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Acwak-N Tablet SR is a combination medicine used to manage diabetic neuropathy, neuropathic pain, and nutritional deficiencies. This medicine works by altering the nerve signals that cause pain and thereby protects nerve fibres. It helps provide a protective effect on the nerve tissues and the brain. You may experience common side effects like nausea, vomiting, diarrhoea, stomach upset, dizziness, and rash.
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Written By Bayyarapu Mahesh Kumar , M Pharmacy
Reviewed By Santoshini Reddy G , M Pharmacy
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More about the Product

Composition :

METHYLCOBALAMIN-1500MG+NORTRIPTYLINE-10MG+PREGABALIN-75MG

Consume Type :

Oral

Expires on or after :

Dec-28

Return Policy :

Not Returnable

About Acwak-N Tablet SR

Acwak-N Tablet SR is a combination medicine indicated to manage neuropathic pain associated with diabetic peripheral neuropathy and postherpetic neuralgia. Neuropathic pain is a chronic progressive nerve disease that causes nerve pain due to nerve damage or a malfunctioning nervous system. Symptoms include spontaneous, untriggered pain, unpleasant feeling, shooting, burning or stabbing pain, and evoked pain (pain caused by events usually not painful).

Acwak-N Tablet SR is a combination of three drugs: Methylcobalamin (vitamin), Nortriptyline (antidepressant), and Pregabalin (anti-convulsant). Methylcobalamin is a vitamin that aids in producing myelin, a substance that protects nerve fibres and regenerates damaged nerve cells. Nortriptyline works by increasing nerve transmitters (serotonin and noradrenaline) in the brain, thereby reducing the pain messages arriving in the brain. Pregabalin reduces pain by interfering with pain messages travelling through the brain and down the spine. Together, Acwak-N Tablet SR helps to treat neuropathic pain.

Take Acwak-N Tablet SR as prescribed. Based on your medical condition, your doctor will decide the dose and duration. In some cases, Acwak-N Tablet SR may cause dizziness, sleepiness, nausea, blurred vision, peripheral oedema (swelling of the lower legs and hands), weight gain, and dry mouth. The majority of these side effects do not necessitate medical attention and will subside gradually over time. However, if you are experiencing these side effects regularly, you should consult your doctor.

Please do not take Acwak-N Tablet SR if you are allergic to any of its ingredients. Consult your doctor before taking Acwak-N Tablet SR if you are pregnant or breastfeeding. Acwak-N Tablet SR may cause drowsiness and dizziness, so drive only if you are alert. Acwak-N Tablet SR should not be given to children as safety and effectiveness have not been established. Avoid consuming alcohol along with Acwak-N Tablet SR 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.

Uses of Acwak-N Tablet SR

Acwak-N Tablet SR is used in the treatment of Neuropathic pain. The detailed uses of Acwak-N Tablet SR are as follows:

  • Neuropathic Pain: Acwak-N Tablet SR is used to treat diabetic neuropathy, post-herpetic neuralgia (shingles), sciatica, and spinal cord injuries.
  • Fibromyalgia: Acwak-N Tablet SR helps manage widespread pain and fatigue.
  • Peripheral Neuropathy: Acwak-N Tablet SR supports nerve repair and reduces tingling, numbness, and burning sensations.
  • Chronic Pain Syndromes: Acwak-N Tablet SR is used to treat pain, including lower back pain and migraine prevention.

Key Benefits

Acwak-N Tablet SR is a combination of three drugs: Methylcobalamin (a form of vitamin B), Nortriptyline (antidepressant), and Pregabalin (anti-convulsant). Acwak-N Tablet SR is indicated for the management of neuropathic pain associated with diabetic peripheral neuropathy, postherpetic neuralgia, spinal cord injury, etc. Methylcobalamin aids in producing myelin, a substance that protects nerve fibres and regenerates damaged nerve cells. Nortriptyline works by increasing nerve transmitters (serotonin and noradrenaline) in the brain, thereby reducing the pain messages arriving in the brain. Pregabalin reduces pain by interfering with pain messages travelling through the brain and down the spine. Together, Acwak-N Tablet SR helps to treat neuropathic pain.

Directions for Use

  • Take Acwak-N Tablet SR with or without food or as advised by a doctor.
  • Follow your doctor's instructions on the dosage and timing of this medication, to ensure the safety.
  • Swallow the medicine as a whole with a glass of water.
  • Do not crush, break, or chew it.

