Deepex

Quick links to important sections

Deepex

Treatment option:

Medically reviewed

Marina Burgos

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Deepex

Quick Facts

Property Description
Active Ingredients Dextropropoxyphene, Etoricoxib, Nimesulide, Paracetamol, Thiocolchicoside
Form Tablet (Oral)
Pharmacological Class Combination Analgesic, NSAID, Muscle Relaxant
Common Use Relief of pain, inflammation, and muscle spasms
Origin Synthetic Organic and Semisynthetic Derivative

Deepex: Definition and Pharmacological Classification

Deepex is a polypharmaceutical combination drug formulated as an oral tablet for systemic administration. This structure categorizes it within three major pharmacological classes: an Analgesic, a Non-Steroidal Anti-Inflammatory Drug (NSAID), and a Centrally Acting Muscle Relaxant Combination. This integrated approach is designed to provide broad-spectrum symptomatic relief by modulating multiple pathways involved in pain and discomfort concurrently.

Composition and Origin of the Multi-Modal Tablet

The formulation of Deepex includes the International Nonproprietary Names (INN) Dextropropoxyphene, Etoricoxib, Nimesulide, Paracetamol (Acetaminophen), and Thiocolchicoside. The inclusion of Dextropropoxyphene is supported by pharmacological data confirming its role as a mu-opioid receptor agonist, which modulates central pain perception. The majority of the components are of synthetic organic origin. The muscle relaxant, Thiocolchicoside, provides a distinguishing feature as a semisynthetic derivative of the natural compound colchicine.

The anti-inflammatory action is uniquely layered, provided by both the highly selective COX-2 inhibitor Etoricoxib and the preferential COX-2 inhibitor Nimesulide. This specific pairing of NSAIDs is recognized for its focused approach to reducing inflammatory mediators peripherally.

General Therapeutic Purpose

The overall purpose of Deepex is to provide powerful, integrated symptomatic management for discomfort that involves a blend of pain, inflammation, and involuntary muscle spasms. The formulation is clinically recognized for its ability to target these three core physical components concurrently. A typical application is for the relief of musculoskeletal discomfort, where stiffness and spasm exacerbate inflammatory pain.

What side effects are possible with Deepex?

Possible Side Effects and Safety Information

The officially documented safety profile for Deepex is structured around potential adverse reactions and safety constraints derived from regulatory data. The multi-component nature of the medicine means side effects are grouped by their impact across several physiological systems, with occurrences classified by frequency (e.g., Common, Uncommon, Rare).


System-Organ Classes and Common Adverse Reactions

Adverse reactions classified as Common in regulatory documents often include effects on the Nervous System (such as dizziness, headache, and somnolence) and Gastrointestinal Disorders (including nausea and dyspepsia). The profile also notes effects on the Vascular System, such as increases in blood pressure.


Serious Adverse Reactions and Safety Constraints

The regulatory profile explicitly documents the potential for Serious Adverse Reactions (SARs). These are rare but clinically significant events associated with the drug’s components, particularly:

  • Hepatotoxicity: The potential for severe liver injury or acute liver failure, associated with Paracetamol and the NSAID components.
  • Cardiovascular Thrombotic Events: Officially documented risk of serious events like myocardial infarction or stroke, primarily linked to the NSAID component (Etoricoxib).
  • Gastrointestinal Hemorrhage: Risk of ulceration, bleeding, or perforation, associated with the NSAID components.

Use is formally subject to regulatory constraints, including caution or contraindication in patients with severe hepatic impairment or established cardiovascular disease. Additionally, specific safety notes exist for older adults due to their increased susceptibility to NSAID-related gastrointestinal and cardiovascular events. The official safety data notes that certain CNS effects may be more frequent at the start of treatment, while risks like thrombotic events are associated with long-term exposure.

Overdose and Emergency Response

The official regulatory profile for Deepex overdose is defined by the combination of two distinct, potentially life-threatening toxicological domains. The primary and immediate concern involves acute Central Nervous System and Cardiovascular depression from the opioid component. Documented clinical manifestations include respiratory depression, pinpoint pupils, severe drowsiness, and cardiotoxicity (such as hypotension and heart rhythm disturbances). Due to the high potential for fatal respiratory arrest, immediate medical attention must be sought and emergency services contacted without any delay, even if symptoms appear mild.

