A fixed-dose combination (FDC) of a centrally-acting muscle relaxant (Eperisone) and a centrally-acting analgesic/antipyretic (Paracetamol). Eperisone acts by suppressing the myotatic reflex and improving muscle tone, while Paracetamol elevates the pain threshold. This combination is primarily indicated for the symptomatic relief of painful muscle spasms associated with musculoskeletal conditions, offering both muscle relaxation and pain relief. It is widely used in the Indian market for conditions like cervical spondylosis, low back pain, and fibromyalgia.
Adult: One tablet (Eperisone 50mg + Paracetamol 325mg) three times daily, after meals. Maximum: 3 tablets per day.
Note: Administer orally with or after food to minimize gastrointestinal discomfort. Swallow whole with a glass of water. Do not crush or chew. Maintain adequate hydration.
Eperisone acts centrally by suppressing the myotatic reflex (monosynaptic and polysynaptic reflexes) at the level of the spinal cord and brainstem. It also has a peripheral vasodilatory effect, improving blood flow to muscles. Paracetamol's exact mechanism is not fully elucidated but is believed to act centrally by inhibiting cyclooxygenase (COX), particularly the COX-2 variant, and modulating the endogenous cannabinoid and serotonergic pathways, leading to analgesia and antipyresis with minimal peripheral anti-inflammatory effect.
Pregnancy: Category C (US FDA). Animal studies show risk; human data insufficient. Use only if potential benefit justifies potential fetal risk, especially in first trimester. Avoid in third trimester due to risk of ductus arteriosus closure (paracetamol).
Driving: May impair alertness, reaction time, and motor coordination. Advise patients not to drive or operate machinery until their individual response is known, especially during initial therapy.
| Alcohol (Chronic/Heavy Use) | Potentiates CNS depression with Eperisone; significantly increases risk of paracetamol-induced hepatotoxicity. | Major |
| Other CNS Depressants (e.g., Benzodiazepines, Opioids, Antipsychotics) | Additive sedation, dizziness, and impaired motor skills. | Major |
| Antihypertensives, Vasodilators | Enhanced hypotensive effect with Eperisone. | Moderate |
| Enzyme Inducers (e.g., Rifampicin, Carbamazepine, Phenytoin) | Increase metabolism of paracetamol, potentially increasing toxic metabolite (NAPQI) formation. | Moderate |
| Warfarin | Paracetamol may potentiate anticoagulant effect with prolonged high-dose use (>4g/day for several days). | Moderate |
| Metoclopramide, Domperidone | May increase absorption rate of paracetamol. | Minor |
| Cholestyramine | Reduces absorption of paracetamol if taken within 1 hour. | Moderate |
| CYP3A4 Inhibitors (e.g., Ketoconazole, Clarithromycin) | May increase Eperisone plasma levels, increasing risk of side effects. | Moderate |
Same composition (Eperisone (50mg) + Paracetamol (325mg)), different brands: