⚡ Quick Answer — What is Intagesic MR?
Intagesic MR is een three-ingredient muscle-relaxant analgesic tablet — diclofenac 50 mg + paracetamol 325 mg + chlorzoxazone 250 mg. It is formulated for short-term treatment of moderate-to-severe musculoskeletal pain with muscle spasm: acute low back pain, neck pain, muscle strain, and post-traumatic soft-tissue injury. Usual adult dose is one tablet two to three times daily with food, for 3 to 7 days. The triple combination targets pain (paracetamol), inflammation (diclofenac), and muscle spasm (chlorzoxazone) simultaneously.
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Intagesic MR is a fixed-dose combination tablet manufactured by Intas Pharmaceuticals. “MR” stands for Muscle Relaxant — distinguishing it from the plain Intagesic (diclofenac + paracetamol) variant by the addition of chlorzoxazone, a centrally-acting skeletal muscle relaxant.
The rationale is that most acute non-radicular low back and neck pain involves three pathways: (1) local tissue inflammation, (2) nociceptive pain signalling, and (3) protective muscle spasm that amplifies and sustains the pain cycle. A three-drug tablet addresses all three in one dose:
- Diclofenac 50 mg — non-selective NSAID; reduces inflammation at the site of injury
- Paracetamol 325 mg — central analgesic and antipyretic; adds pain relief on a different pathway
- Chlorzoxazone 250 mg — centrally-acting muscle relaxant; reduces protective muscle spasm
What Is Intagesic MR Used For?
- Acute low back pain with muscle spasm
- Acute neck pain, torticollis
- Muscle strain — hamstring, calf, trapezius
- Post-traumatic soft-tissue injury (with inflammatory pain + spasm)
- Whiplash-type injury
- Myofascial pain with trigger points
- Sciatica flare (short course, alongside other therapy)
How Does Intagesic MR Work?
The three ingredients act on complementary pathways:
- Diclofenac blocks COX-1 and COX-2, reducing prostaglandin-driven inflammation and peripheral pain
- Paracetamol modulates pain perception centrally (spinal cord and brain) and lowers body temperature via the hypothalamus
- Chlorzoxazone acts at the brainstem and spinal cord to reduce the involuntary tonic muscle contraction that maintains musculoskeletal pain
Intagesic MR Dosing
- Adults: one tablet two to three times daily, with food; maximum 3 tablets/day
- Duration: short-term only — typically 3 to 7 days; muscle relaxants are not for chronic use
- Paracetamol ceiling: each tablet contains 325 mg paracetamol. Three tablets = 975 mg. Do not take additional paracetamol-containing products (Panadol, Crocin, cold remedies) without counting total daily paracetamol — the liver-safety ceiling is 4 g (4,000 mg) per day.
- Ouderen: lowest effective dose; chlorzoxazone and diclofenac have age-related risks
Swallow with water after food. Do not lie down immediately after a dose. If you miss a dose, take it when you remember unless the next dose is due within 4 hours — then skip.
GI safety. Intagesic MR (or its NSAID component) carries real risk of gastritis, peptic ulcer, and upper-GI bleeding. Risk is highest in patients over 65, in those with prior ulcer disease, and in anyone also on low-dose aspirin, corticosteroids, SSRIs, or anticoagulants. Take with food, at the lowest effective dose for the shortest reasonable time, and ask your doctor about adding a proton pump inhibitor (omeprazole, pantoprazole) for courses over 2–4 weeks.
Paracetamol and the liver. Paracetamol is extremely safe at recommended doses but is the single most common cause of acute liver failure worldwide at higher doses. Do not exceed 4 g (4,000 mg) per day from all sources combined. That is 8 tablets of 500 mg. Be careful not to double-dose by combining branded paracetamol (Calpol, Anacin, Panadol, Crocin, Tylenol) with cold/flu preparations that often also contain paracetamol. Liver risk rises with regular alcohol use, chronic liver disease, and prolonged fasting — reduce the daily limit to 2 g in those cases.
