Neurexal is a prescription medication containing the active ingredient pregabalin. Pregabalin belongs to a class of drugs called anticonvulsants, but Neurexal is also used to treat certain types of pain and anxiety disorders. This comprehensive guide aims to provide in-depth information about Neurexal, including its uses, potential benefits, and possible side effects.
What is Neurexal and What Does It Treat?
What is Neurexal?
Neurexal is a brand name for the medication pregabalin. Neurexal is available in capsule form in various strengths, including 25mg, 75mg, 150mg, and 300mg. It works by affecting the way nerve signals are transmitted in the brain and spinal cord.
What Conditions Does Neurexal Treat?
Neurexal is prescribed for the treatment of three main conditions:
- Peripheral and Central Neuropathic Pain: This type of chronic pain arises from damage to the nerves. Various conditions, such as diabetes or shingles (herpes zoster), can cause neuropathic pain. The pain is often described as burning, tingling, stabbing, shooting, or a feeling of numbness. Neurexal helps to reduce these pain signals, providing relief and improving the quality of life for patients.
- Epilepsy: Specifically, Neurexal is used as an add-on therapy to treat partial seizures with or without secondary generalisation in adults. This means it is used alongside other anti-epileptic medications when the current treatment is not effectively controlling seizures.
- Generalised Anxiety Disorder (GAD): GAD is characterised by persistent and excessive anxiety and worry that are difficult to control. Neurexal can help manage the symptoms of GAD, such as restlessness, fatigue, difficulty concentrating, irritability, muscle tension, and sleep disturbances. It is important to distinguish GAD from normal everyday stress and anxiety.
Pregabalin: What You Need to Know
Important Information Before Taking Neurexal
Before starting Neurexal, it’s crucial to be aware of potential contraindications and precautions:
Who Should Not Take Neurexal?
- Individuals with a known allergy to pregabalin or any of the inactive ingredients in Neurexal should not take this medication.
Warnings and Precautions:
- Allergic Reactions: Some patients have reported allergic reactions to Neurexal, with symptoms such as swelling of the face, lips, tongue, and throat, as well as skin rashes. If you experience any of these symptoms, seek immediate medical attention.
- Dizziness and Somnolence: Neurexal can cause dizziness and drowsiness, which may increase the risk of accidental falls, especially in elderly patients. Be cautious and avoid activities requiring alertness until you know how the medication affects you.
- Vision Changes: Neurexal may cause temporary or, in some cases, permanent vision changes, such as blurred vision, double vision, or loss of vision. Report any vision changes to your doctor immediately.
- Diabetes: Patients with diabetes who experience weight gain while taking Neurexal may need adjustments to their diabetes medications.
- Spinal Cord Injury: Individuals with spinal cord injuries may experience more pronounced side effects, such as sleepiness, due to interactions with other medications they are taking.
- Heart Failure: Neurexal has been associated with heart failure in some patients, particularly elderly individuals with pre-existing cardiovascular conditions. If you have a history of heart disease, inform your doctor before taking Neurexal.
- Kidney Failure: Kidney failure has been reported in some patients taking Neurexal. If you notice a decrease in urination, contact your doctor, as stopping the medication may improve this.
- Suicidal Thoughts: A small number of individuals taking anti-epileptic medications like Neurexal have reported thoughts of harming or killing themselves. If you experience such thoughts, seek immediate medical help.
- Gastrointestinal Problems: When Neurexal is taken with other medications that can cause constipation (e.g., certain pain relievers), gastrointestinal problems like constipation or bowel obstruction may occur. Inform your doctor if you experience constipation, particularly if you are prone to this issue.
- Alcoholism and Drug Dependence: If you have a history of alcoholism or drug dependence, it’s important to inform your doctor before starting Neurexal.
- Convulsions: Convulsions have been reported in some patients while taking Neurexal or shortly after stopping the medication. If you experience a convulsion, contact your doctor immediately.
- Encephalopathy: In some cases, Neurexal has been linked to reduced brain function (encephalopathy) in patients with other medical conditions. If you have a history of any serious medical conditions, including liver or kidney disease, inform your doctor before taking Neurexal.
- Breathing Difficulties: Neurexal can cause breathing difficulties in some patients. If you have nervous system disorders, respiratory disorders, kidney impairment, or are over 65, your doctor may recommend a different dosing regimen. Contact your doctor if you experience trouble breathing or shallow breaths.
