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Milgamma N

Milgamma N

Ask a doctor about a prescription for Milgamma N

5.0(102)
Doctor

Alina Tsurkan

Family medicine12 years of experience

Dr. Alina Tsurkan is a licensed family medicine physician based in Portugal, offering online consultations for adults and children. She provides professional primary care, with a focus on prevention, accurate diagnosis, and long-term management of acute and chronic conditions.

Dr. Tsurkan supports patients with a wide range of health issues, including:

  • Respiratory infections: cold, flu, bronchitis, pneumonia, and lingering coughs.
  • ENT conditions: sinusitis, tonsillitis, otitis (ear infections), sore throat, allergic rhinitis.
  • Eye conditions: allergic or infectious conjunctivitis, red eyes, irritation.
  • Digestive issues: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), constipation, bloating, nausea.
  • Urinary and reproductive health: urinary tract infections (UTIs), cystitis, prevention of recurrent infections.
  • Chronic diseases: hypertension, elevated cholesterol, weight management.
  • Neurological complaints: headaches, migraines, sleep disturbances, fatigue, general weakness.
  • Children’s health: fever, infections, digestive issues, follow-ups, vaccination guidance.

She also provides:

  • IMT medical certificates for driving licence exchange in Portugal.
  • Personalised preventive care and wellness consultations.
  • Interpretation of test results and medical reports.
  • Follow-up care and medication review.
  • Support in managing multiple coexisting conditions.
  • Remote prescription management and medical documentation.

Dr. Tsurkan’s approach is evidence-based and holistic. She works closely with each patient to develop an individualised care plan that addresses both symptoms and root causes. Her goal is to empower patients to take control of their health and maintain well-being through lifestyle adjustments, routine check-ups, and early intervention.

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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(102)
Doctor

Alina Tsurkan

Family medicine12 years of experience

Dr. Alina Tsurkan is a licensed family medicine physician based in Portugal, offering online consultations for adults and children. She provides professional primary care, with a focus on prevention, accurate diagnosis, and long-term management of acute and chronic conditions.

Dr. Tsurkan supports patients with a wide range of health issues, including:

  • Respiratory infections: cold, flu, bronchitis, pneumonia, and lingering coughs.
  • ENT conditions: sinusitis, tonsillitis, otitis (ear infections), sore throat, allergic rhinitis.
  • Eye conditions: allergic or infectious conjunctivitis, red eyes, irritation.
  • Digestive issues: acid reflux (GERD), gastritis, irritable bowel syndrome (IBS), constipation, bloating, nausea.
  • Urinary and reproductive health: urinary tract infections (UTIs), cystitis, prevention of recurrent infections.
  • Chronic diseases: hypertension, elevated cholesterol, weight management.
  • Neurological complaints: headaches, migraines, sleep disturbances, fatigue, general weakness.
  • Children’s health: fever, infections, digestive issues, follow-ups, vaccination guidance.

She also provides:

  • IMT medical certificates for driving licence exchange in Portugal.
  • Personalised preventive care and wellness consultations.
  • Interpretation of test results and medical reports.
  • Follow-up care and medication review.
  • Support in managing multiple coexisting conditions.
  • Remote prescription management and medical documentation.

Dr. Tsurkan’s approach is evidence-based and holistic. She works closely with each patient to develop an individualised care plan that addresses both symptoms and root causes. Her goal is to empower patients to take control of their health and maintain well-being through lifestyle adjustments, routine check-ups, and early intervention.

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What patients commonly consult her for:

  • High blood pressure, type 2 diabetes, cholesterol management
  • Cold and flu symptoms: fever, cough, sore throat
  • Fatigue, sleep problems, headaches, general discomfort
  • Ongoing care for chronic conditions and medication review
  • Help interpreting test results and lab reports
  • 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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Areas of expertise:

  • interpretation of test results and personalised treatment planning
  • menstrual irregularities, PCOS, endometriosis
  • 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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Dermatology20 years of experience

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For five years, Dr Grzelewski served as the Head of two paediatric departments in Poland, managing complex clinical cases and leading multidisciplinary teams. He also worked in medical centres in the United Kingdom, gaining experience across both primary care and specialist environments. With over a decade of telemedicine experience, he has provided online consultations across Europe and is valued for his clear, structured and evidence-based medical guidance.

