The article was published on p. 10-11 (World)
Pathology of the peripheral nervous system is one of the most common in neurological practice. It accounts for almost half of neurological morbidity [1, 2]. At the same time, the duration of the recovery period is largely determined by the adequacy of the ongoing treatment and rehabilitation measures. In this regard, expanding the arsenal of pharmacological agents used in the treatment of this pathology is of practical interest to neurologists [3].
Experimental studies have demonstrated a clear increase in the need for pyrimidine nucleotides in cases of peripheral nerve damage [4, 5], and also that the use of uridine triphosphate and cytidine monophosphate nucleotides significantly accelerates the regeneration of nerve pathways after traumatic tissue destruction [6]. The use of pyrimidine nucleotides has been shown to affect the synthesis of nucleic acid and myelin sheaths, as well as metabolic pathways that produce energy [7]. Nerve cells are not able to synthesize these nucleotides because they lack the appropriate reserves of enzymes [8]. Therefore, especially during periods of increased demand, cells depend on exogenous supplies of pyrimidine nucleotides.
The drug containing the active components uridine triphosphate and cytidine monophosphate (Nucleo C.M.F. forte) is currently the only drug on the market containing physiological pyrimidine nucleotides indicated for the treatment of lesions of the peripheral nervous system.
The purpose of the work was to assess the effectiveness and safety of the drug Nucleo C.M.F. forte in patients with manifestations of degenerative-dystrophic changes in the spine.
Use of the drug Nucleo cmf forte
Nucleo CMF Forte capsules are taken orally. Adults are prescribed 1–2 capsules 2 times a day; children over 5 years old - 1 capsule 2 times a day. Nucleo CMF Forte capsules can be taken before or after meals. The recommended duration of treatment is at least 10 days. If necessary, taking capsules can be extended for 20 days. Nucleo CMF Forte injection for intramuscular administration. Before administration, the solvent must be added to the ampoule with lyophilized powder. For adults, including elderly patients, and adolescents over the age of 14 years, 1 injection of the drug Nucleo CMF Forte is administered once a day. Children aged 2–14 years are recommended to administer 1 injection of Nucleo CMF Forte every 2 days. Recommended course of treatment: 1 injection per day for 3 or 6 days, then continue treatment using the drug in oral form - 1-2 capsules 2 times a day for 10 days. If there are medical indications, the drug may be extended for 20 days.
Pharmacological action of Nucleo c.m.f. forte contains pyrimidine nucleotides - cytidine-5-monophosphate (CMP) and uridine-5-triphosphate (UTP), which are necessary components in the treatment of diseases of the nervous system. Phosphate groups are necessary in the body for the reaction of monosaccharides with ceramides, which results in the formation of cerebrosides and phosphatidic acids, which mainly make up sphingomyelin, the main component of the myelin sheath of nerve cells, as well as for the formation of glycerophospholipids. Sphingolipid and glycerophospholipids provide demyelination of nerve fibers, regeneration of axons and myelin sheath in case of damage to the peripheral nervous system and help restore the correct conduction of nerve impulses, and also restore trophism of muscle tissue. As a result, mobility and sensitivity improve, inflammation, pain and numbness decrease. Also, cytidine 5-monophosphate and uridine 5-triphosphate are precursors of DNA and RNA - nucleic acids necessary for the processes of cellular metabolism and protein synthesis. UTP is also an energy source during muscle fiber contraction
Indications for use
Neuralgia, neuritis nervus trigeminus (nervus facialis), plexitis, osteoarticular neuralgia (lumbago, lumbodynia, lumboischialgia, radiculopathy), intercostal neuralgia and herpes zoster, metabolic neuralgia (consequences of alcohol addiction, complications of diabetes (polyneuropathy)), ganglionitis, verte fermentative pain syndrome, Bell's palsy, myopathy, carpal tunnel syndrome.
