Neurological tablets. NSAIDs: drugs used in neurology

Instructions for the medical use of the medicinal product

NEVRALON

Tradename

Nevralon

International non-proprietary name

Dosage form

Solution for injection, 2 ml

Description

Clear dark red solution

Compound

1 ampoule of the drug contains

active substances: thiamine hydrochloride (Vitamin B 1) 100 mg, pyridoxine hydrochloride (Vitamin B 6) 100 mg, cyanocobalamin (Vitamin B 12) 1 mg, lidocaine hydrochloride 20 mg,

Excipients: benzyl alcohol, potassium hexacyanoferrate (III), sodium hexametaphosphate, 10% sodium hydroxide solution, water for injection.

Pharmacotherapeutic group

B vitamins in combination with other drugs.

ATX code A11EX

Pharmacological properties

Pharmacokinetics

Thiamine hydrochloride when administered intramuscularly, it is rapidly and completely absorbed. It is distributed fairly evenly throughout all organs and tissues. The content of thiamine in the myocardium, skeletal muscles, nervous tissue and liver is higher due to the increased consumption of thiamine by these structures. The drug is metabolized in the liver and excreted by the kidneys, about 8-10% - unchanged. The biological half-life of thiamine is 0.35 hours. The accumulation of thiamine in the body does not occur due to limited dissolution in fats.

Vitamin B 6 phosphorylated and oxidized to pyridoxal-5-phosphate. In plasma, pyridoxal-5-phosphate binds to albumin. To pass through the cell membrane, pyridoxal-5-phosphate bound to albumin is hydrolyzed by alkaline phosphatase to pyridoxal.

Vitamin B 12 after parenteral administration, it forms transport protein complexes that are rapidly absorbed by the liver, bone marrow and other proliferative organs. Vitamin B 12 enters the bile and takes part in the enterohepatic circulation. Vitamin B 12 passes through the placenta.

Lidocaine when administered intramuscularly, it is rapidly hydrolyzed in a slightly alkaline environment of tissues and, after a short latent period, acts for 1-1.5 hours. Communication with blood proteins is 60-80%. Biotransformation - 90% in the liver to active metabolites (monoethylglycine exsilidide, glycine exsilidide). Elimination of metabolites by the kidneys, 10% - unchanged.

Pharmacodynamics

Nevralon is a combined preparation of B vitamins.

Neurotropic B vitamins have a beneficial effect on inflammatory and degenerative diseases nerves and motor apparatus, in high doses they have an analgesic effect, increase blood flow and normalize the functioning of the nervous system and the process of hematopoiesis.

Thiamine Hydrochloride (Vitamin B 1) is an important active ingredient. In the body, as a result of phosphorylation processes, it turns into cocarboxylase, which is the coenzyme of many enzymatic reactions. It plays an important role in carbohydrate, protein and fat metabolism, as well as in the processes of nerve excitation in synapses. Protects cell membranes from the toxic effects of peroxidation products.

Pyridoxine Hydrochloride (Vitamin B 6) in the phosphorylated form, it is part of the enzymes involved in the processes of decarboxylation and transamination of amino acids, lipid metabolism. Necessary for the normal functioning of the peripheral nervous system and the central nervous system (CNS).

The physiological function of both vitamins is to potentiate each other's action, which manifests itself in a positive effect on the neuromuscular and cardiovascular systems. With vitamin B 6 deficiency, widespread deficiency states are quickly stopped after the introduction of these vitamins.

Cyanocobalamin (vitamin B 12) necessary for the processes of cellular metabolism. Influences the function of hematopoiesis (external anti-anemic factor), takes part in the formation of choline, methionine, creatinine, nucleic acids, has an analgesic effect.

Lidocaine acts as a local anesthetic.

Indications for use

As a pathogenetic and symptomatic agent in the complex therapy of diseases and syndromes of the nervous system of various origins:

polyneuropathy (including diabetic, alcoholic, etc.)

neuritis and polyneuritis, incl. retrobulbar neuritis

peripheral paresis, incl. facial nerve

neuralgia, incl. trigeminal nerve and intercostal nerves

pain syndrome (radicular, myalgia, herpes zoster)

systemic neurological diseases caused by a proven deficiency of vitamins B 1 and B 6 , as well as B 12 .

Dosage and administration

The drug is administered deep intramuscularly.

With severe pain syndrome, 2 ml daily for 5-7 days, then 2 ml 2-3 times a week for 2 weeks.

The duration is determined by the doctor individually, depending on the severity of the symptoms of the disease, but should not exceed two weeks.

Side effects

allergic reactions(skin reactions in the form of itching, urticaria)

Increased sweating

Tachycardia

Acne

Labored breathing

Quincke's edema

Anaphylactic shock

Arrhythmia, bradycardia, dizziness, convulsions, nausea are possible in case of very rapid parenteral administration.

Contraindications

Hypersensitivity to the components of the drug

Thromboembolism

erythremia

Erythrocytosis

Severe and acute forms of decompensated heart failure

Severe cardiac conduction disorders

Pregnancy and lactation

Children's and adolescence under 18

Drug Interactions

Thiamine completely decomposes in solutions containing sulfites. Levodopa reduces the effect of therapeutic doses of vitamin B 6 .

Other vitamins may be inactivated in the presence of vitamin B1 degradation products.

Interactions with D-penillamin, cycloserine are possible.

Thiamine is incompatible with oxidizing and reducing substances: mercury chloride, iodide, carbonate, acetate, tannic acid, iron ammonium citrate, as well as sodium phenobarbital, riboflavin, benzylpenicillin, dextrose and metabisulfite. Copper accelerates the destruction of thiamine; in addition, thiamine loses its effect with increasing pH values ​​(more than 3).

Vitamin B 12 is incompatible with salts of heavy metals.

With parenteral use of lidocaine simultaneously with epinephrine or norepinephrine, there may be an increase in side effects from the heart. Interactions with sulfonamides are possible. In case of an overdose of local anesthetics, epinephrine or noradrenaline should not be administered additionally.

special instructions

Before using the drug, it is necessary to conduct a skin test for individual sensitivity to lidocaine, which is evidenced by swelling and redness of the injection site. The rapid absorption of lidocaine can cause systemic adverse reactions, so the drug must be administered intramuscularly slowly, due attention should be paid to avoid accidental intravascular administration of the drug.

Nevralon contains benzyl alcohol. The drug should not be prescribed to children due to the content of benzyl alcohol in the preparation.

In rare cases, excessive daily doses of vitamin B 6 (500 mg or more for more than 5 months) lead to peripheral sensory neuropathy, which usually disappears after the end of the drug.

