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Are these drugs suitable for back and knee pain?

Dr Chandra M Gulhati
Editor, MIMS,
New Delhi

Q: I have slip disc. Two of my discs L4 and L5 have developed a gap. I have slight pain and can't walk properly. I live on the 1st floor and climbing the stairs is very difficult as I have pain in my knee. I have done my MRI, and have been advised Gabastar M and Shelcal 500OS. Can my condition be relieved? Are the medicines proper? Please advise a suitable drug for my knee and back.

A:Gabistar-M is an irrational Fixed-Dose combination of two medicines: gabapentin and methylcobalamin (vitamin B-12). Such a combination is not permitted in any advanced country like US, Britain, Canada, Australia etc. Gabistar-M brand is not listed in the national and international databank of quality products of reputed manufacturers.Gabapentin alone (sold under the brand name of Gabapin) is indicated in the treatment of neuropathic pain. Its dosage schedule is as follows: 300mg once on Day 1, then 300mg twice daily on Day 2, then 300mg 3 times on Day 3. Then if necessary, increase by 300mg increments daily. Maximum allowed: 600mg 3 times daily. Generally the optimum effect should be obvious in two weeks time.Methylcobalamin, vitamin B-12 substance (sold as Methycobal) 500mcg is claimed to be useful in peripheral neuropathy. Its dose is 1 tablet of 500mcg daily for no more than two months, unless it is found to be beneficial.Due to their different dose schedules, a fixed-dose combination is unscientific. These medicines should be used individually in appropriate recommended doses.Shelcal (calcium) is needed only if there is deficiency of calcium as determined by blood calcium test. Overdose may lead to side effects such as crystals in urine and kidney stones. Moreover natural sources (such as milk, curd) are preferable.Slip disk is basically a local "mechanical" rather than a systemic problem and hence may need surgical/physiotherapy intervention, if Gabapin and Methycobal are not found effective.