From the Guidelines
Norgesic has a moderate potency for treating muscle pain and spasms, with its efficacy supported by a higher-quality Cochrane review of skeletal muscle relaxants 1. The medication contains a combination of orphenadrine citrate, aspirin, and caffeine, which work together to block nerve impulses, reduce inflammation, and provide mild stimulation to counteract sedative effects.
- A typical dose is one tablet containing 25mg orphenadrine, 385mg aspirin, and 30mg caffeine taken 3-4 times daily, with a maximum daily dose not exceeding 4 tablets in 24 hours.
- Patients should take this medication with food to reduce stomach irritation and avoid alcohol while using it, as it may increase the risk of adverse events, particularly those affecting the central nervous system, as found in the Cochrane review 1.
- Common side effects may include drowsiness, dry mouth, blurred vision, and stomach upset, and those with aspirin allergies, bleeding disorders, or certain heart conditions should avoid Norgesic.
- The medication typically begins working within 30-60 minutes, with effects lasting 4-6 hours, making it suitable for short-term management of acute muscle pain rather than long-term use, as supported by the evidence from the systematic review 1.
From the Research
Potency of Norgesic
The potency of Norgesic, a combination of orphenadrine, aspirin, and caffeine, can be understood through its components and their effects:
- Orphenadrine is a muscle relaxant that helps in relieving pain and discomfort associated with muscle spasms 2.
- Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that provides anti-inflammatory effects equivalent to plain aspirin when used in Norgesic Forte 3.
- Caffeine is known for its stimulant properties, which can enhance the effects of other components.
Efficacy of Components
Studies have shown that:
- The combination of orphenadrine and paracetamol (a component similar to aspirin in pain relief) is effective in relieving myalgia, with significant pain relief from the second day of treatment 4.
- Orphenadrine, as part of a fixed combination, has been used successfully in treating acute back musculoskeletal pain syndrome, although this specific study used diclofenac instead of aspirin 5.
- However, evidence on the efficacy of muscle relaxants, including orphenadrine, in managing chronic musculoskeletal pain is limited, and they are often associated with significant adverse events, such as dizziness and drowsiness 6.
Comparison with Other Treatments
- Norgesic Forte provides salicylic acid levels equivalent to those of plain aspirin, indicating its potential as an anti-inflammatory agent 3.
- The use of fixed drug combinations, like Norgesic, can facilitate clinical practice and increase patient adherence, potentially leading to better treatment outcomes 5.