Flexilor P 4mg/500mg Tablet: Complete Medicine Guide
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026
When to Call Your Doctor IMMEDIATELY
- Blood in stool or vomit
- Severe abdominal pain
- Chest pain or difficulty breathing
- Severe headache with visual changes
- Sudden swelling of face, lips, or throat
- Yellowing of skin or eyes
- Decreased urine output
- Unusual bleeding or bruising
If experiencing severe symptoms, call emergency services immediately.
What is lorsumo plus 4mg/500mg tablet used for?
This medicine is a combination of Lornoxicam 4 mg and Paracetamol 500 mg used for short-term relief of acute pain and inflammation. It works by reducing prostaglandins that cause pain and swelling. Take it with food, avoid alcohol, and do not exceed the prescribed dose.
- Generic Name: Lornoxicam (4mg) + Paracetamol (500mg)
- Manufacturer: Alkem Laboratories Ltd
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 lorsumo plus 4mg/500mg tablet के बारे में (Hindi Summary)
उपयोग: यह दवा लॉर्नोक्सिकैम 4 मिलीग्राम और पैरासिटामोल 500 मिलीग्राम का संयोजन है। इसका उपयोग दर्द और सूजन को कम करने के लिए किया जाता है, जैसे कि मांसपेशियों में खिंचाव, जोड़ों का दर्द, दांत दर्द, माहवारी के दर्द, और सर्जरी के बाद के दर्द में। यह दवा सूजन पैदा करने वाले प्रोस्टाग्लैंडिन को कम करके काम करती है। इसे भोजन के साथ लेना चाहिए ताकि पेट में जलन न हो। इसका सेवन डॉक्टर के निर्देशानुसार ही करें।
साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में मतली, उल्टी, पेट दर्द, अपच, सिरदर्द, चक्कर आना और नींद आना शामिल हैं। गंभीर दुष्प्रभाव दुर्लभ हैं लेकिन इनमें पेट में रक्तस्राव, अल्सर, लीवर की क्षति, गुर्दे की समस्या, और एलर्जी प्रतिक्रियाएं शामिल हो सकती हैं। यदि आपको काला मल, उल्टी में खून, त्वचा या आंखों का पीलापन, या सांस लेने में कठिनाई हो, तो तुरंत डॉक्टर से संपर्क करें।
सुरक्षा सलाह: इस दवा को हमेशा भोजन के साथ लें ताकि पेट में जलन न हो। शराब का सेवन न करें क्योंकि इससे पेट में रक्तस्राव और लीवर की क्षति का खतरा बढ़ जाता है। अन्य दर्द निवारक दवाओं या पैरासिटामोल युक्त दवाओं के साथ इसका सेवन न करें। यदि आप गर्भवती हैं, स्तनपान करा रही हैं, या आपको लीवर या गुर्दे की बीमारी है, तो डॉक्टर से सलाह लें। इस दवा को बच्चों की पहुंच से दूर रखें।
💊 lorsumo plus 4mg/500mg tablet Uses & Benefits
[{"condition":"Acute musculoskeletal pain","description":"Relieves pain and inflammation in conditions such as sprains, strains, and sports injuries.","evidence":"Well-established"},{"condition":"Post-operative pain","description":"Used for short-term management of pain after surgical procedures.","evidence":"Well-established"},{"condition":"Dental pain","description":"Effective for relieving pain following dental extraction or other dental procedures.","evidence":"Well-established"},{"condition":"Osteoarthritis flare-ups","description":"Provides symptomatic relief of pain and stiffness during acute exacerbations.","evidence":"Well-established"},{"condition":"Rheumatoid arthritis","description":"Used as short-term adjunctive therapy for pain and inflammation.","evidence":"Well-established"},{"condition":"Dysmenorrhea","description":"Helps relieve menstrual cramps and associated pain.","evidence":"Moderate"}]
Off-label uses: [{"condition":"Migraine","description":"Sometimes used off-label for acute migraine attacks, but evidence is limited.","evidence":"Limited"},{"condition":"Fever","description":"Paracetamol component may reduce fever, but this combination is not primarily indicated for fever alone.","evidence":"Limited"}]
Primary treatment for: Acute pain and inflammation
Also treats: Osteoarthritis, Rheumatoid arthritis, Dysmenorrhea, Post-operative pain, Dental pain
📋 Drug Information
| Generic Name(s) | Lornoxicam (4mg) + Paracetamol (500mg) |
| Brand Name | lorsumo plus 4mg/500mg tablet |
| Manufacturer | Alkem Laboratories Ltd |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | PAIN ANALGESICS |
| Action Class | |
| Route of Administration | Oral |
| Storage | Store at room temperature between 15°C and 30°C (59°F to 86°F). Keep away from moisture, heat, and direct sunlight. Do not refrigerate unless specified. Keep in the original container, tightly closed. |
| Shelf Life | 24 months from the date of manufacture. |
| WHO Guideline | Not established from the available information. |
| ICMR Guideline | Not established from the available information. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
