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4-Steps 0.5% W/W Gel

Manufacturer: Aeran Lab India Pvt Ltd
Medicine composition: Piroxicam
Prescription vs.OTC: Prescription by Doctor required

4-Steps 0.5% W/W Gel is used in the treatment of swelling, pain and joint stiffness resulting from arthritis. This medication belongs to a group of drugs called NSAIDs (Nonsteroidal anti-inflammatory drugs). It works by inhibiting the production of certain substances in the body that leads to inflammation.

Take the medication orally after consulting with your doctor. The usual dosage in 1 tablet per day. Avoid lying down immediately after taking this medication. You should take this medication with milk, food or an antacid to prevent stomach problems. The doctor will prescribe the dose based on your medical condition and how you are responding to the treatment. It is often recommended to take the lowest possible dose to prevent various problems like stomach bleeding and other problems. Side effects of this medication are stomach problems, drowsiness, nausea and dizziness. You should consult your doctor if these side effects become severe. 4-Steps 0.5% W/W Gel can also raise your blood pressure. In rare cases, this drug can also result in serious liver problems. If you see symptoms of liver damage like dark urine, nausea, vomiting, yellow eyes/skin and loss of appetite then consult a doctor immediately.

You also need to take certain precautions before taking this medication. You need to inform your doctor about any allergies that you may have before starting a course of this medication. This drug may also contain certain inactive ingredients that can cause allergic reactions in the body. You should also inform the doctor about any history of blood disorders, anemia and heart conditions before taking this medication. It is advised to avoid driving or perform any other activity that require alertness immediately after taking this medication. You should also try to stay off alcohol and tobacco while taking this medications as it increases the risk of stomach bleeding.

4-Steps 0.5% W/W Gel is used to relieve symptoms of pain and inflammation in rheumatoid arthritis patients.
4-Steps 0.5% W/W Gel is used to relieve symptoms of pain and inflammation in osteoarthritis patients.
4-Steps 0.5% W/W Gel is not recommended if you have a known history of allergy to Nonsteroidal anti-inflammatory drugs.
4-Steps 0.5% W/W Gel is not recommended in patients with known history of Asthma.
Coronary Artery Bypass Surgery (CABG)
4-Steps 0.5% W/W Gel is not recommended in patients undergone heart surgery.
In addition to its intended effect, 4-Steps 0.5% W/W Gel may cause some unwanted effects too. In such cases, you must seek medical attention immediately. This is not an exhaustive list of side effects. Please inform your doctor if you experience any adverse reaction to the medication.
Abdominal pain Major Common
Constipation Major Common
Headache Major Common
Dizziness Major Less Common
Burning sensation in stomach Major Less Common
Excessive air or gas in stomach Minor Common
shakiness in the legs, arms, hands, or feet Minor Less Common
Loss of strength Minor Less Common
Restlessness Minor Rare
Change in appetite Minor Rare
How long is the duration of effect?
The effect of this medicine lasts for an average duration of 48 to 72 hours.
What is the onset of action?
The effect of this medicine can be observed in 30 min to 1 hour.
Are there any pregnancy warnings?
This medicine is not recommended for pregnant women.
Is it habit forming?
No habit forming tendencies were reported.
Are there any breast-feeding warnings?
This medicine is not recommended for breastfeeding women.
Missed Dose instructions
The missed dose can be taken as soon as you remember. However, the missed dose should be skipped if it is almost time for your next dose.
Overdose instructions
A doctor should be contacted immediately if an overdose of 4-Steps 0.5% W/W Gel is suspected. Signs and symptoms of overdose include stomach irritation, difficulty in breathing, black colored stools etc. Immediate medical attention is needed if an overdose is confirmed.
United States
Whenever you take more than one medicine, or mix it with certain foods or beverages, you're at risk of a drug interaction.
Interaction with Disease
Asthma Major
4-Steps 0.5% W/W Gel should not be taken if you have NSAID-sensitive asthma. Any such history should be reported to the doctor so that appropriate substitution can be done.
Gastro-Intestinal toxicity Major
4-Steps 0.5% W/W Gel and other NSAIDs should be taken after consulting a doctor especially if the intended duration is longer than a month. Any symptom indicating ulceration and bleeding like chronic indigestion, coffee colored dry blood in stools or vomiting of blood should be reported immediately.
Interaction with Alcohol
Alcohol Moderate
This medicine should not be consumed with alcohol. Symptoms of stomach bleeding (such as the presence of dried and coffee colored blood in cough or stools) should be reported to the doctor immediately.
Interaction with Lab Test
Information not available.
Interaction with Food
Information not available.
Interaction with Medicine
Warfarin Major
These medications may increase the risk of bleeding if taken together. Inform the doctor if you are receiving any pain medications or if you have any bleeding disorder. An alternate class of medicine should be considered based on the clinical condition.
Corticosteroids Moderate
Use with caution as this combination will increase the risk of gastrointestinal bleeding. Inform the doctor if you are taking either of the medicines. Consider taking alternative medicine after consulting your doctor.
Fluoroquinolone Moderate
These medications may increase the central nervous system stimulation and causes tremors, involuntary body movements, and seizures. Inform the doctor if you are receiving antibiotics belongs to fluoroquinolones. Consider the alternate class of medicine based on the clinical condition.
Angiotensin converting enzyme inhibitors Moderate
4-Steps 0.5% W/W Gel may alter the effect of antihypertensives, therefore should be used with caution. Inform the doctor if you are receiving antihypertensives like captopril, enalapril, benazepril. Monitoring of blood pressure is necessary. Any changes in the blood pressure should be informed to the doctor. Dose adjustments are to be made based on the clinical condition.
Disclaimer: The information produced here is best of our knowledge and experience and we have tried our best to make it as accurate and up-to-date as possible, but we would like to request that it should not be treated as a substitute for professional advice, diagnosis or treatment.