How Acwak-N Tablet SR Works

Acwak-N Tablet SR contains three active ingredients that work together to target nerve pain and support nerve recovery from different angles: Pregabalin acts as a nerve-calming agent. It binds to specific areas in your brain and spinal cord to reduce the release of excess chemical pain signals, quieting overactive nerves. Nortriptyline is a chemical messenger booster. It increases the levels of natural pain-blocking chemicals, such as serotonin and norepinephrine, in your central nervous system, stopping pain signals from reaching the brain. Methylcobalamin helps produce myelin, the protective outer coating that surrounds and insulates your nerves. By repairing this protective sheath, it helps restore healthy nerve function and reduces abnormal numbness and tingling.
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Alcohol

Unsafe

Avoid consumption of alcohol while taking Acwak-N Tablet SR as it may increase drowsiness and sleepiness.

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Pregnancy

Caution

If you're pregnant, don't take Acwak-N Tablet SR unless your doctor tells you to. Please consult your doctor if you have any concerns about this; your doctor will only prescribe if the benefits outweigh the risks.

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Breast Feeding

Caution

Consult your doctor as there is no substantial research yet on the use of Acwak-N Tablet SR in breastfeeding/nursing mothers.

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Driving

Unsafe

Acwak-N Tablet SR causes drowsiness, sleepiness and blurred vision. Do not drive or operate machinery unless you are alert.

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Liver

Caution

Dose adjustment may be needed in patients with liver impairment. Please consult your doctor if you have a liver impairment or any concerns regarding this. Your doctor will prescribe only if the benefits outweigh the risks.

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Kidney

Caution

Dose adjustment may be needed in patients with kidney impairment. Please consult your doctor if you have kidney impairment or any concerns regarding this. Your doctor will prescribe only if the benefits outweigh the risks.

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Children

Unsafe

Acwak-N Tablet SR should not be given to children as the safety and efficacy have not been established.

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Heart

Caution

Please inform your doctor if you have a history of heart disease before using Acwak-N Tablet SR. Your doctor will prescribe it only if the benefits outweigh the risks.

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Geriatrics

Caution

Acwak-N Tablet SR should be given with caution in elderly patients due to an increased risk of side effects. Please consult your doctor before using Acwak-N Tablet SR.

What if I have taken an overdose of Acwak-N Tablet SR

If you suspect an overdose, seek immediate medical attention or contact a local poison control centre. Symptoms of an overdose may include extreme drowsiness, confusion, rapid heartbeat, or severe dizziness.

Diet & Lifestyle Advise

  • Manage Blood Sugar Levels: If you have diabetes, keeping your blood sugar within your target range is crucial to prevent further nerve damage.
  • Eat a Balanced Diet: Focus on foods rich in B-complex vitamins, such as leafy green vegetables, eggs, lean meats, and whole grains, to support nerve health.
  • Stay Physically Active: Engage in low-impact exercises like walking, swimming, or cycling to improve blood circulation to your nerves and reduce chronic pain.
  • Inspect Your Feet Daily: Nerve damage can reduce your ability to feel pain, so check your feet daily for cuts, blisters, or infections that you might not otherwise feel.
  • Avoid Alcohol: Limit or completely avoid alcohol, as it can worsen nerve damage and significantly increase the drowsy side effects of Acwak-N Tablet SR.
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How Soon It Starts Working

The time required for Acwak-N Tablet SR to start to work: The time required for Acwak-N Tablet SR to show its action is unknown. The time for which the effects of Acwak-N Tablet SR last: The duration of action for Acwak-N Tablet SR is clinically unknown.

What if you forget to take Acwak-N Tablet SR

If you miss a dose, take it as soon as you remember. However, if it is almost time for your next scheduled dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one.

Storage

• Store in a cool and dry place away from sunlight. • Keep Acwak-N Tablet SR out of the sight and reach of children. • Non cold chain - To be stored in cool places at 10ºC to 25ºC or below 30ºC.

Drug Warnings

  • Avoid driving: Do not drive, operate machinery, or perform tasks requiring deep focus until you know how Acwak-N Tablet SR affects your alertness, as it commonly causes drowsiness and dizziness.
  • Do not stop suddenly: Never stop taking Acwak-N Tablet SR suddenly. Stopping abruptly can cause withdrawal symptoms such as nausea, headaches, anxiety, or a return of your nerve pain. Your doctor will help you by gradually decreasing dose levels over time.
  • Do not drink alcohol: Avoid drinking alcohol while taking this medicine, as the combination can lead to dangerous sedation, severe dizziness, and slowed breathing.
  • Let your doctor know: Inform your dentist, surgeon, or any medical specialist that you are taking Acwak-N Tablet SR before undergoing any surgical or dental procedures.
  • Monitor your mental health closely: If you, your family, or your caregivers notice sudden changes in your mood, severe anxiety, depression, or suicidal thoughts, contact your healthcare provider immediately.
  • Children and adolescents: This medicine is generally intended for adults. Its safety and effectiveness in children and adolescents have not been established for most nerve pain conditions, so it should only be used in younger patients if specifically prescribed and closely monitored by a specialist.

verifiedApollotooltip
  • Sedatives and Sleep Medicines: Taking Acwak-N Tablet SR with sleeping pills, tranquillisers, or muscle relaxants can cause extreme drowsiness and dangerous breathing difficulties.
  • Monoamine Oxidase Inhibitors (MAOIs): Do not take Acwak-N Tablet SR with MAO inhibitors (used to treat depression or Parkinson's disease) or within 14 days of stopping an MAOI. Combining these medicines can cause serious, potentially life-threatening reactions, including dangerously high blood pressure, fever, or changes in mental status.
  • Strong Pain Relievers: Combining this medicine with opioid pain medications can increase the risk of severe sleepiness, slowed breathing, and profound sedation.
  • Heart and Blood Pressure Medications: Some drugs used to manage heart rhythms or high blood pressure may interact with Acwak-N Tablet SR, increasing the risk of an irregular heartbeat.

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verifiedApollotooltip
  • Alcohol: Must be completely avoided, as it severely interacts with Acwak-N Tablet SR to cause extreme drowsiness, dizziness, and loss of physical coordination.
  • Grapefruit Juice: May alter how your body breaks down and processes the medicine, potentially increasing the risk of side effects.

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All Substitutes & Brand Comparisons

Habit Forming

No

Therapeutic Class

[MISCELLANEOUS]

FAQs

Acwak-N Tablet SR is used to treat neuropathic pain associated with diabetic peripheral neuropathy and postherpetic neuralgia.
Acwak-N Tablet SR contains Methylcobalamin, Nortriptyline, and Pregabalin. Methylcobalamin aids in producing myelin, a substance that protects nerve fibres and regenerates damaged nerve cells. Nortriptyline alters the way nerves receive pain signals, thereby decreasing pain. Pregabalin reduces pain by interfering with pain messages travelling through the brain and down the spine. Together, Acwak-N Tablet SR helps to treat neuropathic pain.
Dry mouth could be a side-effect of Acwak-N Tablet SR. Limiting caffeine intake, avoiding smoking and mouthwashes containing alcohol, drinking water regularly and chewing sugar-free gum/candy might stimulate saliva and prevent drying of the mouth.
Do not stop taking Acwak-N Tablet SR without consulting your doctor, as this could result in withdrawal symptoms. Continue taking Acwak-N Tablet SR for as long as prescribed to treat your condition effectively. If you experience any difficulty while taking Acwak-N Tablet SR, do not be afraid to speak with your doctor.
Acwak-N Tablet SR is used to treat diabetic neuropathy. Diabetic neuropathy is a condition that causes nerve damage due to high blood glucose levels. It primarily affects the nerves in the legs and feet.
Acwak-N Tablet SR may cause peripheral oedema. The swelling of the hands and lower legs are known as peripheral oedema. If you experience oedema, avoid sitting or standing for extended periods. Raise your legs by laying down and placing a pillow under them.
Acwak-N Tablet SR is not a painkiller. However, it is a combination medicine used to manage neuropathic pain, particularly in conditions like diabetic peripheral neuropathy and postherpetic neuralgia.
The common side effects of Acwak-N Tablet SR include sleepiness, dizziness, nausea, blurred vision, peripheral oedema (swelling of the lower legs and hands), weight gain, and dry mouth. Most of these side effects do not require medical attention and gradually resolve over time. However, please consult the doctor if these symptoms persist or worsen.
Acwak-N Tablet SR is a medication combination consisting of Methylcobalamin (Vitamin B12), Nortriptyline (Tricyclic Antidepressant), and Pregabalin (Anticonvulsant), commonly prescribed for managing neuropathic pain and nerve damage.
To manage weight gain associated with Acwak-N Tablet SR, maintain a balanced diet rich in fibre and protein while avoiding processed and sugary foods. Engage in regular physical activity, including cardio and strength training, to boost your metabolism. Monitor your weight and consult your doctor if you notice any significant changes.
Yes, Acwak-N Tablet SR may cause sleepiness or dizziness as a common side effect. Therefore, avoid driving or operating heavy machinery unless you are fully alert.
Acwak-N Tablet SR may affect sexual health in some individuals. It may cause side effects such as reduced libido, erectile dysfunction, or difficulty achieving orgasm, mainly due to Nortriptyline and Pregabalin affecting neurotransmitters and nerve function. Please consult the doctor for guidance or alternative treatment options if you experience any changes in your sexual health.
Acwak-N Tablet SR is generally well tolerated, but in very rare cases, it may cause allergic reactions, such as rash, itching, or swelling, and breathing difficulties, especially in individuals with pre-existing lung conditions or when combined with CNS depressants.
Acwak-N Tablet SR starts working as soon as you begin taking it. However, it may take a few weeks to show its complete effects. Therefore, continue taking it as prescribed by the doctor, and please consult your doctor if you have any concerns.
If you forget a dose of Acwak-N Tablet SR, take it as soon as you remember. However, if it's almost time for your next dose, skip the missed one and continue with your regular dosing schedule. Do not double the dose.
If you accidentally overdose on Acwak-N Tablet SR, seek immediate medical attention. Overdose symptoms can be severe and include drowsiness, confusion, vision problems, dizziness, irregular heartbeat, low blood pressure, convulsions, and breathing difficulties. In extreme cases, an overdose can lead to coma or even life-threatening complications. Call your doctor or emergency services right away for urgent treatment.
No, taking a higher dose of Acwak-N Tablet SR than recommended will not necessarily be more effective and may increase the risk of serious side effects. Always follow the dosage instructions provided by your doctor or pharmacist.
Avoid consuming alcohol while taking Acwak-N Tablet SR as it may increase drowsiness or sleepiness. Avoid driving or operating heavy machinery until you know how the medication affects you. Avoid taking other medicines, including herbal supplements and OTC medications, without a doctor’s advice.
While taking Acwak-N Tablet SR, your doctor may recommend regular check-ups based on your medical condition to monitor your response, adjust dosages, and manage potential side effects. Please consult your doctor immediately if you experience any changes in your condition.
Acwak-N Tablet SR should be stored in a cool and dry place, away from sunlight. Keep it out of sight and reach of children.
No, you should avoid alcohol while taking this medicine. Alcohol significantly increases drowsiness, dizziness, and the risk of severe breathing difficulties. Talk to your doctor.
Acwak-N Tablet SR is generally not recommended during pregnancy unless your doctor decides that the benefits outweigh the potential risks to the baby. If you suspect you are pregnant, consult your healthcare provider immediately. Talk to your doctor.
Yes, some patients experience weight gain or an increased appetite while taking this medicine. Managing your diet and staying physically active can help control your weight. Talk to your doctor.
No. Acwak-N Tablet SR helps relieve nerve pain and may support nerve health through its methylcobalamin component, but it does not permanently cure the underlying cause of nerve damage. Managing the condition causing the nerve damage, such as diabetes, is also important. Continue taking the medicine only as advised by your doctor.
The length of treatment varies depending on the cause of your nerve pain, how severe it is, and how well you respond to the medicine. Some people may need treatment for several weeks, while others may require longer-term therapy to keep their symptoms under control. Do not stop taking the medicine without consulting your doctor, even if you start feeling better.

Disclaimer

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Reference

  1. National Health Service (NHS). Nortriptyline - NHS Medicines Reference Guide. London, UK: NHS; 2025. [Accessed on 02 Jun. 2026]Check here
  2. National Health Service (NHS). Pregabalin - NHS Medicines Reference Guide. London, UK: NHS; 2025. [Accessed on 02 Jun. 2026]Check here
  3. National Center for Biotechnology Information (NCBI). Pmc3888748 Scientific Research Publication. Bethesda, MD: NLM; 2025. [Accessed on 02 Jun. 2026]Check here
  4. National Center for Biotechnology Information (NCBI). Pmc6003018 Scientific Research Publication. Bethesda, MD: NLM; 2025. [Accessed on 02 Jun. 2026]Check here
  5. Drugs.com Clinical Review Team. Pregabalin Drug Interactions Reference. Auckland, NZ: Drugs.com; 2026. [Accessed on 02 Jun. 2026]Check here
  6. Drugs.com Clinical Review Team. Nortriptyline Drug Interactions Reference. Auckland, NZ: Drugs.com; 2026. [Accessed on 02 Jun. 2026]Check here
  7. Electronic Medicines Compendium (EMC). Pil.5044 Patient Information Leaflet (PIL). Cheshire, UK: Datapharm; 2025. [Accessed on 02 Jun. 2026]Check here

Country of origin

India
Other Info - AC83777
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