Chlorzoxazone (250mg) + Diclofenac (50mg) + Paracetamol (325mg) (Medical Monograph)

Overview

A fixed-dose combination (FDC) analgesic, anti-inflammatory, and centrally-acting muscle relaxant. It provides a synergistic effect for the management of acute, painful musculoskeletal conditions by targeting pain, inflammation, and muscle spasm simultaneously. This combination is widely used in the Indian market for short-term management of conditions like low back pain, sprains, and post-operative pain.

The combination exerts a multi-modal action. Diclofenac inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin synthesis responsible for pain, inflammation, and fever. Paracetamol has weak peripheral anti-inflammatory action but potently inhibits central COX-2 and modulates the endocannabinoid and serotonergic systems, providing analgesic and antipyretic effects. Chlorzoxazone acts primarily at the spinal cord and subcortical levels of the brain, inhibiting polysynaptic reflexes involved in muscle spasm.