Why are Kombilipen injections prescribed, and how to use them correctly?

Combilipen tablets - instructions for use

According to the pharmacological classification, the drug Combilipen Tabs (see photo below) belongs to complex vitamin preparations. This medicine contains B vitamins, which have a positive effect on the patient's health by eliminating neuralgic problems. In addition to tablets, ampoules for injections of Combilipen are produced. Both formats of the vitamin preparation differ in dosage and method of administration.

Compound

The active ingredients of the tablet are B vitamins. Each dose contains: 100 mg of benfotiamine (B1) and pyridoxine hydrochloride (B6), 2 mg of cyanocobalamin (B12). The injection form of the drug, in addition to vitamins B1, B6 and B12, includes lidocaine hydrochloride and purified water. What additional substances are included in the tablets:

Release form

Combilipen vitamins are available in the format of tablets and ampoules for preparing a solution. The first are film-coated, white or almost white in color, and are round biconvex tablets. Packed in 15 pieces in contour packaging with cells, then in cardboard packs of 30 or 60 pieces. Solution for injection - a clear red liquid in ampoules of 2 ml, in a package of 5, 10 or 30 ampoules.

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Pharmacodynamics and pharmacokinetics

The medication is a combined multivitamin preparation, the effect is determined by the composition. Benfotiamine is a fat-soluble form of thiamine (vitamin B1), involved in the conduction of nerve impulses. Vitamin B6 takes part in the metabolism of proteins, carbohydrates, fats, supports normal hematopoiesis, and the functioning of the central and peripheral nervous system.

Pyridoxine hydrochloride ensures the transmission of synapses, inhibition processes in the central nervous system, transport of sphingosine (a constituent substance of the nerve sheath), and the synthesis of catecholamines. Cyanocobalamin takes part in the synthesis of nucleotides, promotes normal growth, the process of hematopoiesis, the development of epithelial cells, and is necessary for the metabolism and synthesis of folic acid and myelin synthesis.

The drug Combilipen - indications for use

According to the instructions for use, Combilipen tablets are used for the following indications:

• trigeminal neuralgia;
• neuritis of the facial nerve;
• pain syndromes caused by diseases of the spine;
• intercostal neuralgia;
• sciatica;
• lumbar, cervical, cervicobrachial, radicular syndromes caused by degenerative changes in the spinal column;
• diabetic, alcoholic polyneuropathy;
• dorsalgia;
• lumbago with sciatica;
• painful tic;
• diabetic neuropathic ulcer of the lower extremities;
• Barre-Lieu syndrome;
• cervical migraine;
• pleural pain;
• degenerative changes and diseases of the spine.

Composition, release forms

The holder of the registration certificate Kombilipen is a Russian pharmaceutical company, this is its own development. Under this brand, a multivitamin product is produced in 2 dosage forms, differing not only in the method of administration into the body, but also in the set of constituent elements. The production of drugs intended for enteral (through the gastrointestinal tract) and parenteral (intramuscular injection) routes of administration has been established.

For the convenience of specialists in the field of medicine and pharmacology, a register of pharmaceutical substances - unique international nonproprietary names (INNs) that unambiguously characterize the essence of the action of a medicinal substance - has been developed and approved by the World Health Organization. In accordance with this list, the INN Combilipen (the Latin name of the drug Combilipen) is a grouping.

Source of article: ©Register of Medicines. Viewing drug data

It is a combination of several active compounds present in the drug in certain dosages, these are:

• Thiamine, known as vitamin B1, 100 mg - in the injection solution is presented in the form of thiamine hydrochloride, which in the body turns into an active phosphorylated form. The tablets contain its fat-soluble analogue Benfotiamine, which is similar in structure and properties to the finished form of the coenzyme.
• Pyridoxine, one of the bioactive forms of vitamin B6, 100 mg - is present in the medicine in the form of a hydrochloride salt (hydrochloride).
• Cyanocobalamin, the main form of vitamin B12 entering the human body, 1 mg in solution, 2 mcg in tablets is a cobalt-containing biologically active substance, it is also called an external antianemic factor.
• Lidocaine, 20 mg is a local anesthetic of the amide series, present only in the injection solution in the form of hydrochloride, ensures painless injections, improves the penetration of vitamins.

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The official instructions describe in detail the appearance of dosage forms, packaging and composition of auxiliary components:

• Film-coated tablets (Combilipeni Tabs) are white, round, with convex surfaces on both sides. Packaged in 15-cell contour packaging. 2 or 4 such blisters are placed in individual cardboard packs. The tablets are filled with microcrystalline cellulose and granulated sugar. Additionally, they contain enterosorbents povidone K-17 and K-30, glidant talc, thickeners sodium carmellose and calcium stearate, nonionic surfactant polysorbate 80, disintegrant hypromellose (disintegrating agent, accelerates the dissolution of active elements). The stabilizer of the shell composition is macrogol, the color correctant is titanium dioxide.
• Injection solution (Combilipeni 2 ml or Combilipeni in ampoules) is a transparent liquid of a reddish color with a pink tint, and has a distinct, specific odor. Instructions for use prescribe its use for intramuscular injections. It is bottled in ampoules made of special light-protective neutral glass intended for storing photosensitive substances. The ampoules are placed in plastic 5-cell trays, sealed on top with film and, together with a scarification tool (knife for opening the vessel), placed in cardboard packs. Auxiliary ingredients are: disinfectant component benzyl alcohol, emulsifier sodium tripolyphosphate, strong oxidizing agent potassium hexacyanoferrate, acidity regulator sodium hydroxide. The solution is brought to the specified volume and concentration by purified water.