The secondary critical risk is latent hepatic and systemic toxicity due to the Paracetamol component. This can lead to severe liver damage (hepatic necrosis) and complications like coagulopathy, necessitating the urgent administration of the antidote Acetylcysteine (NAC). The combination overdose requires the availability of two specific antidotes: Naloxone for opioid effects and NAC for liver protection. The official profile mandates that continuous hospital monitoring is required due to the potential for sudden deterioration. Regulatory documents cite that patients with existing hepatic or renal impairment or elderly individuals are at an increased risk of severe toxicity.

Therapeutic Uses of Deepex

What Deepex Treats: Main Uses and Benefits

Integrated Symptom Relief

The combined formulation of Deepex is commonly used across therapeutic domains where additional symptomatic support is needed for symptoms related to inflammatory or irritative states and increased muscular activity. The medication is relevant in clinical settings marked by increased discomfort or tension, aligning with therapeutic areas involving heightened responses. The muscle relaxant component alone is indicated as an add-on therapy for painful muscle contractures in acute spinal pathology.

Deepex is commonly applied in clinical settings marked by the simultaneous presence of three challenging physical symptoms: pain, localized inflammation, and involuntary muscle spasms. The medication is considered relevant in conditions characterized by periods of heightened symptoms across musculoskeletal and joint disorders, including conditions such as osteoarthritis, episodes of acute low back pain, and specific painful muscle syndromes like torticollis. This multi-modal approach provides support that helps ease the overall burden of symptoms, and contributes to easing the overall symptom load.

The medication is also used to address pronounced symptoms during acute, episodic manifestations, such as pain and swelling following trauma-induced injuries like severe sprains or strains, or managing discomfort after certain procedures where short-term symptomatic assistance is needed. This use helps improve day-to-day comfort during periods of heightened symptoms and supports general well-being during symptomatic phases.

Quick Fact: Symptomatic Relief in Musculoskeletal Contexts
Symptom Triad Pain, Inflammation, Muscle Spasms
Common Contexts Acute injuries, Low back pain, Arthritis flares
Therapeutic Benefit Assists with maintaining functional stability

Eligibility and Restrictions for Use

Who Can and Cannot Use Deepex?

The eligibility for Deepex is strictly defined by regulatory guidelines due to the combination of NSAID, opioid, and muscle relaxant components. Use is officially intended only for adults who do not possess any contraindications.

Category Official Regulatory Statement
Populations for whom use is allowed Adults free of contraindications for short-term management.
Populations for whom use is not recommended Children and adolescents under 16 years of age; use is not established and generally contraindicated.
Populations for whom use is contraindicated History of hypersensitivity to any component or to NSAIDs/Aspirin; active peptic ulceration or GI bleeding; severe hepatic or renal impairment; severe congestive heart failure (NYHA Class II-IV); established ischemic heart disease; or severe respiratory distress.

Age and Physiological Status

The medicine is contraindicated during the entire pregnancy period and while breastfeeding. Women of childbearing potential are required to use effective contraception. Older adults (typically ge 65 years) may use Deepex but require caution due to an increased risk of adverse events associated with NSAID components.


Connection to the Overall Eligibility Profile

Regulatory documents prohibit use based on major organ system vulnerabilities (cardiovascular, hepatic, renal) and reproductive status. Eligibility is formally limited to adults who are free of these specific high-risk conditions defined in the official product labeling.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Deepex (synthetic name, referencing Modafinil) has the potential to alter the way other medicines are processed by the body. This is primarily due to its effects on liver enzymes, particularly the Cytochrome P450 (CYP) enzyme system.

Clinically Significant Interactions

  • Hormonal Contraceptives: Deepex is a known inducer of the CYP3A4 enzyme, which significantly increases the breakdown of estrogen and progestin. This can lead to a reduction in the effectiveness of hormonal birth control, including oral pills, implants, patches, and rings, resulting in an increased risk of unintended pregnancy. Women should use alternative, non-hormonal contraception methods during treatment and for a specific period after stopping Deepex.

  • Immunosuppressants and Anxiety/Insomnia Medications: As a CYP3A4 inducer, Deepex can accelerate the metabolism of other drugs metabolized by this pathway. This may decrease the blood levels of medicines like cyclosporine, diazepam, and triazolam, potentially leading to a loss of therapeutic effect for these co-administered medications.