Taking vitamin B 12 is contraindicated in patients with psoriasis due to the possible worsening of the symptoms of the disease.

Pyridoxine hydrochloride may cause acne.

Features of the effect of the drug on the ability to drive a vehicle or potentially dangerous mechanisms

There are no warnings regarding the use of the drug by drivers of vehicles and persons working with potentially dangerous mechanisms.

Overdose

Symptoms - increased side effects of the drug.

Treatment - symptomatic. There is no specific antidote.

Release form and packaging

2 ml of the drug in dark glass ampoules.

Nevralon

International non-proprietary name

Dosage form

Enteric film-coated tablets

Compound

One tablet contains

active substances:

thiamine hydrochloride (Vitamin B1) 250 mg

pyridoxine hydrochloride (Vitamin B6) 250 mg

cyanocobalamin (Vitamin B12) 1 mg,

Excipients: mannitol, colloidal anhydrous silica, pregelatinized corn starch, polyvinylpyrrolidone, magnesium stearate, ethanol,

shell composition: acrylic-EZE® pink 93O34305 (copolymer of methacrylic acid, titanium dioxide, talc, triethyl citrate, colloidal anhydrous silica, sodium bicarbonate, carmic acid (E120), sodium lauryl sulfate, indigo carmine aluminum varnish (E132), purified water.

Description

Pink, round, biconvex, film-coated tablets

Pharmacotherapeutic group

B vitamins in combination with other drugs.

ATX code A11DB

Pharmacological properties

Pharmacokinetics

Thiamine hydrochloride (vitamin B1 ) after oral administration, it is resorbed in the duodenum and small intestine. It is largely metabolized in the liver and its main metabolites are thiaminecarboxylic acid and pyramine (2,5-dimethyl-4-aminopyridimine). Metabolites along with big amount unchanged thiamine is excreted through the intestines and kidneys.

Pyridoxine hydrochloride (vitamin B6 ) rapidly absorbed from the intestine. Metabolized in the liver with the formation of pharmacological active

metabolites of pyridoxal phosphate and pyridoxamine phosphate. Vitamin B6 functions as a coenzyme after phosphorylation of the CH2OH group in the 5th position, that is, the formation of pyridoxal-5-phosphate (PALP). About 80% of PALP binds to plasma proteins. Pyridoxine mainly accumulates in the muscles, liver and central nervous system. The end product of pyridoxine metabolism is 4-pyridoxylic acid, which is excreted from the body.

Cyanocobalamin (vitamin B12 ) The main amount of cyanocobalamin is absorbed after binding to the "Castle intrinsic factor". Vitamin B12 accumulates mainly in the liver. The elimination half-life from blood serum is approximately 5 days, from the liver - approximately 1 year. It is excreted from the body mainly with bile and urine.

Pharmacodynamics

Nevralon - a combined preparation of vitamins of group B. Neurotropic vitamins of group B have a beneficial effect on inflammatory and degenerative diseases of the nerves and the motor apparatus, in high doses they have an analgesic effect, increase blood flow and normalize the functioning of the nervous system and the process of hematopoiesis.

Thiamine hydrochloride (vitamin B1 ) is an important active ingredient. In the body, as a result of phosphorylation processes, it turns into

cocarboxylase, which is the coenzyme of many enzymatic reactions. It plays an important role in carbohydrate, protein and fat metabolism, as well as in the processes of nerve excitation in synapses. Protects cell membranes from the toxic effects of peroxidation products.

Pyridoxine Hydrochloride (Vitamin B6 ) in the phosphorylated form, it is part of the enzymes involved in the processes of decarboxylation and transamination of amino acids, lipid metabolism. Necessary for the normal functioning of the peripheral nervous system and the central nervous system (CNS).

The physiological function of both vitamins is to potentiate each other's action, which manifests itself in a positive effect on the neuromuscular and cardiovascular systems. In vitamin B6 deficiency, widespread deficiencies are quickly reversed after administration of these vitamins.

Cyanocobalamin (vitamin B12 ) necessary for the processes of cellular metabolism. Influences the function of hematopoiesis (external antianemic

factor), takes part in the formation of choline, methionine, creatinine, nucleic acids, and has an analgesic effect.

Indications for use

As part of complex therapy:

Acute or chronic neuritis, polyneuritis

neuralgia

Neuropathy and polyneuropathy (diabetic, alcoholic, etc.)

Dosage and administration

Nevralon tablets are taken orally, without chewing, washing down enough water.

For prevention, appoint 1 tablet of Nevralon per day.

For the treatment of diseases - 2-4 tablets per day. With the weakening of symptoms, the dose can be reduced to 1 tablet per day.

The course of treatment is at least one month.

Side effects

Rarely

Allergic reactions (itching, urticaria, shortness of breath, Quincke's edema, anaphylactic shock)

Prolactin release is inhibited

Nausea, gastrointestinal bleeding, increased activity

glutamine-oxaloacetic transaminase in blood plasma

- feeling of anxiety, "lump in the throat", tremor, sudden sweating, feeling of weakness, dizziness, restlessness

Acne

Increased body temperature, flushing of the face

In isolated cases

Tachycardia, collapse, cyanosis, pulmonary edema

At high doses (>500 mg/day) for a long time, peripheral sensory neuropathy may occur

Contraindications

Hypersensitivity to the components of the drug

Allergic diathesis in history

Psoriasis

Pregnancy and lactation

Children and adolescents up to 18 years of age

Drug Interactions

Vitamin B6 reduces the therapeutic efficacy of levodopa.

Thiosemicarbazone and 5-fluorouracil reduce the effectiveness of vitamin B1,

being its antagonists. Antacids slow down the absorption of vitamin B1.

Excessive consumption of alcohol for more than 2 weeks or amino salicylates or colchicine (especially aminoglycoside combinations)

reduces the absorption of vitamin B12 from gastrointestinal tract.

High doses folic acid over an extended period of time can reduce the concentration of vitamin B12.

special instructions

Caution should be used in patients with decompensated heart failure and angina pectoris.

In rare cases, excessive daily doses of vitamin B6 (500 mg or more for more than 5 months) lead to peripheral sensory neuropathy, which usually disappears after the end of the drug.

Taking vitamin B12 is contraindicated in patients with psoriasis due to the possible worsening of the symptoms of the disease.

Pyridoxine hydrochloride may cause acne.

Features of the influence of the drug on the ability to drive a vehicle or potentially dangerous mechanisms

There are no warnings regarding the use of the drug in

drivers of vehicles and persons working with potentially dangerous mechanisms.