Directions for use and dosage

The tablets are taken orally after meals. They should be consumed without chewing, but it is recommended to drink half a glass of water or other liquid (except strong tea, milk, coffee, carbonated drinks). Adults take one tablet up to three times a day; the dosage and course are determined by the doctor. It is not recommended to be treated with high doses of the drug for more than four weeks.

The solution for intramuscular administration is applied 2 ml daily for 5-7 days, then treatment continues 2-3 times a week for 14 days. Mild cases of the disease require the use of an ampoule 2-3 times a week for a period of 7-10 days. The duration of therapy is determined by the doctor depending on the severity of the symptoms, but it should not exceed two weeks.

Combilipen application

Sometimes the patient, believing that the dosage prescribed by the doctor does not help him, increases the number of injections. In this case, serious problems may occur due to an overdose:

• body temperature rises;
• difficulty breathing occurs;
• excessive sweating begins;
• swelling occurs;
• a small rash appears on the skin;
• there is dizziness;
• overcome by headaches.

Quincke's edema is considered the most dangerous. If the patient is not helped in time, he will die. Anaphylactic shock is no less dangerous. It occurs after administration of 12 ml of the drug. However, even with heavy sweating, you cannot remain idle, since dehydration will increase the intoxication of the body. As a result, it can even lead to cardiac arrest. For this reason, the manifestation of any signs of overdose is a reason to immediately seek medical help.

Combilipen injections - use will bring the desired result only if all the nuances are taken into account. Before prescribing a medicine, the doctor will definitely check with the patient what medications he is taking. The doctor remembers the incompatibility of some medications. This may lead to an increase in the toxicity of certain substances or a decrease in the healing effect of the drug. The following medications should not be taken simultaneously with Kombipilen:

1. Levodopa - lidocaine reduces the effectiveness of this drug, which is why the patient begins to experience symptoms of Parkinson's disease more intensely.
2. Norepinephrine and Epinephrine - when interacting with lidocaine, their negative effect on the heart increases.
3. Riboflavin and Phenobarbital destroy vitamin B1.
4. Sulfites completely destroy the active ingredients of Combilipen.
5. Preparations containing copper neutralize thiamine.
6. Vitamin complexes and adrenaline provoke an abnormal heart rhythm and can even lead to cardiac arrest.

Knowing why Kombilipen injections are prescribed, it is important to remember about its incompatibility with alcoholic beverages. Drinking alcohol during treatment is strictly prohibited! If the drug was introduced into the body less than 3 hours after drinking alcohol, the following consequences are inevitable:

• severe bleeding will occur;
• breathing will stop;
• heart failure will occur;
• fatty liver degeneration will be provoked;
• anaphylactic shock will occur.

Combilipen in ampoules - dosage

The fractional (also known as daily) injection dose is 2 ml. Just so much of the drug is contained in one ampoule. The treatment regimen depends on the patient's condition.

How to take Combilipen in ampoules?

1. If the disease is advanced, the medicine is administered daily for the first week.
2. After the condition has improved, injections are performed every other day.
3. If the disease is mild, injections are prescribed once every 3 days.
4. The duration of therapy is determined by the doctor, most often it lasts 2 weeks.
5. For preventive purposes (to prevent exacerbation of chronic diseases), a 14-day course is prescribed. It is recommended to carry out procedures every other day.

How to inject Combilipen in ampoules?

Injections are given intramuscularly: into the upper outer part of the buttock. The administered drug is absorbed gradually, which ensures a long-lasting therapeutic effect. Combilipen in ampoules the course is prescribed to each patient individually. The rules for performing the procedure are as follows:

1. The area of ​​skin where the injection will be given is disinfected. To do this, wipe it with a cotton pad soaked in Chlorhexidine or ethyl alcohol.
2. The needle is inserted vertically (the minimum distance between the puncture site and the previous injection should be 1.5 cm).
3. The drug is released very slowly.

Regardless of why Combilipen therapeutic injections are prescribed, injections are recommended in the first half of the day. If the solution is administered before bedtime, it can lead to insomnia. In addition, injections should be given after meals. If the injection is performed on an empty stomach, pain will occur after the administration of the medication. The medicine is absorbed very quickly. It is removed from the body after 8-10 hours.

Can Combilipen in ampoules be taken orally?

This vitamin solution is intended for intramuscular administration only. Some patients are interested in whether it is possible to drink Combilipen in ampoules. Here the answer is clearly negative. Internal consumption of the drug in this form of release is unsafe. For oral administration, the drug is used in tablet form.

special instructions

The instructions for use of the drug contain a special instructions section, which states that taking Combilipen should not be combined with the use of multivitamin complexes that include B vitamins. This is done to avoid an overdose of active components and to exclude hypervitaminosis of vitamin groups B1, B6 and B12.

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What kind of medicine is Combilipen in ampoules?

According to the international classification, this drug is simultaneously classified into two pharmacological groups: “Vitamins” and “General tonics”. This is a combination drug. It has a unique composition, so Combilipen ampoules are effectively used for pathologies of the nervous system. In addition, it is prescribed to increase the body’s resistance to adverse internal and external factors.

