Meds and you

27 September 2013

Orphenadrine and paracetamol

The combination of orphenadrine and paracetamol is a muscle relaxant. Muscle relaxants are drugs that reduce pain by relaxing muscles in spasm.

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The combination of orphenadrine and paracetamol is one of multiple active ingredients found in Norflex Co (Nappi Code: 747548-005/013), Besemax (Nappi Code: 825123-003/011/038) and Besenol (Nappi Code: 881767-18/026/034).

General information
The combination of orphenadrine and paracetamol is a muscle relaxant. Muscle relaxants are drugs that reduce pain by relaxing muscles in spasm.

In South Africa the combination of orphenadrine and paracetamol is registered for the treatment of muscle spasms in skeletal muscles and for the symptomatic treatment of mild to moderate pain.

Orphenadrine is a muscle relaxant that exerts its effect in the brain.

Paracetamol is the analgesic of choice for mild to moderate pain and to reduce fever. It is suited for both adults and children and, as it does not cause stomach irritation, it is safe to use by those who suffer from peptic ulcers and those who cannot take aspirin.

It should be noted that pain is a symptom and not a disease, and although this combination may be useful for short-term pain management, long-term relief often requires treatment of the underlying cause. None of the ingredients in this combination cure the underlying condition responsible for pain or fever, but simply keep the symptoms under control.

Orphenadrine is a muscle relaxant. Muscle relaxants are drugs that reduce pain by relaxing muscles in spasm.

Orphenadrine is furthermore often used to treat extrapyramidal side effects, spasms that cause abnormal movements in the whole body or individual parts thereof. This is often seen in Parkinson’s disease, but may also be caused by some medications.

In South Africa orphenadrine is registered for the treatment of Parkinsonism, extrapyridimal effects, as well as generalised pain and the relief of muscle spasms associated with acute painful muscular conditions.

When used for the treatment of Parkinson’s disease, orphenadrine has to be taken regularly to be effective, even if you do not notice an immediate effect. Treatment should not be stopped without speaking to your doctor, especially if you have been taking Orphenadrine for a prolonged period of time, as symptoms originally being treated may recur.

When applied to treat painful muscular conditions, orphenadrine does not cure any of the underlying conditions leading to these spasms, but simply keeps the symptoms under control.

How does orphenadrine work?
Orphenadrine works in the brain by reducing the activity of a brain chemical called acetylcholine, while paracetamol blocks the production of chemicals in the body that are responsible for pain and fever

Fast facts

Drug schedule: schedule 2
Available as: the combination of orphenadrine and paracetamol is available as tablets.
What does it do? The combination of orphenadrine and paracetamol is a muscle relaxant and painkiller.
Overdose risk: high
Dependence risk: medium
Is this combination available as a generic? yes
Is this combination available on prescription only? no

User information

Onset of effect: within 60 minutes
Duration of action: up to 8 hours
Stopping this medicine: if you have been using this drug as short-term muscle relaxant it can be stopped when no longer needed. After long term-term use you should best consult your doctor first.
Prolonged use: tolerance may occur with long-term use.

Special precautions
Consult your doctor before using this drug if:

  • you have liver or kidney disease

  • you have glaucoma

  • you have heart disease

  • you have heart rhythm disturbance, i.e. a fast heart rate

  • you have a thyroid disorder

  • you have an enlarged prostate

  • you have difficulty urinating

  • you have myasthenia gravis

  • the patient has Down's syndrome

Pregnancy: avoid. Potential risk to the foetus has been reported. Consult your doctor before use, or if you are planning to fall pregnant.
Breastfeeding: avoid. This medication is passed through breast milk and may affect your baby adversely. Consult your doctor before use.
Porphyria: this medication is safe use.
Infants and children: this medication is not intended for use in children.
The elderly: caution is advised in the elderly as adverse effects are more likely.
Driving and hazardous work: caution is advised as use of this medication may lead to dizziness, light-headedness and/or sedation. Avoid such activities until you know how this medication affects you.
Alcohol: avoid concomitant use of alcohol with this medication.

Possible side effects

Side Effect
Frequency
Consult your doctor

Common
Rare
Only if severe
In all cases
dryness of the mouth
X

X

thirst
X

X

difficulty swallowing
X

X

nausea and vomiting
X

X

blurred vision

X
X

dizziness or loss of balance

X
X

confusion, hallucinations

X

X
warm, dry skin

X
X

heart palpitations

X

X
difficulty in passing urine

X

X
yellow-tinged skin and eyes

X

X

Interactions Drug interactions

chlorpromazine risk of increased blood sugar
hyoscine increased risk of orphenadrine side effects
chlorpheniramine increased risk of orphenadrine side effects
diphenhydramine increased risk of orphenadrine side effects
tricyclic antidepressants increased risk of orphenadrine side effects
tropicamide increased risk of orphenadrine side effects
cholestyramine reduced effect of paracetamol
isoniazid increased risk of paracetamol toxicity
metoclopramide, domperidone increased risk of paracetamol toxicity
anticoagulants risk of anticoagulant related side effects with high/prolonged use

Disease interactions
Consult your doctor before using this drug if you have liver or kidney disease, glaucoma, heart disease, a thyroid disorder, an enlarged prostate or if you have difficulty urinating.

Overdose action
An overdose of this medication can be fatal. Seek immediate emergency medical attention.

This material is not intended to substitute medical advice, but is for informational purposes only. Please consult a physician for specific treatment and recommendations.
 
 

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