A fixed-dose combination (FDC) of a centrally-acting muscle relaxant (Eperisone) and a non-steroidal anti-inflammatory drug (NSAID) (Diclofenac). It is primarily used for the symptomatic management of painful musculoskeletal conditions associated with muscle spasm and inflammation. Eperisone acts by reducing muscle tone and spasticity via central pathways, while Diclofenac provides analgesic and anti-inflammatory effects by inhibiting prostaglandin synthesis. This combination is widely used in India for conditions like low back pain, cervical spondylosis, and post-operative orthopedic pain, offering a synergistic effect on pain and muscle stiffness.
Adult: One tablet (Eperisone 150mg + Diclofenac 100mg) once or twice daily after food. Maximum: Two tablets per day.
Note: Take with or immediately after a full meal or a glass of milk to minimize gastric irritation. Swallow whole with a full glass of water. Do not crush, chew, or break. Do not lie down for at least 10 minutes after taking the tablet.
The combination exerts a dual mechanism: Eperisone reduces increased muscle tone and spasticity by acting on the central nervous system (brainstem and spinal cord), possibly by inhibiting gamma and alpha motor neuron activity and increasing blood flow to skeletal muscles. Diclofenac inhibits the enzyme cyclooxygenase (COX-1 and COX-2), thereby blocking the conversion of arachidonic acid to prostaglandins and thromboxanes, which are key mediators of pain, inflammation, and fever.
Pregnancy: Category C (First and Second Trimester): Use only if potential benefit justifies potential fetal risk. Avoid in third trimester (Category D) due to risk of premature closure of ductus arteriosus, oligohydramnios, and prolonged labor. Not recommended.
Driving: May impair alertness, coordination, and reaction time due to Eperisone's CNS effects (dizziness, drowsiness). Patients should not drive or operate machinery until their individual response is known.
| Other NSAIDs (e.g., Aspirin, Ibuprofen, Naproxen) | Increased risk of GI toxicity (ulcers, bleeding) and renal impairment. | Major |
| Anticoagulants (Warfarin, Acenocoumarol) / Antiplatelets (Clopidogrel) | Increased risk of bleeding due to pharmacodynamic synergy and displacement from protein binding. | Major |
| Corticosteroids (e.g., Prednisolone) | Markedly increased risk of GI ulceration and bleeding. | Major |
| ACE Inhibitors (e.g., Ramipril) / ARBs (e.g., Telmisartan) / Diuretics | Reduced antihypertensive efficacy. Increased risk of renal impairment, especially in volume-depleted patients. | Moderate |
| Lithium | Diclofenac can decrease renal clearance of Lithium, leading to increased serum Lithium levels and toxicity. | Major |
| Methotrexate | Diclofenac may decrease renal excretion of Methotrexate, increasing its toxicity (myelosuppression). | Major |
| Cyclosporine, Tacrolimus | Increased risk of nephrotoxicity. | Major |
| SSRIs (e.g., Sertraline, Escitalopram) | Increased risk of upper GI bleeding. | Moderate |
| Antidiabetic drugs (Sulfonylureas) | Diclofenac may potentiate hypoglycemic effect. | Moderate |
| Quinolone antibiotics (e.g., Ciprofloxacin) | Increased risk of CNS stimulation and seizures (theoretical with Eperisone). | Moderate |
| CNS Depressants (Alcohol, Benzodiazepines, Opioids) | Additive sedative effect with Eperisone, impairing alertness. | Moderate |
Same composition (Eperisone (150mg) + Diclofenac (100mg)), different brands: