Pregabalin + Methylcobalmin
Indications
Pregabalin + Methylcobalmin is used for:
Management of peripheral neuropathy.
Adult Dose
Oral
Initially 1 cap bid.
Patient previously on gabapentin should have a wash-out period of 1 wk prior to initiation of pregabalin.
Child Dose
Renal Dose
Administration
Contra Indications
Hypersensitivity
Precautions
Not to be given in patients w/ suspected vit B12 deficiency w/o 1st confirming diagnosis. Monitor blood regularly. Dose >10 mcg daily may produce hematological response in patients w/ folate deficiency. Leber's disease or tobacco amblyopia.
Pregnancy-Lactation
Interactions
Reduced absorption of vit B12 from the GIT w/ neomycin, aminosalicylic acid, histamine H2-antagonists, omeprazole & colchicine. Serum conc may be decreased w/ OCs. Parenteral chloramphenicol may attenuate the effect of vit B12 in anemia.
Adverse Effects
Side effects of Pregabalin + Methylcobalmin :
Pregabalin: Dizziness, somnolence; blurred vision, diplopia, increased appetite, wt gain, dry mouth, constipation, vomiting, flatulence, euphoria, confusion, reduced libido, erectile dysfunction, irritability, vertigo, ataxia, tremor, dysarthria, paresthesia, fatigue, edema.
Methylcobalamin: Anorexia, nausea, vomiting and diarrhoea.
Mechanism of Action
Pregabalin is an analog of the neurotransmitter GABA. It binds potently to the α2-δ subunit resulting in modulation of Ca channels and reduction in the release of several neurotransmitters, including glutamate, norepinephrine, serotonin, dopamine, calcitonin gene-related peptide and substance P.
Methylcobalamin is the neurologically active form of vitamin B12 and occurs as a water-soluble vitamin in the body. It is a cofactor in the enzyme methionine synthase, which functions to transfer methyl groups for the regeneration of methionine from homocysteine. In anaemia, it increases erythrocyte production by promoting nucleic acid synthesis in the bone marrow and by promoting maturation and division of erythrocytes.