Overdose

Symptoms: sensory neuropathy, increased symptoms

side effect of the drug.

Treatment: carry out symptomatic therapy.

Release form and packaging

10 tablets are placed in a blister pack made of PVC / PVDC film and aluminum foil.

Chronic osteochondrosis is characterized by the fact that in its development, acute stages constantly alternate with stages of remission. The period of exacerbation is characterized by pronounced pain manifestations, often of such intensity that people cannot not only move, perform their usual actions, but also simply stand or sit. As a result, the main goal of treatment during the period of attacks is the need to quickly and effectively stop the pain, stop the suffering of a sick person. It is equally important to relieve spasms in the muscles of the back, to release the nerve endings clamped by damaged vertebrae. The use of drugs in the form of tablets or topical agents does not always achieve the desired result, because. they begin to act some time after taking. Therefore, anesthetic injections for osteochondrosis are often prescribed to patients. They allow the active substance of drugs to get into the body very quickly. Right place, begin to act, thereby stopping the pain. Also, with osteochondrosis, medications are prescribed in the form of injection solutions, which help to restore damaged cartilage and eliminate muscle spasms.

When are injections given?

Injections for the treatment of osteochondrosis are used during an attack of pain during the first days in the acute period. The doctor may recommend giving injections if there are signs of osteochondrosis of the lumbar, cervical or thoracic spine. It should be clear to the patient that this treatment technique aims to relieve the pronounced symptoms of the disease, but does not affect or eliminate the cause of its occurrence. Therefore, after several procedures, the doctor usually prescribes medication to the patient in the form of tablets and external agents to continue treatment.

Procedure types

In the process of treating osteochondrosis, the following types of manipulations are practiced:

• Intramuscular injections.
• Intravenous injections.

• Subcutaneous injections.
• medicinal blockade.

Intramuscular injections

Through intramuscular injections medicines are introduced into any of the large muscles of the body: buttock, thigh, shoulder. This type of procedure is in demand for the introduction of a substance in a small amount. Muscles contain, in addition to the muscle fibers themselves, also elements of the circulatory and lymphatic systems of the human body. Therefore, the active substance, administered intramuscularly, in short time enters the blood, starting to act. The duration of exposure is ensured by the gradual entry of the drug into the blood. For best result the patient should relax tense muscles during the manipulation.

How to give injections to yourself will be taught by a rehabilitation doctor Sergey Nikolaevich Agapkin:

Intravenous injections

Intravenous injections, which are given from osteochondrosis, are characterized by the fact that the drug is injected into the blood vessel itself - a vein, i.e. it immediately enters the bloodstream and is quickly delivered to the affected area. This manipulation requires Special attention to the observance of hygienic measures for the treatment of the hands of the medical staff, as well as the place where the medicine is administered. Usually, injections for osteochondrosis are placed in a vein located in the cubital fossa, i.e. middle vein, formed at the junction of the ulnar saphenous and radial vessels.

Subcutaneous injections

Directly under the skin of a person is a fatty layer, which is penetrated by a large number of small blood vessels. The drug, getting into them, practically immediately enters the bloodstream, starting to act. Subcutaneous manipulations in the treatment of osteochondrosis can be delivered to the following areas.

1. Upper shoulder area.
2. Axillary part.

1. Subscapular region.
2. Lateral abdomen.
3. Anterior surface of the femoral region of the leg.

The preparatory stage for a subcutaneous injection does not differ from the preparation when other injections are given for osteochondrosis lumbar spine, as well as the thoracic and cervical. However, the direct injection should be fundamentally different. In any of the above places, a small amount of skin is seized in the form of a fold, the drug is injected. At the same time, the nurse is faced with the task of minimizing the possibility of damaging blood vessels and nerve roots. It is impossible to carry out manipulations in the place where there is swelling of the subcutaneous fatty tissue or a compacted tissue area, which is formed due to incompletely absorbed medication from the procedure performed earlier.

Medicinal blockades

With the help of medicinal blockades used to treat osteochondrosis, excessive muscle tension is removed, spasms are eliminated blood vessels, swelling decreases, inflammatory processes stop, pain stops. There are two types of blockades:

• Paravertebral blockade means that with the help of several injections, active substances are injected into the area where the nerve roots of the spinal column exit. As a result of manipulations, the flow of nerve signals that come due to compression of the roots is prevented. In this way, a sick person is relieved of pain.
• Epidural blockade is characterized by the fact that the injection is placed in the epidural space, which surrounds the spinal cord. Whether the procedure will be effective depends on which substance is administered.

Neurologist Konstantin Sergeevich Susorov shows how paravertebral blockade is done:

Blocking injections are given using combinations with NSAIDs, glucocorticosteroids (Dexamethasone, Hydrocortisone), antispasmodics, or one anesthetic drug (Novocaine, Lidocaine).

In the following cases, treatment with blockades cannot be carried out:

• The presence of pustules on the human body.
• The patient has a significant change anatomical structure spine, which makes the blockade impossible, from a technical point of view.
• The patient has an individual intolerance to anesthetic drugs.

Pathologies of the spine

What is used to treat osteochondrosis

With pain in the back and neck due to osteochondrosis, several groups of medicines help to cope.

Non-steroidal anti-inflammatory drugs

NSAIDs contain active substances that reduce fever, pain, and inflammation. With their help, the sensitivity of the nerve roots is reduced, due to which pain impulses are blocked. In addition, the pain is reduced as a result of the removal of inflammation: the swelling that has formed in the inflamed area decreases.

When injections are prescribed for osteochondrosis of the cervical, thoracic or lumbar, the following non-steroidal anti-inflammatory drugs are often chosen:

• "Diclofenac" - the drug is considered more effective in the process of suppressing inflammation than in the process of reducing pain and lowering the body's temperature response. It has a negative effect on the functioning of the digestive tract and liver, which is why it must be used in combination with drugs that reduce acidity in the stomach. The effect of the Diclofenac injection is observed for about 10-12 hours. The price of the medicine is about 40 rubles.
• Ketorol is a drug that has a pronounced analgesic effect. In the process of suppressing inflammation and reducing fever, it is less effective. It has an undesirable effect on the mucous membranes of the gastrointestinal tract, can provoke bleeding. The result of the injection lasts approximately 5-6 hours. The cost is from 190 rubles.
• "Movalis" is a medicine that is more effective in suppressing inflammatory reactions than in relieving pain and reducing fever. Does not render negative impact on the rate of blood clotting, as well as the occurrence of disorders of the mucous membranes of the stomach and duodenum. The action of movalis persists for one day. The drug costs from 110 rubles.

