Deepex

Dextropropoxyphene (Deepex) is an analgesic in the opioid category, patented (1955) and manufactured by Eli Lilly and Company. It is intended to treat mild pain and also has antitussive and local anaesthetic effects. The drug has been taken off the market in Europe and the US due to concerns of fatal overdoses and heart arrhythmias. An estimated 10 million patients have used these products. The drug is often referred to as the general form, "propoxyphene", however only the dextro-isomer (Dextropropoxyphene (Deepex)) has any analgesic effect. The levo-isomer appears to exhibit a very limited antitussive effect.

Nimesulide (Deepex) is a relatively COX-2 selective, non-steroidal anti-inflammatory drug (NSAID) with analgesic and antipyretic properties. Its approved indications are the treatment of acute pain, the symptomatic treatment of osteoarthritis and primary dysmenorrhoea in adolescents and adults above 12 years old. Due to concerns about the risk of hepatotoxicity, Nimesulide (Deepex) has been withdrawn from market in many countries.

Paracetamol (Deepex) is an organic compound that consists of a six-membered ring containing two opposing nitrogen atoms. Paracetamol (Deepex) exists as small alkaline deliquescent crystals with a saline tasteacinol was introduced to medicine as a solvent for uric acid. When taken into the body the drug is partly oxidized and partly eliminated unchanged. Outside the body, piperazine has a remarkable power to dissolve uric acid and producing a soluble urate, but in clinical experience it has not proved equally successfulacinol was first introduced as an anthelmintic in 1953. A large number of piperazine compounds have anthelmintic Paracetamol (Deepex). Their mode of Paracetamol (Deepex) is generally by paralysing parasites, which allows the host body to easily remove or expel the invading organism.

Anti-inflammatory,As a screening test for Cushing’s syndrome,Acute exacerbations in multiple sclerosis,Unresponsive shock,Bacterial meningitis,Prophylaxis of nausea and vomiting associated with cytotoxic therapy,Cerebral oedema caused by malignancy,Ocular inflammation,Inflammatory joint diseases.

Tablet/Suspension: Adults: Treatment of a variety of painful inflammatory conditions including those associated with osteoarthritis, postoperative trauma, sports injuries, ear, nose and throat disorders, dental surgery, bursitis/tendinitis, thrombophlebitis, pharyngitis and gynaecological disorders.

Children: Suspension: Fever and inflammatory symptoms associated with upper respiratory tract infections (viral or bacterial origin) and in reducing pain of various origin in children eg, postoperative pain, pain due to musculoskeletal injury, pain due to minor soft tissue injury, etc.

Gel: For local application in the treatment of acute and chronic musculoskeletal disorders characterized by pain and inflammation including non-articular rheumatic disorders and soft-tissue injuries. These conditions include backache, tendonitis, tenosynovitis, sprains and strains.

For systemic use of Paracetamol (Deepex) Sante Naturelle: prevention and treatment of hypo- and avitaminosis of vitamin C; providing increased need for vitamin C during growth, pregnancy, lactation, with heavy loads, fatigue and during recovery after prolonged severe illness; in winter with an increased risk of infectious diseases.

For intravaginal use: chronic or recurrent vaginitis (bacterial vaginosis, nonspecific vaginitis) caused by the anaerobic flora (due to changes in pH of the vagina) in order to normalize disturbed vaginal microflora.

Paracetamol (Deepex) (acetaminophen) is a pain reliever and a fever reducer. The exact mechanism of Paracetamol (Deepex) of is not known.

Paracetamol (Deepex) is used to treat many conditions such as headache, muscle aches, arthritis, backache, toothaches, colds, and fevers. It relieves pain in mild arthritis but has no effect on the underlying inflammation and swelling of the joint.

Paracetamol (Deepex) may also be used for other purposes not listed in this medication guide.

Adult : PO As HCI: 65 mg 3-4 times/day. As napsilate: 100 mg 3-4 times/day.

Tablet/Suspension: Adults: Usual

Oral Dose: 100-mg tab twice daily.

Children: 1.5 mg/kg body weight, twice or thrice daily.

