At the third stage, neurotropic vitamins (group B) are prescribed. The main drugs used for diabetic neuropathy are discussed below. Neurotropic vitamins are coenzymes in various biochemical processes, improve the energy of the nerve cell, and prevent the formation of prasugrel pills of protein glycosylation. Preparations of these vitamins were prescribed for diabetic neuropathy for quite a long time, but their therapeutic effect was weakly expressed.
Benfotiamine is a fat-soluble form of vitamin B1, which is 10 times better absorbed in the gastrointestinal tract and more easily enters the nervous tissue than water-soluble preparations of group B. Benfotiamine is used at 150 mg / day for 1.5-3 months. One Milgamma dragee contains 100 mg of benfotiamine and 100 mg of pyridoxine (vitamin B6). She is prescribed 1 tablet 3 times a day for 1.5-2 months. Solution for injection Milgamma (1 ampoule of 2 ml) contains 100 mg of thiamine (vitamin B1), 100 mg of pyridoxine, 1000 mcg of cyanocobalamin (vitamin B12), 20 mg of lidocaine and 40 mg of benzyl alcohol.
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In severe cases and in the painful form of neuropathy, treatment begins with daily injections of Milgamma (2 ml) deep into the muscle (10 injections), and then they switch to taking prasugrel the drug in the form of a dragee. The course of prevention of diabetic neuropathy involves taking Milgamma 1 tablet 3 times a day for 3 weeks every 3 months.
At first, for a long time2-4 weeks, alpha-lipoic acid in the form of the drug Thiogamma (W�rwag Pharma, Germany) is prescribed daily intravenously by drip 600 mg / day (minimum course 15, optimally 20 infusions). In the future, they switch to buy prasugrel online Thiogamma tablets containing 600 mg of alpha-lipoic acid, 600 mg / day for 1.5-2 months. The prophylactic course involves taking 600 mg / day of the drug for 1 month every 3 months. To increase antioxidant protection, improve cell proliferation, tissue respiration, prevent increased permeability and capillary fragility, patients with diabetic neuropathy are prescribed vitamin E preparations, such as Oxytex, 1 capsule daily for 2 months.
To compensate for the deficiency of trace elements in the body, magnesium and zinc preparations are prescribed. In order to eliminate night cramps of the calf muscles, improve the contractile function of the myocardium, magnesium preparations such as magnesium sulfate and magnesium orotate are used. Magnesium sulfate is administered together with alpha-lipoic acid preparations intravenously in a stream slowly (over 10 minutes) in 10-20 ml of a 10% solution. In the future, magnesium orotate is prescribed 1000 mg 3 times a day for 7 days, then 500 mg 2-3 times a day daily. The duration of the course of treatment is at least 4-6 weeks.