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Introduction About MEGANERV PG 75/75MCG CAPSULE
MEGANERV PG 75/75MCG CAPSULE is a combination of Pregabalin and Methylcobalamin which belongs to the group of medicines called Anticonvulsants and Vitamin-B complex respectively. MEGANERV PG 75/75MCG CAPSULE is indicated for the management of neuropathic pain in adults. Neuropathic pain is a chronic painful condition caused by damage or disease affecting the somatosensory (sense of touch) nervous system (such as lesion or disease of spinal cord and/or brain).
It can also be caused by prolonged diabetes mellitus, infectious diseases (such as HIV infection or leprosy), chemotherapy, auto-immune disease (Ex. Guillain-Barre syndrome) or by other metabolic dysfunctions. Symptoms include shooting, burning or stabbing pain, tingling and numbness, spontaneous pain (pain without stimulus) or pain caused by normal daily activities that are typically not painful (such as brushing your hair, being in cold temperatures or rubbing against something). Do not stop taking MEGANERV PG 75/75MCG CAPSULE without consulting your doctor as it could precipitate withdrawal symptoms such as headache, insomnia (lack of sleep), nausea, pain, diarrhea, flu syndrome, anxiety, nervousness, depression, convulsion, excessive sweating, dizziness and physical dependence.
MEGANERV PG 75/75MCG CAPSULE has high potential to cause addiction and therefore caution should be exercised among patients who already has a history of substance abuse. MEGANERV PG 75/75MCG CAPSULE can cause suicidal ideation in some individuals and therefore appropriate management should be considered as soon as the signs emerge. MEGANERV PG 75/75MCG CAPSULE is not recommended for use in pregnant or breastfeeding women unless advised by the doctor and in male patients who plan to father a child. Consult your doctor before taking MEGANERV PG 75/75MCG CAPSULE. The most common side effects of taking MEGANERV PG 75/75MCG CAPSULE are dizziness, sleepiness, headache, dry mouth, mood changes, fluid retention and weight gain. Consult your doctor if any of the side effects worsen.
Uses Of MEGANERV PG 75/75MCG CAPSULE
- Used to manage neuropathic pain
How MEGANERV PG 75/75MCG CAPSULE Works
MEGANERV PG 75/75MCG CAPSULE effectively alleviates the symptoms of various types of neuropathic pain, where Methylcobalamin acts by rejuvenating the damaged neurons by improving the production of myelin (a substance that covers and protects the nerve fibers from damage) and pregabalin acts by interfering with various pain signals travelling through the damaged nerves and the brain, thus leading to a significant pain relief in various neuropathic pain states.
How to use MEGANERV PG 75/75MCG CAPSULE
Take MEGANERV PG 75/75MCG CAPSULE as advised by your physician. Swallow MEGANERV PG 75/75MCG CAPSULE with a glass of water. Do not crush or chew the medicine. Your doctor will decide the correct dose and duration of MEGANERV PG 75/75MCG CAPSULE for you depending upon your age, body weight and disease condition.
Side Effects Of MEGANERV PG 75/75MCG CAPSULE
Common
- Dizziness, sleepiness, headache
- Nasopharyngitis (common cold)
- Nausea, vomiting, increased appetite, constipation, diarrhea, flatulence, abdominal distension, dry mouth
- Euphoric mood (feeling excited or pleasurable)
- Confusion, irritability, disorientation
- Insomnia (lack of sleep)
- Decrease in sex drive, erectile dysfunction
- Ataxia (impaired balance or coordination), tremor (shaking)
- Dysarthria (disorder of speech)
- Memory impairment, attention disturbance
- Paresthesia (tingling and numbness in extremities)
- Hypoaesthesia (decreased sense of touch)
- Tiredness
- Blurred vision
- Vertigo (spinning sensation)
- Muscle cramps
- Pain in limbs, joints or back
- Cervical spasm (a sudden, involuntary contraction of a muscle in the neck)
- Peripheral edema
- Fall (accidental injury)
- Weight gain
Uncommon
- Abnormally low count of a type of white blood cell (neutrophils)
- Loss of appetite
- Low blood sugar levels
- Hallucination, panic attack, restlessness, agitation, depression
- Elevated mood, aggression, mood swings, depersonalisation, word finding difficulty
- Abnormal dreams, libido increased, anorgasmia, apathy
- Fainting, unresponsiveness (stupor)
- Myoclonus (muscle jerks)
- Loss of consciousness, psychomotor hyperactivity
- Dizziness postural
- Involuntary eye movement
- Cognitive disorder
- Mental impairment
- Hyporeflexia (reduction or absence of normal bodily reflexes)
- Hyperaesthesia (excessive physical sensitivity)
- Burning sensation
- Loss of sensation of taste
- General discomfort
- Visual disturbance, eye swelling
- Eye pain or strain
- Photopsia (presence of flashes of light or floaters in the vision)
- Dry eye
- Lacrimation increased, eye irritation
- Disorder in loudness perception
- Fast or slow heart rate, congestive heart failure
- Increased or decreased blood pressure
- Hot flushes, flushing, peripheral coldness
- Shortness of breath, bleeding from nose
- Cough, nasal congestion
- Stuffy nose, snoring, nasal dryness
- Gastrooesophageal reflux disease, salivary hypersecretion
- Oral numbness
- Rash popular, urticaria, itching
- Excess sweating
- Joint swelling, muscle or neck pain
- Muscle twitching or stiffness
- Urinary incontinence, painful urination
- Sexual dysfunction, ejaculation delayed
- Pain menstruation or breast pain
- Generalised oedema, face oedema, chest tightness, pain
- Fever, thirst, chills, lack of energy
- Decreased weight
Rare
- Disinhibition (a pattern of antisocial, impulsive, norm-violating tendency)
- Convulsions
- Parosmia (a smell disorder)
- Dysgraphia (trouble in writing)
- Heart problems (such as prolonged QT interval, sinus tachycardia or sinus arrhythmia)
- Pulmonary edema (fluid retention in the lungs) and throat tightness
- GI tract problems (such as fluid buildup in stomach, pancreatitis, swollen tongue or dysphagia)
- Cold sweats
- Kidney problems (such as renal failure, oliguria and urinary retention)
- Amenorrhea (lack of menstrual periods)
- Breast discharge or enlargement
- Gynecomastia (breast enlargement in males)
Stop taking MEGANERV PG 75/75MCG CAPSULE and contact your doctor immediately if you experience any of the following side effects:
- Severe allergic reactions (such as skin rash, itching, swelling of the face, lips, throat, neck and difficulty in breathing)
- Symptoms of elevated creatine kinase (such as unexplained muscle pain, tenderness or weakness, accompanied by malaise or fever)
- Rhabdomyolysis (severe muscle injury)
- Suicidal ideation or behavior
How To Manage Side Effects
Bloating
Eat smaller and frequent meals. Eat and drink slowly and exercise regularly. Consult your doctor if the symptom did not improve.
Constipation
Eat fiber rich foods such as fresh fruits, vegetables and cereals and drink plenty of water. Try to exercise more regularly. Consult your doctor if the symptom did not improve on its own.
Diarrhea
Drink lots of fluids such as water or fruit juices to keep yourself hydrated. Avoid taking any medicine on your own for managing diarrhea. Consult your doctor if the symptom did not improve.
Dizziness Or Drowsiness
Try to rest and relax. Get enough sleep. Avoid driving or operating any tools or machines while you are feeling dizzy. Do not consume too much of alcohol, as it can aggravate your dizziness. Consult your doctor if the symptom did not improve.
Headache
Rest and relax. Drink plenty of fluids such as water or electrolytes. Apply a pain-relieving balm on the forehead if required. Do not consume too much of alcohol. Consult your doctor if the symptom did not improve.
Nausea And Vomiting
Try to take MEGANERV PG 75/75MCG CAPSULE with or just after a meal or a snack. Stick to simple meals. Avoid eating rich or spicy food. Consult your doctor if the symptom did not improve.
Warning & Precautions
Pregnancy
Consult your doctorThere is no proper information on the use of MEGANERV PG 75/75MCG CAPSULE during pregnancy and therefore should be used only if the benefit to the mother clearly outweighs the potential risk to the fetus. Consult your doctor before taking MEGANERV PG 75/75MCG CAPSULE. Women of childbearing potential should use a suitable contraceptive method to avoid pregnancy while taking MEGANERV PG 75/75MCG CAPSULE.
Breastfeeding
Monitoring requiredMEGANERV PG 75/75MCG CAPSULE is not recommended for use in breastfeeding women unless it is considered clearly necessary. Consult your doctor whether to discontinue breast-feeding or to discontinue therapy with MEGANERV PG 75/75MCG CAPSULE.
