NEUROLIN M CAPSULES (Each capsule contains Pregabalim 75mg/ Mecobalamin 1000mcg)

Indications

• Vitamin B12 deficiency
• Peripheral neuropathy
• Diabetic neuropathy
• Neurological disorders
• Anemia related to vitamin B12 deficiency

Dosage

Children: For children, consult the BNF for Children for appropriate dosing guidelines based on age and clinical condition.

Adults: The usual adult dose for vitamin B12 deficiency is 500 to 1500 micrograms daily, administered intramuscularly or orally, as per clinical need.

Mechanism of action

Mecobalamin acts as a cofactor in the conversion of homocysteine to methionine, thereby playing a significant role in the methylation process necessary for DNA synthesis and repair. It also aids in the maintenance of myelin sheaths in nerve cells, which is vital for proper nerve function and regeneration.

Pharmacodynamics

Mecobalamin enhances cellular energy metabolism and promotes the regeneration of nerve fibers. It influences the synthesis of neurotransmitters and the overall function of the nervous system, reducing symptoms of neuropathy and improving nerve conduction velocities.

Pharmacokinetics

Mecobalamin is rapidly absorbed following intramuscular injection, with peak plasma concentrations occurring within a few hours. It is primarily distributed in tissues, including the liver and kidneys. The drug is metabolized in the liver, and its elimination occurs primarily through urine, with a half-life of several hours.

Adverse effects

• Nausea
• Diarrhea
• Headache
• Dizziness
• Rash
• Pruritus

Precautions

• Use with caution in patients with known hypersensitivity to mecobalamin or any component of the formulation.
• Monitor patients with renal impairment.

Pregnancy

Mecobalamin is generally considered safe during pregnancy, but consult a healthcare provider for individual assessment.

Breast-feeding

Mecobalamin is excreted in breast milk; caution is advised when administered to nursing mothers.

Storage

Store in a cool, dry place away from light. Keep out of reach of children.

Formulations

• Tablets
• Injections

Indications

• Neuropathic pain associated with diabetic peripheral neuropathy
• Postherpetic neuralgia
• Fibromyalgia
• Partial-onset seizures in adults with epilepsy
• Generalized anxiety disorder

Dosage

Children: Refer to the BNF for Children for specific dosing information.

Adults: Refer to the BNF for specific dosing information.

Mechanism of action

Pregabalin binds to the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system. This action inhibits excitatory neurotransmitter release, leading to a reduction in neuronal excitability and modulation of pain pathways.

Pharmacodynamics

Pregabalin exhibits analgesic and anticonvulsant properties. It is effective in reducing neuropathic pain by decreasing the release of several neurotransmitters, including glutamate, norepinephrine, and substance P. It has a rapid onset of action and its effects can be observed within a week of starting treatment.

Pharmacokinetics

Pregabalin is well absorbed after oral administration, with peak plasma concentrations typically reached within 1 hour. It has a bioavailability of approximately 90%, and food does not significantly affect its absorption. The drug is not extensively metabolized in the liver and is excreted unchanged in the urine. It has a half-life of about 6 hours, necessitating multiple daily doses for sustained effect.

Contra-indications

• Hypersensitivity to pregabalin or any of its components
• Severe renal impairment

Adverse effects

• Dizziness
• Somnolence
• Dry mouth
• Edema
• Weight gain
• Blurred vision
• Cognitive dysfunction
• Increased appetite
• Constipation

Interactions

• CNS depressants may enhance the sedative effects of pregabalin
• Pregabalin may increase the risk of respiratory depression when used with opioids
• Alcohol may increase adverse effects and should be used with caution

Precautions

• Monitor for signs of misuse, abuse, or dependence
• Caution in patients with a history of substance abuse
• Assess renal function prior to initiation and adjust dose accordingly
• Risk of suicidal thoughts or behavior has been observed

Pregnancy

Pregabalin should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Animal studies have shown reproductive toxicity.

Breast-feeding

Pregabalin is excreted in breast milk, and caution should be exercised when administering to breastfeeding women.

Storage

Store at room temperature, away from moisture and heat. Keep out of reach of children.

Formulations

• Capsules
• Oral solution