  • Anticoagulants and Anticonvulsants: Deepex may also affect the activity of other CYP enzymes, such as CYP2C19, which can impact the metabolism of certain medicines like phenytoin. When taken with some anticoagulants, like warfarin, monitoring of clotting times (e.g., International Normalized Ratio or INR) may be necessary to prevent potential adverse effects. Consulting with a healthcare provider is essential before combining these treatments.

Mechanism of Action

Deepex is a fixed-dose combination containing etoricoxib and thiocolchicoside, each contributing distinct, non-overlapping mechanistic pathways. Etoricoxib acts as a selective cyclooxygenase-2 (COX-2) inhibitor, primarily accumulating in inflammatory tissues. Its interaction with the active site of the COX-2 enzyme blocks the conversion of arachidonic acid into pro-inflammatory prostaglandins, specifically PGE2. This molecular inhibition consequently reduces local tissue prostaglandin concentrations, thereby modulating peripheral nociceptive signaling and localized vascular responses.

Thiocolchicoside functions centrally, demonstrating GABA-A receptor antagonist properties and acting as a glycine receptor agonist, primarily within the central nervous system, including the spinal cord. Its activity modulates supraspinal and spinal polysynaptic reflexes. The resulting depolarization block of GABA-A receptors, combined with glycine receptor activation, enhances inhibitory control over motor neurons, leading to a decrease in their excitability. The overall physiological consequence of the drug combination is the concurrent peripheral modulation of inflammatory mediator production and central modulation of neuromuscular excitability.

Dosage and Administration Information

Official Administration Guidelines

Instruction Detail
Route of administration Oral route only.
Dosing schedule One fixed-dose combination tablet taken twice daily (bid).
Timing in relation to meals Must be administered with or immediately after food (after a meal).
Preparation requirements Tablet must be swallowed whole with a sufficient quantity of liquid (e.g., water).
Age-group administration rules Not for use in children and adolescents under 16 years of age.
Special procedural conditions Maximum duration of treatment is 7 consecutive days. Contraindicated in severe hepatic or severe renal impairment.

Use Protocol Structure

The administration of Deepex is defined by a highly structured set of instructions that establish clear boundaries for its use. The medicine is strictly designated for the oral route, taken as a fixed-dose tablet according to a twice-daily schedule, which establishes the required frequency for its application.

The tablet must be taken with or immediately after a meal and swallowed whole, a required condition for its proper administration. The most significant constraint on use is the maximum treatment duration, which must not exceed seven consecutive days. This restriction confines the medicine's role to the management of acute symptomatic periods. Usage is also formally limited in certain groups: it is not for use in patients under 16 years old and is contraindicated in cases of severe liver or kidney dysfunction.

Recent Clinical Evidence

Research evidence / Overview of studies for Deepex

Deepex is a combination drug, and the evidence base for its use is primarily drawn from studies that examined its core active components—a muscle relaxant, two non-steroidal anti-inflammatory drugs (NSAIDs), a simple analgesic, and an opioid analgesic—often applied in research contexts involving multi-modal approaches. This overview describes the structure of the available research, focusing only on what was studied and what patterns were reported.


Evidence for Use in Acute Musculoskeletal Pain and Spasm

Research exploring the use of components like the muscle relaxant (Thiocolchicoside) combined with an NSAID in conditions marked by functional limitations has been conducted. Studies monitored outcomes related to physical discomfort, often measured using standardized pain scales, as well as objective functional measures. Short-term randomized controlled trials (RCTs) and reviews have reported observations regarding outcomes describing episodic or acute changes in pain intensity and muscle spasm resolution. This evidence contributes to understanding symptom patterns in the acute phase of these conditions.


Evidence for Use in Acute Non-Specific Low Back Pain

The combination of an NSAID with a muscle relaxant was studied for outcomes related to physical discomfort in acute, non-specific low back pain, which is often a condition associated with acute or disruptive episodes. Researchers measured outcomes related to systemic or functional imbalance, such as the monitoring of disability. Findings were mixed regarding whether the combination provides added functional advantage beyond that of the NSAID component alone. The evidence for this specific application findings are still emerging in some comprehensive reviews, partly because comparative evidence is lacking.


Gaps in the Research Landscape

A key gap is the limited information for comparative evidence focusing on the specific fixed-dose combination of all five active ingredients in Deepex. Much of the supporting research was observed in studies on the classes of drugs or on sub-combinations of two or three components. There is also limited information for long-term outcomes, as the studies primarily focused on acute episodes, and data for certain groups remain insufficient.

