Nervalin 25

Indications

Nervalin is prescribed for:

• Neuropathic pain related to diabetic peripheral neuropathy (DPN)
• Postherpetic neuralgia (PHN)
• Adjunctive therapy for partial-onset seizures in patients aged 1 month and older
• Fibromyalgia
• Neuropathic pain resulting from spinal cord injury

Nervalin CR tablet is specifically used for:

• Neuropathic pain associated with diabetic peripheral neuropathy (DPN)
• Postherpetic neuralgia (PHN)

Pharmacology

Pregabalin, a structural analog of gamma-aminobutyric acid (GABA), does not bind directly to GABAA, GABAB, or benzodiazepine receptors. Instead, it interacts with the alpha2-delta subunit of voltage-gated calcium channels in the central nervous system. This interaction is believed to contribute to its analgesic and anticonvulsant properties, although the exact mechanism remains under study.

Dosage

• Neuropathic Pain (Diabetic Peripheral Neuropathy): Start with 50 mg three times daily (150 mg/day). Adjust to 100 mg three times daily (300 mg/day) within a week, based on tolerance and effectiveness. For Pregabalin CR capsules, begin with 165 mg once daily, increasing to 330 mg once daily as needed. Maximum dose for CR capsules is 330 mg daily.
• Postherpetic Neuralgia: Start at 75 mg twice daily or 50 mg three times daily (150 mg/day). May increase to 150 mg twice daily or 100 mg three times daily (300 mg/day). For CR capsules, start with 165 mg once daily, increasing to 330 mg, with a maximum of 660 mg once daily based on response.
• Fibromyalgia: Start with 75 mg twice daily (150 mg/day). Increase to 150 mg twice daily (300 mg/day) within a week. If necessary, adjust further to 225 mg twice daily (450 mg/day).
• Neuropathic Pain (Spinal Cord Injury): Start with 75 mg twice daily (150 mg/day). Increase to 150 mg twice daily (300 mg/day) within a week, with a maximum of 300 mg twice daily if needed.
• Conversion from Capsules to CR Capsules: On the day of conversion, take the morning dose of regular Pregabalin and switch to Pregabalin CR after the evening meal. Adjust the dose according to the daily equivalent.

Administration

Pregabalin is administered orally and can be taken with or without food. CR tablets should be taken after an evening meal and swallowed whole. If a dose is missed, follow specific guidelines for rescheduling. Gradually taper off the medication over at least one week when discontinuing.

Interaction

Nervalin is unlikely to cause significant pharmacokinetic drug interactions. There are no known interactions with food or other non-medication substances.

Contraindications

Contraindicated in patients with known hypersensitivity to Pregabalin or any of its components.

Side Effects

Common side effects include dizziness, drowsiness, dry mouth, edema, blurred vision, weight gain, and cognitive disturbances. In children, weight gain and increased appetite are also reported.

Pregnancy & Lactation

Pregabalin should be used during pregnancy only if the potential benefit justifies the risk to the fetus. It is not recommended for breastfeeding due to potential risks.

Precautions & Warnings

Monitor for angioedema and hypersensitivity reactions, and discontinue if these occur. Pregabalin may increase suicidal thoughts or behaviors and cause respiratory depression with CNS depressants. Withdrawal should be gradual to avoid adverse effects.

Use in Special Populations

Safety and effectiveness in children, particularly under 1 month of age, have not been established. Pregabalin is not recommended for pediatric use for neuropathic pain or fibromyalgia.

Overdose Effects

Symptoms of overdose may include decreased consciousness, agitation, and possible seizures or heart block. There is no specific antidote. Supportive care and monitoring are essential.

Therapeutic Class

Adjunct and primary anti-epileptic drugs.

Storage Conditions

Store in a cool, dry place below 30°C, protected from light and moisture. Keep out of reach of children.