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Milgamma N

Milgamma N

Ask a doctor about a prescription for Milgamma N

5.0(32)
Doctor

Nuno Tavares Lopes

Family medicine17 years of experience

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC. He offers online consultations in Portuguese, English, and Spanish — combining global expertise with a patient-centred, evidence-based approach.

  • Emergency care: infections, fever, chest/abdominal pain, minor injuries, paediatric emergencies
  • Family medicine: hypertension, diabetes, cholesterol, chronic disease management
  • Travel medicine: pre-travel advice, vaccinations, fit-to-fly certificates, travel-related illnesses
  • Sexual and reproductive health: PrEP, STD prevention, counselling, treatment
  • Weight management and wellness: personalised weight loss programmes, lifestyle guidance
  • Skin and ENT issues: acne, eczema, allergies, rashes, sore throat, sinusitis
  • Pain management: acute and chronic pain, post-surgical care
  • Public health: prevention, health screenings, long-term monitoring
  • Sick leave (Baixa médica) connected to Segurança Social in Portugal
  • IMT medical certificates for driving licence exchange
Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.
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This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use Milgamma N

Package Leaflet: Information for the Patient

Warning! Keep the leaflet! Information on the immediate packaging in a foreign language.

Milgamma N(Milgamma N Injection)
(50 mg + 50 mg + 0.5 mg)/ml, solution for injection
Thiamine hydrochloride + Pyridoxine hydrochloride + Cyanocobalamin
Milgamma N and Milgamma N Injection are different trade names for the same drug.

Read the leaflet carefully before using the medicine, as it contains important information for the patient.


Keep this leaflet, so you can read it again if you need to.

If you have any doubts, consult your doctor or pharmacist.

This medicine has been prescribed to you specifically. Do not pass it on to others. The medicine may harm another person, even if their symptoms are the same.

If you experience any side effects, including those not listed in this leaflet, tell your doctor, pharmacist, or nurse.
See section 4.

Table of Contents of the Leaflet:

  • 1. What is Milgamma N and what is it used for
  • 2. Important information before using Milgamma N
  • 3. How to use Milgamma N
  • 4. Possible side effects
  • 5. How to store Milgamma N
  • 6. Package contents and other information

1. What is Milgamma N and what is it used for

Milgamma N is a mixture of B vitamins.
Milgamma N is used in adults in the following cases:

  • diseases of the nervous system of various origins;
  • neuritis;
  • neuralgia;
  • polyneuropathies (e.g., diabetic, alcoholic, etc.);
  • muscle pain (myalgia);
  • radiculitis;
  • cervical syndrome;
  • shoulder pain;
  • certain forms of optic neuritis (retrobulbar optic neuritis);
  • herpes zoster;
  • facial nerve paralysis;
  • and as a tonic.

2. Important information before using Milgamma N

When not to use Milgamma N:

  • if you are allergic to thiamine hydrochloride (vitamin B1), pyridoxine hydrochloride (vitamin B6), cyanocobalamin (vitamin B12), or any of the other ingredients of this medicine (listed in section 6),
  • if you have conduction disorders and uncontrolled heart failure,
  • during pregnancy and breastfeeding,
  • in children and adolescents under 18 years of age.

Warnings and precautions

Before starting treatment with Milgamma N, discuss it with your doctor, pharmacist, or nurse.
Milgamma N is intended for intramuscular injection (i.m.) only, not for intravenous injections (i.v.). Any accidental intravenous injection must be monitored by a doctor or in a hospital setting, depending on the severity of the resulting symptoms.
This medicine may cause neuropathy if used for more than six months.
There are no special precautions for elderly patients.

Milgamma N and other medicines

Tell your doctor or pharmacist about all medicines you are taking now or have recently taken, as well as any medicines you plan to take.
This is especially important for the following medicines:

  • Solutions containing sulfites (vitamin B1 is degraded in solutions containing sulfites; other vitamins may be inactivated in the presence of vitamin B1 degradation products),
  • 5-fluorouracil - used in cancer treatment,
  • INH (isoniazid) - used in tuberculosis treatment,
  • D-penicillamine - used in rheumatoid arthritis treatment,
  • Long-term use of oral contraceptives containing estrogens,
  • Epinephrine - used in the treatment of severe allergic reactions (anaphylaxis),
  • Norepinephrine - used in the treatment of depression and low blood pressure,
  • Sulfonamides - antibiotics also used in the treatment of inflammatory bowel diseases,
  • L-dopa - used in the treatment of Parkinson's disease.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or plan to have a child, consult your doctor or pharmacist before using this medicine.
Pregnancy
The recommended daily dose of vitamin B1 is 1.2 mg (second trimester) to 1.3 mg (third trimester). During pregnancy, the recommended daily dose of vitamin B6 is 1.9 mg, and vitamin B12 is 2.6 μg. The safety of doses higher than recommended has not been sufficiently studied. Do not use Milgamma N during pregnancy.