Driving and Using Machines
Use with CautionDo not drive or operate any heavy tools or machines if you experience dizziness or sleepiness after taking this medicine. Consult your doctor before taking MEGANERV PG 75/75MCG CAPSULE.
Alcohol
Consult your doctorAvoid consumption of alcohol while taking MEGANERV PG 75/75MCG CAPSULE, as it may cause impairment of motor skills and sedating effects of alcohol. Consult your doctor before taking MEGANERV PG 75/75MCG CAPSULE.
Kidney
Use with CautionMEGANERV PG 75/75MCG CAPSULE should be taken with caution in patients with impaired kidney function. Consult your doctor before taking MEGANERV PG 75/75MCG CAPSULE.
Liver
Use with CautionMEGANERV PG 75/75MCG CAPSULE should be taken with caution in patients with liver disease. Consult your doctor before taking MEGANERV PG 75/75MCG CAPSULE.
Allergy
ContraindicatedDo not take MEGANERV PG 75/75MCG CAPSULE if you are allergic to Pregabalin, Methylcobalamin or any other ingredients of MEGANERV PG 75/75MCG CAPSULE.
Heart Disease
Use with CautionMEGANERV PG 75/75MCG CAPSULE should be taken with caution in patients with heart disease (such as congestive heart failure). Consult your doctor before taking MEGANERV PG 75/75MCG CAPSULE.
Use In Pediatrics
ContraindicatedMEGANERV PG 75/75MCG CAPSULE is not recommended for use in children and adolescents (aged below 18 years) due to lack of safety data. Consult your child’s doctor for advice.
Use In Geriatrics
Use with CautionMEGANERV PG 75/75MCG CAPSULE should be used with caution in elderly patients (aged 65 years and above), especially in patients with decreased renal function. Proper dose adjustments and careful monitoring of kidney function are required in such patients. Consult your doctor before taking MEGANERV PG 75/75MCG CAPSULE.
Others
MEGANERV PG 75/75MCG CAPSULE is not recommended for use if you:
- Have Leber’s disease (a hereditary eye disease)
- Have problems in glucose metabolism (Ex. galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption)
Before taking this medicine, inform your physician if you:
- Have history of misuse or substance abuse
- Have folate deficiency
- Have diabetes
- Have epilepsy
- Have or at risk of encephalopathy (a brain disease)
Interactions
A. Drug-Drug interactions:
Before taking MEGANERV PG 75/75MCG CAPSULE, inform your doctor, if you are taking any of the following medicines:
- Medicines used to reduce blood glucose level (Ex. metformin, pioglitazone, rosiglitazone)
- Anti-spasticity agents (used to reduce muscle stiffness) Ex. dantrolene, baclofen
- Opioid analgesics (Ex. morphine, pethidine) (used to manage severe pain)
- CNS depressants (Ex. lorazepam) (used to manage anxiety)
- Oral contraceptives (birth control pills) Ex. norethisterone and/or ethinyl estradiol
- Chloramphenicol (an antibiotic used to manage bacterial infections)
- Large doses of folic acid (a vitamin supplement)
- Vitamin C supplements
- Medicines used to control blood cholesterol levels (Ex. cholestyramine or colestipol)
- Colchicine (used to manage gout)
- Para-amino salicylic acid (used to manage tuberculosis)
- Potassium chloride (used to manage low potassium levels)
- Nitrous oxide (an anesthetic)
Overdosage:
If you or anyone else accidentally take too much of MEGANERV PG 75/75MCG CAPSULE, contact your doctor immediately or go to a hospital straight away. Overdosage symptoms of MEGANERV PG 75/75MCG CAPSULE might include sleepiness, confusion, agitation, restlessness and seizures.
Synopsis
| Drug | : | Pregabalin, Methylcobalamin |
| Pharmacological Category | : | Anticonvulsants, Vitamin B complex |
| Therapeutic Indication | : | Neuropathic pain |
| Dosage Forms | : | Tablet, Capsule, Soft gels |
More Information
Storage
- Keep MEGANERV PG 75/75MCG CAPSULE out of reach of children
- Store MEGANERV PG 75/75MCG CAPSULE at room temperature
FAQs About MEGANERV PG 75/75MCG CAPSULE
Q: Can MEGANERV PG 75/75MCG CAPSULE affect fertility?
