vorax plus 50mg/400mg tablet - Diclofenac (50mg) + Metaxalone (400mg) medicine

Flexura D Tablet: Comprehensive Guide to Uses, Side Effects, and Safety

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🏭 Staneil Pharma 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 23, 2026
⚠️ Hepatotoxicity Risk ⚠️ Nephrotoxicity Risk 🤰 Pregnancy Category Not established from the available information. Diclofenac is generally avoided in the third trimester due to risk of premature closure of ductus arteriosus. Metaxalone safety in pregnancy is not established. Consult your doctor. 📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: Moderate for short-term use in acute musculoskeletal pain.
Reviewed by
SaathiMed Expert Panel | Sep 23, 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 bruising or bleeding

If experiencing severe symptoms, call emergency services immediately.

What is vorax plus 50mg/400mg tablet used for?

This medicine is a combination of Diclofenac 50 mg and Metaxalone 400 mg used for short-term relief of acute musculoskeletal pain and muscle spasm. It works by reducing inflammation and relaxing muscles. Take it with food, avoid alcohol, and do not exceed the prescribed dose.

  • Generic Name: Diclofenac (50mg) + Metaxalone (400mg)
  • Manufacturer: Staneil Pharma
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 vorax plus 50mg/400mg tablet के बारे में (Hindi Summary)

उपयोग: यह दवा डाइक्लोफेनाक 50 मिलीग्राम और मेटाक्सालोन 400 मिलीग्राम का संयोजन है। इसका उपयोग मांसपेशियों में ऐंठन और तीव्र मस्कुलोस्केलेटल दर्द जैसे कमर दर्द, गर्दन दर्द, और मोच के इलाज के लिए किया जाता है। यह दर्द और सूजन को कम करने और मांसपेशियों को आराम देने में मदद करती है। इसे भोजन के साथ लें और शराब से बचें।

साइड इफेक्ट्स: आम दुष्प्रभावों में मतली, उल्टी, पेट दर्द, सिरदर्द, चक्कर आना, और नींद आना शामिल हैं। गंभीर दुष्प्रभावों में पेट में रक्तस्राव, गुर्दे की समस्या, यकृत की क्षति, और एलर्जी प्रतिक्रिया शामिल हो सकती है। यदि आपको काला मल, खून की उल्टी, तेज पेट दर्द, सीने में दर्द, या सांस लेने में कठिनाई हो तो तुरंत डॉक्टर से मिलें।

सुरक्षा सलाह: इस दवा को भोजन या दूध के साथ लें। निर्धारित खुराक से अधिक न लें। शराब और अन्य दर्द निवारक दवाओं से बचें। यदि आपको अल्सर, गुर्दे या यकृत की बीमारी, हृदय की समस्या, या अस्थमा है तो अपने डॉक्टर को बताएं। यदि आपको नींद या चक्कर आते हैं तो वाहन न चलाएं। गर्भावस्था या स्तनपान के दौरान डॉक्टर से सलाह लें।

💡 Did You Know? Over 80% of the antiretroviral drugs used globally to combat AIDS are supplied by Indian pharmaceutical companies.

💊 vorax plus 50mg/400mg tablet Uses & Benefits

[{"condition":"Acute musculoskeletal pain with muscle spasm","description":"Relieves pain and reduces muscle spasm in conditions such as back pain, neck pain, and sprains.","evidence":"Well-established"},{"condition":"Post-operative pain and spasm","description":"Used short-term to manage pain and muscle spasm after surgery.","evidence":"Moderate"},{"condition":"Traumatic injury pain","description":"Helps reduce pain and inflammation from injuries like strains and contusions.","evidence":"Moderate"}]

Off-label uses: [{"condition":"Tension headache","description":"Sometimes prescribed off-label for tension headaches with muscle tightness.","evidence":"Limited"},{"condition":"Fibromyalgia pain","description":"Occasionally used off-label for short-term relief of fibromyalgia flare-ups.","evidence":"Limited"}]

