it is possible to determine whether the drug is approved in each specific case only after a complete examination of the expectant mother by a doctor). Problems with the cardiovascular system, serious digestive disorders, and severely reduced immunity are considered categorical contraindications. For pregnant women with thrombosis, the initial stages of atherosclerosis and varicose veins, Milgamma can cause the most significant harm.

Overdose

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.

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.

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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.

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).

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

The instructions for use of Milgamma indicate that to quickly eliminate pain, you should use ampoules or tablets (1 tablet three times a day). Treatment can last about one month. The doctor should monitor the patient's health status weekly. Experts advise switching to internal administration of the drug as quickly as possible. Please note that Milgamma suppositories are not available.

The course of treatment with injections can last longer only as prescribed by a doctor. How often you can give injections, and what form of release is preferable in each specific case, you should also ask your doctor.

If there is an overdose of the drug, the patient may experience those symptoms that are described as side effects. In such cases, symptomatic therapy is used.

Exceeding the therapeutic dose of Milgamma may lead to the development of overdose symptoms. Among them, the following clinical signs are noted:

• nausea and vomiting;
• headache, dizziness;
• heart rhythm disturbance;
• tachycardia or bradycardia;
• convulsive syndrome;
• sweating

The appearance of overdose symptoms requires stopping taking Milgamma and seeking medical help. There is no specific antidote. To combat clinical signs, symptomatic therapy is used.

Instructions for use for hernia

There are no special features in the use of Milgamma for intervertebral hernia. The drug is administered as usual, deep intramuscularly. The official instructions recommend that in case of severe pain syndrome, administer 2 milliliters of the drug daily for 5 or 10 days. Then it is advisable to switch to the drug Milgamma compositum for oral administration. It is distinguished by the absence of vitamin B12. The second option is to continue giving injections (shots), but not daily, but every other day. The general course can last 2-3 weeks.

Injections

For intense pain, when tablets help little, injections are used. They are done intramuscularly or intravenously. This method of pain relief is more effective, since the active substance reaches the location of inflammation much faster. For comparison, tablets begin to act after about thirty minutes, while injections take about 15 minutes.

Injectable drugs for osteochondrosis of the lumbar region (and other parts of the spinal column) are divided into the following groups:

• Anesthetics – they relieve pain in the short term, but do not relieve inflammation (Analgin, Baralgin).
• Myotropic antispasmodics - have a relaxing effect on muscle tissue. When the spasm is relieved, the nerve endings are released and the pain goes away.
• Non-steroidal anti-inflammatory drugs - the disease is usually treated with tablets of this group, but in case of severe pain it is relieved by an injection directly into the location of the pain.
• Steroids are stronger painkillers, but the list of side effects is longer.

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One of the types of injections is considered to be a blockade. This is a single or group of injections into the site of inflammation. The pain is blocked for a short period and the doctor has the opportunity to conduct a thorough examination and prescribe adequate treatment. Blockades are often used for lower back pain.

Mydocalm

A drug that is classified as an antispasmodic. The action of the injection is aimed at relieving spasm of the muscle tissue around the spinal column. Nerve receptors are blocked; they cannot conduct nerve impulses to the spinal cord for some time. The patient does not feel pain, the muscles relax. The body manages to at least partially restore the tone of the muscle fibers; they release nerve roots. And as a result, pain sensations decrease.

Injections are given several times a day with a dose of 1 ml of Mydocalm. One ampoule contains 100 mg of active substance and two and a half mg of lidocaine. It is not recommended to use the medicine during pregnancy and lactation, since there are no studies in these groups of patients. Also not prescribed to children. The cost of a package of 5 ampoules of 1 ml each is about 500 rubles.

Mydocalm (500 rub.)

Ambien

A very effective complex injection drug. Due to its composition, it has a multifaceted effect on the disease. The medicine eliminates inflammation and at the same time stimulates the nervous system to renew nerve cells. So, what components are included:

• Dexamethasone is a hormone (glucocorticoid), it relieves the inflammatory process, while the risk of side effects is almost zero.
• Cyanocobalamin – promotes the renewal of nerve cells. Their regeneration is very important, especially in severe forms of osteochondrosis, when a significant part of the nervous tissue at the site of the inflammatory process is destroyed.
• Phenylbutazone is a non-hormonal anti-inflammatory component, it relieves pain and reduces the inflammatory process.
• Salicylamide – promotes high-quality and effective absorption of other components in the medicine
• Lidocaine - performs the function of anesthesia during the injection.

Ambene (5500 rub.)

Ambene is available in the form of a syringe in which all components are mixed, or two ampoules with solutions A and B. They are injected alternately into the buttock. The course of treatment is three injections, given once every two days. A repeat course is prescribed no earlier than a few weeks later. But all the nuances are discussed individually with the doctor.

Ambene is a serious drug that has a number of side effects. Therefore, it should be used only after consultation with a specialist. The cost of the drug is about 5,500 rubles per package of 10 ampoules of two ml.