Kombilipen injections - composition

These injections are intended for intramuscular administration. The combilipen composition is as follows:

1. Thiamine or vitamin B1 (old version of the name - Aneurin).
   This element has a positive effect on the functioning of the central nervous system, for example, it affects mood and brain function. In addition, thiamine maintains the tone of the heart muscle and digestive tract.
2. Pyridoxine or vitamin B6
   is actively involved in metabolic processes and hematopoiesis. In addition, this element is responsible for the synthesis of adrenaline and norepinephrine. Pyridoxine also transports sphingosine, a substance that is part of the nerve sheath. Vitamin B6 also produces serotonin: it affects appetite, sleep quality and emotions.
3. Cyanocobalamin (vitamin B12)
   – can normalize blood pressure. It also has a regenerating effect on the body, thereby slowing down the aging process.
4. Lidocaine
   is an anesthetic agent. Thanks to its presence, injections are completely painless. In addition, lidocaine has an anti-inflammatory effect. It also improves the absorption of B vitamins.

This medicine also contains auxiliary components:

• sodium hydroxide;
• benzyl alcohol;
• sodium tripolyphosphate;
• water for injections;
• potassium hexacyanoferrate.

Drug interactions

When taking Combilipen in tablet format, its drug interactions with other medications should be taken into account:

• Levodopa reduces the effect of therapeutic doses of vitamin B6.
• It is prohibited to combine vitamin B12 with heavy metal salts.
• To avoid overdose, it is not recommended to take other multivitamin complexes with B vitamins during treatment with Combilipen.
• Diclofenac enhances the effect of Combilipen. This combination is very successful in the treatment of acute radiculitis, relieves swelling, treats affected nerve tissue and epithelial cells.
• Ketorol is combined with tablets and injections to relieve severe pain caused by inflammation.
• Ketonal Duo capsules in combination with Combilipen are used for radiculitis and neuralgia with moderate pain.
• Mydocalm and Movalis enhance the effect of the drug in the treatment of neuralgia associated with damage to the spinal column.
• Mexidol improves the effectiveness of the drug in the treatment of acute and chronic cerebrovascular accidents, cerebrovascular disease, and alcoholism.
• Alflutop in combination with Kombilipen restores damaged bone and cartilage tissue and is used to treat osteochondrosis.
• Nicotinic acid enhances the effect of tablets and injections in the treatment of neuritis of the facial nerve, tissue damage due to osteochondrosis.
• Vitamin B1 is dissolved by sulfites, incompatible with mercuric chloride, iodide, carbonate, acetate, tannic acid. It also does not combine with ferric ammonium citrate, sodium phenobarbital or riboflavin, benzylpenicillin, dextrose or sodium metabisulfite.

Indications for use

This is an auxiliary therapy drug designed to enhance the therapeutic effect of the main treatment and reduce the severity of pain symptoms. Combilipen tablets can also be used as an independent medicine for vitamin therapy, prevention of hypo- and vitamin deficiencies of the corresponding vitamins.

According to the instructions, the indications for taking Combilipen tablets and injections are the same - why they are prescribed:

• trigeminal neuralgia – idiopathic or symptomatic (secondary);
• neuritis (inflammatory lesion) of the facial nerve;
• reflex pain syndrome accompanying intercostal neuralgia;
• degenerative diseases of the spine - changes in the cervical spine, damage to the roots of the brachial plexus (osteochondrosis of the cervico-brachial joint), sacrolumbar spine;
• radiculopathy;
• all types of lumboischialgia;
• various types of mono and polyneuropathy, incl. manifested in other diseases or developed as a result of the toxic effects of alcohol.

Contraindications

The summary of the drug Combilipen indicates the following contraindications, in which the use of the drug is strictly prohibited:

• hypersensitivity to the components of the drug;
• severe or acute form of decompensated heart failure;
• children and adolescents up to 18 years of age;
• pregnancy;
• breastfeeding (lactation).

Use during pregnancy, childhood and lactation

The manufacturers of this vitamin complex do not recommend including it in the treatment of neurological diseases for pregnant women and children, since no safety studies have been conducted. The solution can also pass into breast milk and enter the baby's body.

Contraindications, side effects, overdose

Analogues and the drug Combilipen itself in the form of a solution are prohibited from being prescribed for the following conditions:

• serious disturbances in the functional activity of the cardiovascular system;
• high sensitivity to at least one of the components of the drug;
• childhood;
• congenital physiological pathologists of the cardiovascular system;

Side effects:

The instructions for Combilipen contain a warning about possible negative reactions from the body: Quincke's edema, problems with respiratory function, urticaria, allergies in the form of redness and itching.

In rare cases, patients undergoing treatment with vitamin complexes experienced attacks of tachycardia, increased sweating, and the appearance of acne.

All medications cause allergic reactions if taken for a long time or in the maximum dosage. Therefore, a doctor must develop a treatment regimen and select the optimal dosage of the solution based on data on the nature of the disease and its severity.

Overdose:

When a large dose of Combilipen is administered parenterally, adverse reactions may worsen, as well as nausea, gag reflex and dizziness.

In this case, the patient requires therapy aimed at eliminating symptoms. There is no special scheme of medical measures to eliminate intoxication. This drug does not affect vital functions, all consequences are reversible.

Combilipen and its structural analogues are available in pharmacies with a prescription.

The article has been verified by the editors

Combilipen - side effects

The instructions for use of the drug describe possible side effects from taking it:

• allergic reactions – skin itching, urticaria;
• increased sweating;
• nausea;
• tachycardia;
• acne;
• difficulty breathing;
• Quincke's edema;
• anaphylactic shock.

Side effects

If the instructions are not followed, patients experience adverse reactions.
The most common symptoms are nausea, vomiting, severe headache and dizziness, persistent constipation or frequent loose stools. Patients often talk about increased work of the sweat glands, especially at night. As a rule, this indicates that there is an excess of B vitamins in the body. Tachycardia is considered another side effect. More often, this symptom appears in patients who suffer from chronic pathologies of the cardiovascular system and take medications on an ongoing basis. There are cases of temporary impairment of visual and auditory function, but they are quite rare.

