COM D3 N Plus Tablet 10'S

Introduction About COM D3 N PLUS TABLET

COM D3 N PLUS TABLET is combination of Methylcobalamin, Vitamin D3 (Cholecalciferol), Nortriptyline, and Pregabalin which belongs to the group of medicines called Vitamins, Antidepressants, and Anticonvulsants respectively. It is used to manage and relieve neuropathic pain.

Neuropathic pain is a spontaneous shooting or burning pain that occurs due to damage or injury to the nerves and is a symptom of any underlying nerve disorder. It is accompanied by tingling, numbness, or a "pins and needles" feeling.

COM D3 N PLUS TABLET is not recommended for use if you are allergic to methylcobalamin, vitamin D3 (cholecalciferol), nortriptyline, or pregabalin. It is also not recommended for use in patients with hypercalcaemia, hypercalciuria, hypervitaminosis D, kidney stones, or any serious kidney disease.

COM D3 N PLUS TABLET should be used with caution in patients with renal failure, other kidney diseases, liver impairment, or heart disease. COM D3 N PLUS TABLET is not recommended for use by pregnant or breastfeeding women. COM D3 N PLUS TABLET is not recommended for use by children (aged below 12 years). COM D3 N PLUS TABLET should be used with caution in elderly patients (aged above 70 years). Consult your doctor before taking it.

The common side effects associated with the use of COM D3 N PLUS TABLET are dizziness, sleepiness, trouble concentrating, blurry vision, dry mouth, weight gain, and swelling of your hands or feet. Contact your doctor or a nearby hospital if any of the conditions worsen.

Uses Of COM D3 N PLUS TABLET

• Manage and relieve neuropathic pain

How COM D3 N PLUS TABLET Works

COM D3 N PLUS TABLET helps in relieving neuropathic pain where Methylcobalamin helps in the production of myelin (a substance that protects nerve fibres) and rejuvenates damaged nerve cells. Vitamin D3 (Cholecalciferol) decreases pain by modulating calcium channel activity of the nerve cells.

Nortriptyline inhibits the reuptake of the neurotransmitter serotonin and noradrenaline which leads to blockage of the pain signals whereas pregabalin modulates the release of several excitatory neurotransmitters in the damaged nerve endings, thereby relieving the associated pain.

How to use COM D3 N PLUS TABLET

Take COM D3 N PLUS TABLET as advised by your physician. Swallow the medicine with a glass of water. 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.

Side Effects Of COM D3 N PLUS TABLET

How To Manage Side Effects

Dizziness Or Drowsiness

Lie down until the dizziness passes, and then get up slowly. Do not bend down suddenly. Get a lot of rest. Walk slowly and carefully. Take plenty of fluids. Avoid drinking coffee, alcohol, or smoking. Consult your doctor if the condition persists for a long time or gets worse.

Dry Mouth

Drink a lot of cold water in regular sips during the day and keep some water by your side at night. Suck on ice cubes. Chew chewing gum or suck on sugar-free sweets. Use lip balm on your dried lips.

Weight Gain

Try to eat more high-fibre foods, such as fresh fruit, vegetables, and cereals, and drink plenty of water. Cut down on carbs and high-calorie diets. Try doing exercise regularly (going for a daily walk or run).

Warning & Precautions

Pregnancy

Contraindicated

COM D3 N PLUS TABLET is not recommended for use in pregnant women. Consult and inform your doctor before taking it.

Breastfeeding

Contraindicated

COM D3 N PLUS TABLET is not recommended for use in breastfeeding women as it passes through the milk. Consult your doctor before taking it.

Driving and Using Machines

Use with Caution

Do not drive or operate any machines after taking COM D3 N PLUS TABLET as it may impair thinking, reactions, mental alertness, and motor coordination.

Alcohol

Consult your doctor

Avoid consumption of alcohol while taking COM D3 N PLUS TABLET as it can increase the effects of alcohol, which can be dangerous.

Kidney

Consult your doctor

COM D3 N PLUS TABLET is not recommended to be used in patients with kidney stones or serious kidney disease. It should be used with caution in patients with renal failure or other kidney diseases. Consult your doctor before taking it.

