Thiogamma 600 oral film-coated tablets 600 mg (thioctic acid) – treatment of symptoms of diabetic polyneuropathy

Thiogamma 600 oral is a medicine in the form of film-coated tablets containing 600 mg of thioctic acid (also known as alpha-lipoic acid). Thioctic acid is a normal product of the body’s metabolism, influences certain metabolic functions and has antioxidant properties that protect nerve cells from reactive breakdown products. The medicine belongs to the group of various alimentary tract and metabolism products (ATC A16AX01).

According to the official leaflet, Thiogamma 600 oral is used to treat symptoms of peripheral (sensorimotor) diabetic polyneuropathy – burning, pain, numbness and pins and needles caused by nerve damage in people with diabetes. It is intended for adults only and is prescription-only. Unlike dietary supplements with alpha-lipoic acid, this is an authorised medicine with a precisely defined indication and dosage.

What is Thiogamma 600 oral used for and how should it be taken?

Key facts about the medicine

What is Thiogamma 600 oral used for?

According to the official patient leaflet, Thiogamma 600 oral is used for:

• treatment of symptoms of peripheral (sensorimotor) diabetic polyneuropathy – burning, pain, numbness and pins and needles in the limbs.

Diabetic polyneuropathy is a chronic disease, so treatment is usually long-term; the doctor decides on the duration. The medicine does not replace good blood sugar control, which remains the basis of treatment.

How is it used and dosed?

• The score line is not for dividing into equal doses – it only makes swallowing easier.
• Taking it with food makes it harder for the medicine to enter the bloodstream and the effect may be lost; this is especially important in people with delayed stomach emptying.
• According to the summary of product characteristics, in pronounced sensory disturbances treatment may be started with an infusion form of thioctic acid, as decided by the doctor.

This is the general dosage from the official leaflet and is not an individual recommendation.

Special patient groups

• Children and adolescents: the medicine must not be given as there is no clinical experience in these age groups.
• People with diabetes on insulin or oral antidiabetics: more frequent blood sugar checks are needed, especially at the start; the doctor may reduce the antidiabetic dose.

Contraindications – when the medicine must not be used

Do not take Thiogamma 600 oral if you are allergic (hypersensitive) to thioctic acid or any of the other ingredients.

Precautions and warnings

• People with a certain human leukocyte antigen (HLA) genotype – more common in people of Japanese and Korean origin but also present in Caucasians – may develop insulin autoimmune syndrome during treatment, with a significant drop in blood sugar.
• The medicine contains lactose monohydrate: if you have an intolerance to some sugars, contact your doctor.
• The medicine contains less than 1 mmol (23 mg) sodium per tablet, i.e. it is essentially “sodium-free”.
• Tell your doctor about other medicines, chronic diseases, metabolic disorders and previous allergic reactions.

Interactions with other medicines, alcohol and food

• Cisplatin (a cancer medicine): thioctic acid may reduce or abolish its effect.
• Products containing metals – iron, magnesium and dairy products (calcium): thioctic acid forms chelates with them and may lose its effect. If the medicine is taken in the morning 30 minutes before breakfast, iron or magnesium products should be taken at midday or in the evening.
• Insulin and oral antidiabetics: their blood sugar–lowering effect may be increased; careful blood sugar monitoring is needed and sometimes a lower dose on the doctor’s advice.
• Alcohol: daily drinking is a significant risk factor for the development and progression of neuropathy and may reduce the effectiveness of treatment – avoid alcohol, also during treatment-free periods.

Pregnancy and breastfeeding

The doctor decides on use during pregnancy and breastfeeding after careful assessment of benefits and risks. Animal studies have not shown effects on fertility or negative effects on embryo development. It is not known whether thioctic acid passes into breast milk.

Driving and using machines

Thiogamma 600 oral has no or negligible influence on the ability to drive and use machines. However, if you notice symptoms of low blood sugar (dizziness, sweating, visual disturbances), do not drive.

Possible side effects

• Very rare (up to 1 in 10,000): taste changes or disturbances; nausea, vomiting, stomach or bowel pain, diarrhoea; allergic reactions (rash, hives, itching); symptoms of hypoglycaemia due to increased glucose utilisation – dizziness, sweating, headache, visual disturbances.
• Frequency not known: insulin autoimmune syndrome – a disorder of the hormones that regulate blood sugar, with a significant drop in blood sugar.

If these reactions occur, stop taking the medicine and see a doctor as soon as possible. Report suspected side effects to your doctor, pharmacist or ALIMS.

Overdose, missed dose and stopping treatment

• Overdose: nausea, vomiting and headache may occur. After intake of more than 10 g of thioctic acid, especially with large amounts of alcohol, serious life-threatening poisoning has been described (generalised seizures, lactic acidosis, severe blood clotting disorders) – if significant poisoning is suspected (e.g. more than 10 tablets of 600 mg in adults), urgent hospitalisation is needed.
• Missed dose: do not take a double dose to make up for a forgotten one.
• Stopping treatment: do not stop without consulting your doctor – symptoms may get worse.

Related information

• What is neuropathy, what are the symptoms and how is it treated?

For additional care and support with diabetic neuropathy and foot care, see also the Creams for diabetics category – products in this category do not replace the medicine you have been prescribed.

Composition, packaging and manufacturer

• Active substance: thioctic acid, 600 mg per film-coated tablet.
• Tablet core: hypromellose, colloidal anhydrous silica, microcrystalline cellulose, lactose monohydrate, carmellose sodium, talc, dimeticone, magnesium stearate.
• Film coating: macrogol 6000, hypromellose, talc, sodium lauryl sulfate.
• Appearance: oblong yellow film-coated tablets with a slight sheen, whitish specks and a score line on both sides.
• Pack: PVC/PVDC/Al blister of 10 tablets; carton with 3 or 6 blisters (30 or 60 tablets).
• Marketing authorisation holder: Representative office of Wörwag Pharma GmbH & Co. KG (Novi Beograd), Bulevar Zorana Đinđića 81, Belgrade.
• Manufacturer: Wörwag Pharma GmbH & Co. KG, Böblingen, Germany.

Storage

• Store below 25 °C in the original package.
• Keep out of the sight and reach of children; do not use after the expiry date.
• Return unused medicine to a pharmacy that collects unused medicines.

Frequently asked questions

When is Thiogamma 600 oral taken?

Once a day, 30 minutes before the first meal, on an empty stomach. If taken with food, it is absorbed less well and the effect may be lost.

Is Thiogamma the same as alpha-lipoic acid from supplements?

The active substance is the same (thioctic or alpha-lipoic acid), but Thiogamma 600 oral is an authorised medicine for symptoms of diabetic polyneuropathy. Do not combine it with supplements containing the same substance.

Can Thiogamma lower blood sugar?

Yes, it may increase the effect of insulin and oral antidiabetics. Blood sugar should be monitored carefully at the start, and the doctor adjusts the antidiabetic dose if needed.

How long is Thiogamma 600 oral taken?

Diabetic polyneuropathy is a chronic disease, so treatment is usually long-term. The duration is decided by the doctor; do not stop on your own.

Can the medicine be taken with milk or iron and magnesium products?

Not at the same time. Thioctic acid forms chelates with metals and may lose its effect – take such products at midday or in the evening.

Sources

• ALIMS – Patient leaflet Thiogamma® 600 oral, 600 mg, film-coated tablets (August 2022)
• ALIMS – Summary of product characteristics Thiogamma® 600 oral, 600 mg

Sources checked on: 23 October 2026.