Pharmacist Maria Luneva talks about Ketorol:

Almost all drugs of the NSAID group negatively affect the organs of the gastrointestinal tract and liver. Often they cause internal bleeding, provoke the progression of pathological changes in them. Parenteral intake of these drugs in the body to some extent reduces the likelihood of adverse reactions.

Painkillers

To alleviate the human condition, reduce the pain reaction, injections are prescribed, painkillers for osteochondrosis of the lumbar, thoracic, cervical spine.

• "Analgin" - effectively relieves pain, is not used against inflammation. It is administered intramuscularly or intravenously after 8-12 hours.
• "Voltaren" - helps to cope with fever and inflammation.

• "Tramadol" is a medicine that belongs to the group of analgesics. By acting on brain receptors, it effectively suppresses pain. The effect of the drug occurs approximately 20-30 minutes after the manipulation and lasts for 5-6 hours. Long-term use of the drug is not recommended because of the rapid addiction to it.
• Analgesics are combined with antispasmodics for best results. Manipulations relax the muscles of the back, reducing soreness. Medicines in this group cost from 120 rubles (Tizalud, Tizanidin) to 400 rubles (Mydocalm). Injections are repeated 2 times a day.

Chondroprotective agents

Chondroprotectors stop the destructive processes in cartilage, stimulate their regeneration. Also stop pain, inflammatory manifestations. In the form of injections for lumbar, thoracic, cervical osteochondrosis, the following chondroprotective drugs are prescribed:

• "Alflutop" - relieves pain well, and also helps to reduce inflammation. Stimulates metabolic processes in tissues, regulates their nutrition.
• "Mukosat" - an agent that prevents the destruction of cartilaginous tissue, has a pronounced analgesic effect, reduces the inflammatory response. The action after the injection lasts up to 48 hours.
• They also prescribe "Chondrogard", "Rumalon", "Don" and other similar medicines to restore damaged cartilage tissue.

Instructions for use of the drug "Dona":

When prescribing chondroprotectors, injections are given intramuscularly every day or 2-4 times a week. In any case, treatment with chondroprotectors is long-term, noticeable results, according to patients, occur approximately six months after the start of treatment.

Vitamin complexes

"Milgamma" is a complex drug that contains B vitamins and an anesthetic element (lidocaine). It costs about 200 rubles. It has a positive effect on the body with osteochondrosis: improves blood flow, blocks pain, relieves inflammation. The result develops quickly, but lasts a short time. Milgamma injections contribute to the restoration of pinched nerve endings of the spinal cord, eliminate discomfort in the affected area. The drug is administered intramuscularly (using 1 ampoule per day) for 7 to 10 days.

Similarly, as a combined agent, injections of combilipen are given.

In the form of injections for osteochondrosis, the doctor often recommends piercing vitamins. They promote regeneration, stop the inflammatory reaction, increase the blood supply to tissues. Vitamin complexes are practiced in the remission stage.

• Vitamins A and E are available as oil-based solutions. They put these vitamins exclusively intramuscularly. The usual course of treatment lasts several weeks.
• Vitamin D (ergocalciferol) is needed to restore the balance of calcium and phosphorus. They put it intravenously and subcutaneously.

• Vitamin C (ascorbic acid) is produced as a solution in water. They put ascorbic acid both intramuscularly and intravenously. The required number of procedures for treatment will be determined by the doctor.
• Nicotinic acid (vitamin PP) has a beneficial effect on blood vessels. Injections for cervical osteochondrosis restore tissue nutrition, improving blood flow. Nicotinic acid is administered intramuscularly for two weeks.

Contraindications

Each group of drugs has contraindications for use. In any case, injections for osteochondrosis are not given if a person has an individual intolerance to the drug, hemophilia, purulent inflammation in the injection area. It is often forbidden to inject during pregnancy and while breastfeeding.

Injections in the treatment of osteochondrosis of any part of the spine effectively relieve pain, help relieve inflammation, spasms. However, it is impossible to put them without the permission of a doctor, so as not to aggravate the situation.

When there is severe pain in the back, lower back, joints, of course, first of all, it is necessary to determine the cause of its occurrence. If it is a backache from hypothermia, lumbago, or a pinched sciatic nerve, intervertebral hernia, etc., you should definitely be examined by a neurologist, osteopath, and possibly a gynecologist, urologist, gastroenterologist, since back pain can be not only from spasm of muscles and ligaments but also in some diseases internal organs. After a thorough diagnosis, the doctor may prescribe as part of complex therapy - NSAIDs, B vitamins in injections for back pain.

What are the drugs that relieve back pain in injections?

Today, in the treatment of acute pain in the lumbar region, back medicine finds new principles and algorithms than 50 years ago. The main emphasis in the fight against painful sensations is done to eliminate pain with the help of NSAIDs - non-steroidal anti-inflammatory drugs, which both suppress inflammation and reduce pain, as well as muscle blockades.

And after the removal of severe spasms, it is recommended that the patient not be immobilized, that is, conducting classes physical therapy, massage exercise. Most doctors insist that a person during pain syndromes in the back area does not limit his activity as much as possible.

It has also become popular and effective to prescribe combined vitamin complexes that can have a moderate analgesic effect, these are vitamins B12, B6, and B1. It is believed that vitamin B12 has a more significant analgesic property. Why these particular vitamins?

Recently, these drugs have been considered in medicine as moderate analgesics, since they are neurotropic - they normalize muscle innervation, participate in the transmission of excitation, in the metabolism of mediators, affect metabolism, nervous system, contribute to the restoration of damaged nerves.

Over 90 different studies have proven that the use of B vitamins in clinical practice led to a significant reduction in pain in acute phases inflammation in complex treatment. Therefore, they can be used both individually and in the form of complex preparations of B vitamins.

The composition of most complex preparations of this group contains the anesthetic lidocaine, which enhances the local analgesic effect. However, it should be remembered that the use of this group of vitamins makes sense only for acute pain in the back, joints, alcoholic polyneuropathy, B12 myasthenia gravis for 10-14 days, and in chronic recurrent diseases they already become ineffective.

In cases where painkillers do not help, specialists can offer the patient a method of injection and stretching. It consists in the following: after the patient lies on his stomach, the most painful lumps or points where the pain is most intense, and an injection is made exactly perpendicular with a solution of novocaine.

Immediately after the injection, passive stretching of the muscle is performed, after which a hot compress is placed on this place. Then, when the compress is removed, the patient must make active movements, exposing the painful muscle to the maximum movement.

The purpose of novocaine blockade is to “turn off” the nerve. Therefore, the injection points should be as close as possible to the exit points of the nerves, for example, the sciatic - at the greater trochanter of the thigh, with intercostal neuralgia - in the corresponding intercostal space, with osteochondrosis - at the outer edge of the back extensor, etc. It is also advisable to perform epidural blockades in chronic pain syndrome, for example, in case of herniated intervertebral discs.

Below is a list of drugs prescribed by the attending physician according to indications. Only a doctor determines the advisability of using B vitamins, NSAIDs, muscle relaxants, and chondoprotectors. The information below is for informational purposes only, the course of treatment and dosage is determined by the specialist.

When your back or joints hurt, injections of B vitamins should help

B vitamins can also be taken in tablet form, but naturally, intramuscular administration of drugs is considered more effective. Consider what drugs of this group exist on the modern pharmaceutical market, their general indications, contraindications, side effects, methods of application and comparative prices in pharmacies:

Milgamma Milgamma 5 amp. price in pharmacies 220 rubles, 10 amp. 400 rub. 25 amp. 900 rub. The composition of all these drugs is the same: Lidocaine, Thiamine, Pyridoxine Cyanocobalamin. Indications: It is used for neurological diseases and syndromes of nervous system disorders in complex therapy: Neuritis, paresis of the facial nerve, trigeminal neuralgia Back pain caused by diseases of the spine, neurological manifestations (radiculopathy, lumboischialgia, muscular-tonic lumbar, cervical, cervico-shoulder syndromes, intercostal neuralgia, radicular syndrome due to degenerative changes in the spine) nocturnal muscle cramps, alcoholic, diabetic polyneuropathy, shingles.

Kombilipen 5 amp. 100 -120 rubles, 10 amp. 170-210 rub. Contraindications: You can not carry out treatment with: Pregnancy, lactation acute, severe types of heart failure hypersensitivity to the components of the combined vitamins of group B due to lack of research childhood

Neurobion 3 amp. 220 rub.- Neurobion does not contain Lidocaine in its composition Side effects: Tachycardia, increased sweating, rarely - allergic reactions - rash, itching, urticaria, skin reactions, shortness of breath, anaphylactic shock. In case of overdose - nausea, vomiting, dizziness, tachycardia.

Trigamma 5 amp. about 100 rubles. Application: All of the above injections for back pain are injected deep intramuscularly at 2 ml 1 r / day for 5-10 days, then you should switch to 2-3 r / week for 14-21 days. or taking vitamins orally.

Efficacy, contraindications and side effects of NSAIDs

Painkillers, of course, are used only as a symptomatic therapy, they help eliminate pain in the joints, back, but do not eliminate the cause of its appearance, in addition, 50% of patients may experience various side effects.

In more than 50 studies looking for the best pain reliever, researchers have found that no NSAID drug is more effective than other pain relievers, and some of them are very expensive drugs. The only thing to pay attention to when choosing is that some generics (Russian diclofenac, for example) are significantly inferior in effectiveness to original drugs (European Diclofenac).

Also, these studies were aimed at determining the drug with the lowest side effects. As a result, Ibuprofen was found to be the least toxic of all NSAIDs.

Manufacturers of the new Cox-2 inhibitor Celebrex claimed that it had the least side effects, but no convincing evidence of this fact was found during the studies.

Therefore, when choosing a non-steroidal anti-inflammatory drug, it should be remembered that they have almost the same anesthetic property, the same side effects, but different frequency, intensity, severity of side effects, harmful effects, and, not least, different prices. For example, Meloxicam has less effect on the stomach and intestines than aceclofenac (Aertal). Indomethacin gives a pronounced analgesic effect, but destroys cartilage when long-term use and is now used less and less.

Moreover, doubling the dose does not reduce the intensity of pain, and in the case when one non-steroidal drug does not help (if it is not a fake), replacing it with another does not make sense. Moreover, based on research, it can also be concluded that they are not much more effective than regular paracetamol. Details about all ointments for back pain can be found in our article.

Choice of painkillers

In chronic pain, before prescribing an anesthetic, the doctor determines the causes and nature of chronic pain - referred, neuropathic or central, and prescribes the appropriate treatment.

If the pain is acute, then the doctor determines the risk of side effects on the gastrointestinal tract, cardiovascular complications, if the risks are not high, and:

• no dyspepsia - then any NSAID
• there is dyspepsia - ibuprofen (or diclofenac, naproxen), nimesulide (or miloxicam) is better

If the risk of cardiovascular complications is high, then NSAIDs should be avoided, and Paracetamol, opioids should be used. At moderate risk, nimesulide may be prescribed, provided adequate correction of blood pressure (amlodipine, see drugs to reduce pressure).

If there is a high risk of gastrointestinal bleeding - NSAIDs + necessarily proton pump inhibitors (omeprazole). It is understood that taking NSAIDs is in itself a sufficient risk even with a single dose, therefore, according to the standard, all NSAIDs are taken in combination with proton pump blockers, regardless of the risks of gastroduodenal bleeding.

With a combination of risks of the gastrointestinal tract of side effects and complications of the cardiovascular system - Nimesulide + acetylsalicylic acid + omeprazole.

If within 5-7 days the pain subsides, then continue treatment until it is completely relieved.
If acute pain does not subside within a week, then muscle relaxants, local anesthetics are prescribed. Local administration of corticosteroids is possible with the exclusion of the diagnosis - tuberculosis of the joints or spine. With very severe pain and no effect from painkillers, the infectious nature of the pain should be excluded (tuberculous pathology - consultation and examination in a tuberculosis dispensary), joint pain with gonorrhea, syphilis or other infection.

An overview of painkillers in injections

All known NSAIDs in injections, with their general contraindications and side effects, average prices in pharmacies are presented in the table:

Meloxicam Movalis(3 amp. 530 rubles) Amelotex(3 amp. - 280 rubles) Artrozan(3 amp. 190 rubles) Indications for the use of NSAIDs: Symptomatic treatment of ankylosing spondylitis, osteoarthritis, rheumatoid arthritis, elimination of pain - musculoskeletal, back pain of any etiology, postoperative and other pain.

Ketoprofen artrosilene(6 amp. 170 rubles) Ketonal(10 amp. 200 rubles) Flamax(5 amp. 110 rubles). Flexen(6 amp. 280 rubles) Contraindications: Hypersensitivity to any component of the drug, heart failure, pregnancy and lactation, severe liver or kidney failure, bronchial asthma aspirin, children under 16-18 years old, inflammatory bowel disease, exacerbations peptic ulcer stomach, gastrointestinal bleeding. cerebrovascular disease, ischemic disease heart disease, any serious illness of cardio-vascular system, joint use of antiplatelet agents (clopidogrel, acetylsalicylic acid) prednisolone, impaired liver function, severe somatic diseases. With caution: diseases of the gastrointestinal tract, the presence of Helicobacter pylori infection, edema, fluid retention, diabetes, long-term use of NSAIDs.

