— Product
BGESIC-MR TAB(P.BOX)B/L
DICLOFENAC 50MG + PARACETAMOL 325MG + CHLORZONE 250MG
BGESIC-MR TAB(P.BOX)B/L is a fixed-dose tablet of diclofenac 50 mg, paracetamol 325 mg and chlorzoxazone 250 mg. It is used for painful musculoskeletal conditions where muscle spasm accompanies inflammation — acute low back pain, neck and shoulder spasm, sprains, strains, and post-traumatic musculoskeletal pain.
01
Benefits
- Diclofenac inhibits cyclo-oxygenase, reducing prostaglandin production and with it the swelling and inflammatory pain at the site of injury.
- Chlorzoxazone is a centrally acting muscle relaxant that damps the spinal reflex arcs maintaining muscle spasm.
- Paracetamol raises the pain threshold centrally, allowing useful analgesia at a lower NSAID burden.
- Addressing inflammation, spasm and pain in one tablet simplifies the regimen for the patient.
- Relieving spasm restores range of movement and allows physiotherapy to begin sooner.
02
Side effects
Not everyone gets these. Most are mild and settle as the course finishes.
Common
- Nausea, indigestion or epigastric discomfort
- Abdominal pain or diarrhoea
- Drowsiness, dizziness or light-headedness
- Headache
Less common
- Gastric erosion, ulceration or gastrointestinal bleeding
- Raised liver enzymes on testing
- Skin rash or itching
- Orange or reddish-purple discolouration of the urine from chlorzoxazone, which is harmless
Stop and get medical help if any of these occur
- Black, tarry stools or vomiting of blood
- Yellowing of the skin or eyes, or persistent right-upper-abdominal pain
- Chest pain, breathlessness, or weakness or numbness down one side
- Swelling of the face, lips or tongue, or difficulty breathing
- Widespread rash with blistering or peeling skin
03
Precautions
- Diclofenac carries a higher cardiovascular risk than several other NSAIDs. Contraindicated in established ischaemic heart disease, cerebrovascular disease, peripheral arterial disease and moderate to severe heart failure.
- Contraindicated in active peptic ulcer disease or a history of gastrointestinal bleeding.
- Contraindicated in severe hepatic or renal impairment, and in NSAID hypersensitivity including aspirin-sensitive asthma.
- Check the patient's total daily paracetamol intake across all products before adding this one.
- Avoid alcohol during the course — it raises both gastrointestinal bleeding and liver injury risk, and chlorzoxazone adds to that hepatic risk.
- May cause drowsiness. Warn the patient before driving or operating machinery.
- Avoid in the third trimester of pregnancy; use earlier in pregnancy and while breastfeeding only on medical advice.
- Use the lowest effective dose for the shortest period, and take with or after food.