Cobalmax NT Tablet is a combination medicine indicated for the management of neuropathic pain associated with diabetic peripheral neuropathy, postherpetic neuralgia, spinal cord injury, etc. Neuropathic pain is a chronic progressive nerve disease which causes nerve pain due to nerve damage or a malfunctioning nervous system.

Cobalmax NT Tablet is a combination of two drugs: Pregabalin (anti-convulsant) and Nortriptyline (antidepressant). Pregabalin affects the chemicals in the brain that send pain signals across the nervous system. Nortriptyline works by increasing nerve transmitters (serotonin and noradrenaline) in the brain, thereby reducing the pain messages arriving in the brain. Together, Cobalmax NT Tablet helps to treat neuropathic pain.

In some cases, you may experience certain common side-effects such as dizziness, sleepiness, nausea, blurred vision, peripheral oedema (swelling of lower legs and hands), weight gain and dry mouth. Most of these side-effects do not require medical attention and will resolve gradually over time. However, you are advised to talk to your doctor if you experience these side-effects persistently.

Consult your doctor if you are pregnant or breastfeeding. Cobalmax NT Tablet may cause drowsiness and dizziness, so drive only if you are alert. Cobalmax NT Tablet should not be given to children as safety and effectiveness have not been established. Avoid consuming alcohol along with Cobalmax NT Tablet as it could lead to increased dizziness and sleepiness. Keep your doctor informed about your health condition and medicines to rule out any side-effects.

Cobalmax NT Tablet is a combination of two medicines, namely: Pregabalin and Nortriptyline. Cobalmax NT Tablet is indicated for the management of neuropathic pain associated with diabetic peripheral neuropathy, postherpetic neuralgia, spinal cord injury, etc. Pregabalin is an anti-convulsant which affects the chemicals in the brain that send pain signals across the nervous system. Nortriptyline is an antidepressant which works by increasing the levels of nerve transmitters (serotonin and noradrenaline) in the brain, thereby reduces the pain messages arriving in the brain. Together, Cobalmax NT Tablet helps to treat neuropathic pain (pain due to nerve damage).

• Dizziness
• Sleepiness
• Nausea
• Blurred vision
• Peripheral oedema (swelling of lower legs and hands)
• Weight gain
• Dry mouth

Do not take Cobalmax NT Tablet if you are allergic to any of its contents. Inform your doctor before taking Cobalmax NT Tablet if you have or had heart problems, bipolar syndrome, severe liver disease or if you have taken MAO inhibitors in the last 14 days. Consult your doctor before taking cough-cold medicines containing adrenaline-like drugs such as ephedrine, phenylpropanolamine, isoprenaline, noradrenaline or phenylephrine. Consult your doctor if you are pregnant or breastfeeding. Cobalmax NT Tablet may cause drowsiness and dizziness, so drive only if you are alert. Cobalmax NT Tablet should not be given to children as safety and effectiveness have not been established. Avoid consuming alcohol along with Cobalmax NT Tablet as it could lead to increased drowsiness and sleepiness.

Drug-Drug Interactions: Cobalmax NT Tablet may interact with antidepressants (amitriptyline, duloxetine, mirtazapine, fluoxetine, sertraline, citalopram, escitalopram, bupropion), pain killer (codeine, fentanyl, hydrocodone, morphine, oxycodone, tramadol, acetaminophen), anti-convulsant (gabapentin, phenobarbital, phenytoin, clonazepam, topiramate), anti-anxiety (diazepam, alprazolam), sedative-hypnotics (zolpidem), antihistamine (diphenhydramine, cetirizine), muscle relaxant (cyclobenzaprine), antiemetic (ondansetron).

Drug-Food Interactions: Avoid alcohol consumption while taking Cobalmax NT Tablet as it might cause increased drowsiness and sleepiness.

Drug-Disease Interactions: Inform your doctor if you have angioedema, creatine kinase elevations, heart problems, depression, fits, pheochromocytoma (tumour of the adrenal gland), bone marrow suppression, tardive dyskinesia (involuntary facial movements), glaucoma, schizophrenia, bipolar disorder, thyroid problems, urinary retention, kidney and liver problems.

• AMITRIPTYLINE
• DULOXETINE
• MIRTAZAPINE
• FLUOXETINE
• SERTRALINE
• CITALOPRAM
• ESCITALOPRAM
• BUPROPION
• CODEINE
• FENTANYL
• HYDROCODONE
• MORPHINE
• ACETAMINOPHEN
• TRAMADOL
• OXYCODONE
• GABAPENTIN
• PHENOBARBITAL
• PHENYTOIN
• CLONAZEPAM
• TOPIRAMATE
• DIAZEPAM
• ALPRAZOLAM
• ZOLPIDEM
• DIPHENHYDRAMINE
• CETIRIZINE
• CYCLOBENZAPRINE
• ONDANSETRON

• Include food rich in vitamin B and D in your diet.
• Include cayenne pepper in your diet as it can help in lowering neuropathic pain.
• Exercising regularly helps in improving overall health and combating pain.
• Rest well, get plenty of sleep.
• Try taking a warm bath as it can be soothing.
• Avoid smoking and alcohol consumption.
• Meditation and yoga can help lower the stress, decrease pain sensitivity and improves coping skills.
• Acupuncture can be helpful by stimulating pressure points.
• Using essential oils for massages can help increase circulation.

• Cobalmax NT Tablet contains Nortriptyline which may cause suicidal thoughts. People taking Cobalmax NT Tablet should be closely monitored for suicidal thoughts or behaviour. Do not be reluctant to speak with your doctor immediately if you experience suicidal tendencies.

Neuropathic pain: Neuropathic pain is caused due to damaged sensory nerves. It is caused by chronic progressive nerve disease, infection or injury. The pain could be intermittent or continuous, which is felt as a prickling, stabbing, tingling or burning sensation. A feeling of numbness and loss of sensations is also common with neuropathic pain. Usually, the body sends the pain signals when there is an injury, but with neuropathic pain, the pain is not triggered by an injury; the body unpromptedly sends the pain signals. Symptoms include spontaneous, untriggered pain, unpleasant feeling, shooting, burning or stabbing pain, difficulty resting or sleeping and evoked pain (pain caused by events usually not painful).