Allergies to the drug often occur, especially if used independently and excessively. A red rash of various shapes and sizes appears on the skin, mild swelling, severe itching, peeling and irritation are observed. If left untreated and continued to take the medication, the symptoms worsen. Much less often, vitamins provoke Quincke's edema or urticaria.

If such symptoms appear, it is recommended to immediately stop taking the drug and seek qualified help. Violation of this recommendation leads to serious consequences.

Analogue Combilipen

Based on the active substance and pharmacological action, a number of analogues of the drug are distinguished. All of them belong to multivitamin complexes:

• Milgamma;
• Olijim;
• Duovit;
• Multimax;
• Pikovit;
• Pentovit;
• Multi-tabs;
• Multivita;
• Hexavit;
• Complivit;
• Foliber;
• Gendevit;
• Revit;
• Unigamma;
• Neurogamma;
• Polybion;
• Makrovit;
• Heptavit.

Analogue drugs in ampoules

Analogues of Kombilipen in injections are not always cheaper than the original product. Milgamma is in a high price segment, but its effectiveness justifies all financial costs. CompligamV – 1-2 times cheaper than the original.

Milgamma

Milgamma is available in the form of tablets and in a solution for injections of 2 ml. The solution contains: pyridoxine (B6), cyanocobalamin (B12) and thiamine (B1) in a dosage of 100 mg each component, as well as additional agents that enhance the therapeutic effect of the drug. The active ingredient in the tablets is benfotiamine.

Properties of Milgamma

Indications for use of the medicine are:

• neuralgia and radiculitis;
• neuritis of various etiologies;
• polyneuropathy of sclerotic and diabetic origin;
• alcoholic and drug polyneuropathy;
• myalgia;
• paresis in the peripheral parts and on the face.

Milgamma can be included in the complex therapy of herpes and other viral pathologies. The drug is not prescribed in the following situations:

• during lactation and pregnancy;
• up to 16 years old;
• with heart failure;
• with impaired conduction of cardiac impulses through the myocardium.

The solution should be injected deep into the muscle fibers, 2 ml once a day. For therapeutic purposes, take the drug for 1 week. After this, the doctor can continue therapy with tablets - 1 tablet once a day. If it is necessary to relieve acute pain, then the doctor prescribes 3 tablets per day for 3-5 calendar days. The drug course of Milgamma should not exceed 30 calendar days.

CompligamV

CompligamB is available in solution for injection. The medicine contains B1, B6 and B12. The drug has a wide range of applications:

• polyneuropathy of alcoholic and diabetic etiology;
• neuritis;
• mononeuropathy;
• neuropathy of peripheral and facial nerves;
• neuralgia;
• ganglioneuritis;
• lumboschialgia;
• lumbodynia and cervicalgia;
• painful syndromes in the cervical and lumbar regions.

Directions for use of CompligamV

Contraindications for the use of CompligamV are:

• women during pregnancy;
• lactation period;
• myocardial failure;
• age up to 16 years;
• allergy to components in the medicine;
• severe kidney disease.

The medication is prescribed 2 ml once a day. The injection should be carried out deep into the muscle fibers. Therapeutic course – from 1 to 2 weeks. After this, the doctor may prescribe maintenance therapy for 2 months - 1 medication administration procedure per week.

Price of Combilipen tablets

You can buy Combilipen on the Internet or order it through the pharmacy department. How much tablets and ampoules cost depends on the pricing level and the quantity in the package. Approximate prices:

Analogs

Kombilipen injection ampoules are produced by the Pharmstandard association in the city of Ufa. In pharmacies you can buy drugs from the domestic pharmacological industry that are similar in composition, such as Vitagamma and Trigamma. Of the foreign medicines, Neurorubin (country of manufacture – Norway), Neurobion (country of manufacture – Germany) and Milgamma (country of manufacture – Austria) have the same properties. Foreign drugs differ from Combilipen injections at an increased price.

The drug "Kombilipen": reviews from patients and doctors

Reviews about this medicine are mostly positive. Doctors consider the drug indispensable in the treatment of certain neurological diseases, and sometimes recommend it when the body is exhausted. Patients note that the injections are not painful, and the effect appears immediately. The solution not only normalizes the functioning of the nervous system, but, thanks to the lidocaine content, quickly relieves pain. The advantages include low price - popular analogues of the drug cost at least twice as much.

Combilipen

I try to lead a healthy lifestyle and take care of my health, but despite my efforts, situations happen when I am unable to change something. On my next trip to the dacha, I got my hands on something I loved, so to speak, and wanted to quickly put things in order. But as it turned out, I overdid it and broke my back. Like most people, I began to self-medicate, rubbed it with ointments, tightened my back with a special belt, but I felt worse. I tried to take painkillers, but the effect was too short-lived, and then my husband persuaded me to go to the clinic. The doctor prescribed intramuscular injections of Combilipen, which I bought on the official website.

How to use Combilipen

This drug is sold in pharmacies only with a doctor's prescription. This means that the patient who is about to receive the injections is already aware of how to inject the medicine and exactly how much of it is required. The instructions for Kombilipen injections provide for some standard dosages, but they must be selected individually in each case.

If the condition is accompanied by severe pain, it is usually recommended to inject one ampoule, which contains 2 ml of medication, intramuscularly. The medicine should not be taken on an empty stomach or with alcohol. The average duration of treatment is from five to ten days. Sometimes after this, experts recommend switching to tablet form.