Drug analogues

Milgamma is produced by the German company Ferwag-Pharma, it is produced in ampoules of 2 milliliters, used only intramuscularly, there are three packaging options - 5 ampoules, 10 and 25. Accordingly, the medicine can be designed for a long course of treatment. The cost of the most popular package - 10 ampoules - ranges from 405 to 730 rubles.

Milgamma is a popular drug in the CIS countries, and it has quite a lot of imitators. These include:

• Binavit;
• Vitaxon;
• the more famous and widely used Kombilipen;
• Compligam B;
• Larigama.

Binavit is a domestic drug produced by the Armavir biofactory with a price for a similar package of 239 rubles. Combilipen is a drug from Pharmstandard, with an average cost of 270 rubles. Compligam B is produced by the domestic company Sotex, with an average cost of 250 rubles, and Larigama is produced by the Russian company Grotex LLC, and its cost is approximately 260 rubles per package.

Attention. There is also the drug Milgamma compositum, which has a slightly different effect. Firstly, it contains only one vitamin B6, and benfotiamine, a derivative of vitamin B1, and secondly, it is available in tablets and is more expensive, that is, it does not have a form for parenteral administration.

There is also the drug Milgamma compositum, which has a slightly different effect. Firstly, it contains only vitamin B6 and benfotiamine, a derivative of vitamin B1, and secondly, it is available in tablets and dragees, it does not have a form for parenteral administration. Accordingly, the drug Milgamma can be considered more effective because it contains vitamin B12, or cyanocobalamin.

A deficiency of this vitamin can lead to a neurological disorder such as sensory or posterior columnar ataxia. In this case, the pathways of the joint-muscular sense lying in the posterior columns of the spinal cord are affected. They carry proprioceptive sensitivity, or muscle-joint sense, to the brain for analysis. Thanks to the work of this analyzer, we can be aware in complete darkness where our limbs are, and when walking on a flat surface in the dark, we do not fall, because we know how our legs are rearranged and where our torso is. With posterior columnar ataxia, this sensation is blurred or lost altogether. Therefore, one of the characteristic clinical symptoms will be a fall, or an unsteady gait of patients at night, for example, when getting up to go to the toilet. The patient should walk in good light to see the position of his legs.

If such symptoms are present, it is very likely that there is a deficiency of vitamin B 12, since sensitive ataxia is a characteristic sign of deep pernicious anemia.

Pharmacokinetics and pharmacodynamics

The abstract indicates that after intramuscular injection, thiamine is quickly absorbed and enters the blood. It is distributed unevenly in the body. Since there are no significant reserves of thiamine in the body, it must be supplied every day. The substance can penetrate the blood-brain and placental barriers. Excreted through the kidneys. Thiamine, compared to other vitamins, is stored in the body in the smallest quantities.

Pyridoxine, after the solution has been administered intramuscularly, quickly enters the bloodstream and is distributed throughout the body. Approximately 80% of the vitamin is bound to plasma proteins. The substance is able to penetrate the placenta and enters breast milk. Later it is oxidized to 4-pyridoxic acid, which is excreted through the kidneys after 2-5 hours.

Cyanocobalamin, entering the human blood, binds to proteins, resulting in the formation of a transport complex. Then, in this form, it is absorbed by the liver tissue. It also accumulates in the bone marrow. After cyanocobalamin is excreted into the intestines with bile, it can be reabsorbed.

Manufacturer

Solupharm Pharmazoitische Erzeugnisse GmbH, Industriestrasse 3, 34212 Melsungen, Germany or

Manufacturer of the finished dosage form. Solupharm Pharmazoitische Erzeugnisse GmbH, Industrstrasse 3, 34212 Melsungen, Germany.

Packer. LLC "Ellara", 601122, Russia, Vladimir region, Petushinsky district, Pokrov, st. Franz Stollwerk 20, p. 2.

Representative office/organization receiving claims: Representative office in the Russian Federation 117587, Moscow, Varshavskoe sh., 125 Zh., bldg. 6.

Possible side effects

It is worth remembering that this drug has some side effects. If they appear after the first doses of the medicine, you should seek help from a doctor. The main adverse effects include itching, allergies, angioedema, increased sweating, nausea, dizziness, convulsions, and changes in heart rate.

Side effects usually occur due to incorrect or too rapid administration of the drug. Similar effects also occur if the correct dosage is not followed.

It is not recommended to use this drug for more than six months, as there is a high risk of problems with the nervous system. The drug may cause frequent headaches.

In some cases, side effects may occur, but this usually happens if the patient used the drug without consulting a doctor.

Sometimes it provokes diarrhea and other diseases associated with the gastrointestinal tract. It affects the heart, lungs, and causes the development of tachycardia and high blood pressure.

Sometimes side effects manifest themselves in the form of problems with sleep, increased anxiety, loss of consciousness, paresthesia, problems with hearing and vision.