Lybrate is a medium to provide our audience with the common information on medicines and does not guarantee its accuracy or exhaustiveness. Even if there is no mention of a warning for any drug or combination, it never means that we are claiming that the drug or combination is safe for consumption without any proper consultation with an expert.

Lybrate does not take responsibility for any aspect of medicines or treatments. If you have any doubts about your medication, we strongly recommend you to see a doctor immediately.

Popular Questions & Answers

For infection doctor given me the AF- kit, itraconazole gel 1.0%w/w and clindamycin phosphate and clotrimazole soft gelatin vaginal capsules is given to follow, capsules and AF-kit course completed then also there is no stopping of white bleeding but no itching what can I do.

Diploma in Anesthesia, MBBS
General Physician, Hyderabad
your age and marital status is not given, if married the treatment need to be taken by your husband also or else avoid intercourse. if no itching means infection is contained. depending on the need some of the medicines need to be taken for some more days. maintain perfect cleanliness of the genitals and keep them dry by wiping with cloth even after passing urine. good luck
1 person found this helpful

Hi, Let me brief you about the situation, I have tight foreskin on my penis, I cannot retract the foreskin all the way when I have an erection. I can pull the foreskin back when my penis is not erect. I believe a small part of the foreskin has to be attached at the bottom of the penis so I don't know if that attachment is stopping me to retract the skin all the way. But any way after I got the answer I was told to apply a Betamethasone cream 0.05%. So now the problem is I bought a cream name "Diprovate plus" which is composed of Betamethasone Dipropionate IP equivalent to Betamethasone 0.05% w/w and Zinc sulphate IP 0.50% w/w. I believe you guys know all about the cream but I just wanted to be 100% sure that it won't harm my penis in any manner. As we all know we don't have any spare one to use if something had to happen to this one. So can anyone please tell me if its okay to apply the cream to my penis, is there anything I need to worry about, if I can apply it how do I apply, where to apply, what happens if I accidentally apply it on the head of the penis. How many times do I apply the cream and when? I don't know if I asked everything but if you think I missed anything please let me know everything about it so that I can go ahead and start using the cream! Thank you in advance.

Homeopath, Murshidabad
 Let me brief you about the situation, I have tight foreskin on my penis, I cannot retract the foreskin all the w...
If you have any cuts or small injury on your penis then wait until it gets fully healed. Just apply a little bit of the cream at the point where your foreskin is attached at the bottom of penis & follow the instructions which you got in your previous message

I have sever headache since 2days. What are home remedies ww can do in home. Can you help me?

MBBS, Diploma in Nutrition and Health Education (DNHE), Diploma in Clinical Cosmetology
General Physician, Noida
I have sever headache since 2days. What are home remedies ww can do in home. Can you help me?
You can take(If No drug allergy) : 1. Tablet Crocin (Paracetamol 500 mg) one tablet after food when required for headache after food for 2-3 days (maximum 2 tablets with gap of 12 hour can be taken in a day) you may be having headache because of stress/ refractory problems/ any ENT problem or may be Migraine Headache follow advises given below: Adequate sleep 6-8 hr in a day Get check eyes for refractive error complete history of your headache for further management like duration, severity, aggravating factors/relieving/ triggering/ associated factor to reach diagnosis It may be due to stress This problem can be solved by Meditation you can go for regular Physical exercise consult privately

I am suffering from Anal Fissure due to tighten of Anal Sphincter, Doctor Prescribe Ruticool Cream (containing Lidocaine Topical (3% w/w, Calcium Dobesilate Topical (0.025% w/w, Hydrocortisone Topical (0.025% w/w, Phenylephrine (0.1% w/w, Zinc Oxide (5% w/w)), But after use of cream I feel my anus is tighten more then relax, Is this Cream is Ok for this condition? Thanks.