This medicine combines two active ingredients with complementary mechanisms. Lornoxicam is a non-steroidal anti-inflammatory drug that reversibly inhibits the cyclooxygenase enzymes COX-1 and COX-2, leading to decreased synthesis of prostaglandins, prostacyclin, and thromboxane. This results in analgesic, anti-inflammatory, and antipyretic effects. Paracetamol acts primarily in the central nervous system by inhibiting prostaglandin synthesis and possibly activating descending serotonergic pathways, producing analgesia and antipyresis. The combination provides enhanced pain relief through both peripheral and central mechanisms.
Mechanism Steps
💡 How to Take lorsumo plus 4mg/500mg tablet
Strength: Each tablet contains Lornoxicam 4 mg and Paracetamol 500 mg.
Dosage Information
| Adult Dosage | The usual adult dose of this medicine is one tablet taken orally two to three times daily, depending on the severity of pain and the prescribing doctor's instructions. The maximum recommended daily dose is typically three tablets in 24 hours. This medicine should be taken with food or milk to reduce stomach upset. The dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function. Do not exceed the prescribed dose or duration of treatment without medical advice. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatrician. |
| Elderly Dosage | Elderly patients (above 65 years) may be more sensitive to the side effects of this medicine, especially gastrointestinal bleeding and kidney impairment. The lowest effective dose should be used for the shortest duration. Dose must be individualized by a qualified clinician based on renal and hepatic function. |
| Renal Impairment | Dose adjustment is required in patients with kidney impairment. This medicine is contraindicated in severe kidney impairment (creatinine clearance <30 mL/min). In mild to moderate impairment, the dose should be reduced and kidney function monitored. Dose must be individualized by a qualified clinician. |
| Hepatic Impairment | Dose adjustment is required in patients with liver impairment. This medicine is contraindicated in severe liver disease. In mild to moderate impairment, the dose should be reduced and liver function monitored. Dose must be individualized by a qualified clinician. |
| Maximum Daily Dose | The maximum recommended daily dose is three tablets (12 mg lornoxicam and 1500 mg paracetamol) in 24 hours. Do not exceed this dose. |
Dosage Timeline
🍽️ Food Timing Guide
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of lorsumo plus 4mg/500mg tablet
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Warfarin | Major | |
| Ibuprofen | Major | |
| Methotrexate | Major | |
| Lithium | Major | |
| ACE inhibitors | Moderate | |
| Diuretics | Moderate | |
| SSRIs | Moderate | |
| Fluconazole | Moderate | |
| Antacids | Minor | |
| Cholestyramine | Minor |
🚨 Major Interactions
- Warfarin
- Other NSAIDs (e.g., ibuprofen, naproxen)
- Corticosteroids
- Methotrexate
- Lithium
⚡ Moderate Interactions
- ACE inhibitors and ARBs
- Diuretics
- SSRIs
- CYP2C9 inhibitors (e.g., fluconazole)
🍷 Alcohol Interaction
Avoid alcohol while taking this medicine. Alcohol increases the risk of gastrointestinal bleeding and can worsen liver damage, especially due to the paracetamol component. It may also increase drowsiness and dizziness.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Known allergy or hypersensitivity to lornoxicam, paracetamol, or any other NSAID.","Active or history of recurrent peptic ulcer, gastrointestinal bleeding, or perforation.","Severe liver impairment or active liver disease.","Severe kidney impairment (e.g., creatinine clearance
⚠️ Warnings & Precautions
["Take this medicine with food to reduce gastrointestinal irritation.","Do not exceed the recommended dose or duration of treatment.","Avoid alcohol while taking this medicine.","Use with caution in the elderly due to increased risk of side effects.","Inform your doctor if you have a history of asthma, especially aspirin-sensitive asthma.","Do not use this medicine for minor pain without consulting a doctor.","Stop the medicine and seek medical help if you experience signs of allergic reaction.","Use with caution in patients with dehydration or volume depletion.","May cause dizziness or drowsiness; avoid driving or operating machinery until you know how it affects you.","Do not take other medications without consulting your doctor, especially blood thinners, corticosteroids, or antidepressants."]
