Muscle relaxant


About the drug

Midostad Kombi – centrally acting muscle relaxant.

Indications and dosage

Indications of the drug Midostad Kombi:

Muscle relaxant

Muscular spasticity, including post-stroke. Spasticity, in cases where the injection form is the method of choice.

For parenteral use only.

Use only for adults. The drug is administered intramuscularly at 100 mg (based on tolperisone) twice a day or as a slow injection of 100 mg (based on tolperisone) 1 time per day.

The duration of treatment is determined by the doctor depending on the nature of the course of the disease and the effectiveness of treatment.


Data on drug overdose Midostad Kombi limited.

In the course of acute toxicity studies, the administration of high doses resulted in ataxia, tonic-clonic convulsions, difficulty in and cessation of breathing.

For tolperisone, there is no specific antidote. In case of overdose, symptomatic and supportive treatment is recommended.

Side effects

The adverse reactions of Midostad Kombi are listed by organ system classes in accordance with the MedDRA medical dictionary of regulatory activities using MedDRA frequency definitions: very often (≥1 / 10), often (≥1 / 100, *

Redness at the injection site

Chest discomfort

Lower blood pressure

Increasing the concentration of bilirubin in the blood

Changes in liver enzyme activity

Platelet count reduction

Increasing the concentration of creatinine in the blood

* The frequency is unknown (can not be determined from the available data) – changes at the site of injection.


Contraindications of the drug Midostad Kombi:

Muscle relaxant

Hypersensitivity to the active or any of the excipients, as well as to other amide local anesthetics.

Interaction with other drugs and alcohol

Interaction studies were conducted only with the use of the drug in adult patients.

Despite the central mechanism of action, tolperisone does not show a sedative effect, so it can be administered in combination with sedatives, hypnotics and tranquilizers.

The drug enhances the effect of alcohol on the central nervous system.

Enhances the effect of nifluminic acid while prescribing it at the same time it may be necessary to reduce the dose of niflumine acid.

Composition and properties

active ingredients: tolperisone hydrochloride, lidocaine hydrochloride

1 ml of 100 mg of tolperisone hydrochloride and 2.5 mg of lidocaine hydrochloride

Excipients: methyl parahydroxybenzoate (E 218), diethylene glycol monoethyl ether, water for injection

Release form: Solution for injections.

Pharmacodynamics. A muscle relaxant centrally acting. The exact mechanism of action is unknown. As a result, the membrane stabilizing and local anesthetic action prevents the initiation of excitation in the primary afferent fibers, blocking the mono- and polysynaptic reflexes of the spinal cord. The secondary mechanism of action is to block the release of the transmitter by blocking the entry of calcium ions into synapses.

Reduces reflex readiness in the reticulospinal paths of the brain stem. Reduces the increased tone and muscle rigidity caused by animal decerebration during the experiment.

Enhances peripheral circulation. This action is not related to the effect of the drug on the central nervous system. It may be due to the weak antispasmodic and antiadrenergic action of tolperisone.

Muscle relaxant

Pharmacokinetics. Subjected to intensive metabolism in the liver and kidneys. Excreted by the kidneys, 99% – in the form of metabolites. Pharmacological activity of metabolites is unknown. With intravenous administration, the half-life is approximately 1.5 hours.

Storage conditions: Store Midostad Kombi in its original packaging at a temperature of 8 to 15 ° C. Keep out of the reach of children.

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