Mode of application
Nucleo c.m.f. forte capsules The drug can be used by adults and children. Adults: 1 to 2 capsules twice daily; Children are prescribed 1 capsule twice a day from the age of 5, can be taken before or after meals. The course of treatment is at least 10 days. If indicated, the drug can be extended up to 20 days. Nucleo c.m.f. forte ampoules for intramuscular administration Before administration, it is necessary to dissolve the powder with the supplied solvent. Adults, as well as elderly people and children under 14 years of age are prescribed 1 injection once every 24 hours. Children from 2 to 14 years old are prescribed 1 injection every 48 hours. The course of treatment lasts from three to six days, then continue oral administration of the drug from 1 to 2 capsules twice a day for 10 days. If indicated, the drug can be extended up to 20 days.
Side effects
Not described.
Contraindications
An allergic reaction to the components of the drug may occur. Age under two years is a contraindication to the use of Nucleo c.m.f. forte.
Pregnancy
Taking the drug is not contraindicated, but it is necessary to evaluate the ratio of the real benefits of taking the drug and the potential risk to the intrauterine fetus, since there is no information regarding the safety of use during pregnancy.
Overdose
The drug is low-toxic, the likelihood of overdose is very low even if the therapeutic dose is exceeded.
Release form
Capsules, blister 30 pcs. To prepare a solution for injection - lyophilized powder (61 mg of active substance) in 2 ml ampoules; No. 3 per pack.
Storage conditions
Store at room temperature (no more than 30 degrees Celsius).
Compound
1 capsule contains cytidine-5-monophosphate disodium 5 mg, uridine-5-trisodium phosphate, uridine-5-diphosphate disodium, uridine-5-monophosphate disodium only 63 mg (corresponding to 1.33 0 mg of pure uridine). Excipients: citric acid, Na citrate dihydrate, Mg stearate, Aerosil 200, mannitol. 1 ampoule with lyophilized powder contains cytidine-5-monophosphate disodium 10 mg, uridine-5-trisodium phosphate, uridine-5-diphosphate disodium, uridine-5-monophosphate disodium only 6 mg (corresponding to 2.660 mg of pure uridine). Excipients: mannitol; solvent: water, Na chloride. Attention! The description of the drug on this page is simplified. Before purchasing and using the drug, consult your doctor or pharmacist, and also read the instructions approved by the manufacturer. Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. ATTENTION! This section is provided for informational purposes only and is not a catalog or price list of our company. To obtain information about the availability of drugs, call + 99871 202 0999 Pharmacy Network Helpline 999.
Action
The medicine is specially developed based on pyrimidine nucleotides. It is used to eliminate pathology in the peripheral nervous system. This pyrimidine complex is absolutely safe, has improved properties when used in combination with other groups of drugs and does not cause side effects.
In most cases, patients turn to a neurologist for help with complaints of headaches and sleep disturbances. Indicators of disability in patients are increasing significantly. The peripheral nervous system is an internal mechanism of the body that connects the spinal cord and brain with other organs. Unlike the central nervous system, the PNS did not receive powerful protection and therefore remained vulnerable to external damage and negative influences. The drug Nucleo CMF Forte helps to correct the situation. The instructions for use indicate that the medication is capable of relieving any unpleasant symptoms in a short time. The product can be used as part of complex therapy.
Why should you take Nucleo CMF?
The peripheral nervous system involves two types of neurons: sensory neurons and motor neurons. They are the ones who transmit impulses to the central nervous system. There are more than a hundred reasons why the transmission of these impulses is disrupted. These can be all kinds of toxins, diseases, negative external factors, and medications. In modern medicine, treatment of the peripheral system often comes down to relieving the symptoms that caused the disorder. This treatment will not have a long-term effect. But the drug “Nucleo CMF”, thanks to its unique composition, can restore the morphological structure of the PNS and normalize the transmission of impulses from the central nervous system.
