Nurogesic B Special Precautions

Pregabalin is eliminated from the systemic circulation primarily by renal excretion as unchanged drug. As Pregabalin clearance is directly proportional to creatinine clearance, dose reduction in patients with compromised renal function must be individualized according to creatinine clearance. Some diabetic patients who gain weight on Pregabalin treatment may need to adjust hypoglycemic medicinal products.
Pregabalin should be discontinued immediately if symptoms of hypersensitivity such as angioedema, such as facial, perioral, or upper airway swelling occur.
Pregabalin treatment has been associated with dizziness and somnolence, which could increase the occurrence of accidental injury (fall) in the elderly population. Therefore, patients should be advised to exercise caution until they are familiar with the potential effects of the medicinal product.
Pregabalin may cause blurred vision in some patients. Discontinuation of Pregabalin may result in resolution or improvement of these visual symptoms.
In the treatment of central neuropathic pain due to spinal cord injury the incidence of adverse reactions in general, central nervous system adverse reactions and especially somnolence was increased. This may be attributed to an additive effect due to concomitant medicinal products (e.g. anti-spasticity agents) needed for this condition. This should be considered when prescribing Pregabalin in this condition.
Dose adjustment in patients with reduced renal function or undergoing hemodialysis is necessary. Vitamin B₁₂ supplementation can mask folate deficiency. In such patients, folate supplementation may be needed.
Effects on Ability to Drive: Pregabalin may cause dizziness and somnolence and therefore may influence the ability to drive or use machines. Patients are advised not to drive, operate complex machinery or engage in other potentially hazardous activities until it is known whether Pregabalin + Methylcobalamin capsule affects their ability to perform these activities.
Use in Children: Safety of Pregabalin + Methylcobalamin has not been established in children.