Primary treatment for: Acute musculoskeletal pain with muscle spasm

Also treats: Back pain, Neck pain, Sprains and strains, Post-operative pain

📋 Drug Information

Generic Name(s)Diclofenac (50mg) + Metaxalone (400mg)
Brand Namevorax plus 50mg/400mg tablet
ManufacturerStaneil Pharma
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassPAIN ANALGESICS
Action Class
Route of AdministrationOral
StorageStore at room temperature between 15°C and 30°C (59°F to 86°F). Protect from moisture and direct sunlight. Keep in the original container.
Shelf Life24 months from the date of manufacture.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Take this medicine with food or milk to reduce stomach upset.
2
Avoid alcohol and other CNS depressants while taking this medicine.
3
Do not drive or operate machinery if you feel drowsy or dizzy.
4
Use the lowest effective dose for the shortest duration possible.
5
Do not take other NSAIDs concurrently without consulting your doctor.
6
Report any signs of gastrointestinal bleeding, such as black stools or vomiting blood, immediately.
7
Stay well hydrated throughout the day.
8
Consult your doctor if pain persists beyond 7 days or worsens.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

Acute back pain with muscle spasm
This medicine is commonly prescribed for this.
Likely Use
Neck pain with stiffness
This medicine can help relieve pain and spasm.
Likely Use
Fever
This medicine is not a primary fever reducer.
Not Primary
Chronic arthritis pain
Not recommended for long-term use without medical supervision.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionDiclofenac is rapidly and completely absorbed from the gastrointestinal tract. Metaxalone is also absorbed from the gastrointestinal tract. Food may delay absorption of diclofenac but does not significantly reduce the extent of absorption.
DistributionDiclofenac is highly bound to plasma proteins and distributes into synovial fluid. Metaxalone distribution is not well characterized but is believed to be widely distributed.
Protein BindingDiclofenac: >99% bound to plasma proteins, primarily albumin. Metaxalone: Not established from the available information.
MetabolismDiclofenac is metabolized in the liver by cytochrome P450 enzymes, primarily CYP2C9, to several metabolites. Metaxalone is metabolized in the liver, but specific enzymes are not fully established.
Half-LifeDiclofenac: Approximately 1-2 hours. Metaxalone: Approximately 2-3 hours.
ExcretionDiclofenac metabolites are excreted mainly in urine and bile. Metaxalone is excreted in urine as metabolites.
BioavailabilityDiclofenac: Approximately 50-60% due to first-pass metabolism. Metaxalone: Not established from the available information.
Onset of ActionDiclofenac: Pain relief begins within 30-60 minutes. Metaxalone: Muscle relaxation effects may begin within 1 hour.
Peak Plasma TimeDiclofenac: 1-2 hours. Metaxalone: 2-4 hours.
Duration of ActionDiclofenac: 4-6 hours. Metaxalone: 4-6 hours. The combination is usually dosed 2-3 times daily.

How It Works

Diclofenac inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin synthesis and thereby decreasing inflammation, pain, and fever. Metaxalone acts as a central nervous system depressant, likely by blocking polysynaptic reflexes in the spinal cord and brainstem, leading to skeletal muscle relaxation. The combination provides both anti-inflammatory and muscle relaxant effects.

Mechanism Steps

1
COX inhibition by Diclofenac: Diclofenac binds to and inhibits cyclooxygenase enzymes, blocking the conversion of arachidonic acid to prostaglandins.
2
Reduced prostaglandin synthesis: Lower prostaglandin levels decrease inflammation, pain, and fever at the site of injury.
3
Central muscle relaxation by Metaxalone: Metaxalone acts on the central nervous system to inhibit polysynaptic reflex arcs, reducing muscle spasm.
4
Combined symptomatic relief: The anti-inflammatory and muscle relaxant effects work together to relieve pain and improve function.

💡 How to Take vorax plus 50mg/400mg tablet

Strength: Each tablet contains Diclofenac 50 mg and Metaxalone 400 mg.

1Take the tablet orally with a full glass of water.
2Take with food or milk to reduce stomach upset.
3Swallow the tablet whole; do not crush or chew.
4Follow the prescribed dose and duration exactly.
5Do not take more than the recommended dose.
6If you miss a dose, follow the missed dose instructions.
7Do not stop abruptly without consulting your doctor if you have been taking it for a long time.