Liver

Use with Caution

COM D3 N PLUS TABLET should be used with caution in patients with liver impairment . Consult your doctor before taking it.

Allergy

Contraindicated

COM D3 N PLUS TABLET is not recommended for use if you are allergic to methylcobalamin, vitamin D3 (cholecalciferol), nortriptyline, pregabalin, or any of the other ingredients of this medicine. Consult your doctor before taking it.

Heart Disease

Use with Caution

COM D3 N PLUS TABLET should be used with caution in patients with heart disease. Consult your doctor before taking it.

Use In Pediatrics

Contraindicated

COM D3 N PLUS TABLET is not recommended for use in children (below 12 years). Consult your doctor before taking it.

Use In Geriatrics

Use with Caution

COM D3 N PLUS TABLET should be used with caution in elderly patients (above 70 years). Consult your doctor before taking it.

Interactions

A. Drug-Drug Interactions:

Before taking COM D3 N PLUS TABLET, inform your doctor, if you are taking any of the following medicine:

• arbutamine (a medicines used to manage heart dysfunction)
• blood thinners (medicines use to delay blood clotting) Ex. warfarin
• disulfiram (a medicine used to manage long-standing alcoholism)
• thyroid supplements (medicines used to manage thyroid disorders)
• anticholinergic drugs (medicines that block the activity of acetylcholine which is a neurotransmitter) Ex. benztropine
• belladonna alkaloids (medicines used to manage symptoms of stomach and intestinal cramping) Ex. hyoscine
• medicines used to manage high blood pressure Ex. clonidine, guanabenz
• medicines used to manage depression such as MAO inhibitors (Ex. isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, procarbazine, rasagiline, safinamide, selegiline, tranylcypromine), SSRIs (Ex. fluoxetine, paroxetine), SNRIs (Ex. duloxetine, venlafaxine)
• medicines used to manage irregular heart rate Ex. quinidine, propafenone, flecainide
• medicines used to manage high blood pressure Ex. benazepril, enalapril, captopril, everolimus, imidapril, fosinopril, lisinopril, moexipril, perindopril, quinapril, ramipril
• medicines used to manage certain cancers Ex. sirolimus, temsirolimus
• cardiac glycosides (medicines used to manage heart diseases) Ex. digoxin
• calcium and vitamin D supplements
• medicines used to manage epilepsy Ex. phenytoin)
• medicines used to induce sleep such as barbiturates Ex. phenobarbitone)
• medicines used to manage pain and swelling such as glucocorticoids Ex. hydrocortisone, prednisolone)
• medicines used to manage constipation such as laxatives Ex. paraffin oil
• medicines used to lower blood cholesterol levels Ex. colestyramine
• actinomycin (a medicine used to manage certain cancers)
• imidazole antifungals (medicines used to manage fungal infections) Ex. clotrimazole, ketoconazole

B. Drug-Food Interactions:

Avoid eating grapefruit and drinking grapefruit juice while taking COM D3 N PLUS TABLET. Consult your doctor before taking it.

Overdosage:

If you or anyone else accidentally takes too much of COM D3 N PLUS TABLET, consult your doctor immediately or visit the nearby hospital. Symptoms of overdosage are nausea, vomiting, constipation, stomach pains, muscle weakness, tiredness, lack of appetite, kidney problem,  and irregular heartbeat.

Synopsis

More Information

• Keep the medicine out of reach of children
• Store COM D3 N PLUS TABLET at room temperature

FAQs About COM D3 N PLUS TABLET

Q: What is COM D3 N PLUS TABLET used for?

A: COM D3 N PLUS TABLET is used to relieve neuropathic pain, which is a spontaneous shooting or burning pain occurring due to damage or injury to the nerves and is a symptom of any underlying nerve disorder.

Q: What happens if you take more COM D3 N PLUS TABLET than your required dose?

A: If you or anyone else accidentally takes too much COM D3 N PLUS TABLET, consult your doctor immediately or visit the nearby hospital. Symptoms of overdosage are nausea, vomiting, constipation, stomach pains, muscle weakness, tiredness, lack of appetite, a kidney problem, and an irregular heartbeat.

Q: What side effects are seen with COM D3 N PLUS TABLET?