  • The safety of doses higher than recommended has not been sufficiently studied. Do not use Milgamma N during pregnancy.

Breastfeeding
The recommended daily dose of vitamin B1 is 1.3 mg, vitamin B6 - 1.9 mg, and vitamin B12 - 2.6 μg during breastfeeding.
The safety of doses higher than recommended has not been sufficiently studied.
Vitamins B1, B6, and B12 pass into breast milk. High doses of vitamin B6 may inhibit milk secretion.
Do not use Milgamma N during breastfeeding.

Driving and using machines

There are no special restrictions.

The medicine contains benzyl alcohol, sodium, and potassium

Benzyl alcohol

Milgamma N contains 40 mg of benzyl alcohol in 1 ampoule of 2 ml. Large volumes of benzyl alcohol should be administered with caution and only when necessary, especially in patients with renal or liver function disorders due to the risk of toxicity accumulation (metabolic acidosis).

Sodium

Milgamma N contains less than 1 mmol (23 mg) of sodium per 1 ampoule of 2 ml, which means the medicine is considered "sodium-free".

Potassium

Milgamma N contains less than 1 mmol (39 mg) of potassium per 1 ampoule of 2 ml, which means the medicine is considered "potassium-free".

3. How to use Milgamma N

This medicine should always be used as directed by your doctor or pharmacist. If you are unsure, consult your doctor or pharmacist.
This medicine is for intramuscular injection only. Any accidental intravenous injection must be monitored by a doctor or in a hospital setting, depending on the severity of the resulting symptoms.
Your doctor will determine the appropriate dose for you and how often to administer it.
The recommended dose is:
In severe and acute pain states and to quickly achieve high blood levels:
the initial dose is 1 injection (2 ml) per day. After the acute phase has subsided and in cases of mild symptoms: 1 injection 2-3 times a week.
There is no need to adjust the dose in elderly patients and patients with renal impairment.
There are insufficient studies on the use of Milgamma N in children and adolescents under 18 years of age. Therefore, Milgamma N should not be used in children and adolescents under 18 years of age. The safety and efficacy of Milgamma N have not been established in patients with liver failure. Therefore, Milgamma N should not be used in patients with severe liver failure.
Treatment should be monitored by a doctor at weekly intervals.
It is recommended to switch to oral administration as soon as possible.

Using a higher dose of Milgamma N than recommended

This medicine is administered under medical supervision. It is unlikely that the dose of the medicine will be too high or too low, but if you suspect that this has happened, inform your doctor or nurse.

4. Possible side effects

Like all medicines, Milgamma N can cause side effects, although not everybody gets them.
Side effects are listed by frequency of occurrence:
Very common:may affect more than 1 in 10 people
Common:may affect up to 1 in 10 people
Uncommon:may affect up to 1 in 100 people
Rare:may affect up to 1 in 1,000 people
Very rare:may affect up to 1 in 10,000 people
Frequency not known:frequency cannot be estimated from the available data

Inform your doctor immediately in the following cases:

Rare:

  • Allergic reactions (e.g., skin rash, difficulty breathing, shock, swelling of the eyes, face, tongue, and throat)

If you experience any of the following side effects, consult your doctor as soon as possible:
Very rare:

  • Rapid heartbeat (tachycardia);
  • Excessive sweating, acne, skin reactions with itching and hives;

Frequency not known:

  • Dizziness, drowsiness;
  • Slow heart rate (bradycardia), heart rhythm disorders;
  • Vomiting;
  • Cramps;
  • The occurrence of systemic reactions (reactions that affect the entire body) is possible after rapid injection (accidental intravenous injection, injection into tissues with high blood flow) or overdose.

