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Paco-4 is a fixed-dose combination drug containing acetylsalicylic acid, caffeine, orphenadrine citrate, and paracetamol. It is used as a centrally acting skeletal muscle relaxant and analgesic for the symptomatic relief of painful musculoskeletal conditions, such as muscle spasms, sprains, and post-traumatic muscle pain. Within this combination, paracetamol and acetylsalicylic acid act as analgesics and antipyretics, with acetylsalicylic acid also providing anti-inflammatory effects. Orphenadrine citrate functions as a centrally acting muscle relaxant, likely through anticholinergic and NMDA receptor antagonist mechanisms. Caffeine acts as a mild central nervous system stimulant that enhances the analgesic efficacy of paracetamol and acetylsalicylic acid.
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