According to medical prescription, it is permissible to buy this product for preventive purposes. In this case, the injections are also given intramuscularly. This is done once every two to three weeks. In this way, chronic diseases that may begin acute periods are affected. As for Combilipen Tabs, they drink it after meals for two weeks.

How to inject Combilipen correctly

Injections are given only intramuscularly. The medicine is not intended for intravenous administration. The best area for injection is the upper outer quadrant of the gluteal region. The pharmacological solution is absorbed gradually into dense adipose tissue, which improves its therapeutic effect on the body.

The exact dosage of the medication is determined only by the doctor.

In order to make an injection, the skin must first be thoroughly disinfected with alcohol or Chlorhexidine. Before giving an injection of the drug Combilipen, the drug is drawn into a syringe through a needle and slowly injected into the patient.

An opened ampoule with solution cannot be stored.

It is necessary to carefully study the instructions for the medicine and follow the doctor’s recommendations (in the prescription description). The medicine must be administered in the morning. Since it contains vitamins, when used in the evening, their effect may cause difficulty falling asleep.

In addition, this remedy is best used after meals due to its indirect effect on the gastric mucosa.

The duration of the medication is from 8 to 10 hours.

Is it necessary to breed

Combilipen is sold by pharmacies in ampoules containing the substances required for administration.

Therefore, there is no additional need to dilute the injection solution before the procedure.
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Which syringe to inject and is it a painful injection?

The volume of the syringe used to inject Combilipen depends on the dose prescribed by the attending physician. The drug is contained in 2 ml ampoules.

Because it contains vitamins, the injection can be painful for some patients.

The component of the medication, the anesthetic substance lidocaine, reduces discomfort during the injection, preventing the spread of pain along the nerve endings.

This is one of the best anesthetics for intramuscular administration. Thanks to it, vasodilation quickly occurs, so Kombipilen is actively absorbed into the bloodstream and has a rapid effect on the inflammatory process.

Distilled water in the composition of the drug promotes better absorption of both active and excipients.

This effect of the pharmacological agent also reduces the overall intensity of pain during injection. Most often, the patient experiences negative emotions if the medicine is injected into the tissue to a too shallow depth.

The needle should enter the muscle vertically, deeply, then its impact will injure the surrounding areas less.

Kombilipen solution is administered slowly and carefully.

When using the right amount of medication and following all the rules prescribed by the neurologist and the instructions, most often the patient does not experience any unpleasant sensations. Most often, pain occurs in those people who suffer from hypersensitivity. Then you should consult your doctor.

If the negative sensations are intolerable, the specialist may prescribe another drug, including for oral use. Then no needles or syringes will be required.

For adults

As a rule, only adults take a course of therapy with such a pharmacological agent. It is prescribed to patients over 12 years of age. The medicine is most often prescribed in the complex treatment of neurological diseases.

In medical practice, ampoules of 2 ml are used, the solution is administered intramuscularly, 1 time per day.

The course of treatment with the drug in this form ranges from 3 to 14 days. The scheme for its use is drawn up only by a neurologist and must be strictly followed by the patient.

For children

Doctors do not recommend prescribing Combilipen to children before they reach the age of 16 due to the high concentration of vitamins in its composition and the presence of benzyl alcohol.

In case of therapeutic necessity, injections are allowed to a child only after 12 years of age. The dose and duration of the course are determined by the pediatrician depending on the severity and severity of the disease.

Pregnant women and during lactation

During pregnancy and subsequent breastfeeding, the use of Combipen is strictly prohibited.

This is due to the fact that any vitamins easily overcome the placental barrier, and then penetrate into the milk through the bloodstream.

How often can you bet

If the patient has severe pain, the drug is administered once a day for 10 days. As a rule, such a course of therapy is the standard decision of the attending physician.

When relieving conditions that are not accompanied by a significant disturbance in a person’s well-being, he is given intramuscular injections of Combilipen at the rate of 2 ml once every 3 days for 3 weeks. A more intensive mode of administration of the solution can lead to the development of side effects. If the specialist considers it necessary to continue therapy with the drug, then tablets are prescribed. In the future, the doctor must conduct a full examination of the patient, identify the effect of the medication on his body, make the necessary adjustments and additional prescriptions.

As a rule, Combilipen therapy is carried out 2-3 times a year. Most often, the medicine is injected in combination with other pharmacological agents, especially painkillers.

Main and relative contraindications

Like any medicine, the Combilipen multivitamin complex has a certain number of contraindications:

• decompensated pathologies of the cardiovascular system;
• pregnancy period and subsequent lactation of the baby;
• individual hyperreaction to the active and auxiliary substances of the drug “Combilipen”, from which injections and tablets can cause allergies;
• pediatric patients up to 15–18 years of age and adolescents.

If one or more of the above contraindications is identified, the specialist will select another medicine with a similar mechanism of pharmacological action.

What vitamins are included in Combilipen?

Combilipen contains a group of B vitamins:

1. Thiamine. Normalizes the functioning of nerve cells, nourishes them with glucose.
2. Pyridoxine. Takes part in the metabolic processes of the central nervous system. The action of the vitamin is aimed at normalizing the transmission of nerve impulses, excitation and inhibition. Synthesizes catecholamine and transports sphingosine.
3. Cyanocobalamin. Participates in the production of choline and hematopoiesis, the synthesis of nucleic acids, folic acid, myelin. Promotes tissue regeneration.

In addition, the drug contains lidocaine. It has an analgesic effect. Dilates blood vessels, making vitamins better absorbed. The local anesthetic effect of lidocaine is based on the blockade of voltage-gated sodium channels. Thanks to this, the process of generating impulses and eliminating the pain syndrome is prevented.