Reporting side effects

If you experience any side effects, including those not listed in this leaflet, tell your doctor, pharmacist, or nurse. Side effects can be reported directly to the Department of Monitoring of Adverse Reactions to Medicinal Products of the Office for Registration of Medicinal Products, Medical Devices, and Biocidal Products, Al. Jerozolimskie 181C, 02-222 Warsaw, tel.: +48 22 49 21 301, fax: +48 22 49 21 309, website: https://smz.ezdrowie.gov.pl.
By reporting side effects, you can help gather more information on the safety of the medicine.

5. How to store Milgamma N

Keep the medicine out of sight and reach of children.
Store in a refrigerator (2°C-8°C) in the original packaging. Protect from light.
Do not use this medicine after the expiry date stated on the packaging. The expiry date refers to the last day of the month.
Medicines should not be disposed of via wastewater or household waste. Ask your pharmacist how to dispose of medicines that are no longer needed. This will help protect the environment.

6. Package contents and other information

What Milgamma N contains

2 ml of solution for injection contains:
Active substances:
Thiamine hydrochloride (vitamin B1)
100 mg
Pyridoxine hydrochloride (vitamin B6)
100 mg
Cyanocobalamin (vitamin B12)
1 mg
Excipients:
Benzyl alcohol 40 mg, lidocaine hydrochloride 20 mg, sodium hydroxide, potassium hexacyanoferrate (III), sodium polyphosphate, water for injections.

What Milgamma N looks like and what the package contains:

The package contains: 5 ampoules of 2 ml solution for injection.
For more detailed information, contact the marketing authorization holder or the parallel importer.

Marketing authorization holder in Latvia, the country of export:

Wörwag Pharma GmbH & Co.KG
Flugfeld-Allee 24
71034 Böblingen
Germany

Manufacturer:

Solupharm Pharmazeutische Erzeugnisse GmbH
Industriestrasse 3
D-34212 Melsungen
Germany

Parallel importer:

InPharm Sp. z o.o.
ul. Strumykowa 28/11
03-138 Warsaw

Repackaged by:

InPharm Sp. z o.o. Services sp. k.
ul. Chełmżyńska 249
04-458 Warsaw
Marketing authorization number in Latvia, the country of export:99-0934
Parallel import authorization number:350/16
Date of leaflet approval: 16.02.2022

  • Country of registration
  • Active substance
  • Prescription required
    Yes
  • Marketing authorisation holder (MAH)
    Wörwag Pharma GmbH & Co.KG
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Online doctors for Milgamma N

Discuss dosage, side effects, interactions, contraindications, and prescription renewal for Milgamma N – subject to medical assessment and local rules.

5.0(32)
Doctor

Nuno Tavares Lopes

Family medicine17 years of experience

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC. He offers online consultations in Portuguese, English, and Spanish — combining global expertise with a patient-centred, evidence-based approach.

  • Emergency care: infections, fever, chest/abdominal pain, minor injuries, paediatric emergencies
  • Family medicine: hypertension, diabetes, cholesterol, chronic disease management
  • Travel medicine: pre-travel advice, vaccinations, fit-to-fly certificates, travel-related illnesses
  • Sexual and reproductive health: PrEP, STD prevention, counselling, treatment
  • Weight management and wellness: personalised weight loss programmes, lifestyle guidance
  • Skin and ENT issues: acne, eczema, allergies, rashes, sore throat, sinusitis
  • Pain management: acute and chronic pain, post-surgical care
  • Public health: prevention, health screenings, long-term monitoring
  • Sick leave (Baixa médica) connected to Segurança Social in Portugal
  • IMT medical certificates for driving licence exchange
Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.
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Duarte Meneses

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Dr. Duarte Meneses is a licensed family medicine and general practice doctor based in Portugal, with additional expertise in occupational health. He provides online consultations for adults, offering medical support for both acute symptoms and chronic health conditions.

  • Common symptoms such as fever, sore throat, cough, fatigue, or digestive issues
  • Chronic conditions including hypertension, diabetes, high cholesterol, and thyroid problems
  • Mental health concerns such as stress, sleep issues, anxiety, and burnout
  • Preventive care: health check-ups, lifestyle advice, and follow-up for existing conditions
  • Work-related health questions, sick leave documentation, and medical guidance for returning to work
Dr. Meneses graduated from the University of Beira Interior and has years of experience working with diverse patient populations. He is fluent in Portuguese, English, Spanish, and French.