🤱 Lactation Safety
Not established from the available information. Lornoxicam may pass into breast milk, and its effects on the nursing infant are unknown. Paracetamol is excreted in breast milk in small amounts and is generally considered compatible with breastfeeding. Consult your doctor before using this medicine while breastfeeding.
💊 Overdose Management
Overdose of this medicine can cause severe liver damage due to paracetamol and gastrointestinal bleeding or kidney failure due to lornoxicam. Symptoms of overdose may include nausea, vomiting, abdominal pain, confusion, and drowsiness. If you suspect an overdose, seek emergency medical attention immediately. Treatment may include activated charcoal, N-acetylcysteine for paracetamol toxicity, and supportive care. Do not induce vomiting unless instructed by a healthcare professional.
⏰ Missed Dose
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose to make up for a missed one.
Additional Safety Advice
Always take this medicine with food or milk to reduce the risk of stomach irritation. Do not take more than the prescribed dose, and do not use it for longer than recommended without medical supervision. Avoid alcohol while taking this medicine because it increases the risk of stomach bleeding and liver damage. Do not take other medicines containing paracetamol or other NSAIDs without consulting your doctor, as this can lead to overdose or increased side effects. Inform your doctor if you have a history of stomach ulcers, kidney or liver disease, high blood pressure, heart disease, or asthma. If you are pregnant, planning to become pregnant, or breastfeeding, consult your doctor before using this medicine. Do not drive or operate heavy machinery if you feel dizzy or drowsy after taking this medicine. Keep this medicine out of reach of children. Store it at room temperature, away from moisture and direct sunlight. If you experience any signs of allergic reaction, severe stomach pain, or unusual bleeding, seek medical help immediately.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Elderly patients are at higher risk of gastrointestinal bleeding, kidney impairment, and cardiovascular events. Use the lowest effective dose for the shortest duration. Monitor renal and hepatic function regularly. Avoid concurrent use with other NSAIDs or anticoagulants.
🤰 Pregnancy Planning (TTC)
If you are planning to become pregnant, consult your doctor before taking this medicine. NSAIDs like lornoxicam may affect ovulation and are generally avoided during pregnancy, especially in the third trimester. Paracetamol is considered relatively safe but should be used at the lowest effective dose for the shortest time.
🏥 Post-Surgery Considerations
This medicine may be used for post-operative pain relief, but it should be used with caution due to the risk of bleeding and kidney impairment. Follow your surgeon's instructions regarding dosing and duration. Inform your surgeon if you are taking this medicine before any surgery.