Drug analogues

Despite the effectiveness of the product, its use is not always possible, and there are cases when it is necessary to find a suitable replacement. There are several analogues of the drug that have similar composition and pharmacological properties:

1. Milgamma is considered an absolute analogue of the original medicine and is available in the form of tablets, as well as a solution for intramuscular injection. The ampoule volume is 2 ml and is made of dark glass. The product is actively used for the treatment of neuritis, neuralgia, radiculitis, plexitis, pinched nerve endings. It is often included in the complex treatment of type 1 diabetes. Not prescribed for pregnant and lactating women, children and adolescents under 18 years of age, patients with hypersensitivity to its components or a tendency to allergic reactions.
2. Neurorubin is also available in tablet and injection form. It has immunostimulating, regenerating properties, improves the conductivity of nerve impulses to tissues, and prevents disruption of metabolic processes in cells. Prescribed for the treatment and prevention of pathologies of the nervous system in the acute and chronic stages. It is strictly contraindicated for women during pregnancy and lactation, children and patients with a severe allergic reaction to the components of the drug.
3. The drug Neurobeks has a similar composition and therapeutic properties. It is actively used in the treatment of patients with radiculitis, trigeminal neuralgia, neuritis, myositis and other disorders. Available in tablet form, taken orally during or immediately after meals. The duration of use of the vitamin complex is 14−30 days, depending on the disease and associated disorders.
4. Neuromultivit tablets can be used as a substitute, since they contain thiamine, cyanocobalamin and pyridoxine in the same dosage. They have a pronounced therapeutic effect on the body of patients with disorders of the central and peripheral nervous system. Prescribed in short courses of 10-14 days. As a rule, this time is enough to obtain the desired result. The medicine is contraindicated in nursing and pregnant women, adolescents and children, patients with peptic ulcers and chronic constipation.

Only a specialist should select a replacement for the original product. This is due to the need for an individual approach to the treatment of each patient.

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Contraindications for use

Despite the fact that Combilipen contains identical natural substances synthesized by the body itself, there are still certain groups of people for whom it is better not to use such a remedy for treatment. This especially applies to the following persons:

1. Women during pregnancy or breastfeeding - the vitamin complex is perfectly absorbed in the body and penetrates the blood and breast milk, is adsorbed in the liver, which can negatively affect the baby’s health.
2. If the child is under 12 years of age, it contains benzene alcohol, which makes the product very dangerous for children.
3. Chronic diseases of the cardiovascular system, as well as severe vascular dystonia.
4. The drug is also contraindicated for those who have hypersensitivity to the components contained in the drug.

Since the drug and its dosage must be prescribed by the doctor himself, it is important that the medical history is open, including a list of chronic diseases (their duration and general stage), as well as the presence of allergic reactions to drugs

Drug overdose

The medication contains Lidocaine, which helps reduce pain. Most people, trying to speed up their recovery, significantly increase the dosage of the drug they drink, while completely ignoring the instructions of the treating specialist. It is because of this that the body of such patients very quickly accumulates vitamin B, the excess of which is known to lead to negative health consequences.

By increasing the dosage of the drug to 4 milliliters, a person may experience such negative symptoms as:

• nausea and vomiting - this especially often occurs when the drug is taken orally;
• headaches, dizziness and confusion;
• increased sweating process;
• an increase in the patient’s general body temperature, which may be accompanied by attacks of fever;
• tachycardia;
• allergic reactions, which are represented by a rash on the skin, swelling of soft tissues;
• Quincke's edema, as well as anaphylactic shock - this happens very rarely when the daily dosage of B vitamins reaches 12 milliliters.

If signs of intoxication are detected, you should immediately call an ambulance, and place the sick person in a horizontal position, while ensuring plenty of fluids.
Pure boiled water will help reduce the level of toxins in the body, after which you can notice an improvement in the general condition of the patient. Dehydration in this case can only lead to a worsening of the situation and provoke fatal symptoms, for example, anaphylaxis or respiratory arrest. You cannot deviate from the injection schedule drawn up by the doctor, as it was selected taking into account all your characteristics and the form of the disease. Compiling the dosage of a medicine yourself can lead to irreversible health processes that put a person’s life at risk. If you notice even the slightest signs of an allergy, you should immediately stop taking this drug until the causes are identified.

Possible side effects

If the dosage and treatment schedule are followed, the medicine is most often well tolerated and does not cause any side effects. In some cases, with individual intolerance to the components of the drug, the patient may complain of the following symptoms:

• increased level of sweating;
• cardiopalmus;
• skin and hair problems;
• with a severe allergic reaction, angioedema, anaphylactic shock or urticaria may occur.

Due to the presence of such side effects, the first two injections should be performed under medical supervision.
If side effects are nevertheless identified, the drug is replaced with a similar one; first, the doctor conducts a test to determine the presence of a negative reaction on the part of the patient’s body. The action of Kombilipen can be compared with the following analogues - Milgamma in ampoules (Kombilipen is a cheaper Russian substitute for this popular drug), Neurobion, Neurobex, Binavit, Vatagamma, Neurorubin.

For young children, preparations containing B vitamins are produced as plates that have a pleasant taste, aroma and color. For very young children you can find syrups that are very convenient to give to the child from a spoon. They can be mixed with a small amount of water. The difference between children's drugs and combilipen is a lower dosage, which is not capable of harming the child even if it is slightly exceeded.

What is it prescribed for?

When a doctor prescribes Combilipen, the indications for the use of the drug are quite extensive.

Most often it is prescribed for diseases of the spinal column or peripheral nervous system.

