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Orally administered melatonin is shown to alleviate formalin-induced nociception at a low dose, whereas high doses are reported to have anti-allodynia and anti-hyperalgesic effects in DM rats ( Melatonin alone or in combination with drugs such as gabapentin enhanced the hepatic gene expression of peroxisome proliferator–activated receptor and mitochondrial transcription factor-A

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however, because of its limited immediate effectiveness, it is typically not recommended during acute flare-ups (Dalbeth et al., 2017[21]