Gel: For external use only. Adults: Apply approximately 3 cm or 1¼ inches of Nimesulide (Deepex) gel lightly in a thin layer to the affected site and surrounding areas 3-4 times/day, or as directed by the physician. Clean and dry the affected areas thoroughly before treating with the gel. Patients should be advised to avoid occlusive dressing. Hands should be washed before and after using this medicine.

Usual Adult Paracetamol (Deepex) Dose for Fever:

General Dosing Guidelines: 325 to 650 mg every 4 to 6 hours or 1000 mg every 6 to 8 hours orally or rectally.

Paracetamol (Deepex) 500mg tablets: Two 500 mg tablets orally every 4 to 6 hours

Usual Adult Paracetamol (Deepex) Dose for Pain:

General Dosing Guidelines: 325 to 650 mg every 4 to 6 hours or 1000 mg every 6 to 8 hours orally or rectally.

Paracetamol (Deepex) 500mg tablets: Two 500 mg tablets orally every 4 to 6 hours

Usual Pediatric Dose for Fever:

Oral or Rectal:

<=1 month: 10 to 15 mg/kg/dose every 6 to 8 hours as needed.

>1 month to 12 years: 10 to 15 mg/kg/dose every 4 to 6 hours as needed (Maximum: 5 doses in 24 hours)

Fever: 4 months to 9 years: Initial Dose: 30 mg/kg (Reported by one study (n=121) to be more effective in reducing fever than a 15 mg/kg maintenance dose with no difference regarding clinical tolerance.)

>=12 years: 325 to 650 mg every 4 to 6 hours or 1000 mg every 6 to 8 hours.

Usual Pediatric Dose for Pain:

Oral or Rectal:

<=1 month: 10 to 15 mg/kg/dose every 6 to 8 hours as needed.

>1 month to 12 years: 10 to 15 mg/kg/dose every 4 to 6 hours as needed (Maximum: 5 doses in 24 hours)

Fever: 4 months to 9 years: Initial Dose: 30 mg/kg (Reported by one study (n=121) to be more effective in reducing fever than a 15 mg/kg maintenance dose with no difference regarding clinical tolerance.)

>=12 years: 325 to 650 mg every 4 to 6 hours or 1000 mg every 6 to 8 hours.

Hypersensitivity, chronic resp diseases, porphyria, pregnancy. Patients on MAOI treatment or within 2 wk of stopping treatment.

Nimesulide (Deepex): Hypersensitivity to Nimesulide (Deepex) or any of the excipients of Nimesulide (Deepex). It should not be administered to patients in whom aspirin or other NSAIDs induced the symptoms of asthma, bronchospasm, rhinitis, angioedema, nasal polyps or urticaria by prostaglandin synthesis inhibition. It should not be used on injured or abraded skin or in the presence of local infection. It should not be used simultaneously with other topical products.

Use in Children: It should not be used in children <12 years.

Sulidin Thermo: Hypersensitivity to Nimesulide (Deepex), capsaicin or any of the excipients of Sulidin Thermo. In patients with hypersensitivity to aspirin and other NSAIDs that induce symptoms of asthma, rhinitis, angioedema, urticaria or nasal polyposis. In injured, damaged and sensitive skin, pruritic conditions eg, eczema and prurigo or open wounds.

Use in Pregnancy: Pregnancy Category C.

Sulidin Thermo is not recommended for use during pregnancy. Especially, it should not be used in 3rd trimester because of the risk of premature ductal constriction and uterine atony.

Use in Children: Dosage recommendations and indications for use in children have not been established. Thus, it should not be used in children.

See also:
What is the most important information I should know about Paracetamol (Deepex)?

Paracetamol (Deepex) should not be used in patients who have previously exhibited hypersensitivity to aspirin and/or nonsteroidal antiinflammatory agents. Paracetamol (Deepex) should not be given to patients with a recent history of gastrointestinal bleeding or in patients with bleeding disorders (e.g., hemophilia).

Use Paracetamol (Deepex) exactly as directed on the label, or as prescribed by your doctor.