The medication treats advanced lumboischialgia, intercostal neuralgia and neuritis.

When the patient begins to regularly use Combilipen, the benefit of the drug becomes especially pronounced in case of polyneuropathy, damage to the facial or trigeminal nerve, or radiculitis.

It quickly helps with shingles or osteochondrosis.

This remedy improves hematopoietic processes, promotes the activation of cell division of nervous tissue, stabilizes the body's metabolism, and enhances the release of certain hormones.

After a course of treatment with such vitamin medications, the patient’s gastric juice production is activated, overall tone is increased, sleep is strengthened and mood improves.

Combilipen injections are of great importance for the body during the development of various inflammatory pathologies and radicular syndrome.

"Kombilipen" and "Milgamma": which is more effective

"Milgamma" has the same composition as the drug "Kombilipen". This product also contains B vitamins and lidocaine. These two medications are never used together, as their combination can lead to hypervitaminosis and lidocaine overdose.

Patients are often interested in the question of which of the two drugs is better. Both medications have the same list of indications and contraindications. They contain the same active ingredients. The only difference between these drugs is that this is a domestic product, while Milgamma is produced in Germany. In terms of their effect on the body and effectiveness, these drugs are almost identical.

Comparison of Neuromultivit and Combilipen

The composition of these 2 vitamin complexes is the same in terms of the main components (B1, B6 and B12), but differs in their ratio in 1 dose. Such a difference in the amount of a particular vitamin has a reduced or, conversely, increased effect on the disease. This is what the doctor takes into account when prescribing medication.

Taking Neuromultivit without a doctor's prescription is not recommended.

Similarities

Neuromultivit and Combilipen have the same action of active elements:

1. B1 stimulates the reproduction of carboxylase, which is responsible for the metabolism of fats and carbohydrates. Once inside the body, thiamines are converted into triphosphates, which stimulate the conduction of nerve impulses, prevent the formation of oxidation processes, and slow down the development of pathological abnormalities. The vitamin improves the circulation of blood cells and is responsible for its rheological parameters (fluidity). Without thiamine, nerve fibers are subject to destruction under the influence of acids (pyruvates and lactates), which accumulate in the body and cause radicular pain syndrome.
2. B6 is needed for the formation of neurotransmitters (brain hormones that transmit information between neurons), histamine (a neurotransmitter of immediate allergic reactions) and hemoglobin (a protein responsible for the supply of oxygen from the lungs to the body and carbon dioxide back to the lungs). Strengthens the immune and nervous system, promotes the functioning of blood vessels and the heart, takes care of the balance of Na and K volumes (this eliminates the accumulation of fluid in the body, relieves swelling). Helps accelerate tissue regeneration to create new cells.
3. B12 is indispensable in the prevention of anemia, it regulates blood pressure, takes part in hematopoietic processes, improves sleep, and calms the nervous system. Cyanocobalamin is involved in the synthesis of neurotransmitters (substances responsible for the creation and accumulation of energy resources, improving memory, concentration and attention). A sufficient dose of the vitamin will protect against senile madness, increase endurance, and help deliver impulses to nerve endings. B12 is a strong hepatoprotector that can protect the liver from fat accumulation.

The drugs have the same contraindications. They are not prescribed:

• cores;
• in severe vascular conditions;
• women during pregnancy and lactation;
• in childhood;
• in case of hypersensitivity to the ingredients included in the drug.

Side symptoms from an overdose of vitamins are also the same:

• tachycardia;
• dyspepsia (intestinal disorders);
• hives.

What is the difference

The first difference is the manufacturer. The domestic drug, produced in the form of a ready-made solution, contains an anesthetic (lidocaine). This quality makes it most popular among consumers.

Combilipen has additional symptoms in case of overdose:

• swelling;
• anaphylactic shock;
• acne;
• increased sweating (hyperhidrosis).

Due to additional adverse reactions, the prescription of vitamin formulations is individual for each patient. You cannot use medicinal compositions and forms on your own; for an effective effect, competent consultation with a doctor is required.

The price also makes a difference. The average cost of drugs depends on the region of sale, form, and volume of packaging. But the domestic analogue will be cheaper.

Which is cheaper?

Prices for Neuromultivit:

• 20 pcs. — 310 rub.;
• 60 pcs. — 700 rub.;
• 5 ampoules (2 ml) - 192 rubles;
• 10 ampoules (2 ml) - 354 rub.

Prices for Combilipen:

• 30 pcs. — 235 rub.;
• 60 pcs. — 480 rub.;
• 5 ampoules (2 ml) - 125 rubles;
• 10 ampoules (2 ml) - 221 rub.

Overdose of Combilipen

If the rules for using the medicine are not followed, the patient risks not only a deterioration in health, but also the development of a fatal threat. Each drug is useful only if used in moderation, and an excess of a particular drug can contribute to the development of death.

Most people believe that if a drug does not help at the dosage prescribed by the doctor, then it needs to be increased. By increasing the dosage of the drug, various negative consequences develop, in which the development of a fatal danger cannot be excluded. Excess accumulated vitamins in case of drug overdose lead to undesirable consequences. The main consequences of an overdose of Combilipen include the following manifestations:

• development of symptoms of nausea and vomiting, especially if the medicine is taken orally;
• excessive sweating;
• tachycardia and difficulty breathing;
• dizziness, headaches and confusion;
• increased body temperature;
• swelling of soft tissues;
• an allergy that manifests itself as a rash on the surface of the skin.