Ketorolac Ketorol(10 amp. 130-150 rubles), Ketanov(10 amp. 100 rubles) Ketorolac(10 amps 70-90 rubles) Application: A solution for injections for back pain should be administered deep intramuscularly at a dosage selected by the doctor, depending on the age of the patient, the intensity of the pain. Up to 65 years, a single dose of 10-30 mg is prescribed. IM every 4-6 hours. Persons with impaired renal function or older than 65 years at a dose of 10-15 mg / m once, or every 4-6 hours. The maximum daily dose should not exceed 60-90 mg. and the duration of therapy is not more than 5 days.

Diclofenac Diclofenac(5 amp. 40 rubles) Voltaren(5 amp. 270 rubles) Naklofen(5 amp. 50 rubles), Ortofen(10 amp. 40 rubles) Side effects: Digestive system: often - diarrhea, gastralgia, constipation, vomiting, nausea, heartburn, hepatitis, acute pancreatitis. Urinary system: frequent urination, nephritis, edema, acute renal failure. Respiratory system: shortness of breath, laryngeal edema, allergic rhinitis, difficulty breathing. CNS: dizziness, headache, drowsiness, hyperactivity, psychosis, hearing loss, depression, visual impairment. CCC: syncope, elevation blood pressure, pulmonary edema. Organs of hematopoiesis: eosinophilia, anemia, leukopenia. Blood coagulation: rectal, nasal, gastric bleeding, from a postoperative wound. Dermatological manifestations: urticaria, skin rash, skin peeling, Lyell's syndrome, Stevens-Johnson syndrome. Allergic reactions: swelling of the eyelids, wheezing, shortness of breath, discoloration of the skin of the face, itching of the skin, rash, heaviness in chest. Other: often - weight gain, swelling of the ankles, face, fingers, legs, excessive sweating.

Lornoxicam Xefocam(5 amp. 700-720 rubles) Tenoxicam Texamen 1 vial. 200 rub. Overdose: vomiting, nausea, abdominal pain, the occurrence of peptic ulcers of the stomach, metabolic acidosis, impaired renal function. Interaction: Simultaneous use of NSAIDs with acetylsalicylic acid or other non-steroidal painkillers, as well as corticosteroids, calcium preparations, ethanol, can lead to gastrointestinal bleeding and the formation of gastrointestinal ulcers. Simultaneous reception with paracetamol increases the risk of nephrotoxicity.

Painkillers in tablets

When the back hurts a lot, the doctor can prescribe anti-inflammatory, painkillers in tablets, it was previously believed that oral administration slows down the onset of action, reduces effectiveness and leads to more severe side effects from the gastrointestinal tract. To date, it is believed that intramuscular administration and oral administration give the same bioavailability of the drug. Side effects from the gastrointestinal tract are realized through the suppression of the arachidonic acid system, that is, not through direct contact with the mucosa, but after absorption into the blood. Therefore, the side effects are almost the same when taken orally and when injected.

Basic NSAIDs in tablets

• Celebrex (active ingredient celecoxib 10 pieces 400-420 rubles)
• Arcoxia (active ingredient etoricoxib 7 pcs. 520-600 rubles)
• Texamen (active ingredient tenoxicam 10 pcs. 200-250 rubles)
• Nise, Nimulid, Nimika (active ingredient nimesulide price 20 pcs. 80-140 rubles)
• Nalgezin (active ingredient naprxen 10 pieces 110-130 rubles)
• Movalis, Artrozan, Meloxicam (substance Meloxicam price 20 tab. 40 rubles, Movalis 20 tab. 250 rubles)
• Ketanov, Ketarol, Ketorolac (substance Ketorolac price 20 tab. 40-60 rubles)
• Naproxen, Nalgezin (substance Naproxen, 120-260 rubles)
• Artrosilen, Bystrumcaps, Ketonal, Flexen (substance ketoprofen 20 pcs. 150 rubles, Bysrumcaps 10 pcs. 250-270 rubles, Flexen 30 pcs. 170 rubles)
• Burana, Nurofen, Faspik, Ibuprofen (substance Ibuprofen price 20 pcs. 15 rubles, Nurofen 12 pcs. 110 rubles, Faspic 6 pcs.
• Voltaren, Diklak, Naklofen, Ortofen
• Aertal 20 tab. 400 rub. - Active ingredient Aceclofenac.
• Ksefokam 10 pcs. 130-200 rubles. - Lornoxicam.

Combined pain medications

Dolaren, Panoxen (20 pieces 120 rubles) - diclofenac + paracetamol.

• Neurodiclovit (30 pcs. 300 rubles) - diclofenac + vitamins of group B.
• Next (120-170 rubles) - paracetamol and ibuprofen.

Muscle relaxants

Most of the pain is based on muscle spasm, which in itself stretches the nerve root and causes a secondary radicular syndrome, therefore, in many cases, muscle relaxants are prescribed as an anesthetic:

• Tolperisone - peripheral action, Mydocalm (instruction for use, tablets, injections 30 tab. 50 and 150 mg 300-400 rubles), Tolperizon 30 pcs. 150-200 rub.
• Hydroxyzine - central with CNS inhibition, suitable for severe pain, Atarax 25 pcs. 300 rubles, Hydroxyzin 25 pcs. 200 rub.
• Baclofen is also a central action, Baclosan.
• Tizanidin - central action, Sirdalud (2 mg 30 pcs. 230 rubles, 4 mg. 30 pcs. 330 rubles), Tizanil (2 mg. 30 pcs. 170 rubles, 4 mg. 30 pcs. 250 rubles), Tizalud (2 mg. 30 pcs. 140 rubles), Tizanidin 4 mg. 30 pcs. 150-200 rub.

Chondoprotectors

Chondroitin sulfate Mukosat(5 amp. 250-500 rubles), Chondrogard(10 amp. 600 rubles), Chondrolon(10 amp. 800-1100 rubles), Artradol(10 amp. 700 rubles) Chondroitin sulfate - this drug belongs to anti-inflammatory drugs, which is prescribed for the treatment of diseases of the joints and spine. It slows down the resorption of bone tissue, improves calcium-phosphorus metabolism in cartilage tissues, stops the destruction of connective and cartilage tissue, and accelerates recovery processes. Reduces pain and increases mobility of the spine and joints. It has a structural similarity with heparin, therefore it prevents the formation of blood clots in the subchondral and synovial bed.