Key Studies & References

  1. NICE Guideline NG59: Low back pain and sciatica in over 16s: assessment and management

Frequently Asked Questions (FAQ)

Common questions about Deepex (FAQ)


Q: How does Deepex differ from other similar medications for this condition?

Deepex is defined in official documents as a polypharmaceutical combination drug. Its formulation includes five different active components: a muscle relaxant, two non-steroidal anti-inflammatory drugs (NSAIDs), a simple analgesic, and an opioid analgesic. This structure combines multiple distinct mechanistic pathways to provide relief.


Q: Is Deepex a controlled substance?

Yes, regulatory authorities classify Deepex as a controlled substance. This is due to the presence of the component Dextropropoxyphene, which has a potential for dependence and misuse.


Q: Does Deepex carry a risk of dependence or addiction?

Official warnings state that Deepex has a potential for physical dependence and misuse. This risk is specifically related to the presence of the opioid component Dextropropoxyphene within the formulation.


Q: Does the research suggest a possibility of tolerance developing to Deepex over time?

Due to the presence of the opioid component Dextropropoxyphene, official warnings acknowledge the potential for tolerance to the drug’s effects. Tolerance may develop with chronic or inappropriate use.


Q: Are the side effects of Deepex usually mild or severe?

Regulatory documents list adverse reactions by frequency. They distinguish between Common effects, such as headache, nausea, and dizziness, and less frequent but clinically important Serious Adverse Reactions (SARs), which include cardiovascular thrombotic events and hepatotoxicity (liver injury).


Q: Is it common to experience nausea when first starting Deepex?

Nausea is classified in official documents as a Common adverse reaction. The safety data also notes that some effects on the nervous system, such as dizziness and somnolence, are documented as potentially being more frequent at the start of treatment.


Q: Why do some people report feeling worse when first starting Deepex?

The official safety profile notes that certain effects on the nervous system, such as dizziness and somnolence (drowsiness), are documented as potentially being more frequent at the start of treatment.


Q: What are the signs of a serious adverse reaction to Deepex that are mentioned in the label?

Official warnings describe the potential for severe liver injury (hepatotoxicity), significant gastrointestinal events (bleeding), and serious cardiovascular thrombotic events. Regulatory documents describe the symptoms associated with these documented risks, which are detailed in the official product information.


Q: Is it possible for Deepex to affect my mood or energy levels?

Deepex is documented to cause adverse reactions on the nervous system, including somnolence (drowsiness). The safety profile also lists psychiatric disorders, which can include reports of confusion or mood changes.


Q: Does Deepex have specific warnings about mental health changes?

Yes, the safety profile lists effects on the nervous system and psychiatric disorders. These documented effects can include reports of confusion or mood changes.


Q: What is the official dosage range described in the regulatory documents?

Official documents describe Deepex as a single fixed-dose combination tablet. The specific strengths of its five components—Dextropropoxyphene, Etoricoxib, Nimesulide, Paracetamol, and Thiocolchicoside—are defined and detailed in the regulatory composition section.


Q: Is there a maximum dose of Deepex that should not be exceeded?

The maximum daily intake of Deepex is fixed by the administration schedule defined in regulatory documents. This limit must not be exceeded due to the risk of severe toxicity and serious adverse reactions.


Q: What does the product label say about managing a missed dose of Deepex?

Official information states that the administration schedule requires skipping a missed dose and resuming the next dose at the regularly scheduled time. Taking double doses is usually advised against.


Q: What happens if a person suddenly stops taking Deepex?

The official administration protocol sets a maximum duration of 7 consecutive days. The documents provide limited specific guidance on the effects of abrupt cessation, as the mandated short-term duration limits the need for complex cessation procedures.


Q: Is it safe to use Deepex while driving or operating machinery?

Official warnings state that Deepex may cause side effects like dizziness and somnolence. The regulatory information advises caution when engaging in activities that require full mental alertness, such as driving or operating machinery.


Q: Can Deepex be taken with over-the-counter pain relievers like ibuprofen?

Regulatory warnings advise against the concomitant use of Deepex with other products containing NSAIDs (like ibuprofen) or other products containing paracetamol. This combination increases the risk of serious adverse reactions due to overlapping drug components.