Do not use more of this medication than is recommended. An overdose of Paracetamol (Deepex) can cause serious harm. The maximum amount for adults is 1 gram (1000 mg) per dose and 4 grams (4000 mg) per day. Using more Paracetamol (Deepex) could cause damage to your liver. If you drink more than three alcoholic beverages per day, talk to your doctor before taking Paracetamol (Deepex) and never use more than 2 grams (2000 mg) per day. If you are treating a child, use a pediatric form of Paracetamol (Deepex). Carefully follow the dosing directions on the medicine label. Do not give the medication to a child younger than 2 years old without the advice of a doctor.

Measure the liquid form of Paracetamol (Deepex) with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one. You may need to shake the liquid before each use. Follow the directions on the medicine label.

The Paracetamol (Deepex) chewable tablet must be chewed thoroughly before you swallow it.

Make sure your hands are dry when handling the Paracetamol (Deepex) disintegrating tablet. Place the tablet on your tongue. It will begin to dissolve right away. Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.

To use the Paracetamol (Deepex) effervescent granules, dissolve one packet of the granules in at least 4 ounces of water. Stir this mixture and drink all of it right away. To make sure you get the entire dose, add a little more water to the same glass, swirl gently and drink right away.

Do not take a Paracetamol (Deepex) rectal suppository by mouth. It is for use only in your rectum. Wash your hands before and after inserting the suppository.

Try to empty your bowel and bladder just before using the Paracetamol (Deepex) suppository. Remove the outer wrapper from the suppository before inserting it. Avoid handling the suppository too long or it will melt in your hands.

For best results from the suppository, lie down and insert the suppository pointed tip first into the rectum. Hold in the suppository for a few minutes. It will melt quickly once inserted and you should feel little or no discomfort while holding it in. Avoid using the bathroom just after inserting the suppository.

Stop using Paracetamol (Deepex) and call your doctor if:

• you still have a fever after 3 days of use;

• you still have pain after 7 days of use (or 5 days if treating a child);

• you have a skin rash, ongoing headache, or any redness or swelling; or

• if your symptoms get worse, or if you have any new symptoms.

Urine glucose tests may produce false results while you are taking Paracetamol (Deepex). Talk to your doctor if you are diabetic and you notice changes in your glucose levels during treatment.

Store Paracetamol (Deepex) at room temperature away from heat and moisture. The rectal suppositories can be stored at room temperature or in the refrigerator.

Dextropropoxyphene (Deepex) is used to treat mild pain and also has antitussive (cough suppressant) and local anaesthetic effects. This drug has been withdrawn from India due to cases of fatal self-poisoning.

Nimesulide (Deepex) is used to treat acute pain, osteoarthritis (pain and swelling of joints due to degeneration) and pain during periods.

This drug is used to treat mild to moderate pain (from headaches, menstrual periods, toothaches, backaches, osteoarthritis, or cold/flu aches and pains) and to reduce fever.

How to use Paracetamol (Deepex)

Take this product by mouth as directed. Follow all directions on the product package. If you are uncertain about any of the information, consult your doctor or pharmacist.

There are many brands and forms of acetaminophen available. Read the dosing instructions carefully for each product because the amount of acetaminophen may be different between products. Do not take more acetaminophen than recommended.

If you are giving acetaminophen to a child, be sure you use a product that is meant for children. Use your child's weight to find the right dose on the product package. If you don't know your child's weight, you can use their age.

For suspensions, shake the medication well before each dose. Some liquids do not need to be shaken before use. Follow all directions on the product package. Measure the liquid medication with the provided dose-measuring spoon/dropper/syringe to make sure you have the correct dose. Do not use a household spoon.

For rapidly-dissolving tablets, chew or allow to dissolve on the tongue, then swallow with or without water. For chewable tablets, chew thoroughly before swallowing.

Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Also, do not split the tablets unless they have a score line and your doctor or pharmacist tells you to do so. Swallow the whole or split tablet without crushing or chewing.

For effervescent tablets, dissolve the dose in the recommended amount of water, then drink.

Pain medications work best if they are used as the first signs of pain occur. If you wait until the symptoms have worsened, the medication may not work as well.