Alflutop Alflutop (10 amp. 1400-1500 rubles) This modern drug, which is a concentrate of fine sea ​​fish regulating cartilage metabolism. The composition of the bioactive concentrate includes amino acids, potassium, sodium, copper, iron, calcium and zinc ions, as well as mucopolysaccharides, peptides. This tool stimulates the processes of restoration of cartilage tissue, inhibits the destruction of the structures of bone and cartilage tissues, which provides a moderate analgesic effect. The drug is prescribed only for adults with osteochondrosis or polyosteoarthritis, it should be administered intramuscularly deeply 1 ml / day for 20 days. If large joints are affected, then it is possible to administer the drug into the joint once every 3-4 days, 1-2 ml, a course of 5-6 injections.

Drugs affecting the tone of cerebral vessels, microcirculation, metabolism of brain cells:

• Cellex
• Neipilept (injections)
• Carnitex
• vitrum memory
• Thiolepta (tablets)
• Berlition 300 (tablets)
• Thioctacid T600 (solution)
• Thioctacid BV (tablets)
• Actovegin
• Halidor (solution)
• Gliatilin
• Cavinton
• Carnitene
• Mexidol
• Noocholine
• Recognan
• Ceraxon
• Cerepro
• Delecite
• Cerebrolysin
• Cereton
• Cytoflavin
• Trental: 400 mg tablets, concentrate, 100 mg tablets
• Elkar (ampoules)

Drugs used for dizziness:

• Betaserc

Anti-migraine drugs:

• Amigrenin

Drugs used to relieve pain:

• Provimenol
• Nicoflex (ointment)
• Ketonal DUO
• Dolobene
• Diklonat P
• Viprosal (ointment)
• Nanoplast forte
• Apizartron
• Arthrodarin
• Fastum (gel)
• Nurofen (gel)
• Dolgit (cream)
• Finalgon
• Aertal (tablets, sachet, cream)
• Versatis
• Voltaren (gel)
• Diclofenac (ointment)
• Ibuprofen
• Kapsikam (ointment)
• Katadolon
• Neurodolone
• nolodatac
• Ketonal (ointment, cream)
• Xefocam
• Meloxicam (suppositories, tablets, injections)
• Nise gel
• Nizilat
• Boyko mix
• Celebrex
• Pepper plaster

Drugs used to relieve neuropathic pain:

• Convalis

Chondroprotectors:

• Artra MSM forte
• Chondroitin (ointment)
• Chondroitin Akos
• Structum
• Alflutop
• Artra
• Artradol
• Artrakam
• Teraflex
• Mukosat
• Chondrolon

Muscle relaxants:

• Baklosan
• Mydocalm
• Sirdalud
• Sirdalud MR
• Tizanil (tablets)
• Tolperisone

Drugs that affect blood clotting:

• Cardiomagnyl

Light sedatives:

• Nervochel
• Valerian (tincture, extract)
• Valemidin drops
• Glycine
• Glycine Forte Ozone
• Novopassit
• Persen
• motherwort extract
• Tenoten (adult)
• Tenoten (children's)
• Zelenin drops
• Bekhterev's medicine
• Potion Quatera
• Ravkin's potion
• Pavlova's potion

Tranquilizers:

• Grandaxin
• Atarax
• Afobazole
• Relanium
• Stresam

Antidepressants:

• Adepress
• Amitriptyline (available as tablets, solution for intramuscular injection). Often used as a sleep aid;
• Valdoxan
• Negrustin (capsules, solution)
• Fevarin
• fluoxetine
• Cipralex

Anti-asthenic drugs (anxiolytics)

• cogitum
• Ladasten
• Stimol

Antiepileptic drugs:

• Pregabalin-Richter
• Tiagabine (Gabitril)
• Depakine (Depakine Chrono, Depakine Chronosphere)
• Convulsofin (Convulex)
• Lamictal (lamotrigine)
• Lyrics
• Sabril
• Suxilep
• Topamax
• Chloracon
• Chloral hydrate
• Felbamate
• Finlepsin (Carbomazepine)

Drugs affecting the DOPA system (antiparkinsonian drugs):

• Azilect
• Madopar
• On whom
• pc-mertz
• Pronoran
• Requip
• Stalevo

Sleeping pills:

• Circadin
• Donormil
• Reslip
• Melaxen
• Melarena
• Melarithm
• Phenazepam
• Phenobarbital

Nootropic drugs:

• Neurobutal
• Pantogam (syrup, tablets)
• Lucetam (solution, tablets)
• Pantocalcin
• Picamilon
• Piracetam
• Phezam
• Metaprote
• Phenotropil
• Phenibut
• Biotredin
• Bemitil
• Noben
• Tanakan;
• Cortexin
• Semax
• Nooklerin
• Noopept

B vitamins (neurometabolic and general tonic):

• Benfogamma
• Neurobion
• Compligam
• Kombilipen
• Panangin plus vitamin B6
• Milgamma
• Milgamma compositum
• berocca
• Vitagamma
• Trigamma
• Vitamin B12
• Vitakson

Homeopathic remedies:

• Traumeel S solution for injections
• Ointment Traumeel C
• Traumeel C tablets
• Gel Traumeel S

Other means:

• Petrov's mixture
• Glucose-potassium-insulin mixture (GIKS)

• NovoKapillary

Drugs in neurology are used to treat diseases of the nervous system of varying severity. On our website you can see a list of all available drugs in this category in the 36.6 pharmacy network, as well as order the right product.

Our Internet resource has a convenient search system, you can also use the catalog by going to the "Medicines" section and selecting the "Neurological and mental diseases" category.

Indications

Drugs used in neurology can be prescribed to a patient in the presence of the following diseases:

• Migraine;
• Neuralgia;
• Schizophrenia;
• Depression. According to WHO More than 300 million people in the world suffer from this disease, and most of them? women ;
• neuroses;
• Vertigo of various etiologies.

Neurological preparations contain strong active ingredients therefore, before using them, you should consult a doctor so that he can make an accurate diagnosis based on your symptoms and prescribe the most effective and safe medicines.

Contraindications

Medicines used for mental disorders, as well as other medicines, have a number of contraindications for use.

Such drugs should not be used in the following cases:

• With hypersensitivity to the components of the drug;
• With heart failure;
• Pregnant and lactating women;
• With renal failure;
• At acute illnesses gastrointestinal tract.