How to Take Neurexal
Your doctor will determine the appropriate dose of Neurexal based on your individual condition and needs.
Dosage:
- The typical dose of Neurexal ranges from 150mg to 600mg per day.
- Your doctor may prescribe Neurexal to be taken either twice a day (morning and evening) or three times a day (morning, afternoon, and evening).
- It is essential to take Neurexal exactly as prescribed by your doctor.
- If you feel the effect of Neurexal is too strong or too weak, consult your doctor or pharmacist.
Administration:
- Neurexal is for oral use only.
- Swallow the capsules whole with water.
- Take Neurexal at approximately the same time each day to maintain a consistent level of medication in your body.
Elderly Patients:
- Elderly patients (over 65 years of age) generally take Neurexal at the same dosage as younger adults, unless they have kidney problems. Your doctor may adjust the dosage or frequency based on your kidney function.
What to Do If You:
- Miss a Dose: Take the missed dose as soon as you remember, unless it is almost time for your next scheduled dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed dose.
- Take More Than Prescribed: If you accidentally take more Neurexal than prescribed, contact your doctor or go to the nearest hospital emergency department immediately. Take the box of Neurexal capsules with you. Overdose symptoms may include sleepiness, confusion, agitation, restlessness, and seizures.
- Want to Stop Taking Neurexal: Do not stop taking Neurexal without consulting your doctor. Abruptly stopping the medication can lead to withdrawal symptoms. Your doctor will guide you on how to gradually discontinue Neurexal over a minimum of one week. Potential withdrawal symptoms may include trouble sleeping, headache, nausea, anxiety, diarrhoea, flu-like symptoms, convulsions, nervousness, depression, pain, sweating, and dizziness.
Possible Side Effects of Neurexal
Like all medications, Neurexal can cause side effects. It is important to note that not everyone experiences side effects, and the severity can vary from person to person. Here are some of the possible side effects of Neurexal, categorised by their frequency:
Very Common Side Effects (May Affect More Than 1 in 10 People):
- Dizziness
- Drowsiness
- Headache
Common Side Effects (May Affect Up to 1 in 10 People):
- Increased appetite
- Feeling of elation
- Confusion
- Disorientation
- Decreased sexual interest
- Irritability
- Disturbance in attention
- Clumsiness
- Memory impairment
- Loss of memory
- Tremor
- Difficulty speaking
- Tingling sensation
- Numbness
- Sedation
- Lethargy
- Insomnia
- Fatigue
- Feeling abnormal
- Blurred vision
- Double vision
- Vertigo
- Problems with balance
- Falls
- Dry mouth
- Constipation
- Vomiting
- Flatulence
- Diarrhoea
- Nausea
- Swollen abdomen
- Difficulties with erection
- Swelling of the body, including extremities
- Feeling drunk
- Abnormal walking style
- Weight gain
- Muscle cramps
- Joint pain
- Back pain
- Pain in limb
- Sore throat
Uncommon Side Effects (May Affect Up to 1 in 100 People):
- Loss of appetite
- Weight loss
- Low blood sugar
- High blood sugar
- Changes in perception of self
- Restlessness
- Depression
- Agitation
- Mood swings
- Difficulty finding words
- Hallucinations
- Abnormal dreams
- Panic attacks
- Apathy
- Aggression
- Elevated mood
- Mental impairment
- Difficulty thinking
- Increase in sexual interest
- Problems with sexual functioning including inability to achieve a sexual climax
- Delayed ejaculation
- Changes in eyesight
- Unusual eye movements
- 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
- Dry eyes
- Eye swelling
- Eye pain
- Weak eyes
- Watery eyes
- Eye irritation
- Heart rhythm disturbances
- Increased heart rate
- Low blood pressure
- High blood pressure
- Changes in heartbeat
- Heart failure
- Flushing
- Hot flushes
- Difficulty breathing
- Dry nose
- Nasal congestion
- Increased saliva production
- Heartburn
- Numbness around the mouth
- Sweating
- Rash
- Chills
- Fever
- Muscle twitching
- Joint swelling
- Muscle stiffness
- Pain including muscle pain, neck pain
- Breast pain
- Difficulty with or painful urination
- Incontinence
- Weakness
- Thirst
- Chest tightness
- Changes in blood and liver test results
- Hypersensitivity
- Swollen face
- Itchiness
- Hives
- Runny nose
- Nosebleed
- Cough
- Snoring
- Painful menstrual periods
- Coldness of hands and feet
Rare Side Effects (May Affect Up to 1 in 1,000 People):
- Abnormal sense of smell
- Swinging vision
- Altered perception of depth
- Visual brightness
- Vision loss
- Dilated pupils
- Cross eyes
- Cold sweats
- Tightness of the throat
- Swollen tongue
- Inflammation of the pancreas
- Difficulty swallowing
- Slow or reduced body movement
- Difficulty 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
- Interrupted menstrual periods
- Kidney failure
- Reduced urine volume
- Urinary retention
- Decrease in white blood cell count
- Inappropriate behaviour
- Allergic reactions (which may include difficulty breathing, inflammation of the eyes (keratitis) and a serious skin reaction characterized by rash, blisters, peeling skin and pain
- Jaundice (yellowing of the skin and eyes)
Very Rare Side Effects (May Affect Up to 1 in 10,000 People):
- Liver failure
- Hepatitis (inflammation of the liver)
Important Note: Some side effects, such as sleepiness, may be more common in patients with spinal cord injuries who are taking other medications to treat pain or spasticity. This is because these medications may have similar side effects to Neurexal, and the effects can be intensified when taken together.
