Pain management

Description

• Pregabalin is a structural derivative of the inhibitory neurotransmitter, gamma- aminobutyric acid (GABA).
• It binds with high affinity to the alpha-2 delta site (an auxiliary subunit of voltage-gated calcium channels) in the central nervous system tissues.
• Pregabalin reduces the calcium-dependent release of several neurotransmitters, possibly by modulation of the calcium channel function. It does not block sodium channels, is not active at opiate receptors, and does not alter cyclo-oxygenase enzyme activity.
• It is inactive at serotonin and dopamine receptors and does not inhibit dopamine, serotonin, or noradrenaline reuptake.
• Methylcobalamin is one of the two biologically active forms of vitamin B12.  Methylcobalamin acts as an important cofactor in the reaction of methyltransferases. The B12, dependent methyltransferases play an important role in amino acid metabolism in many organisms as well as in one-carbon metabolism and CO2 fixation in anaerobic microbes.
• As the cofactor of the enzyme methionine synthase, methylcobalamin functions to catalyze the transfer of the methyl group from methylene tetrahydrofolate to homocysteine (Hcy) to form methionine and tetrahydrofolate. Deficiency of vitamin B₁₂ results in the lack of methylcobalamin and has been associated with significant neurological pathology, especially peripheral neuropathy.

Indications

• PRENEUROLIN PLUS is indicated for the management of neuropathic pain associated with diabetic peripheral neuropathy.

Dosage

• PRENEUROLIN PLUS is given orally with or without food. Dosing should begin at 2 capsules per day divided in two doses. Because pregabalin is eliminated primarily by renal excretion, the dose should be adjusted for patients with reduced renal function.