The most dangerous consequence of an overdose is the development of Quincke's edema and anaphylactic shock. If you do not provide timely assistance to a patient with such complications, he may die. It is worth noting that the development of anaphylactic shock and edema is extremely rare due to overdose, since to achieve these conditions a dosage of the drug of 12 ml will be required.

If you develop heavy sweating, you should drink as much water as possible to avoid dehydration. Dehydration leads to worsening intoxication, which contributes to the development of mortal danger in the form of cardiac arrest.

Drug use

There are a number of conditions that this drug can quickly and efficiently cope with. These include, first of all, painful sensations in the spine, the cause of which lies in the disorder of nerve endings:

• intercostal neuralgia;
• sciatica;
• radicular syndrome;
• lumbar and cervical syndrome;
• pinching of nerve endings by vertebrae.

The drug is also indicated for inflammation of the facial nerve:

• polyneuropathy of various types, this will also include congenital malformations of the central nervous system, as well as acquired complications due to chronic diseases, for example, cirrhosis of the liver or diabetes mellitus;
• triangular neuralgia;
• minor processes of inflammation in the nerve endings that occur due to injury to the spine or limbs.

If the pain syndrome is severe, then the medicine is administered intramuscularly, two millimeters (one ampoule) every day in the morning.
However, it is strictly forbidden to perform such injections on an empty stomach, as well as while drinking alcohol. The time of treatment with such a remedy directly depends on the severity of the disease and its characteristics, but most often it varies from 5 to 10 days, after which, if particularly necessary, the treating specialist can change the injections and prescribe oral tablets with similar components in the composition. If chronic diseases associated with the functioning of the nervous system have become aggravated, then they need to be eliminated with treatment, which will be expressed by the degree of the disease and its nature of manifestation.

In some cases, the drug may not be prescribed in the form of injections; in this case, the instructions for use of Combilipen tablets recommend using the drug after meals with a small amount of water. The course of treatment should not be more than two weeks, after which you need to take a break for about a month.

If the attending physician has prescribed this remedy, then you should stop using other multivitamin complexes that were used previously, since they may also contain vitamins from group B. This can develop an overdose and provoke side effects. Before a course of treatment with such a drug, you need to inform your doctor about the presence of a chronic disease, and also tell about all the medications that you must take on a regular basis for some reason.

How to store

According to the storage conditions, the solution in ampoules should be placed in the refrigerator, at a temperature of +2...+8°C, out of the reach of children and pets.

Be sure to carefully check the date of manufacture and expiration date of the drug (2 years). Using the solution after the expiration date indicated on the packaging is strictly prohibited.

Reviews from the network about the drug

I looked through a lot of forums about health and medications, people told their stories and how they were able to recover. I didn’t find a single negative review about Combilipen, most were positive, people praised the rapid onset of relief after the injections and the return to normal life. I found only a few neutral reviews that described the painful administration of the drug. But this is a moot point; the inept introduction of an inexperienced person could have contributed to this, and even if so, then for the sake of pain relief, you can endure it. In general, people responded positively and some are saved only by it.

“I took Combilipen a year ago when I had a pinched facial nerve. It was unbearable, I couldn’t feel half of my face and I was afraid that I would remain like that. But the doctor prescribed me this drug and the very next day I felt much better. A very good remedy! The injections are not painful and work quickly; I liked the fact that the medicine not only relieves pain, but also heals. ”

I liked people’s reviews and I was once again convinced that this is truly a worthy drug that not only relieves pain, but also eradicates the problem.

What are the similarities

If you compare Neurobion and Combilipen, you can see that the drugs have a number of similarities:

• Compound . The preparations include a complex of B vitamins.
• Effect on the body . They increase neurotropic activity, restore the sensitivity of nerve receptors and stimulate natural tissue repair. Helps reduce pain.
• Release form . A solution for injection is produced in ampoules and tablets (Kombilipen tabs and Neurobion).
• Application . Medicines are prescribed for neuropathies, neuralgia, osteochondrosis and a number of other neurological diseases.
• Portability . Combilipen and Neurobion are well tolerated by patients and rarely cause adverse reactions.

Compatibility

How to inject "Kombilipen" along with other medications? This remedy is often used as part of complex therapy. However, the vitamin preparation is not compatible with all medications. It should not be administered simultaneously with the following drugs:

• other drugs with B vitamins;
• drugs based on adrenaline and norepinephrine;
• medications for Parkinson's disease.

During the course of injections, you must stop drinking alcohol. Ethanol significantly impairs the absorption of vitamins.

It should be remembered that the injection form of the drug "Combilipen" cannot be mixed in the same syringe with other medications. This product is chemically incompatible with many medications.

FAQ

Despite the clarification that Neurobion and Combilipen are direct analogues, patients often ask questions about the compatibility and comparative characteristics of drugs.

Let's answer the most common ones:

• Is it possible to drink Neurobion at the same time as Combilipen to speed up recovery? It is forbidden. The drugs are identical in composition and taking the drugs together will cause an overdose. Only one of the medications is prescribed.
• What will help better: Neurobion or Combilipen? Both medications are effective for neurological pathologies and the indications for use are the same. The choice of drug depends on the doctor, and if there are no special instructions, then it is allowed to use the one that inspires more confidence in the patient. If a person believes that Kombilepen helps better, then treatment with Neurobion will be less effective - the psychological factor should also be taken into account.
• Is it allowed to take Combilipen Tabs after Neurobion injections? After a five-day course of injections, the patient is prescribed a tablet form. Such a replacement is possible, but this should be discussed with your doctor.

It is impossible to say unequivocally: Combilipen or Neurobion is better. Both drugs help well with neurological pathologies, have almost the same composition and can replace each other without compromising the quality of treatment.