Dr Grzelewski is actively involved in clinical programmes focused on modern anti-allergic therapies. As a Principal Investigator, he leads research projects on sublingual and oral allergen desensitisation, supporting evidence-based progress in allergy treatment for both children and adults.

In addition to his background in allergology and paediatrics, he completed dermatology studies through the Cambridge Education Group (Royal College of Physicians of Ireland) and a Clinical Endocrinology course at Harvard Medical School. This advanced training enhances his ability to manage skin manifestations of allergies, atopic conditions, urticaria, endocrine-related symptoms and complex immunological reactions.

Patients commonly seek his care for:

  • seasonal and perennial allergies
  • allergic rhinitis and chronic nasal symptoms
  • asthma and breathing difficulties
  • food and medication allergies
  • urticaria, atopic dermatitis and skin reactions
  • recurrent infections in children
  • sports-related health questions
  • general family medicine concerns
Dr Tomasz Grzelewski is known for his clear communication style, structured medical approach and ability to explain treatment options in a concise and accessible way. His multidisciplinary background across allergy, paediatrics, dermatology and endocrinology allows him to provide safe, up-to-date and comprehensive care for patients of all ages.
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Areas of medical care include:

  • Respiratory conditions: colds, flu, acute and chronic bronchitis, mild to moderate pneumonia, bronchial asthma.
  • ENT and eye conditions: sinusitis, tonsillitis, pharyngitis, otitis, infectious and allergic conjunctivitis.
  • Digestive issues: gastritis, acid reflux (GERD), IBS, dyspepsia, bloating, constipation, diarrhoea, functional bowel symptoms, intestinal infections.
  • Urological and infectious diseases: acute and recurrent cystitis, bladder and kidney infections, prevention of recurrent UTIs, asymptomatic bacteriuria.
  • Chronic conditions: hypertension, diabetes, hypercholesterolemia, metabolic syndrome, thyroid disorders, excess weight.
  • Neurological and general symptoms: headache, migraine, dizziness, fatigue, sleep disturbances, reduced concentration, anxiety, asthenia.
  • Chronic pain support: back, neck, joint, and muscle pain, tension syndromes, pain associated with osteochondrosis and chronic conditions.

Additional care areas:

  • Preventive consultations and check-up planning.
  • Medical advice and follow-up consultations.
  • Test interpretation and diagnostic guidance.
  • Structured support for undiagnosed complaints.
  • Second opinion on diagnoses and treatment plans.
  • Nutritional and lifestyle support for vitamin deficiencies, anaemia, metabolic issues.
  • Post-operative recovery support and pain management.
  • Preconception counselling and postpartum support.
  • Immunity support and strategies to reduce frequency of infections.

Dr. Travkina combines evidence-based medicine with an attentive, personalised approach. Her consultations focus not only on treatment, but also on prevention, recovery, and long-term wellbeing.

If during the consultation it becomes clear that your case requires in-person assessment or specialised care outside of her scope, the session will be terminated and the payment fully refunded.

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  • assessment of sudden or unclear symptoms
  • ongoing care for chronic conditions
  • follow-up after hospital discharge
  • interpretation of test results
  • medical support while abroad
Dr Cayatte earned his degree from the University of Lisbon and taught internal medicine at Boston University School of Medicine. He holds active medical registrations in both Portugal and the UK and is a Fellow of the American Heart Association.

Consultations are available in English and Portuguese. Patients value his clarity, professionalism, and balanced approach to evidence-based care.

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  • Respiratory infections (cold, flu, bronchitis, pneumonia).
  • ENT conditions such as sinusitis, ear infections, and tonsillitis.
  • Digestive issues including gastritis, acid reflux, and irritable bowel syndrome (IBS).
  • Urinary tract infections and other common infections.
  • Management of chronic diseases: high blood pressure, diabetes, thyroid disorders.
  • Acute conditions requiring urgent medical attention.
  • Headaches, migraines, and minor injuries.
  • Wound care, health check-ups, and ongoing prescriptions.