Dosage Information

Adult DosageThe usual adult dose is one tablet taken orally two to three times daily, preferably with food. The maximum recommended dose is typically three tablets in 24 hours. 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. Use the lowest effective dose for the shortest possible time.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageElderly patients may be more sensitive to the effects of this medicine. Use with caution, starting at the lowest effective dose. Monitor kidney and liver function, and watch for gastrointestinal bleeding. Dose must be individualized by a qualified clinician.
Renal ImpairmentUse with caution in patients with kidney impairment. Dose adjustment may be necessary. Avoid in severe kidney disease. Consult your doctor for individualized dosing.
Hepatic ImpairmentUse with caution in patients with liver impairment. Dose adjustment may be necessary. Avoid in severe liver disease. Consult your doctor for individualized dosing.
Maximum Daily DoseThe maximum recommended daily dose is typically three tablets (150 mg diclofenac and 1200 mg metaxalone) in 24 hours. Do not exceed the prescribed dose.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

With food
Take with meals
Reduces stomach upset and gastrointestinal irritation.
Alcohol
Avoid
Increases risk of gastrointestinal bleeding and sedation.
Grapefruit juice
Avoid or limit
May increase diclofenac levels.

⏰ What to Do If You Miss a Dose

📌 Less than half the dosing interval has passed
→ Take the missed dose as soon as you remember.
💡 Continue with the regular schedule.
📌 More than half the dosing interval has passed
→ Skip the missed dose.
💡 Do not double dose to catch up.

⚠️ Side Effects of vorax plus 50mg/400mg tablet

✅ Common Side Effects

Nausea (Common (5-10%))
Take with food. If persistent, consult your doctor.
Dizziness (Common (5-10%))
Avoid driving or operating machinery until you know how it affects you.
Drowsiness (Common (5-10%))
Avoid alcohol and other sedatives. Rest if needed.
Stomach pain (Common (5-10%))
Take with food or milk. If severe, contact your doctor.
Headache (Common (5-10%))
Usually resolves. Stay hydrated. Consult if severe.

🚨 Serious Side Effects

Gastrointestinal bleeding (Rare (<0.1%))
Seek immediate medical attention if you notice black stools, vomiting blood, or severe abdominal pain.
Kidney injury (Rare (<0.1%))
Report decreased urine output, swelling, or fatigue to your doctor immediately.
Liver damage (Rare (<0.1%))
Seek medical help if you develop yellowing of skin or eyes, dark urine, or severe fatigue.
Severe allergic reaction (Rare (<0.1%))
Call emergency services if you experience swelling of face, lips, throat, or difficulty breathing.
Cardiovascular events (Rare (<0.1%))
Seek immediate care for chest pain, shortness of breath, or weakness on one side of the body.

⚠️ Rare Side Effects

Blood disorders
Report unusual bruising, bleeding, or infections to your doctor.
Pancreatitis
Seek immediate care for severe upper abdominal pain radiating to the back.
Severe skin reactions
Stop the medicine and seek emergency care if you develop a rash with blisters or peeling skin.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
Warfarin Major
Aspirin Major
Ibuprofen Major
Methotrexate Major
Lithium Major
ACE inhibitors Moderate
SSRIs Moderate
Benzodiazepines Moderate
Cyclosporine Moderate
Digoxin Moderate

🚨 Major Interactions

  • Warfarin
  • Other NSAIDs (e.g., aspirin, ibuprofen)
  • Corticosteroids
  • Methotrexate
  • Lithium

⚡ Moderate Interactions

  • Antihypertensives (e.g., ACE inhibitors, ARBs, diuretics)
  • SSRIs
  • CNS depressants (e.g., benzodiazepines, opioids, alcohol)
  • Cyclosporine
  • Digoxin

🍷 Alcohol Interaction

Avoid alcohol while taking this medicine. Alcohol increases the risk of gastrointestinal bleeding, ulcers, and liver damage from diclofenac, and adds to the sedative effects of metaxalone, increasing drowsiness and impairing coordination.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Known hypersensitivity to diclofenac, metaxalone, or any component of the formulation","History of asthma, urticaria, or allergic reaction to aspirin or other NSAIDs","Active or history of peptic ulcer or gastrointestinal bleeding","Severe heart failure, ischemic heart disease, or peripheral arterial disease","Severe liver impairment","Severe kidney impairment","Third trimester of pregnancy","Children under 12 years of age (safety not established)"]