His approach is friendly, clear, and focused on delivering practical medical advice tailored to each patient’s needs.

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Key areas of consultation:

  • Preventive and family medicine
  • Women’s health, including gynaecology and obstetrics
  • Chronic disease management: hypertension, diabetes, and more
  • Mental health support, anxiety, and counselling
  • Postoperative care and lab test interpretation
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  • Hypertension control and cardiovascular disease prevention
  • Interpretation of ECG, blood tests, and Holter monitor results
  • Management of heart failure and coronary artery disease
  • General medical issues: infections, fever, fatigue, gastrointestinal symptoms
  • Guidance on diagnostics, treatment plans, and medication adjustments
Dr. Alhasan’s approach is based on thorough assessment, clear communication, and personalised care – helping patients understand their health and make informed decisions about their treatment.
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Main areas of consultation:

  • Diagnosis and treatment of acute and chronic conditions (high blood pressure, diabetes, respiratory infections, cardiovascular symptoms)
  • Evaluation of symptoms and guidance on further diagnostic testing
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  • Medical support during travel or after relocation
  • Treatment adjustments and lifestyle recommendations based on your personal history
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Dr. Agami is committed to evidence-based, patient-centred care, ensuring that each person receives trusted medical support tailored to their health goals.

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Areas of medical expertise:

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  • Internal medicine: heart, lungs, gastrointestinal tract, urinary system. Management of chronic conditions, symptom control, second opinions.
  • Pre- and postoperative care: risk assessment, decision-making support, follow-up after surgery, rehabilitation strategies.
  • General and paediatric surgery: hernias, appendicitis, congenital conditions, both planned and urgent surgeries.
  • Injuries and trauma: bruises, fractures, sprains, soft tissue damage, wound care, dressing, referral when in-person care is required.
  • Oncological surgery: diagnosis review, treatment planning, and long-term follow-up.
  • Obesity treatment and weight management: a medical approach to weight loss, including assessment of underlying causes, evaluation of comorbidities, development of a personalised plan (nutrition, physical activity, pharmacotherapy if needed), and ongoing progress monitoring.
  • Imaging interpretation: analysis of ultrasound, CT, MRI, and X-ray results, surgical planning based on imaging data.
  • Second opinions and medical navigation: clarifying diagnoses, reviewing current treatment plans, helping patients choose the best course of action.

Experience and qualifications:

  • 12+ years of clinical experience in university hospitals in Germany and Spain.
  • International education: Ukraine – Germany – Spain.
  • Member of the German Society of Surgeons (BDC).
  • Certified in radiological diagnostics and robotic surgery.
  • Active participant in international medical conferences and research.

Dr Yakovenko explains complex topics in a clear, accessible way. He works collaboratively with patients to analyse health issues and make evidence-based decisions. His approach is grounded in clinical excellence, scientific accuracy, and respect for each individual.

If you are unsure about a diagnosis, preparing for surgery, or want to discuss your test results – Dr Yakovenko will help you evaluate your options and move forward with confidence.

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  • Preventive check-ups and advice on healthy lifestyle habits

Dr Kovalenko combines evidence-based practice with a respectful, patient-centred approach. She takes time to explain, listens attentively, and helps each person make confident, informed decisions about their health.

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  • Supportive care for oncology patients – pain control, symptom relief, and side effect management.
  • Preventive medicine and health screenings.
  • Development of tailored treatment plans based on clinical guidelines.

With a patient-centred approach, Dr. Raevskii helps individuals manage both chronic illnesses and complex oncological cases. His consultations are guided by current medical standards and adapted to each patient’s needs.

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Areas of expertise:

  • interpretation of test results and personalised treatment planning
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  • abnormal uterine bleeding, endometrial hyperplasia, cervical dysplasia
  • care during perimenopause and menopause, hormonal balance, cancer prevention
  • breastfeeding issues: nipple pain, cracked skin, blocked ducts, low milk supply
  • support during the postpartum and lactation period
Dr Reznychenko offers a clear, attentive and professional approach. Her consultations help prevent minor discomforts from developing into more serious concerns – all in a convenient online format.
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  • General and urgent care: fever, fatigue, infections, digestive issues, respiratory symptoms, and other common concerns
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