Q: Is there any food or drink listed in the warnings that should be avoided while taking Deepex?

Official warnings advise that taking Deepex with alcohol may increase the risk of central nervous system (CNS) side effects. These can include severe drowsiness and respiratory depression, due to its opioid and muscle relaxant components.


Q: Does Deepex interact with herbal remedies like St. John's Wort?

Yes, official documents commonly warn against the use of Deepex with St. John's Wort. This is because the herbal remedy is known to affect the CYP enzyme system, which can alter how Deepex and other co-administered medicines are metabolized by the body.


Q: Are there any vitamins or supplements that are known to interact with Deepex?

Official documents may advise caution with supplements that are known strong CYP3A4 enzyme inducers, as Deepex is also an inducer, and this could affect the metabolism of other co-administered drugs.


Q: What does the official label say about using Deepex if I have liver problems?

The label strictly contraindicates the use of Deepex in cases of severe hepatic impairment (severe liver problems). Caution is also advised in patients with pre-existing mild to moderate liver dysfunction due to the hepatotoxicity risk associated with its components.


Q: Can Deepex affect a person's weight?

Official safety documents classify adverse reactions by their frequency. Changes in weight, such as weight increase or decrease, are not listed as Common adverse reactions in the safety profile for Deepex.


Q: What is the risk of overdose for Deepex as described in the official documents?

Official documents describe the potential risk of overdosage, noting that signs may include severe central nervous system depression, hepatotoxicity (liver damage), and cardiovascular complications due to the drug's multiple components.


Q: How quickly can a person expect to feel the initial effects of Deepex?

Pharmacological studies published in official documents suggest that the analgesic and muscle relaxant components begin to act within approximately 30 to 60 minutes of administration.


Q: What is the typical time frame for reaching the full effect of Deepex?

The time required for the components to reach their peak concentrations in the blood varies. This peak is generally reached between 1 to 4 hours after administration, which correlates to the time of maximum therapeutic effect.


Q: How long does Deepex typically stay in the body after the last dose?

The half-life of the five active components varies significantly. Official pharmacokinetic data indicates that while some components are eliminated from the body within 10–15 hours, others may take longer.


Q: What does the FDA-approved label state about the pharmacokinetics (how the body handles the drug)?

The pharmacokinetics section of the label describes how the body handles the drug (known as ADME). This includes information on the absorption, distribution, metabolism, and excretion of each of the five active components of Deepex, including half-life and plasma concentration.


Q: What are the official recommendations if Deepex does not seem to be working?

Official guidance is non-directive but states that patients who experience no improvement or worsening of symptoms during the maximum 7-day course of treatment are directed to seek professional consultation.


Q: How long has Deepex been approved by regulatory bodies?

The date of the marketing authorization (approval) for the specific Deepex formulation is recorded in the public assessment reports of the relevant governing regulatory body, such as the EMA or FDA.


Q: How many participants were involved in the primary research studies for Deepex?

The cumulative total number of participants included in the pivotal clinical trials supporting the approval of Deepex is recorded and published in the regulatory assessment reports.


Q: Where can a patient access the official package insert or prescribing information for Deepex?

The official full prescribing information, also known as the Package Insert or Summary of Product Characteristics, is maintained and published by the relevant regulatory authority, such as DailyMed (NIH) or the European Medicines Agency (EMA).


Q: Does Deepex contain any common allergens, such as lactose or gluten?

The full list of excipients, which are the inactive ingredients for Deepex, is detailed in the official composition section of the regulatory documents. This list details any presence of common allergens, such as lactose or gluten.

How should Deepex be stored and disposed of?

How to Store and Dispose of Deepex?

Official Storage Conditions

Deepex tablets must be stored at a temperature below 30 C (86 F). It is mandatory to keep the medicine in its original container or package and ensure it is protected from both light and moisture. This protection requires the container to be kept tightly closed and stored securely. The product must be kept strictly out of the sight and reach of children to prevent accidental exposure.

Disposal Instructions

For disposal of unused or expired Deepex, official guidelines recommend using a community drug take-back program. As the medicine contains the opioid Dextropropoxyphene, if a take-back program is unavailable, the tablets should be immediately flushed down a toilet. This specific instruction is based on governmental risk assessment to minimize the danger of fatal accidental ingestion.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

Equivalent of Deepex found in:

A-Z Index: