Orphenadrine Citrate / Paracetamol

Brand Names: Myogesic

Drug Class: Skeletal Muscle Relaxant/Analgesic Combination

Overview

Orphenadrine Citrate/Paracetamol is a combination medication containing a centrally-acting skeletal muscle relaxant (orphenadrine) and an analgesic/antipyretic (paracetamol/acetaminophen). It is primarily used for the relief of acute painful musculoskeletal conditions associated with muscle spasm.

Mechanism of Action

Orphenadrine citrate acts as a centrally-acting anticholinergic agent that produces skeletal muscle relaxation through inhibition of cerebral motor neurons and possibly via atropine-like effects. Paracetamol (acetaminophen) acts as an analgesic and antipyretic through inhibition of prostaglandin synthesis in the central nervous system, with minimal anti-inflammatory effects.

Indications

  • Relief of acute painful musculoskeletal conditions associated with muscle spasm
  • Muscle pain
  • Back pain
  • Muscle spasms

Dosage

Typically 1-2 tablets every 6-8 hours as needed for pain. Maximum daily dose should not exceed 8 tablets (4000 mg paracetamol). Duration should be limited to short-term use (usually 2-3 weeks).

Contraindications

  • Hypersensitivity to orphenadrine, paracetamol, or any component
  • Glaucoma
  • Prostatic hypertrophy or bladder neck obstruction
  • Myasthenia gravis
  • Severe hepatic impairment
  • Concurrent use with monoamine oxidase inhibitors (MAOIs)

Side Effects

  • Drowsiness
  • Dizziness
  • Dry mouth
  • Blurred vision
  • Nausea
  • Constipation
  • Headache
  • Tachycardia
  • Urinary retention
  • Rash
  • Hepatotoxicity (with overdose)

Interactions

  • Alcohol (increased CNS depression)
  • Anticholinergic drugs (additive effects)
  • CNS depressants (sedatives, hypnotics, opioids)
  • Monoamine oxidase inhibitors (MAOIs)
  • Warfarin (potential increased INR with chronic high-dose paracetamol)
  • Drugs metabolized by CYP2E1