⚠️ Warnings & Precautions

["Take with food to reduce gastrointestinal irritation.","Avoid alcohol and other CNS depressants.","Do not drive or operate machinery if drowsy.","Use with caution in elderly patients due to increased risk of side effects.","Monitor for signs of gastrointestinal bleeding.","Use with caution in patients with cardiovascular risk factors.","Do not use for longer than prescribed without medical advice.","Inform your doctor if you have kidney or liver disease.","May cause dizziness; avoid sudden changes in posture.","Do not take other NSAIDs concurrently."]

🤱 Lactation Safety

Diclofenac is excreted in breast milk in small amounts. Metaxalone safety during breastfeeding is not established. Consult your doctor before use.

💊 Overdose Management

Overdose may cause nausea, vomiting, abdominal pain, drowsiness, dizziness, and in severe cases, gastrointestinal bleeding, kidney failure, or respiratory depression. Seek immediate medical attention. Treatment is supportive and symptomatic. There is no specific antidote. Activated charcoal may be considered if ingestion is recent. Monitor vital signs, kidney and liver function, and provide supportive care.

⏰ 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 double the dose to catch up.

Additional Safety Advice

General Safety

Take this medicine with food or milk to reduce stomach upset. Do not exceed the prescribed dose or duration. Avoid alcohol and other NSAIDs while taking this medicine. Inform your doctor if you have a history of ulcers, kidney or liver disease, heart problems, or asthma. Do not drive or operate machinery if you feel drowsy or dizzy. Use the lowest effective dose for the shortest possible time. Do not use this medicine for minor aches or without a prescription. Keep out of reach of children. Store at room temperature away from moisture and heat. If you are pregnant, planning pregnancy, or breastfeeding, consult your doctor before use.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients are at higher risk of gastrointestinal bleeding, kidney problems, and cardiovascular events. Use with caution, starting at the lowest effective dose. Monitor kidney and liver function regularly. Avoid long-term use.

🤰 Pregnancy Planning (TTC)

Consult your doctor before taking this medicine if you are planning pregnancy. Diclofenac may affect ovulation and is generally avoided in the third trimester. Metaxalone safety in pregnancy is not established.

🏥 Post-Surgery Considerations

This medicine may be prescribed for short-term post-operative pain and muscle spasm. However, it should not be used for peri-operative pain in coronary artery bypass graft (CABG) surgery. Follow your surgeon's instructions carefully.

🦷 Dental Procedures

Inform your dentist if you are taking this medicine before any dental procedure. It may increase bleeding risk. Your dentist may advise stopping it temporarily before surgery.

💚 Lifestyle Tips for Better Results

🏃
Maintain a healthy weight to reduce stress on muscles and joints.
🥗
Regular low-impact exercise like swimming or walking can help.
😴
Practice good posture while sitting and standing.
💧
Include anti-inflammatory foods like omega-3 rich fish, fruits, and vegetables.
🧘
Get adequate sleep to aid muscle recovery.
🌞
Apply heat or cold packs to affected areas as advised.
🚭
Avoid heavy lifting and sudden movements during acute pain.

🏋️ Exercise Considerations

Avoid strenuous exercise or heavy lifting while taking this medicine, especially if you have muscle spasm or pain. Gentle stretching and low-impact activities may be beneficial once acute pain subsides. Consult your doctor or physiotherapist before starting any exercise program.

🥗 Diet Recommendations

Include omega-3 rich foods like salmon, flaxseeds, and walnuts.
Reduce processed and fried foods.
Stay well hydrated by drinking plenty of water.
Eat a balanced diet rich in fruits and vegetables.
Limit caffeine and alcohol.

💼 Impact on Daily Work & Life

This medicine may cause drowsiness and dizziness, which can affect your ability to drive or operate machinery. Avoid these activities until you know how the medicine affects you. It may also cause stomach upset; taking it with food can help. Inform your employer if your job involves operating heavy machinery.