If you experience any side effects, including those not listed here, consult your doctor or pharmacist. Reporting side effects helps gather more information on the safety of this medicine.
How to Store Neurexal
Proper storage ensures the effectiveness and safety of Neurexal:
- Keep Neurexal out of sight and reach of children.
- Do not use Neurexal after the expiry date printed on the blister pack and outer packaging.
- Store Neurexal below 30°C and keep away from humidity.
- Do not use Neurexal if you notice any visible signs of deterioration, such as discolouration or capsule damage.
- Dispose of unused Neurexal properly. Do not throw medications in the wastewater. Ask your pharmacist for guidance on safe medication disposal methods.
Neurexal and Other Medications
It is crucial to inform your doctor about all other medications you are taking, including prescription drugs, over-the-counter medicines, herbal supplements, and vitamins, before starting Neurexal. Some medications can interact with Neurexal, potentially leading to adverse effects:
- Potential for Drug Interactions: Neurexal can interact with certain medications and may increase the risk of serious side effects, including respiratory failure and coma.
- Increased Side Effects: Neurexal may potentiate the effects of certain drugs, such as oxycodone (a pain reliever) and lorazepam (used for treating anxiety).
- Alcohol Interaction: Alcohol can also intensify the side effects of Neurexal. It is advisable to avoid alcohol consumption while taking this medication.
- Oral Contraceptives: Neurexal can be taken safely with oral contraceptives.
Neurexal and Lifestyle
Here’s how Neurexal might interact with certain lifestyle factors:
Food and Drink:
- Neurexal can be taken with or without food.
- Avoid drinking alcohol while taking Neurexal as it can increase the risk of side effects.
Pregnancy and Breastfeeding:
- Neurexal is generally not recommended during pregnancy or breastfeeding unless specifically advised by your doctor.
- Women of child-bearing potential should use effective contraception while taking Neurexal.
- If you become pregnant, think you may be pregnant, or are planning to become pregnant while taking Neurexal, inform your doctor immediately.
Driving and Using Machines:
- Neurexal can cause dizziness, sleepiness, and decreased concentration. It’s essential to avoid driving, operating complex machinery, or engaging in other potentially hazardous activities until you know how the medication affects your ability to perform these tasks safely.
Conclusion
Neurexal can be an effective treatment for neuropathic pain, epilepsy, and generalised anxiety disorder. However, like any medication, it is important to be aware of potential side effects and precautions. Always consult with your doctor before starting Neurexal or making any changes to your medication regimen.
Remember, this blog post is intended for informational purposes only and should not be considered a substitute for professional medical advice. If you have any concerns or questions about Neurexal, please consult your doctor or pharmacist.
Call to Action
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Dr. Ahmad Baker, PharmD
Senior Pharmacist & Health Educator
With over 23 years of clinical experience in hospital and community pharmacy across Egypt and Saudi Arabia, Dr. Ahmad specializes in reproductive health and pharmaceutical safety. He is dedicated to providing evidence-based guidance to empower patients in the MENA region.
Medical Disclaimer: This content is for educational purposes and reflects the latest pharmaceutical protocols. It is not a substitute for personal medical advice. Always consult Dr. Ahmad Baker or your healthcare provider before starting any treatment.