Ketoflam T 4 Tablet is a combination medication containing Flupirtine 100 mg and Thiocolchicoside 4 mg, indicated for the management of acute musculoskeletal pain and associated muscle spasms. Flupirtine, a centrally acting non-opioid analgesic, provides effective pain relief by modulating neuronal excitability through selective neuronal potassium channel opening and NMDA receptor antagonism, thereby exerting analgesic and neuroprotective effects without typical opioid-related adverse events. Thiocolchicoside, a muscle relaxant with anti-inflammatory properties, acts as a competitive antagonist of glycine receptors, leading to the relief of muscle stiffness and spasms. The synergistic action of these two agents makes Ketoflam T 4 Tablet suitable for conditions such as lower back pain, neck pain, and other musculoskeletal disorders where pain is accompanied by muscle spasm. It is recommended to be used under medical supervision, with dosage and duration tailored to the severity of symptoms and patient response. Caution is advised in patients with hepatic impairment, and it is contraindicated in individuals with known hypersensitivity to either component. Common side effects may include gastrointestinal discomfort, dizziness, or allergic reactions. Ketoflam T 4 Tablet should not be used during pregnancy or lactation unless deemed necessary by a healthcare professional.