Injections Midokalm: instructions for use, what is prescribed, composition, analogues of the drug

“Midokalm” injections are an injectable form of the drug, which is designed to relieve spasm and reflex contractions of skeletal muscles and at the same time provide a local analgesic effect. Belongs to the class of central muscle relaxants (drugs that relax muscles) and is purposefully used in the treatment of neurological disorders, diseases of the vascular system, joint pathologies.

Composition, release form and packaging

This form of the drug is an injection solution for intramuscular and intravenous injections.

Active therapeutic substances in 1 ml: tolperisone - 100 mg and lidocaine - 2.5 mg (in the form of hydrochloride compounds).

Auxiliary components in the ampoule: water, iron oxide, methyl parahydroxybenzoate, colloidal silicone, diethylene glycol monoethyl ether.

The solution with a medicinal odor is in 1 ml glass brown ampoules. In a pack of cardboard, a cellular pallet of transparent plastic with 5 ampoules is placed.

Pharmacological properties and pharmacokinetics

The mechanism of the therapeutic effect of Midokalm is based on the healing properties of its active components.

Tolperisone:

• inhibits the activity of the spinal cord of nerve cells, providing a motor reaction of muscles to external stimuli;
• reduces the excitability of nerve fibers conducting impulses from tissues and organs to the central nervous system, as well as the sensitivity of motor nerve cells that transmit a signal from nerve trunks to muscles;
• blocks the release of adrenaline and its stimulating effect on muscle tissue;
• stabilizes the membranes of nerve cells, preventing their damage;
• enhances blood movement in the vessels of the limbs, regardless of the influence of the nervous system.

Lidocaine moderately alleviates pain in muscles and joints and relieves pain during injection.

Thanks to these characteristic features, “Midokalm” in injections is able to effectively eliminate the effects of organic damage during CNS pathologies:

• increased rigidity (rigidity) and abnormally high muscle tone;
• spasmodic reflex muscle contractions;
• muscle soreness and swelling.

Having the indicated therapeutic properties, the medication:

• facilitates motor function, painless performance of active movements;
• moderately dilates the lumen of blood vessels and activates blood flow and lymph movement.

An important property of the medication - "Midokalm" does not cause muscle weakness, disorientation, apathy. It does not affect the cerebral cortex, and when it is taken, there is a complete preservation of the level of wakefulness and psycho-emotional activity, which is an advantage and distinguishes it from other pharmaceuticals with a similar therapeutic effect.

With long-term use, muscle relaxant practically does not impair renal function and does not affect the hematopoiesis system.

Active components quickly spread with blood flow through the tissues. Processed in the liver and kidneys and removed with urine.

Why is prescribed Midokalm in injections

The central muscle relaxant is actively used in the treatment of pathologies of the vascular system, organic lesions of the brain and spinal cord, and the musculoskeletal system.

In the framework of complex therapy, "Midokalm" is prescribed for the following abnormal conditions:

• pathologically high level of muscle tension (tone) at the time of their relaxation, spasm of muscle fibers against the background of neurosis and the effects of circulatory disorders of the brain (encephalitis, multiple sclerosis, cerebral and spinal paralysis, stroke, myelopathy, encephalomyelitis);
• trembling and stiffness of limb movements (phenomena of parkinsonism) against the background of encephalitis and atherosclerosis;
• limb contractures for spinal injuries, paraparesis (paralysis) of the legs or arms;
• contractures against the background of skeletal-articular lesions such as spondylosis, arthrosis of the knee, hip joints, cervicobrachial neuralgia, osteochondrosis of the sacro-lumbar zone, spondylarthrosis;
• disorder of lymph circulation and blood flow in the veins after thrombosis (atherosclerosis of the vessels of the extremities, ulcerative formations on the legs, obliterating diseases of the arteries);
• angiopathy (neurological spasm and vascular paralysis) of various origins (including diabetes), thromboangiitis obliterans (Buerger's disease), Raynaud's syndrome, diffuse scleroderma;
• angioneurotic dysbasia (gait disturbances in vascular lesions and breakdown of connections in the central nervous system);
• acrocyanosis (cyanosis and cooling of the skin with impaired blood flow in small capillaries).

"Midokalm" intramuscularly effectively used in pediatrics:

• to eliminate spastic phenomena in childhood CP (Little disease) and other brain tissue lesions, accompanied by a change in muscle tone;
• with speech disorders associated with spasm of the muscle fibers of the larynx.

The medication is effective in treating young patients from epilepsy and mental disorders associated with neurovascular damage to the brain.

In addition, Midokalm helps:

• in the postoperative period for recovery after orthopedic interventions and trauma surgery;
• during electroconvulsive therapy of severe depressive psychopathic conditions - for muscle relaxation and reduce the risk of injuries.

