Talk to your doctor before taking this medicine, if you:

• are allergic to Mecobalamin, Nortriptyline and Pregabalin or to any of the other ingredients of this medicine
• have recently had a heart attack, heart problems irregular heartbeats
• are having an operation under general anaesthetic
• have thyroid problem
• ever had epilepsy
• are diabetic
• have an enlarged prostate
• have glaucoma or raised intra-ocular pressure
• suffer from schizophrenia
• have low blood pressure
• have severe liver or kidney disease
• have suffered from urinary retention
• have suicidal thoughts
• have a history of alcoholism

• If you are pregnant or breast-feeding, think you may be pregnant or planning to have a baby, ask your doctor for advice before taking this medicine

• Consult your doctor before giving this medicine to children

• PREGABANYL NTM may produce dizziness, sleepiness and decreased concentration. You should not drive or operate complex machinery until you know whether this medicine affects your ability to perform these activities

Mecobalamin

• rash
• anorexia, nausea/vomiting and diarrhoea
• headache
• anaphylactoid reaction: decrease in blood pressure or dyspnoea, may occur
• hot sensation
• diaphoresis

Nortriptyline

• serious heart problems along with ringing in the ears, stomach cramps and clumsiness
• swelling of ankles and in severe cases of the face & tongue
• alterations in brain function (including perhaps seizures)
• blood disorders which may cause you to bruise easily, become anaemic or be unable to fight off infections
• changes in blood sugar level
• swelling of breasts & testicles in men and increase in breast size and spontaneous lactation in women
• inflamed liver (hepatitis) and liver damage
• flu like symptoms including sore throat if occurring during the first 10 weeks of treatment
• thoughts of harming or killing yourself at any time

Nortriptyline

• dry mouth, sweating, flushing, constipation, blurred vision, dizziness, nausea (feeling sick), tremors, low blood pressure when standing, headache and irregular fast heart beat
• strange body movements, concentration problems, taste problems, weakness, fatigue, decreases in libido and erectile dysfunction, tingling in arms or legs, dilation of pupils, confusion, weight gain

Pregabalin

• blurred vision, double vision
• vertigo, problems with balance, fall
• difficulties with erection
• swelling of the body including extremities
• feeling drunk, abnormal style of walking
• muscle cramp, joint pain, back pain, pain in limb

Nortriptyline

• changes in sleep patterns (including nightmares), feeling excessively happy and hyperactive, numbness, convulsions, vomiting, problems urinating (increased or decreased), rash, hives, anxiety, diarrhoea, high blood pressure, sleeplessness, increased pressure in the eyes are all uncommon side effects

Pregabalin

• loss of appetite, weight loss, low blood sugar, high blood sugar
• change in perception of self, restlessness, depression, agitation, mood swings, difficulty finding words, hallucinations, abnormal dreams, panic attack, apathy, aggression, elevated mood, mental impairment, difficulty with thinking, increase in sexual interest, problems with sexual functioning including inability to achieve a sexual climax, delayed ejaculation
• changes in eyesight, unusual eye movement, changes in vision including tunnel vision, flashes of light, jerky movements, reduced reflexes, increased activity, dizziness on standing, sensitive skin, loss of taste, burning sensation, tremor on movement, decreased consciousness, loss of consciousness, fainting, increased sensitivity to noise, feeling unwell
• heart rhythm disturbances, increased heart rate, low blood pressure, high blood pressure, changes in heartbeat, heart failure
• changes in blood and liver test results (blood creatinine phosphokinase increased, alanine amino transferase increased, aspartate aminotransferase increased, platelet count decreased, neutropaenia, increase in blood creatinine, decrease in blood potassium)
• painful menstrual periods
• coldness of hands and feet

Nortriptyline

• jaundice, weight loss, increased salivary glands, abnormal liver function, increased blood alkaline phosphatase, increased transaminase, hair loss, sensitivity to light, fever, confusional states (especially in the elderly), hallucinations

Pregabalin

• abnormal sense of smell, swinging vision, altered perception of depth, visual brightness, vision loss
• slow or reduced movement of the body
• difficulty with writing properly
• increased fluid in the abdomen
• fluid in the lungs
• convulsions
• changes in the recording of electrical changes (ECG) in the heart which correspond to heart rhythm disturbances
• muscle damage
• breast discharge, abnormal breast growth, breast growth in males
• reduced urine volume, urinary retention
• inappropriate behaviour

• hepatitis (inflammation of the liver)

NA

• Store at room temperature (15-25°C)
• Do not use this medicine after the expiry date
• Keep it out of reach of children