For detailed information about the contraindications of the medicine you need, go to the product card and read its instructions for use.

Release forms

Our website presents various drugs in neurology (vasoactive, metabolic, antioxidant), which have the following dosage forms:

• Drops;
• Capsules;
• Ampoules;
• Pills.

All of them differ from each other in their own way. state of aggregation, method of administration and exposure time. Most medications in the category "Neurological and mental diseases" are dispensed only by prescription.

Manufacturing countries

Our site features both Russians and foreign funds from mental disorders.

Here you can find the following preparations:

• German,
• indian,
• Hungarian,
• Latvian and others.

The list provided is not complete. More detailed information about manufacturers can be found on the website of the network of pharmacies 36.6.

BEFORE USING THE DRUGS, READ THE INSTRUCTIONS FOR USE OR CONSULT WITH A SPECIALIST.

Bibliography:

1. [i] " Mental disorders”, WHO fact sheet April 2017

In the treatment of pain syndrome caused by pinched nerve roots as a result of muscle spasms, various diseases of the spine, stressful situations, hypothermia, hernial protrusions, and tumors, medications for neuralgia are prescribed. Their list includes various groups of pharmaceuticals characterized by a wide range actions.

Neuralgia is a serious disease that requires timely treatment when the first signs of a pain attack appear. Timely seeking help from a qualified specialized specialist provides an opportunity to avoid aggravation of the situation, breathing difficulties, clouding of consciousness, and the development of complications.

Drug therapy is in first place in the treatment of acute pain attacks caused by pinching of nerve endings in various areas. human body. The appointment of drugs for neuralgia provides for the achievement of certain goals. These include:

• decrease in the intensity of pain syndrome caused by pinching of the nerve roots;
• adjustment of treatment after the removal of the combat syndrome, aimed at improving metabolic processes in nerve fibers;
• achievement of anti-inflammatory, stabilizing, analgesic, sedative, analgesic effect;
• strengthening the immune system, which determines the protective functions of the human body;
• restoration of the activity of nerve endings after the relief of pain, their stimulation
• prevention of recurrence of neuralgia;
• increase in the content of vitamins, minerals, trace elements in the patient's body.

Strict adherence to the recommendations, prescriptions of the attending physician is an important condition for achieving positive results when diagnosing neuralgia. Self-selection of tablets and other forms medications to relieve pain can cause a deterioration in the patient's health, the development of complications provoked by side effects from the medications taken.

Different forms of medications are used to treat neuralgia. Their list includes: tablets, capsules, emulsions, ointments, gels, injections. The correct conduct of drug therapy involves strict adherence to the doses and frequency of medication prescribed by a neurologist.

Analgesics to eliminate neuralgia

To effectively solve the problem of pinched nerve roots in different zones the human body is designed different groups pharmacological agents that differ in multidirectional action, properties, speed of action on the focus of inflammation, side effects. What medications to take for neuralgia is determined only by the attending physician. The results of diagnostic measures form the basis of their choice. Among the common components of pharmacotherapy that successfully eliminate the manifestations pathological condition, as well as effectively eliminating the main causes of its development, it should be noted analgesics, which are painkillers. Their action is aimed at relieving a painful neuralgic syndrome caused by pinched nerve roots.

Medicinal painkillers are available in the form of tablets, capsules, creamy substances, ointments, gels, injection ampoules. A diverse type of analgesics provides the opportunity to use them externally, orally or in the form of intramuscular injections. The most popular analgesics include: Sedalgin, Baralgin, Spazmalgon, Analgin, Tempalgin, Bral. The use of novocaine and lidocaine blockades eliminates acute pain that cannot be treated with tablets and topical agents. Painkillers are recommended to be used for 3-4 days. Longer intake of analgesics can lead to inflammation of the gastrointestinal tract.

NSAID medications

Pharmaceutical drugs NSAIDs are non-steroidal drugs characterized by a pronounced anti-inflammatory effect. With their help, it is possible to localize the neuralgic syndrome, reduce the intensity of pain and seizures, significantly improve general state patients with neurological disease. Such properties of NSAID drugs, which have the ability to influence not only the inflammatory process, but also the magnitude of the thermal state of the body of a sick person, pain, play an important role in the treatment of pathology.

Drug therapy of neuralgia involves the use of a wide range of drugs of this type. The most common of these include: Diclofenac, Ortofen, Ibuprofen, Ketoprofen, Piroxekam, Voltaren, Indomethacin. Such medications and their analogues are available in the form of tablets, capsules. They are recommended to be taken no more than 1-2 times a day. It is strictly forbidden to exceed the dosage prescribed by the attending physician. Ignoring the recommendations of a neurologist can lead to the development of diseases of the gastrointestinal tract, including ulcerative conditions of the mucous membranes of the stomach and duodenum, gastritis and other pathologies. The course of drug therapy based on non-steroidal anti-inflammatory drugs is 5-7 days.

In addition to the form of tablets and capsules, NSAID drugs are available in the form of rectal suppositories, injections. For external use, ointments, creams, gels, special plasters are produced. These include Diprilif, Voltaren, Ketonal, Nise, Diclofenac and other analogues with a similar composition. When using NSAIDs for external use, careful handling is recommended, careful rubbing into the foci of painful sensations, excluding pressure and massaging the inflamed areas. Special patches, which include Ketonal thermo, are considered a modern alternative to applications with ointments, creams, gels.

Muscle relaxants, vitamin complexes, neuroprotectors

When diagnosing neuralgia, drugs designed to relieve muscle spasms play an important role in drug therapy. They are called muscle relaxants. Their use allows achieving positive results, significantly reducing the intensity of the pain syndrome due to the relaxation of muscle fibers and reducing the amount of pressure on the affected nerve process, as well as alleviate the patient's condition. The list of popular muscle relaxants includes: Clonazepam, Baclofen, Sirdalud, Mydocalm, Tizanidin. The treatment course is prescribed by the attending physician.

Complexes based on vitamins of group "B" are designed to compensate for their deficiency in the patient's body, effective fight With inflammatory process. The purpose of neuroprotectors is due to their ability to improve and normalize metabolic processes in the brain tissues and the peripheral nervous system. Their list includes: Mexidol, Actovegin, Milgama, Neurobion. In addition to the above drugs

the attention and praise of patients deserve ointments based on bee or snake venom, as well as pepper patches, the use of which allows you to get an excellent effect.

Drug treatment of pathology with strict adherence to the recommendations, doctor's prescriptions is the key to a successful solution to the problem of pinched nerve roots, acute pain syndrome, as well as the exclusion of relapse.