🛑 When to Stop This Medicine

Stop taking this medicine and consult your doctor if you experience severe side effects such as gastrointestinal bleeding, allergic reactions, or if your pain does not improve within 7 days. 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 problems, liver damage, and cardiovascular events. Regular monitoring of kidney and liver function is advised. Use the lowest effective dose for the shortest duration possible. Consult your doctor if you need to take it for more than 7 days.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Physical therapy

Can complement medicine for chronic pain and improve muscle strength.

Evidence: Well-established
Heat or cold therapy

Applying heat or cold packs can help reduce pain and inflammation.

Evidence: Moderate
Acupuncture

May help relieve musculoskeletal pain in some patients.

Evidence: Limited

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

Not established from the available information. Consult your doctor regarding vaccination timing while 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

Carry this medicine in its original packaging with a copy of your prescription. Store at room temperature and protect from moisture and direct sunlight. If traveling across time zones, adjust dosing schedule as advised by your doctor. Check customs regulations for carrying prescription medicines. Do not leave in a hot car or checked luggage.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 45-year-old office worker with acute lower back pain and muscle spasm
Ravi started this medicine as prescribed for acute back pain. He took it with food and avoided alcohol. Within a few days, his pain and muscle stiffness improved significantly. He was advised to do gentle stretching exercises and maintain good posture.
💡 Lesson: Taking the medicine with food and following lifestyle advice improves both efficacy and tolerability.
👤 A 60-year-old woman with knee pain after a fall
Mrs. Sharma was prescribed this medicine for knee pain and swelling after a fall. She experienced mild drowsiness initially but it subsided. She was advised not to drive and to use a knee brace. Her pain improved over a week.
💡 Lesson: Drowsiness can occur; avoid driving until you know how the medicine affects you.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: Pain relief typically begins within 30-60 minutes, with peak effects in 1-2 hours.

Q: Can I take this medicine on an empty stomach?

A: It is best taken with food or milk to reduce stomach upset.

Q: What should I do if I miss a dose?

A: Take it as soon as you remember if less than half the dosing interval has passed. Otherwise, skip the missed dose and continue with your regular schedule. Do not double dose.

Q: Is it safe to take this medicine with alcohol?

A: No, avoid alcohol as it increases the risk of gastrointestinal bleeding and sedation.

Q: Can I take this medicine for a long time?

A: This medicine is intended for short-term use only. Long-term use should be under strict medical supervision.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine long-term?
  • Will it affect my kidney function?
  • Can I drive after taking this medicine?
  • Does it interact with my blood pressure medicine?
  • What if I miss a dose?
  • Can I drink alcohol while taking this?
  • Is it safe during pregnancy?
  • Can I take it with other painkillers?

🔄 Substitutes for vorax plus 50mg/400mg tablet

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: This medicine can be taken long-term for chronic pain.
    Fact: This medicine is intended for short-term use only. Long-term use increases the risk of serious side effects.
  • Myth: It is safe to take extra doses if pain is severe.
    Fact: Taking more than the prescribed dose can lead to serious complications. Follow your doctor's instructions exactly.
  • Myth: This medicine is safe to take without a prescription.
    Fact: This is a prescription medicine. It should only be taken under medical supervision.

🔄 Alternative Options

Generic Alternatives

  • Diclofenac 50 mg + Metaxalone 400 mg tablet (generic)

Brand Alternatives

  • Flexura D Tablet

📊 Comparison with Similar Medicines

[{"medicine":"This medicine (Diclofenac + Metaxalone)","composition":"Diclofenac 50 mg + Metaxalone 400 mg","uses":"Acute musculoskeletal pain with spasm","notes":"Combines NSAID and muscle relaxant."},{"medicine":"Diclofenac + Paracetamol","composition":"Diclofenac 50 mg + Paracetamol 325 mg","uses":"Pain and inflammation","notes":"No muscle relaxant effect."},{"medicine":"Aceclofenac + Paracetamol","composition":"Aceclofenac 100 mg + Paracetamol 325 mg","uses":"Pain and inflammation","notes":"Alternative NSAID combination."}]

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