Side-effects and incomplete response to standard therapy of patients with multiple sclerosis (MS) stimulate the development of an alternative therapy, that influences, in particular, metabolic functions of MS patients. Metabolic therapy (vitamins, antioxidants and others) have been used for a long time in neurologic practice for the treatment of MS on the basis of pathophysiological mechanisms, positive clinical experience, low rate of side-effects and practical availability. Recent objective scientific data explain the necessity of correction of the disturbed metabolic profile (metabolome) in MS, and the first evidence of the efficacy of several metabolic agents, particularly, biotin and vitamin D, was shown. Taking into account the mechanisms of action and clinical experience, the authors consider the prospects of using the combined medicine cytoflavin, that contains succinate, nicotinamide, riboflavin and inosine, in metabolic therapy of MS.