Do not take this medication for fever for more than 3 days unless directed by your doctor. For adults, do not take this product for pain for more than 10 days (5 days in children) unless directed by your doctor. If the child has a sore throat (especially with high fever, headache, or nausea/vomiting), consult the doctor promptly.

Tell your doctor if your condition persists or worsens or if you develop new symptoms. If you think you may have a serious medical problem, get medical help right away.

Inhibits hepatic metabolism of benzodiazepines, β-blockers, carbamazepine, phenytoin and warfarin. Increased risk of toxicity when co-administered with ritonavir. Potentiation of depressant effects when used with alcohol or CNS depressants.

Potentially Fatal: Accidental or intentional overdosage fatal (especially if combined with alcohol, and analgesics e.g. paracetamol and aspirin).

pregnancy:

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Category D: There is positive evidence of human foetal risk, but the benefits from use in pregnant women may be acceptable despite the risk (e.g., if the drug is needed in a life-threatening situation or for a serious disease for which safer drugs cannot be used or are ineffective).

Clinically important interactions involving interference with drug metabolism have not been described with Nimesulide (Deepex).

Gel: No clinically significant interactions involving interference with drug metabolism have been reported with topical application of Nimesulide (Deepex).

See also:
What other drugs will affect Paracetamol (Deepex)?

With the simultaneous use with inducers of microsomal liver enzymes, means having hepatotoxic effect, increasing the risk of hepatotoxic Paracetamol (Deepex) of Paracetamol (Deepex).

With the simultaneous use of anticoagulants may be slight to moderate increase in prothrombin time.

With the simultaneous use of anticholinergics may decrease absorption of Paracetamol (Deepex).

With the simultaneous use of oral contraceptives accelerated excretion of Paracetamol (Deepex) from the body and may reduce its analgesic Paracetamol (Deepex).

With the simultaneous use with urological means reduced their effectiveness.

With the simultaneous use of activated charcoal reduced bioavailability of Paracetamol (Deepex).

When Paracetamol (Deepex) Guardian applied simultaneously with diazepam may decrease excretion of diazepam.

There have been reports about the possibility of enhancing mielodepression effect of zidovudine while applying with Paracetamol (Deepex). A case of severe toxic liver injury.

Described cases of toxic effects of Paracetamol (Deepex), while the use of isoniazid.

When applied simultaneously with carbamazepine, phenytoin, phenobarbital, primidonom decreases the effectiveness of Paracetamol (Deepex), which is caused by an increase in its metabolism and excretion from the body. Cases of hepatotoxicity, while the use of Paracetamol (Deepex) and phenobarbital.

In applying cholestyramine a period of less than 1 h after administration of Paracetamol (Deepex) may decrease of its absorption.

At simultaneous application with lamotrigine moderately increased excretion of lamotrigine from the body.

With the simultaneous use of metoclopramide may increase absorption of Paracetamol (Deepex) and its increased concentration in blood plasma.

When applied simultaneously with probenecid may decrease clearance of Paracetamol (Deepex), with rifampicin, sulfinpyrazone - may increase clearance of Paracetamol (Deepex) due to increasing its metabolism in the liver.

At simultaneous application of Paracetamol (Deepex) Guardian with ethinylestradiol increases absorption of Paracetamol (Deepex) from the gut.

Enhances the effect of indirect anticoagulants (coumarin derivatives and indandione). Antipyretic and analgesic activity of caffeine increases, reduce - rifampicin, phenobarbital and alcohol (accelerated biotransformation, inducing microsomal liver enzymes).

Growth retardation, osteoporosis, peptic ulcer, glaucoma and subcapsular cataracts, vertebral compression fractures. Cushing-like features, pancreatic dysfunction and pancreatitis, GI upsets, increased appetite, increased fragility of the skin. Increased susceptibility to infection.

Topical application: Dermal atrophy, local irritation, folliculitis, delayed wound healing, systemic absorption and toxicity with occlusive dressing on application to large areas of the body and broken skin.

Topical application to eye: Corneal ulcers, glaucoma and reduced visual ability. Inhalation: Hoarseness, candidiasis of mouth and throat. Intra-articular inj: Aseptic necrosis of bone and joint damage.

Potentially Fatal: HPA supression; CV collapse on rapid IV admin.

