The fixed combination of diclofenac and orphenadrine in the treatment of acute pain syndromes

Acute pain, especially musculoskeletal and postoperative pain, is widespread pathology associated with quality of life deterioration, temporary disability, a tendency to relapse, and, in some cases, chronicity, so the timely and adequate treatment of this condition is important, including from the point of view of the prevention of serious medical, social, and economic consequences. Nonsteroidal anti-inflammatory drugs (NSAIDs) are considered as first choices in modern guidelines for the treatment of musculoskeletal pain. Centrally acting muscle relaxants and their combinations with NSAIDs are also the basic component of dorsalgia treatment. However, the evidence base is available only for individual muscle relaxants, for orphenadrine in particular. The incorporation of NSAIDs as part of multimodal postoperative analgesia considerably reduces the need for opioids, lowers the risk of developing adverse reactions of the latter, and enhances patient satisfaction with the quality of pain relief. Centrally acting muscle relaxants having analgesic properties, for example tizanidine and orphenadrine, would be appropriate for use as part of multimodal analgesia. The paper discusses the pharmacological properties of a fixed combination of diclofenac and orphenadrine (Neodolpasse®), its advantages over monotherapy with individual ingredients, and the results of clinical trials of this combination in spinal pain syndromes and in the postoperative period. © 2016 IMA Press