The drug is absolutely harmless. A person can regain their ability to work in a short period of time by taking Nucleo CMF (tablets). The instructions describe the dosage regimen of the drug.
Materials and research methods
An analysis of the results of treatment of 20 patients aged from 25 to 65 years of both sexes, weighing from 55 to 90 kg with neurological manifestations of degenerative-dystrophic changes in the spine was carried out.
Clinical group 1 included 10 patients who received the drug Nucleo C.M.F. forte in the first three days, 2 ml intramuscularly once a day, then 1 capsule 3 times a day for 15 days.
Clinical group 2 included 10 patients who received the drug Nucleo C.M.F. forte in the first six days, 2 ml intramuscularly once a day, then 1 capsule 3 times a day for 30 days.
Patients did not receive analgesics, corticosteroids, or non-steroidal anti-inflammatory drugs in order to objectively assess the effect of Nucleo C.M.F. forte.
The inclusion criteria for the study were patients with degenerative-dystrophic changes in the spine (lumbago, sciatica, cervical neuralgia, spinal neuralgia, intercostal neuralgia).
Exclusion criteria from the study were patients under 25 years of age and over 65 years of age; the presence of serious cardiac, hepatic and renal pathology; malignant or benign neoplasms; bone fractures; wounds with partial or complete dissection of the nerve; bursitis, tenosynovitis; rheumatoid arthritis, psoriasis, systemic lupus erythematosus, gout, amyloidosis, chondrocalcinosis; pregnancy, taking contraceptives, edema; diabetes, hypo- or hyperthyroidism; acromegaly; hemodialysis patients; alcoholism; hypovitaminosis B; known allergy to any component of the drug.
The effectiveness was assessed by assessing changes in symptomatology during visits: for clinical group 1 - days 1, 3, 18, 33, for clinical group 2 - days 1, 6, 36, 50.
Symptoms were assessed using the neuropathy pain intensity scale.
Evaluation of the data obtained showed that all patients completed the study as planned. The treatment adherence rate was 1.0.
Dynamic assessment of somatic parameters in both groups did not reveal any deviations from the baseline data for the entire observation period.
The dynamics of pain characteristics at the stages of observation in the first clinical group are presented in Table. 1.
In clinical group 1, on the 1st day of observation, the average pain intensity score was 6.4 ± 0.6. This indicator improved at all stages of observation. Thus, on the 3rd day the pain intensity was 5.5 ± 0.7, on the 18th day - 3.40 ± 0.67 (p < 0.01), and on the 33rd - 2.00 ± 0 .54 (p < 0.05) compared with the 1st day.
When analyzing indicators characterizing the severity of pain, positive dynamics were also noted. Thus, before the start of treatment (day 1), the average score was 4.60 ± 1.22, after 3 days - 3.90 ± 1.09, on the 18th day - 2.1 ± 0.9 (p < 0.05), by the 33rd day - 1.10 ± 0.54 (p < 0.05) in comparison with the initial stage of observation.
When assessing the burning sensation in this group of patients, the average score was 4.50 ± 1.24, on the 3rd day - 4.80 ± 1.13, by the 18th day it significantly decreased to 2.0 ± 0.9 ( p < 0.01), and by the 33rd - up to 1.50 ± 0.87 (p < 0.05).
Aching pain was assessed at 5.20 ± 0.82 points at the initial stage of observation, by the 3rd day - at 5.3 ± 0.8 points. The changes were not statistically significant. By the 18th day there was a significant improvement in this indicator - 2.50 ± 0.56 (p < 0.05), and by the 33rd day - 1.9 ± 0.5 (p < 0.05).
The average score characterizing the feeling of pain on the 1st day was 3.9 ± 1.1, on the 3rd day - 3.2 ± 0.1, on the 18th day - 5.50 ± 1.37. The changes were not statistically significant, while by the 33rd day of observation there was a significant improvement in this indicator - 0.90 ± 0.54 (p < 0.01) compared to the 1st day.
Skin sensitivity at the initial stage of observation was assessed at 4.30 ± 0.88 points, by the 3rd day - 4.4 ± 0.9, by the 18th - 2.90 ± 0.84. The recorded changes were not statistically significant. By the 33rd day of observation, the average score reached 2.00 ± 0.42 (p < 0.05), which is statistically significant in comparison with the indicator on the 1st day.
At all stages of the study, a decrease in the unpleasant sensations experienced by patients was noted. Thus, on the 1st day of observation, the studied parameter was estimated at 7.50 ± 0.54 points, on the 3rd day - at 6.30 ± 0.78, and by the 18th - at 3.09 ± 0, 75 (p < 0.01), by 33 - 2.50 ± 0.48 points (p < 0.01). These changes turned out to be statistically significant.
The severity of deep pain in relation to superficial pain was 5.90 ± 0.71 points on the 1st day, 5.60 ± 0.79 on the 3rd day, and 3.6 ± 0.7 on the 18th day. These changes were not statistically significant, but by the 33rd day there was a significant decrease in the assessed parameter - 1.90 ± 0.46 (p < 0.01) in comparison with the 1st day of observation.
The severity of superficial pain in relation to deep pain also changed at all stages of observation. Thus, on the 1st day the average score was 5.5 ± 7.0, on the 3rd day - 4.70 ± 0.87. By the 18th and 33rd days, these changes turned out to be statistically significant - 2.8 ± 0.7 (p < 0.05) and 1.40 ± 0.52 (p < 0.001), respectively.
The dynamics of pain characteristics at the initial and final stages of observation in clinical group 1 are presented graphically in Fig. 1.
The dynamics of pain characteristics during the observation stages in the second clinical group are presented in Table. 2.
In clinical group 2, on the 1st day of observation, the average pain intensity score was 6.20 ± 0.75. A comparative analysis of this indicator throughout the study revealed its decrease by the 6th day - to 4.4 ± 0.6, by the 36th - to 2.00 ± 0.56 (p < 0.001), and by the 50th days - up to 1.10 ± 0.31 (p < 0.01). These changes turned out to be statistically significant.
The severity of pain on the 1st day of observation was 4.40 ± 1.05 points, on the 6th day - 2.60 ± 0.99, on the 36th and 55th days there was a significant improvement in this indicator compared to 1 day - 0.5 ± 0.5 (p < 0.01) and 0.1 ± 0.1 (p < 0.01).
The analysis of the results obtained in this clinical group showed that the burning sensation gradually decreased throughout the study. Thus, by the 6th day it was estimated at 1.80 ± 0.88 points, by the 36th - 0.40 ± 0.36 (p < 0.05), by the 50th day - 0.1 ± 0.1 (p < 0.001). The changes are statistically significant in comparison with the results obtained on the 1st day of observation.
Indicators characterizing aching pain also decreased at all stages of observation. Thus, on the 1st day the average score was 7.00 ± 0.86, on the 6th - 5.0 ± 0.5 (the changes are not statistically significant), and by the 36th day there was a significant decrease in this indicator to 2.00 ± 0.47 points (p < 0.001), by the 50th day - up to 1.20 ± 0.33 (p < 0.01).
The feeling of pain on the 1st day of observation was 5.90 ± 1.23 points, and by the 6th day it was 3.20 ± 0.87; the changes were not statistically significant. By the 36th and 50th days there was a significant improvement in this indicator - 0.90 ± 0.43 (p < 0.01) and 0.2 ± 0.2 (p < 0.1) compared to the 1st for days.
In terms of the severity of skin sensitivity, the results of the study improved by the 6th day - 1.20 ± 0.57, by the 36th day they were 2.40 ± 0.46 points. But these differences were not expressed statistically significantly. Whereas by the 50th day there was a significant improvement in the studied indicator - 1.3 ± 1.3 (p < 0.01) in comparison with the 1st day of observation.