Chlorzoxazone hepatotoxicity. Chlorzoxazone has a small but recognised risk of idiosyncratic liver injury — usually in the first 2–4 weeks of therapy. This risk is part of why the muscle-relaxant component of Intagesic MR is a short-term drug. Stop the tablet and seek medical advice if you develop yellow skin/eyes, dark urine, unexplained nausea, or right-upper-abdominal pain during or just after a course.
Who Should Not Take Intagesic MR?
- Known hypersensitivity to diclofenac, paracetamol, chlorzoxazone, or any NSAID
- Active peptic ulcer or GI bleed
- Severe hepatic or renal impairment
- Severe heart failure, established ischaemic heart disease
- Recent CABG surgery
- Third trimester of pregnancy
- Aspirin- or NSAID-induced asthma, urticaria, or angioedema
- Chronic alcohol use (paracetamol and chlorzoxazone hepatotoxicity risk)
- Concurrent use of another paracetamol-containing product, another NSAID, or another muscle relaxant
Bijwerkingen
- Vaak voorkomend: drowsiness, dizziness, dyspepsia, nausea, abdominal pain, headache, dry mouth
- Important to recognise: peptic ulcer/GI bleed (diclofenac), liver injury (paracetamol or chlorzoxazone), hypertension and fluid retention (diclofenac), orange or red-tinged urine (chlorzoxazone metabolite — harmless)
- Zeldzaam maar ernstig: severe hepatotoxicity, Stevens-Johnson syndrome, myocardial infarction, acute kidney injury, anaphylaxis
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Medisch disclaimer. The information on this page is provided for general education only. It is not a substitute for advice from your own doctor or pharmacist. Talk to a qualified healthcare professional before starting, stopping, or changing therapy, especially if you have a history of ulcer disease, heart disease, kidney disease, asthma, liver disease, or are pregnant.
Veelgestelde vragen
What is Intagesic MR used for?
Intagesic MR is used for acute musculoskeletal pain with muscle spasm — low back pain, neck pain, torticollis, muscle strain, whiplash, and post-traumatic soft-tissue injury.
Why does Intagesic MR have three ingredients?
Acute musculoskeletal pain involves inflammation, pain signalling, and muscle spasm all at once. The three ingredients address each pathway: diclofenac (inflammation), paracetamol (pain perception), and chlorzoxazone (muscle spasm). One tablet covers what would otherwise be three separate medicines.
Does Intagesic MR cause drowsiness?
Yes — the chlorzoxazone component can cause drowsiness, dizziness, and slowed reaction time. Do not drive or operate machinery until you know how you respond.
How long can I take Intagesic MR?
Short courses of 3 to 7 days are typical. Do not use for longer than 2 weeks without medical review — both the NSAID and the muscle relaxant are short-term medications.
Can I take additional paracetamol with Intagesic MR?
Only with care. Each tablet already contains 325 mg paracetamol. Combining Intagesic MR with Panadol, Crocin, Calpol, Anacin, or cold/flu remedies can push your daily paracetamol dose above the 4 g safety ceiling. Check every label.
Can I take Intagesic MR with ibuprofen or another NSAID?
No. The diclofenac component already provides NSAID coverage. Adding another NSAID sharply increases GI bleed and kidney injury risk.
Can I drink alcohol on Intagesic MR?
Avoid alcohol. It increases drowsiness (chlorzoxazone), raises liver risk (paracetamol and chlorzoxazone), and worsens GI bleed risk (diclofenac).
Why is my urine orange?
A metabolite of chlorzoxazone can give urine a harmless orange or red-tinged colour. This is not blood and resolves within a day or two of stopping the tablet.
Is Intagesic MR safe in pregnancy?
No — the diclofenac component is avoided after 20 weeks and contraindicated in the third trimester. Chlorzoxazone data in pregnancy are limited. Paracetamol alone is the first-line pain medicine in pregnancy.
Can children take Intagesic MR?
No — the triple combination is for adults. Paediatric dosing would need individual component titration, not a fixed-combination tablet.
What if I miss a dose of Intagesic MR?
Take it when you remember, unless the next dose is due within 4 hours — then skip. Never double up.
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