Pharmaceutical composition comprising (1r,4r)-6′-fluoro-N,N-dimethyl-4-phenyl-4′,9′-dihydro-3′H-spiro[cyclohexane-1,1′-pyrano-[3,4,b]indol]-4-amine and a propionic acid derivative

1. A pharmaceutical composition comprising:

a) a first pharmacologically active ingredient, which is selected from

and the physiologically acceptable salts thereof, and

b) a second pharmacologically active ingredient, which is selected from the group consisting of naproxen and physiologically acceptable salts thereof, wherein the relative weight ratio of the first pharmacologically active ingredient to the second pharmacologically active ingredient is within the range of 1:100 to 1:1,000,000.

2. The pharmaceutical composition according to claim 1 , wherein the first pharmacologically active ingredient is

3. The pharmaceutical composition according to claim 1 , wherein the relative weight ratio of the first pharmacologically active ingredient to the second pharmacologically active ingredient is within the range of from 1:1,000 to 1:500,000.

4. A pharmaceutical dosage form comprising the pharmaceutical composition according to claim 1 .

5. The pharmaceutical dosage form according to claim 4 , which contains the first pharmacologically active ingredient in a dose of from 10 to 800 μg.

6. The pharmaceutical dosage form according to claim 4 , which contains the second pharmacologically active ingredient in a dose of from 0.1 to 3 g.

7. The pharmaceutical dosage form according to claim 4 , which is for oral, intravenous, intraperitoneal, transdermal, intrathecal, intramuscular, intranasal, transmucosal, subcutaneous, or rectal administration.

8. A kit comprising a first pharmaceutical dosage form comprising the first pharmacologically active ingredient and a second pharmaceutical dosage form comprising the second pharmacologically active ingredient as defined in claim 1 .

9. The kit according to claim 8 , wherein the first and the second pharmaceutical dosage form are adapted for simultaneous or sequential administration, either by the same or a different pathway of administration.

10. A method of treating acute post-operative pain or chronic inflammatory pain, comprising administering a pharmaceutical dosage form comprising a pharmaceutical composition as in claim 1 to a subject in need thereof, wherein the pharmaceutical composition comprises a therapeutically effective amount to treat acute post-operative pain or chronic inflammatory pain.

11. The method according to claim 10 , wherein the acute post-operative pain or the chronic inflammatory pain is peripheral pain, central pain, or muscle skeletal pain.

12. The method according to claim 10 , wherein the acute post-operative pain or the chronic inflammatory pain is moderate to severe pain.

13. The method according to claim 10 , wherein the acute post-operative pain or the chronic inflammatory pain is neuropathic pain, psychogenic pain, nociceptive pain, or mixed pain.

14. The method according to claim 10 , wherein the acute post-operative pain or the chronic inflammatory pain is low back pain, visceral pain, or headache.

15. The method according to claim 10 , wherein the first pharmacologically active ingredient is

16. The method according to claim 10 , wherein the relative weight ratio of the first pharmacologically active ingredient to the second pharmacologically active ingredient in the pharmaceutical composition is within the range of 1:1,000 to 1:500,000.

17. The method according to claim 10 , wherein the pharmaceutical dosage form contains the first pharmacologically active ingredient in a dose of 10 to 800 μg.

18. The method according to claim 10 , wherein the pharmaceutical dosage form contains the second pharmacologically active ingredient in a dose of 0.1 to 3 g.

19. The method according to claim 10 , wherein the pharmaceutical dosage form is for oral, intravenous, intraperitoneal, transdermal, intrathecal, intramuscular, intranasal, transmucosal, subcutaneous, or rectal administration.