The feeling of itching in the study group at the initial stage was estimated at 0.7 ± 0.6 points, on the 6th day - at 0.50 ± 0.48 (the indicator is statistically insignificant).
By the 36th and 50th days, a statistically significant decrease in this indicator to 0.2 ± 0.2 (p < 0.01; p < 0.05, respectively) was noted.
The indicator characterizing the unpleasantness of pain on the 1st day of the study was 7.70 ± 0.86 points, decreasing by the 6th day to 6.50 ± 0.78, by the 36th day - to 5.50 ± 1.01 (statistically unreliable). And by the 50th day, a significant decrease was noted to 1.60 ± 0.43 points (p < 0.01) in comparison with the 1st day.
The severity of deep pain relative to superficial pain decreased at all stages of the study. Thus, by the 6th day the average score was 5.70 ± 0.73, by the 36th and 50th days - 2.60 ± 0.58 (p < 0.01) and 1.40 ± 0.37 (p < 0.01) respectively.
The severity of superficial pain in relation to deep pain decreased non-significantly by the 6th day to 5.20 ± 0.66, and by the 36th and 50th days - to 2.20 ± 1.44 (p < 0.01 ) and 1.10 ± 0.31 (p < 0.05) in comparison with the results obtained at the initial stage of observation.
The dynamics of pain characteristics at the initial and final stages of observation in clinical group 2 are presented graphically in Fig. 2.
Side effects associated with taking the drug Nucleo C.M.F. forte, was not noted in the present study.
How can I replace Nucleo CMF?
The instructions indicate that the drug can be part of complex therapy. But what if there is no Nucleo CMF in the pharmacy? A specialist will select a high-quality substitute. The product “Neoton” is popular. The medicine is used to treat the peripheral nervous system and myocardial infarction. The drug increases the outflow of excess fluid from the tissue and normalizes blood circulation in ischemic areas. The product provides protection to tissues and neurons, helps eliminate pathological processes in membranes and myelon membranes.
The dosage depends on the individual characteristics of the organism, as well as on the severity of the disease. The course lasts from 3 to 5 days. The drug is often used to improve the physical performance of professional athletes.
The medicine has no contraindications or side effects. The same can be said about the Nucleo CMF product. Instructions, price of the medication, dosage regimen - all this information must be studied before starting treatment.
Other analogues include “Armadin” and “Glitsed”.
conclusions
1. Drug Nucleo C.M.F. forte is indicated for the treatment of patients with degenerative-dystrophic changes in the spine.
2. A statistically significant positive effect of the drug Nucleo C.M.F was revealed. forte on the manifestation of disease symptoms in patients with degenerative-dystrophic changes in the spine.
3. Drug Nucleo C.M.F. forte has a pronounced analgesic effect, helping to reduce pain in patients with degenerative changes in the spine.
4. Use of the drug Nucleo C.M.F. forte in patients with degenerative-dystrophic changes in the spine is effective and safe, regardless of the proposed therapeutic regimens.
Compound
There are two types of pyrimidine nucleotides in the drug. The active ingredient is cytidine monophosphate. It is involved in the synthesis of lipid metabolisms that form the neuronal membrane. This nucleotide is considered the main component of the myelin sheath.
Another component in the drug is uridine triphosphate. It is involved in the synthesis of glycolipids in the myelin sheath.
Reviews
Most experts speak well of Nucleo CMF. The drug has a unique effectiveness in restoring the functioning of the peripheral nervous system. It is well tolerated by patients and has no side effects or contraindications. The medicine has a therapeutic effect when used in combination with other drugs.
The medicine has undergone many studies. Thanks to this, it was possible to find out that the medicine is absolutely harmless. Most patients were able to restore their working capacity in a short time and noted positive dynamics in treatment. However, before starting therapy, you must read the instructions for the Nucleo CMF product. The price is the only disadvantage of the drug that patients note. For one package you will have to pay about 900 rubles.
