INTRODUCTION

NERVZ D TABLET contains Alpha Lipoic Acid, Folic Acid, Methyl cobalamin, Pyridoxine, Cholecalciferol (Vitamin D3) which belongs to the group of medicines called Antioxidants and Vitamin supplements respectively. It is used to treat Diabetic neuropathy (diabetic nerve damage).

NERVZ D TABLET is also used for the treatment of alcoholic neuropathy (damage to the nerves due to excessive alcohol intake), diabetic retinopathy (diabetic eye disease), peripheral neuropathy (weakness, numbness and pain usually in the hands and feet), degenerative diseases like Parkinson’s disease (a brain disorder that affects movement) and Alzheimer’s disease (a brain disorder that affects memory and thinking), chronic pain and Vitamin Deficiency.

NERVZ D TABLET is not recommended for use if you have hypercalcaemia (increased levels of calcium levels in the blood), malabsorption syndrome (difficulty absorbing nutrients from diet) and hypervitaminosis D (increased level of Vitamin D in the body). Consult your doctor before taking it.

NERVZ D TABLET should be used with caution in patients suffering from kidney impairment and kidney stones, heart problems. Consult your doctor before taking it.

NERVZ D TABLET should be used with caution in pregnant and breastfeeding women. Consult your doctor if you experience any side effects after taking this medicine.

USES OF NERVZ D TABLET

NERVZ D TABLET is used for the treatment of:

• Diabetic neuropathy
• Alcoholic neuropathy
• Diabetic retinopathy
• Peripheral neuropathy
• Parkinson’s disease
• Alzheimer’s disease
• Chronic pain
• Vitamin deficiency

HOW NERVZ D TABLET WORKS

NERVZ D TABLET helps to treat neuropathies and supports the health of the brain where Alpha Lipoic acid is an antioxidant delays or reverses diabetic neuropathy. Folic acid is useful for enhancing nerve conduction velocity in diabetic neuropathy. Methylcobalamin works by producing a compound called myelin, which covers and protects nerve fibres and helps to rejuvenate the damaged nerves. Pyridoxine is an essential nutrient which is required for the metabolism of lipids, carbohydrates and proteins. It is also needed for the synthesis of neurotransmitters (chemical messengers) and Vitamin D increase the level of nerve growth factor (helps in the development and survival of nerves) by stimulating its production and preventing its depletion.

DIRECTIONS FOR USE

Take NERVZ D TABLET as advised by your physician. Swallow NERVZ D TABLET with a glass of water and do not crush or chew the medicine. Your doctor will decide the correct dose and duration for you depending on your age, body weight and disease condition.

WARNING & PRECAUTIONS

PREGNANCY

NERVZ D TABLET should be used with caution in pregnant women. Consult your doctor before taking NERVZ D TABLET.

BREASTFEEDING

NERVZ D TABLET should be used with caution in breastfeeding women as it may pass through breast milk. Consult your doctor before taking NERVZ D TABLET.

ALCOHOL

Do not consume alcohol while taking NERVZ D TABLET as it impairs the absorption of Vitamin B12 from the stomach and intestine.

KIDNEY

NERVZ D TABLET should be used with caution in patients suffering from kidney impairment and kidney stones. Consult your doctor before taking NERVZ D TABLET.

ALLERGY

Do not take NERVZ D TABLET if you are allergic to alpha lipoic acid, folic acid, methyl cobalamin, pyridoxine, cholecalciferol (Vitamin D3) or any other ingredients of this medicine.

HEART DISEASE

NERVZ D TABLET should be used with caution in patients suffering from heart problems. Consult your doctor before taking NERVZ D TABLET.

