Gabapentin + Methylcobalamin + Alpha lipoic acid

Indications

Gabapentin + Methylcobalamin + Alpha lipoic acid is used for: All peripheral neuropathy Post-herpetic neuralgia Reflex sympathetic dystrophy Alcohol induced neuropathy

Adult Dose

Should start with once daily preferably at bedtime and gradually increase to one tablet - BID or TID. The effective dosage should be individualized according to patient response and tolerability.

Child Dose

Renal Dose

Administration

Contra Indications

Hypersensitivity to any of the ingredients.

Precautions

Patient w/ mixed seizures including absences. Discontinue if acute pancreatitis develop. Not recommended for patients who needed to sleep during daytime and remain awake at night. Abrupt withdrawal may cause rebound seizures. Renal impairment and to those undergoing haemodialysis. Childn. Pregnancy and lactation. Patient Counselling May impair ability to drive or operate machinery. Monitoring Parameters Monitor for signs of suicidal ideation and behaviours.

Pregnancy-Lactation

There is no information regarding safety in pregancy or lactation.Drugs should be given only if the potential benefit outweighs the potential risk to the fetus.

Interactions

Antacids will decrease the amount of gabapentin that is absorbed in the stomach.Alcohol may increase the risk of having side effects while taking gabapentin.Gabapentin may increase the effects of other drugs that cause drowsiness including antidepressants, antihistamines, sedatives, and anxiety medicines.

Adverse Effects

Side effects of Gabapentin + Methylcobalamin + Alpha lipoic acid : Somnolence/sedation, angioedema, blood glucose fluctuation, breast enlargement, elevated creatine kinase and LFTs, jaundice, fever, hyponatraemia, movement disorder, Stevens-Johnson syndrome, erythema multiforme; pneumonia, viral and resp infection, UTI, infection, otitis media, leucopenia, anorexia, increased appetite; depression, anxiety, hostility, confusion and emotional lability, nervousness, abnormal thinking; dizziness, ataxia, convulsions, hyperkinesias, dysarthria, amnesia, tremor, insomnia, headache, sensations (e.g. paraesthesia, hypoaesthesia, abnormal coordination, nystagmus), visual disturbances (e.g. amblyopia, diplopia), vertigo, HTN, vasodilatation, vomiting, nausea, gingivitis, abdominal pain, dyspepsia, constipation, diarrhoea, dry mouth or throat, flatulence, dental abnormalities, facial oedema, purpura, trauma, rash, pruritus, acne, arthralgia, myalgia, back pain, twitching, impotence, fatigue, peripheral oedema, abnormal gait, asthenia, pain, malaise, flu syndrome, decreased WBC, wt gain, accidental injury, abrasion, fracture.

Mechanism of Action

Gabapentin: Gabapentin inhibits the central L-type calcium channels situated on the axon terminal and reduces the hyperactivated neurotransmitter release.Gabapentin relieves the severe pain associated with neuropathy. Alpha lipoic acid: Alpha lipoic acid inhibits the nerve damage caused by free radicals due to increased oxidative stress. ALA improves nerve blood flow and increases sensory conduction. Methylcobalamin: Methylcobalamin is the neurologically active form of vitamin B12, which increases Myelin sheath formation and regenerates neurons.