Tolperisone and Midokalm, the choice of drug

The drugs in question belong to one pharmacological group of direct muscle relaxants. They contain the same active substance, so they can be considered analogues of each other. They have similar indications for use, side effects, almost the same contraindications. If necessary, it is allowed to replace one drug with another.

Diseases of the musculoskeletal system require complex treatment, which includes massage, physiotherapy, and medication. Very popular among them are Tolperizon and Midokalm.

Characterization of the drug Tolperisone

It is a central muscle relaxant used to treat muscle spasm and other pathologies associated with increased muscle tone. Its active substance is directed to local anesthesia, as a result of which hypertonicity is eliminated, and then the pain symptoms disappear.


It improves peripheral blood circulation, relieves spasms, inhibits the work of adrenergic receptors, which helps to prevent narrowing of the venous walls. Available in tablet form for oral administration.

The main indications for the use of this drug are:

  • Cerebrospinal and cerebral palsy, including hypertonicity, muscle spasm, spinal automatism, limitation of motor functions of limbs.
  • Pathologies accompanied by constant contraction, spasm, increased muscle tone.
  • Violation of arterial blood supply to the hands or feet, as well as the narrowing of their veins.
  • Bluish skin color associated with insufficient blood supply to small capillaries.
  • Imbalance, gait.
  • Neurological syndrome associated with impaired voluntary movement.
  • Violation of the movement of lymph through the lymphatic vessels and capillaries, as well as poor venous circulation.
  • Skin defects of the lower extremities associated with tissue necrosis.
  • Cerebral palsy.
  • The predisposition of the body to the sudden appearance of convulsive attacks.
  • Damage to brain tissue due to a prolonged decrease in arterial circulation.

It is not allowed to receive in the presence of the following factors:

  1. The period of pregnancy and breastfeeding.
  2. Children’s age up to one year.
  3. Autoimmune disease characterized by impaired neuromuscular transmission.
  4. Individual intolerance of incoming components.

Caution should be taken by those whose activities are associated with increased concentration of attention.

During the reception, undesirable side effects may occur, among which are possible:

  • Headache.
  • Pain in the abdomen, pelvis.
  • Nausea, gag reflexes.
  • Lowering blood pressure.
  • Allergic reactions.

If such reactions occur, the dosage used should be reduced and the doctor should be informed.

The characteristic of the drug “Midokalm”

It is a drug that provides a decrease in the tone of skeletal muscles. Refers to muscle relaxants of central action. With the help of it, inhibition of the overestimated reflex excitability of the spinal cord occurs. It also affects nerve endings. Available in the form of tablets and solutions for intravenous or intramuscular administration.


The main indications for use are:

  • A pathological increase in tone, spasm of striated muscle tissue that occurs due to diseases of the central nervous system.
  • Increased tension of muscle fibers accompanying diseases of the motor organs, including spondylosis, spondylarthrosis, osteochondrosis, arthrosis of large joints.
  • Recovery after orthopedic, traumatic operations.
  • Combined treatment of arteries with ischemic syndrome, including diseases of the arterial walls, damage to small vessels in diabetes mellitus, pathology of connective tissue.
  • Bluish skin color associated with insufficient capillary blood flow.
  • Muscular dystonia, including cerebral spastic paralysis.

It is contraindicated for children under three years of age, with myasthenia gravis, and also if there is an increased sensitivity to the constituent substances. Data on the use during pregnancy and lactation are not available, therefore, during these periods, administration is not recommended.

This drug can cause the following reactions:

  1. Muscle weakness, migraine.
  2. Lowering blood pressure.
  3. Nausea, vomiting, stomach pain.
  4. Skin rashes, urticaria, severe redness of the skin, resulting from the expansion of capillaries.

With a decrease in the dosage used, such symptoms begin to disappear.

Comparison, differences, what and for whom it is better to choose

Despite a sufficient number of common characteristics, there are some differences between them. The main ones include:

  1. The mechanism of work. Tolperisone does not affect the nervous system. It acts on some parts of the brain, suppressing them, due to which there is a decrease in spasms. The action of Midokalm is directed to the nervous system, providing an antispasmodic and relaxing effect, and a decrease in muscle tone.
  2. Country of origin. Tolperisone is a domestic drug, its counterpart is Hungarian.
  3. Cost. The price of a Russian product will be about 176 rubles for a package of 30 tablets, a foreign drug will cost about 365 rubles for the same pack. In this case, Tolperisone has the advantage.
  4. Release form. Tolperisone does not have an injectable form, unlike Midokalm.

Both drugs are quite safe and effective. However, there is some evidence that the action after taking the imported drug comes faster, and also lasts longer. In addition, patient reviews suggest that Midokalm causes fewer adverse reactions.

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