OTHERS

NERVZ D TABLET is not recommended for use if you have:

• hypercalcaemia (increased levels of calcium levels in blood)
• malabsorption syndrome (difficulty absorbing nutrients from diet)
• abnormal sensitivity to the toxic effects of vitamin D
• hypervitaminosis D (increased level of Vitamin D in body)

Before taking NERVZ D TABLET inform your doctor if you have:

• folate deficiency
• megaloblastic anaemia (type of red blood cell disorder)
• leber’s disease (a hereditary eye disease)
• vitamin B12 deficiency
• folate dependent cancers

INTERACTIONS

A. Drug-Drug interactions:

Before taking NERVZ D TABLET, inform your doctor if you are taking any of the following medicine:

• isoniazid, amino-salicylic acid, rifampicin (medicines used to treat tuberculosis)
• oral contraceptives (medicines used to prevent pregnancy) (Ex. oestradiol valerate)
• levodopa (a medicine used to treat Parkinson’s disease)
• penicillamine, neomycin, chloramphenicol, co-trimoxazole (medicines used to treat bacterial infections)
• colchicine (used for the treatment of gout)
• methotrexate (used to treat rheumatoid arthritis, cancer)
• medicines used to treat peptic ulcers (Ex. cimetidine, omeprazole, lansoprazole)
• mercaptopurine (a medicine used for treatment of leukaemia)
• altretamine (a medicine used to treat ovary cancer)
• antiepileptics (medicines used to treat fits) (Ex. phenytoin, phenobarbital, primidone, carbamazepine)
• sulfasalazine (a medicine used treat ulcerative colitis, Crohn’s disease)
• ketoconazole (a medicine used for treatment fungal infection)
• mineral oil
• corticosteroids (medicines used for treatment of inflammatory conditions)
• vitamin c supplements
• potassium supplements
• thiazide diuretics (used to treat high blood pressure, heart diseases) (Ex. chlorothiazide, hydrochlorothiazide)
• calcium or phosphate supplements
• paricalcitol (used to treat or prevent hypoparathyroidism)

Overdosage:

If you or anyone else accidentally use too much of NERVZ D TABLET, consult your doctor immediately or visit the nearby hospital. Symptoms of overdosage include loss of appetite, weakness, weight loss, vague aches and stiffness, nausea and vomiting, constipation or diarrhoea, polyuria (increased urination), nocturia (frequent urination at night), polydipsia (increased thirst), sweating, headache, somnolence, vertigo, mental retardation, anaemia (decreased in red blood cell count) and mild acidosis, hypercalciuria (excess calcium in urine), reversible azotemia (elevation of metabolic products), high blood pressure, nephrocalcinosis (deposition of calcium in the kidneys), generalized vascular calcification (abnormal accumulation of calcium in blood) or irreversible kidney damage which may result in death.

Widespread accumulation of calcium in the heart, blood vessels, renal tubules and lungs. Bone demineralization (osteoporosis) in adults occurs concomitantly. Decline in the average rate of linear growth and increased mineralization of bones in infants and children (dwarfism) may also occur.

SYNOPSIS

MORE INFORMATION

• Keep NERVZ D TABLET out of reach of children.
• Store NERVZ D TABLET below 30°C

FAQs ABOUT NERVZ D TABLET

Q: How often can I take NERVZ D TABLET?

A: Take NERVZ D TABLET as advised by your physician. Take one or two tablet or as directed by your doctor. Swallow NERVZ D TABLET with a glass of water and do not crush or chew the medicine. Your doctor will decide the correct dose and duration for you depending upon your age, body weight and disease condition.

Q: What are the side effects of taking NERVZ D TABLET?

A: NERVZ D TABLET is possibly safe for most adults. There is no disadvantage associated with this medicine if taken under the recommended dosage. However, some may experience side effects such as headache, nausea, vomiting and upset stomach. Consult your doctor if any of the symptoms worsen.

Q: Is NERVZ D TABLET safe in pregnancy?

A: Yes. NERVZ D TABLET should be used with caution in pregnant women. Inform your doctor if you are pregnant or planning for pregnancy before taking this medicine.

Q: For what conditions NERVZ D TABLET is used?