🦷 Dental Procedures
This medicine can be used for dental pain, but inform your dentist if you are taking it before any dental procedure. It may increase the risk of bleeding during dental surgery. Your dentist may recommend stopping it temporarily before extensive dental work.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
While taking this medicine, you may feel dizzy or drowsy. Avoid strenuous exercise or activities that require alertness until you know how the medicine affects you. If you have pain, gentle stretching and low-impact exercises may be beneficial, but consult your doctor before starting any new exercise routine.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine may cause dizziness or drowsiness, which can affect your ability to drive or operate machinery. Avoid these activities until you know how the medicine affects you. It is generally safe to continue desk work, but take regular breaks and maintain good posture. Inform your employer if your work involves operating heavy machinery.
🛑 When to Stop This Medicine
Stop taking this medicine and consult your doctor if your pain does not improve within a few days, if you experience side effects, or if you develop any signs of a serious reaction such as gastrointestinal bleeding, allergic reaction, or liver problems. Do not stop abruptly if you have been taking it for a long time without consulting your doctor.
📅 Long-Term Use Effects
Long-term use of this medicine may increase the risk of gastrointestinal bleeding, ulcers, kidney impairment, liver damage, and cardiovascular events. Regular monitoring of liver and kidney function, as well as blood counts, is recommended. Use the lowest effective dose for the shortest duration possible. Consult your doctor if you need to use this medicine for more than a few days.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Can complement medicine for chronic pain and improve mobility.
Evidence: Well-establishedMay help reduce pain and inflammation in localized areas.
Evidence: ModerateSome evidence for pain relief in certain conditions.
Evidence: Limited💉 Vaccination Considerations
💉 If You're Getting Vaccinated
There are no known interactions between this medicine and vaccines. However, if you are scheduled for vaccination, inform your healthcare provider that you are taking this medicine.
📦 Storage Guide
✅ DO
Store at room temperature (15-30°C)
❌ DON'T
Do not refrigerate unless specified
✅ DO
Keep in original container
❌ DON'T
Do not transfer to unmarked containers
✅ DO
Keep away from direct sunlight
❌ DON'T
Do not store in bathroom cabinet
✈️ Traveling with This Medicine
When traveling, carry this medicine in its original packaging along with a copy of your prescription. Store it at room temperature and protect it from extreme heat or moisture. If crossing time zones, adjust dosing times gradually as advised by your doctor. Check local customs regulations regarding prescription medicines before traveling internationally.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: This medicine usually starts relieving pain within 30 to 60 minutes after taking it with food.
A: No, it should be taken with food or milk to reduce the risk of stomach irritation.
A: If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not double dose.
A: No, you should not take this medicine with other NSAIDs or paracetamol-containing products without consulting your doctor, as it can increase the risk of side effects.
🤔 Common Patient Concerns
🔄 Substitutes for lorsumo plus 4mg/500mg tablet
View AllAlternative brands with exact same active ingredient:
-
indloxp 4 mg/500 mg tabletIndchemie Health Specialities Pvt Ltd ₹27.19 16% CHEAPER
-
lorniflex plus 4 mg/500 mg tabletAristo Pharmaceuticals Pvt Ltd ₹33.10 2.3% COSTLIER
-
lorpijen 4mg/500mg tabletJenburkt Pharmaceuticals Ltd ₹34.18 5.6% COSTLIER
-
lorflex plus 4 mg/500 mg tabletMacleods Pharmaceuticals Pvt Ltd ₹42.00 29.8% COSTLIER
-
curio 4mg/500mg tabletDewcare Concept Pvt.Ltd. ₹45.00 39.1% COSTLIER
Medical Note: Always consult your doctor before switching medications.
🛑 Myths vs. Facts
- Myth: This medicine can be taken on an empty stomach.
Fact: It should be taken with food to reduce stomach irritation. - Myth: It is safe to take this medicine for long periods without monitoring.
Fact: Long-term use requires medical supervision and monitoring of liver and kidney function. - Myth: This medicine is safe to take with other painkillers.
Fact: Combining with other NSAIDs or paracetamol can increase the risk of side effects.
🔄 Alternative Options
Generic Alternatives
- Lornoxicam 4 mg + Paracetamol 500 mg tablet (generic)
Brand Alternatives
- Flexilor P 4mg/500mg Tablet