Norflex Co combines paracetamol 450 mg with orphenadrine citrate 35 mg — a painkiller plus a muscle relaxant. It is used for painful muscle spasm: acute back and neck pain, stiff neck, and muscle pain after injury. It causes drowsiness, and it contains paracetamol, so do not take other paracetamol with it.
What is Norflex Co?
Norflex Co is registered in South Africa as Schedule 2, available from a pharmacist:
| Contains | Per tablet |
|---|---|
| Paracetamol | 450 mg |
| Orphenadrine citrate | 35 mg |
The two ingredients address different halves of the same problem.
Paracetamol relieves pain and reduces fever, acting mainly within the central nervous system. It has little effect on inflammation. See the paracetamol guide for more detail.
Orphenadrine is a centrally acting muscle relaxant with anticholinergic and antihistamine properties. It does not act on muscle directly. Instead it works in the central nervous system to reduce the nerve signalling that keeps a muscle contracted — which is why it is described as “centrally acting”.
The combination targets a specific, common problem: the pain–spasm cycle. An injured or strained muscle goes into spasm; the spasm itself causes pain; pain causes further protective spasm. Left alone, the loop sustains itself long after the original injury would have settled. Relieving pain and reducing spasm together interrupts it more effectively than either alone.
This is why the combination is aimed at muscular pain specifically, not at general aches, headache or inflammatory joint pain. For pain without spasm, plain paracetamol or an anti-inflammatory is more appropriate and will not sedate you.
What is Norflex Co commonly used for?
- Acute low back pain with muscle spasm.
- Neck pain and stiff neck, including after awkward sleeping or whiplash-type strain.
- Muscle spasm after injury or strain.
- Fibrositis and muscular rheumatism, for short-term relief.
- Painful muscle conditions where spasm is a significant part of the problem.
- Tension-related muscular pain in the shoulders and upper back.
It is intended for short-term use — typically a few days to a couple of weeks. Muscle relaxants generally work best in the acute phase, and their benefit fades while the drowsiness and anticholinergic effects continue.
Movement matters more than most people expect. For acute back pain, current advice is to stay as active as possible rather than resting in bed — prolonged rest slows recovery. The medicine is there to make movement bearable, not to replace it.
It relieves symptoms rather than treating a cause. Persistent or recurrent back pain needs assessment.
How Norflex Co fits into this medicine category
| Group | Examples | What it does |
|---|---|---|
| Simple analgesics | Paracetamol (Donapan) | Pain and fever; minimal anti-inflammatory effect |
| Muscle relaxant + analgesic | Norflex Co (orphenadrine + paracetamol) | Painful muscle spasm |
| Centrally acting muscle relaxants | Orphenadrine, methocarbamol, cyclobenzaprine | Reduce muscle spasm; sedating |
| NSAIDs | Ibuprofen, diclofenac | Pain and inflammation |
| Corticosteroids | Prednisone | Powerful anti-inflammatory, given as courses |
| Compound analgesics | Stilpane, Mybulen | Paracetamol with codeine and others |
An anti-inflammatory is often used alongside this for back pain, since it works by a different mechanism — but check first, and never add more paracetamol. See the pain, inflammation and musculoskeletal medicines hub.
What to check before using Norflex Co
Check everything else you take for paracetamol. This is the most important practical point. Paracetamol appears in a great many cold and flu remedies, sinus products, and prescription painkillers containing codeine. Taking one of those alongside Norflex Co means taking paracetamol twice — the most common route to serious accidental overdose.
Do not drive or operate machinery until you know how it affects you. Orphenadrine causes drowsiness and can blur vision.
Speak to a pharmacist or doctor first if you:
- Have glaucoma, particularly narrow-angle — the anticholinergic effect can raise eye pressure.
- Have prostate enlargement or difficulty passing urine, which can be worsened to the point of retention.
- Have myasthenia gravis.
- Have a bowel obstruction, or achalasia of the oesophagus.
- Have heart disease, a fast or irregular heartbeat, or heart failure.
- Have liver disease, or drink alcohol heavily — relevant to the paracetamol.
- Have kidney disease.
- Weigh under 50 kg, which reduces the maximum safe paracetamol amount.
- Are elderly. Confusion, drowsiness, falls, constipation and urinary retention are all more likely.
- Are pregnant or breastfeeding.
- Take warfarin.
- Take any other sedating medicine — opioids, benzodiazepines, sleeping tablets, sedating antihistamines — or alcohol.
- Take other anticholinergic medicines, whose effects add up.
- Are giving it to a child, which generally requires advice.
Follow the pack instructions and do not exceed the stated maximum in 24 hours. This page does not set doses.
Possible cautions and when to ask a pharmacist or doctor
Common effects come mainly from the orphenadrine: drowsiness, dry mouth, blurred vision, dizziness, constipation, difficulty passing urine and a faster heartbeat.
Stop and seek medical attention if you develop:
- Inability to pass urine.
- Marked confusion, agitation or hallucinations, particularly in an older person.
- A fast or irregular heartbeat, or palpitations.
- Severe dizziness or fainting.
- Eye pain with blurred vision or halos around lights — possible acute glaucoma, which is an emergency.
- Tremor or involuntary movements.
- Swelling of the face, lips or tongue, or difficulty breathing.
- A rash, blistering or peeling skin.
- Yellowing of the eyes or skin.
Paracetamol overdose is a medical emergency and does not feel like one at first. Someone who has taken too much may feel entirely well for a day or more while liver damage develops silently. If you think you or someone else has taken too much — even accidentally, even if they seem fine — go to an emergency department immediately with the packaging. The antidote works best given early.
See a doctor rather than continuing if:
- Pain lasts more than a week or two, or worsens.
- You have numbness, tingling, or weakness in a limb.
- You have loss of bladder or bowel control, or numbness around the groin — seek emergency care immediately.
- Back pain follows significant injury or a fall.
- Pain comes with fever, unintended weight loss or night sweats.
- Pain wakes you at night, or is worse lying down.
- You are over 50 with new back pain, or have a history of cancer or osteoporosis.
Related medicine guides
- Browse Pain, Inflammation & Musculoskeletal Medicines guides
- Read: Prednisone used for
- Read: Donapan used for
Frequently asked questions
What are Norflex Co tablets used for? Painful muscle spasm — acute back and neck pain, stiff neck, and muscle pain after strain or injury. Each tablet contains paracetamol 450 mg with orphenadrine citrate 35 mg.
Is Norflex Co a muscle relaxant? Partly. The orphenadrine is a centrally acting muscle relaxant; the paracetamol relieves pain. Together they interrupt the pain–spasm cycle.
Does it make you drowsy? Yes, often. Do not drive or operate machinery until you know how it affects you.
Can I take it with paracetamol? No. It already contains paracetamol, and adding more risks overdose. Check cold and flu remedies too.
Can I take it with ibuprofen? Usually yes, as they work differently, but check with a pharmacist. What you must avoid is extra paracetamol.
How long can I take it? Short-term — a few days to a couple of weeks. Muscle relaxants work best in the acute phase.
Should I rest my back? Staying as active as you can manage generally speeds recovery. Prolonged bed rest slows it.
Can I drink alcohol with it? No. Alcohol adds to the drowsiness and increases the risk of liver harm from paracetamol.