This combination contains pregabalin and nortriptyline which are used to treat neuropathic pain associated with different activities. tricyclic antidepressants do not inhibit uptake of other neurotransmitters such as dopamine and monoamine oxidase enzymes. Nortriptyline also exhibit the antimuscarinic actions by binding with the acetylcholine receptors. pregabalin is not very lipophilic and its absorption is decreased by food intake, pregabalin does not modulate the activity of serotonin, dopamine etc.

Therapeutic Indication
Treats neuropathic pain associated with fibromyalgia, diabetic neuropathy, spinal cord injury.

About Composition
Pregabalin has similar structure to the inhibitory neurotransmitter i.e. Gaba (Gama amino butyric acid) and is commonly used in the treatment of neuropathic pain.
Nortriptyline belongs to the category of tricyclic antidepressants drugs. It helps to mainly treats depression but it is also used to treat chronic pain, irritatable bowel syndrome.

Mechanism of Action
Pregabalin binds to the alpha-2 subunits of the voltage gated calcium channels present in central nervous system.
Nortriptyline prevents the reuptake process at the neuronal synapse junction of serotonin and nor-adrenergic receptors.

Pharmacokinetics

Pregabalin:
It is absorbed orally
It does not show any protein binding
It is 2% metabolized in the liver
It is excreted unchanged in the urine

Nortriptyline:
It is absorbed orally
It is 93% bound to plasma proteins
It undergoes demethylation and hydroxylation
It is excreted via urine

Side Effects
● Constipation
● Difficulty in urination
● Weight gain
● Sleepiness
● Blurred vision
● Dryness of mouth

Contraindication
● Contraindicated in depression
● Contraindicated in lung disorders

Precaution
Do not use grapefruit with this combination

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