Instructions for use of the drug

The dosage regimen and dosage of Midokalm in the form of an injection solution is developed individually taking into account the type of pathology, the severity of the manifestations accompanying the disease, and the patient's reaction to the medicine.

Average Dosages:

1. An injection is made into the muscle 2 times a day, slowly introducing 1 ampoule of solution (100 mg).
2. The dosage regimen for intravenous administration is once 100 mg per day.

The drug is injected into a vein using droppers, slowly, to minimize the risk of adverse reactions, including acute allergies with intolerance to the drug.

Injectable medicine is not used in patients under 13 to 15 years of age. In some cases, it is used only for the purpose of a pediatric neurologist, and the dosage is calculated with high accuracy according to the body weight of the child.

Midokalm injections during pregnancy and lactation

Tolperisone does not lead to impaired embryo development and congenital malformations of the fetus. However, evidence of the complete harmlessness of Midokalm for lactating and pregnant women is not yet available. Therefore, in these periods of particular vulnerability of the female body, they try not to prescribe a medication, especially in the first trimester.

In extreme cases, if the expected therapeutic effect for the mother (after 12 weeks of pregnancy) or a lactating woman exceeds the possible negative effect on the fetus or on the baby, "Midokalm" can be applied only with the permission of the doctor conducting the pregnancy, neonatologist and pediatrician.

But it should be noted that in gynecology, a medication in tablets (but not in injections) is prescribed for pregnant women with the threat of miscarriage due to increased uterine tone.

Can I drink alcohol while taking the drug

Ethanol does not affect the absorption and medicinal effect of Midokalm. The drug also does not enhance the negative properties of ethanol, so moderate alcohol consumption is allowed during therapy.

Drug Interactions with Other Drugs

Information on the dangerous interaction of Midokalm with other pharmacological products is not available.

But it is reliably proven that:

• the medication does not cause apathy and daytime sleepiness, therefore it is allowed to use it in combination with sedative pharmaceuticals, sleeping pills, soothing tinctures containing ethyl alcohol;
• with parallel use, the drug enhances the therapeutic effect of niflumic acid;
• the therapeutic effect of Midokalm becomes more pronounced when combined with Clonidine, psychotropic drugs, anesthetics for general anesthesia, and other relaxants.

In the practice of treating neuralgia, degenerative inflammatory joint lesions, Midokalm is actively and successfully used, combining it with non-hormonal anti-inflammatory drugs (Diclofenac, Movalis). Such complex treatment allows to achieve marked improvement and long-term subsidence of all manifestations of the disease.

Special instructions for use

Midokalm does not lead to negative consequences when driving, working with technological mechanisms and labor operations, requiring concentration and a quick psychomotor reaction, as well as activities associated with increased danger.

But it should be borne in mind that injection treatment with a medication can cause more severe adverse reactions, therefore, if dizziness, muscle weakness, disorientation occur, you should immediately contact your doctor for dose adjustment and dosage regimen.

Contraindications, side effects and overdose

The drug is well tolerated, but has a number of contraindications, which include:

• Hypersensitivity or intolerance to any Midokalm ingredients, including allergies to lidocaine;
• myasthenia gravis (pathological muscle weakness);
• age 13 to 15 years with injection treatment.

Undesirable manifestations during treatment with Midokalm are rarely observed, but if the medication is administered by injection or drip, the following adverse reactions may occur:

• weakness, dizziness, tinnitus;
• headache, rise in blood pressure, nausea;
• itching, swelling and redness of the skin, urticaria.

With a decrease in dose, the level of side effects decreases or all unpleasant manifestations disappear. If this does not happen, you should switch to taking the medicine in tablets (lidocaine is not included in their composition).

If the ban on the jet injection of Midokalm into a vein is violated (especially with rapid administration), the following can be observed:

• a sharp drop in blood pressure, blurred consciousness;
• increased heart rate (tachycardia);
• acute allergy in the form of such signs of intolerance to the drug as: redness, rash, blisters, severe itching, swelling of the lips, eyes, tongue, difficulty swallowing and breathing due to swelling of the larynx, bronchospasm with shortness of breath, anaphylactic shock.

If similar symptoms develop, the administration of the drug solution is immediately stopped and an ambulance crew is urgently called.

Cases of overdose during treatment with muscle relaxant are very rare. Even in children, a dose within 600 mg usually does not cause signs of an overdose.

If an overdose occurs during the injection treatment, this is manifested in the strong severity of all side effects, as well as sharp weakness, loss of orientation, shortness of breath, convulsions, and paralysis of the respiratory center.

This condition requires an immediate call to the resuscitation team of the ambulance.

Analogs of injections Midokalm

Analogues of Midokalm are medicines with a different composition, but with a similar or similar therapeutic effect: Kalmireks, Tolperizon, Tolperisone hydrochloride, Tolperil, Baklosan (Baclofen), Tolizor, Sirdalud .