A: NERVZ D TABLET is used to treat Diabetic neuropathy. It is also used for the treatment of alcoholic neuropathy, diabetic retinopathy, peripheral neuropathy, degenerative diseases like Parkinson’s disease and Alzheimer’s disease, chronic pain and vitamin deficiency. Consult your doctor before taking it.

Q: Who should not take NERVZ D TABLET?

A: NERVZ D TABLET is not recommended for use if you have hypercalcaemia (increased levels of calcium levels in blood), malabsorption syndrome (difficulty absorbing nutrients from diet), abnormal sensitivity to the toxic effects of vitamin D and hypervitaminosis D (increased level of Vitamin D in body). Consult your doctor before taking it.

REFERENCES

1. KD Tripathi. Drugs Affecting Blood and Blood Formation, Vitamins, Hormones and Related Drugs. Essentials of Medical Pharmacology. 7th edition. 2013. Page – 608, 915, 340.

2. Aylin Sari, Zeynep Akdogan Altun, Cigdem Arifoglu Karaman, Basak Bilir Kaya, Bekir Durmus. Does Vitamin D affect Diabetic Neuropathic Pain and Balance. NIH National Library of Medicine, National Center for Biotechnology Information. PubMed Central.  January 2020. [Accessed on 4th October 2022].https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6970609/

3. Ming Zhang, Wenjuan Han, Sanjue Hu, Hui Xu. Methylcobalamin: a potential vitamin of pain killer. NIH National Library of Medicine, National Center for Biotechnology Information. PubMed Central.  December 2013. [Accessed on 4th October 2022]. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3888748/

4. Akums drugs & Pharmaceuticals Ltd. (Alpha Lipoic Acid+ Methyl Cobalamin+ Folic Acid+ Pyridoxine+ Cholecalciferol). [Revised in June 2018] [Accessed on 4th October 2022]. https://www.torrentian.com/pisheet/Upload/PI_Sheet/2663.pdf

5. GLIAREN-D Tablet (Alpha Lipoic Acid+ Methyl Cobalamin+ Folic Acid+ Pyridoxine+ Cholecalciferol). La Renon Healthcare Private Limited. [Accessed on 4th October 2022].https://www.larenon.com/wp-content/uploads/2020/12/GLIAREN-D-_-LBL.pdf

6. Myovit-D3 (Alpha Lipoic Acid+ Methyl Cobalamin+ Folic Acid+ Pyridoxine+ Cholecalciferol). Solitaire Pharmacia Pvt. Ltd. [Accessed on 4th October 2022]. www.solitairepharmacia.co.in/methylcobalamin-1500-mcg-alpha-lipoic-acid-100-mg-folic-acid-1-5-mg-pyridoxine-3-mg-vit-d3-1000-i-u--5666651.html

7. Meconic Plus Tablet (Alpha Lipoic Acid+ Methyl Cobalamin+ Folic Acid+ Pyridoxine+ Cholecalciferol). Bionics Remedies. [Accessed on 4th October 2022].http://www.bionicsremedies.com/HAEMETINIC-MULTIVITAMIN-MULTI%20MINERAL-ANTIOXIDANT-CALCIUM-NUTRITION-PRODUCTS.php#c72

8. Neuronis-D3 Tablet (Alpha Lipoic Acid+ Methyl Cobalamin+ Folic Acid+ Pyridoxine+ Cholecalciferol). Nutronis Lifesciences Pvt. Ltd. [Accessed on 4th October 2022].http://nutronis.com/Product_Details.aspx?Product_ID=9

9. GM Vital (Alpha Lipoic Acid+ Methyl Cobalamin+ Folic Acid+ Pyridoxine+ Cholecalciferol). Alaina Pharma. [Accessed on 4th October 2022].http://alainapharma.com/Methylcobalamin,%20Vitamin%20B1,%20Alphalipoic%20Acid,%20Folic%20Acid%20and%20Vitamin%20D3%20Tablet.html

USEFUL DIAGNOSTIC TESTS

• Serum Calcium
• Serum Phosphate
• Serum 25 hydroxy Vitamin D
• Vitamin B12