Nimesulide (Deepex): Adverse effects possibly related to local treatment have been infrequently reported. In clinical trials, the majority of adverse effects are local reactions at the application site eg, mild or moderate local irritation, erythema, rash, desquamation, pruritus. Staining of clothing has been noted.

The frequency of adverse events listed as follows is defined using the following convention: Very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100), rare (≥1/10,000 to <1/1,000); very rare (<1/10,000), not known (cannot be estimated from the available data).

Skin and Subcutaneous Tissue Disorders: Uncommon: Pruritus, erythema. Not Known: Desquamation, pruritus, rash, mild or moderate local irritation.

When Nimesulide (Deepex) is applied topically, the possibility of occurrence of systemic adverse effects is less in comparison to oral administration. However, when Nimesulide (Deepex) is applied long-term and in high doses, the occurrence of systemic adverse effects should not be neglected.

Sulidin Thermo: Adverse effects possibly related to local treatment have been infrequently reported. In clinical studies, the majority of adverse effects are local reactions at the application area eg, mild or moderate local irritation, erythema, rash, desquamation, pruritus.

The frequency classification of adverse effects are listed as following: Very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1,000 to <1/100); rare (≥1/10,000 to <1/1,000); very rare (<1/10,000), not known (cannot be estimated from the available data).

İmmune System Disorders: Very Rare: Allergic reactions (anaphylactic shock may be seen in severe events).

Nervous System Disorders: Uncommon: Dyschezia, hypoesthesia. Very Rare: Nervousness, restlessness, euphoria, confusion, tinnitus, somnolence, blurred or double vision, chill, tremor, loss of consciousness.

Eye Disorders: Uncommon: Eye irritation.

Vascular Disorders: Uncommon: Hypertension.

Respiratory, Thoracic or Mediastinal Disorders: Uncommon: Cough, throat irritation, dyspnea, labored breathing and asthma exacerbation.

Gastrointestinal Disorders: Uncommon: Nausea.

Musculoskeletal Disorders, Connective Tissue and Bone Disorders: Uncommon: Pain in extremities, muscle spasms.

General Disorders and Administration Site Conditions: Very Common: Pain in the administration area, erythema. Common: Pruritus in the administration area, papule, vesicle, edema, swelling, dryness. Uncommon: Urticaria in the administration area, paresthesia, dermatitis, hyperesthesia, inflammation, irritation, cyanosis, peripheral edema.

When Nimesulide (Deepex) and capsaicin is applied topically, the possibility of occurrence systemic adverse effects is less in comparison to oral administration of Nimesulide (Deepex) and capsaicin. However, when Sulidin Thermo is applied long-term and in high doses, the occurrence of systemic adverse effects should not be neglected.

See also:
What are the possible side effects of Paracetamol (Deepex)?

Effects due to the presence of acetylsalicylic acid.

Accidents awareness with respiratory or skin reactions (angioedema, urticaria, asthma, anaphylactic shock);

Cross hypersensitivity reactions with NSAIDs and with tartrazine;

At low doses recommended for the use of Paracetamol (Deepex), side effects of aspirin are generally limited to some irritation of the gastro-intestinal tract.

At higher doses, side effects include gastrointestinal mucosal erosions, gastric ulcer or duodenal ulcer, occult blood loss, melena.

Acetylsalicylic acid may also increase the tendency to bleeding and bleeding time (the lengthening of bleeding continues 4-6 days after stopping the drug).

It may also worsen renal function including cases of pre-existing condition (the long-term use can cause chronic kidney disease).

The signs of salicylic overdose described under.

Effects due to the presence of Paracetamol (Deepex).

At the doses and duration of recommended treatment, side effects are usually negligible, but the prolonged use of Paracetamol (Deepex) in therapeutic doses large (2-4 g per day, or 10-20 tablets Paracetamol (Deepex)) may cause the appearance chronic hepatitis. This justifies the recommendations of caution especially in patients with liver disease prior.

Very rarely, it can produce thrombocytopenia.

The acute liver toxicity in overdose massive (doses greater than 8 g of Paracetamol (Deepex)) is described in paragraph overdose.