Usage of Medigab NT
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Diabetic peripheral neuropathy
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Post-herpetic neuralgia
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Sciatica and radiculopathy
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Fibromyalgia
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Chronic low back pain with neuropathic features
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Trigeminal neuralgia
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Chemotherapy-induced neuropathic pain
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Painful polyneuropathy (alcoholic, HIV-related, etc.)
Common Side Effects
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Pregabalin-related: Dizziness, somnolence, blurred vision, weight gain, dry mouth
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Nortriptyline-related: Constipation, dry mouth, sedation, orthostatic hypotension
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Others: Fatigue, mild cognitive impairment, edema in lower limbs
These effects are generally dose-dependent and improve with continued use or dose adjustment.
Precautions
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Use with caution in elderly patients—start with lower doses
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Avoid abrupt discontinuation—taper gradually to prevent withdrawal symptoms
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Avoid in angle-closure glaucoma, cardiac arrhythmias, or severe hepatic impairment
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Pregnancy Category C – not recommended unless benefit outweighs risk
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May impair ability to operate machinery or drive
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Monitor for suicidal ideation, especially in early treatment phase
Drug Interactions
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CNS depressants (e.g., alcohol, benzodiazepines): Additive sedative effect
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Anticholinergics: Potentiate nortriptyline side effects (dry mouth, constipation)
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MAO inhibitors: Contraindicated with nortriptyline
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SSRIs/SNRIs: May increase risk of serotonin syndrome (rare)
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Diuretics or NSAIDs: Caution due to edema with Pregabalin
Dosage and Administration
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Once or twice daily, preferably after meals to minimize gastric discomfort
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Typically started at night to minimize sedation during the day
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Dose titration may be done based on patient tolerance and response
Storage
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Store in a cool, dry place below 25°C
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Protect from light and moisture
Patient Counselling Tips
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May cause drowsiness—avoid alcohol and driving until you know how it affects you
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Take at the same time each day to maintain consistent levels
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Report symptoms like palpitations, mood changes, or swelling
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Do not stop medication abruptly—tapering is required
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Benefits on pain and sleep may take 1–2 weeks to be noticeable
