Pregabalin (75mg) + Methylcobalamin (1500mcg) + Vitamin B6 (Pyridoxine) (3mg) + Folic Acid (5mg) (Medical Monograph)

Overview

A fixed-dose combination (FDC) medication primarily indicated for the management of neuropathic pain, particularly diabetic peripheral neuropathy (DPN) and post-herpetic neuralgia (PHN), with adjunctive neurotropic B vitamins. Pregabalin is a gabapentinoid that modulates calcium channels to reduce neuronal excitability, while Methylcobalamin, Pyridoxine, and Folic Acid support nerve health, myelin synthesis, and homocysteine metabolism, potentially offering a synergistic effect in neuropathic conditions prevalent in the Indian population.

Pregabalin binds with high affinity to the alpha2-delta subunit of voltage-gated calcium channels in the central nervous system, reducing calcium influx and subsequent release of excitatory neurotransmitters (e.g., glutamate, substance P). This dampens neuronal hyperexcitability, the hallmark of neuropathic pain. Methylcobalamin is essential for myelin synthesis and maintenance of neuronal integrity. Pyridoxine is a cofactor in neurotransmitter synthesis (GABA, serotonin). Folic Acid, along with B12, is crucial for homocysteine metabolism; elevated homocysteine is implicated in neurovascular damage in diabetes.