A: The common side effects associated with the use of COM D3 N PLUS TABLET are dizziness, sleepiness, trouble concentrating, blurry vision, dry mouth, weight gain, and swelling of your hands or feet. Contact your doctor or a nearby hospital if any of the conditions worsen.

Q: Who should avoid taking COM D3 N PLUS TABLET?

A: COM D3 N PLUS TABLET is not recommended for use if you are allergic to methylcobalamin, vitamin D3 (cholecalciferol), nortriptyline, or pregabalin. It is also not recommended for use in patients with hypercalcaemia, hypercalciuria, hypervitaminosis D, kidney stones, or any serious kidney disease. It is not recommended for use in pregnant women, breastfeeding women, or children (under 12 years of age). Consult your doctor before taking COM D3 N PLUS TABLET.

Q: Is COM D3 N PLUS TABLET safe to use in children or elderly patients?

A: COM D3 N PLUS TABLET is not recommended for use in children (below 12 years). It should be used with caution in elderly patients (aged above 70 years). Consult your doctor before taking COM D3 N PLUS TABLET.

Q: How does COM D3 N PLUS TABLET work?

A: COM D3 N PLUS TABLET helps in relieving neuropathic pain, where methylcobalamin helps in the production of myelin (a substance that protects nerve fibres) and rejuvenates damaged nerve cells. Vitamin D3 (cholecalciferol) decreases pain by modulating the calcium channel activity of the nerve cells. Nortriptyline inhibits the reuptake of the neurotransmitters serotonin and noradrenaline, which leads to blockage of the pain signals, whereas pregabalin modulates the release of several excitatory neurotransmitters in the damaged nerve endings, thereby relieving the associated pain.

Q: Is COM D3 N PLUS TABLET safe for use by pregnant and breastfeeding women?

A: COM D3 N PLUS TABLET is not recommended for use in pregnant and breastfeeding women due to its high strength of vitamin D (cholecalciferol). Consult your doctor before taking COM D3 N PLUS TABLET.

Q: What if I forget to take my COM D3 N PLUS TABLET dose?

A: If you forgot to take your COM D3 N PLUS TABLET dose, take it as soon as possible. Do not double up the dose to make up for the forgotten one. Consult your doctor before taking COM D3 N PLUS TABLET.

Q: Is COM D3 N PLUS TABLET safe to use in kidney patients?

A: COM D3 N PLUS TABLET is not recommended to be used in patients with kidney stones or serious kidney disease. It should be used with caution in patients with renal failure or other kidney diseases. Consult your doctor before taking COM D3 N PLUS TABLET.

Q: Is it safe to drive while taking COM D3 N PLUS TABLET?

A: Do not drive or operate any machines after taking COM D3 N PLUS TABLET as it may impair thinking, reactions, mental alertness, and motor coordination. Consult your doctor before taking COM D3 N PLUS TABLET.

References

1. KD. Tripathi. Antiepileptic Drugs. Essentials of medical pharmacology. Seventh edition. 2013. Page - 419.

2. Meghan Meehan, Sue Penckofer. The Role of Vitamin D in the Aging Adult. NIH National Library of Medicine. National Centre for Biotechnology Information. PMC PubMed Central. December 2014. [Assessed on 3rd September 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4399494/

3. Swiss Caps GmbH. Electronic Medicines Compendium (EMC). [Revised in May 2019] [Assessed on 3rd September 2022] https://www.medicines.org.uk/emc/files/pil.3659.pdf

4. Centaur Pharma. Nursing NT Tablets. [Assessed on 3rd September 2022] https://www.centaurpharma.com/downloads/neurology/NURING%20NT.pdf

5. Leeford. PREGABANYL-NTM. [Assessed on 3rd September 2022] https://www.leeford.in/product/782/pregabanyl-ntm

6. Steris Healthcare PVT Ltd. Pregabrial NT D3. [Assessed on 3rd September 2022] https://www.sterisindia.com/latest-update/pregabalin-methyl-/4390

Useful Diagnostic Tests

• Blood tests
• Urine analysis

Author Details

Written By Dr. Dhivakaran R - BDS

Reviewed For Accuracy By Dr. Sankara Babu Gorle - MBBS, MD (Pharmacology)

Last updated on 30 Mar 2023 | 04:19 PM(IST)