With a patient-focused and evidence-based approach, Dr. Ben Ami supports individuals at all stages of life — offering clear medical guidance, timely interventions, and continuity of care.

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Andrei Popov

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He specialises in diagnosing and treating pain conditions that affect quality of life, including:

  • Chronic pain lasting more than 3 months.
  • Migraines and recurring headaches.
  • Neck, back, lower back, and joint pain.
  • Post-traumatic pain following injury or surgery.
  • Nerve-related pain, fibromyalgia, and neuralgia.
In addition to pain management, Dr. Popov helps patients with:
  • Respiratory infections (colds, bronchitis, pneumonia).
  • High blood pressure and metabolic conditions such as diabetes.
  • Preventive care and routine health check-ups.

Online consultations last up to 30 minutes and include a detailed symptom review, personalised treatment planning, and medical follow-up when needed.

Dr. Popov’s approach is rooted in evidence-based medicine, combined with individualised care tailored to each patient’s history, lifestyle, and clinical needs.

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Tetiana Fedoryshyn

General medicine29 years of experience

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Her focus is on helping patients regain health through deep understanding of symptoms, personalised nutrition plans, and evidence-based correction of deficiencies, stress-related conditions, and metabolic imbalances. Dr Fedoryshyn works with adults experiencing chronic conditions, fatigue, hormonal disruption, and post-stress exhaustion.

She integrates medical analysis, psychological insight, and real-life behaviour change tools to offer treatment plans tailored to each patient’s biochemistry, mental state, and lifestyle.

Main areas of practice:

  • Chronic condition management and medical counselling
  • Weight loss programmes based on metabolic profiling
  • Diagnosis and treatment of micronutrient deficiencies
  • Recovery from stress, burnout, and hormonal imbalances
  • Emotional support and psychosomatic symptom care
Her approach is never one-size-fits-all – each consultation begins with a deep dive into your unique health history, test results, and emotional landscape. Consultations are available in Ukrainian, Polish, and Russian.
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Cardiology – Diagnosis and treatment of:

  • High blood pressure, blood pressure fluctuations, and cardiovascular risk prevention.
  • Chest pain, shortness of breath, arrhythmias (tachycardia, bradycardia, palpitations).
  • Leg swelling, chronic fatigue, reduced exercise tolerance.
  • EKG interpretation, lipid profile evaluation, cardiovascular risk assessment (heart attack, stroke).
  • Post-COVID-19 cardiac monitoring and care.
Endocrinology – Diabetes, thyroid, metabolism:
  • Diagnosis and management of type 1 and type 2 diabetes, and prediabetes.
  • Individual treatment plans including oral medications and insulin therapy.
  • GLP-1 therapy– modern pharmacological treatment for weight management and diabetes control, including drug selection, monitoring, and safety follow-up.
  • Thyroid disorders – hypothyroidism, hyperthyroidism, autoimmune thyroid diseases (Hashimoto’s, Graves’ disease).
  • Metabolic syndrome – obesity, lipid disorders, insulin resistance.
Gastroenterology – Digestive health:
  • Abdominal pain, nausea, heartburn, gastroesophageal reflux (GERD).
  • Stomach and intestinal conditions: gastritis, irritable bowel syndrome (IBS), indigestion.
  • Management of chronic digestive disorders and interpretation of tests (endoscopy, ultrasound, labs).
General internal medicine and preventive care:
  • Respiratory infections – cough, colds, bronchitis.
  • Lab test analysis, therapy adjustments, medication management.
  • Adult vaccinations – planning, contraindications assessment.
  • Cancer prevention – screening strategies and risk assessment.
  • Holistic approach – symptom relief, complication prevention, and quality of life improvement.
Dr Biriukova combines internal medicine with specialist insight, offering clear explanations, personalised treatment plans, and comprehensive care tailored to each patient.
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