A: Fertility studies in men have shown that there were no effects on sperm motility. However, MEGANERV PG 75/75MCG CAPSULE can be associated with an increased risk of male-mediated teratogenicity (abnormalities in fetus). Men being managed with MEGANERV PG 75/75MCG CAPSULE who plan to father a child should be informed about the potential risk of male-mediated teratogenicity. There are not enough clinical data on the effects of this medicine on female fertility.
Q: Can MEGANERV PG 75/75MCG CAPSULE cause weight gain?
A: Yes, MEGANERV PG 75/75MCG CAPSULE can cause weight gain in some individuals mainly due to the formation of peripheral edema (fluid retention). Weight gain can be more prominent among diabetic patients who are managed with thiazolidinediones (Ex. pioglitazone, rosiglitazone) and so inform your doctor if you have diabetes prior to management with MEGANERV PG 75/75MCG CAPSULE as a precaution.
Q: Can MEGANERV PG 75/75MCG CAPSULE decrease libido?
A: Yes, MEGANERV PG 75/75MCG CAPSULE may cause decrease in sex drive (libido) in some individuals, although not everybody gets them. Consult your doctor if this symptom troubles you.
Q: Is MEGANERV PG 75/75MCG CAPSULE addictive?
A: Yes, MEGANERV PG 75/75MCG CAPSULE has high potential to create substance abuse or dependence and therefore caution should be exercised among patients who already has a history of substance abuse. Careful monitoring of symptoms of abuse are required in such patients.
Q: Can I stop taking MEGANERV PG 75/75MCG CAPSULE once my pain is relieved?
A: No. Do not stop taking MEGANERV PG 75/75MCG CAPSULE without consulting your doctor as it could precipitate withdrawal symptoms such as headache, lack of sleep, nausea, pain, diarrhea, flu syndrome, anxiety, nervousness, depression, convulsion, hyperhidrosis and dizziness and dependence. If your condition improves, contact your doctor so that he might reduce the dose appropriately before discontinuation of the therapy with MEGANERV PG 75/75MCG CAPSULE.
References
1. KD. Tripathi. Antiepileptic Drugs & Hematinics and Erythropoietin. Essentials of medical pharmacology. Seventh edition. 2013. Page – 420 & 608.
2. Gerald G. Briggs and Roger K. Freeman. A reference guide to fetal and neonatal risk: Drugs in Pregnancy and Lactation. Tenth Edition. 2015. Page – 3223-3225.
3. Yasmin U Dongre and Onkar C Swami. Sustained release pregabalin with Methylcobalamin in neuropathic pain: an Indian real-life experience. NCBI; PMC US National Library of Medicine, National Institute of Health. May 2013. [Accessed on 21st October 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3674019/
4. Gupta JK and Qureshi Shaiba Sana. Potential Benefits of Methylcobalamin: A Review. Austin Potential benefits of Pharmacology and Therapeutics. 2015. [Accessed on 21st October 2022] https://austinpublishinggroup.com/pharmacology-therapeutics/fulltext/ajpt-v3-id1076.php
5. Ram Prabhoo, Atul Panghate, Raj Pavitra Dewda, Balaji More, Tanay Prabhoo and Rajiv Rana. Efficacy and Tolerability of a Fixed Dose Combination of Methylcobalamin and Pregabalin in the Management of Painful Neuropathy. NCBI; PMC US National Library of Medicine, National Institute of Health. November 2012. [Accessed on 21st October 2022] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3503385/
6. Torrent Pharmaceuticals Ltd. Predgeb M OD (Pregabalin Sustained Release and Methylcobalamin Tablets). Torrentian.com. May 2017. [Accessed on 21st October 2022] https://www.torrentian.com/pisheet/Upload/PI_Sheet/1836.pdf
7. Torrent Pharmaceuticals Ltd. Pregalin M. (Pregabalin & Methylcobalamin Capsules). Torrentian.com. May 2017. [Accessed on 21st October 2022] https://www.torrentian.com/pisheet/Upload/PI_Sheet/1428.pdf
8. Cipla Ltd. Nova M Capsules (Pregabalin + Methylcobalamin). Ciplamed.com. [Revised in May 2016]. [Accessed on 21st October 2022] https://www.ciplamed.com/content/nova-m-capsules
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