MD - Homeopathy, BHMS
Homeopath, Gurgaon
Some dietary restrictions and Homeopathic Medicines will certainly help you. Edibles To Avoid :- Amchoor Amchur, Ajwain, Elaichi Cardamom, Imli Tamarind, Laung Cloves, Teekha-Mirch (Red-Green), Fig, millet, Cluster Beans, Brinjal-Eggplant, sesame, peanuts, pickle, Buckwheat Flour,  Pain killar Medicines, >>>To eat more :- Guava, Orange, Pear, Mosambi (Sweet orange), Curd, Salad >>>To continue as usual :- Cumin Seeds, coriander, turmeric, Salt, Aniseed-Fennel, Kashmeeri Lal-hari mirch and all other food items not mentioned above, unless not forbidden due to other ailments If you have faith in homeopathic medicine, you can take following medication: (1) Alpha Liv (2) R 13 Take medicine under supervision of homeopathic consultant only You can consult me in person through Lybrate online for more information.

Popular Health Tips

12 Steps for Self Care

Unani Specialist, Delhi
12 Steps for Self Care
12 Steps for Self Care

1. If it feels wrongs, don't do it.
2. Say "exactly" what you mean.
3. Don't be a people pleaser.
4. Trust your instincts.
5. Never speak bad about yourself.
6. Never give up on your dreams.
7. Don't be afraid to say "no"
8. Don't be afraid to say "yes"
9. Be kind to yourself.
10. Let go of what you can't control.
11. Stay away from drama & negativity.
12. Love.
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How Nosebleed Can Be Stopped?

MBBS, Fellowship In FESS, MS - ENT, MS - (Oto-Rhino-Laryn)
ENT Specialist, Faridabad
How Nosebleed Can Be Stopped?

A nosebleed also called epistaxis medically is normally not dangerous, but if you are old nosebleeds come with a number of risks. Treating a bloody nose incorrectly can only make it more dangerous, because of prolonged bleeding. Before we explain the ways to stop nosebleeds, let’s take a look at its causes:
Nosebleeds usually start from just inside the entrance of the nostril. But, why? Because the blood vessels here are quite fragile and are also prone to rupture easily. This is the reason why children suffer from nosebleeds so easily. Other common reasons are

  1. A blocked nose due to colds
  2. Picking one's nose roughly
  3. Blowing one's nose
  4. Injuries
  5. Use of cocaine

A nosebleed usually lasts for about 10-20 minutes and is usually easy to treat. But in some conditions, this bleeding can be profuse and last longer like in cases of 

  1. Heart failure
  2. Blood clotting disorders
  3. Due to 'blood thinning' medicines
  4. Hypertension

Bleeding can sometimes also happen in areas further back in the nose due mostly to injuries and disorders of the nose.

Usually, nosebleeds can be stopped using simple first aid.

  1. Sitting up straight helps, especially along with tipping your head forward. It is vital that you don’t tip your head backwards as this can allow the blood to go down your throat and cause vomiting. And this can make your nosebleed worse. So, take care to spit out the blood in your mouth and not to swallow it.
  2. To stop a nosebleed, pinch the soft, cartilaginous part of your nose using your thumb and forefinger. Spraying your nose with a medicated nasal spray before pinching it can help the bleeding to stop faster. Apply pressure for 10 minutes to get results. Check if your nosebleed has stopped after 10 minutes if it’s not; apply pressure for another 10 minutes. Nosebleeds usually stop after 10 to 20 minutes of pressure.
  3. Use an ice pack to your nose and cheeks. This will constrict the blood vessels in the nose and stop the nosebleed.
  4. Use a saline- or water-based nasal gel inside your nose to stop bleeding.
  5. Remember not to blow your nose or insert anything into your nose for at least 12 hours after your nosebleed is over.
  6. If the bleeding doesn’t stop even after 20 minutes of applying direct pressure, it’s prudent to rush to a doctor. He will treat your nose to stop the bleeding.
  7. In a few rare cases, the bleeding is so severe that a blood transfusion is needed, and surgery may be needed to stop it.

In case you have a concern or query you can always consult an expert & get answers to your questions!

3404 people found this helpful

Steps To De-Addiction!

Psychiatrist, Mumbai
Steps To De-Addiction!

Addiction is the absolute dependency on a particular substance or situation. Substance addiction includes a variety of substances apart from alcohol and drugs. Examples include porn, food, chocolate, nicotine, etc. Situation addiction includes gambling, shopping and sex among others. The problem in our society with addiction is it is treated like a choice than as a major problem faced by an individual. De-addiction is the process of ridding the individual of his dependence on certain substances or activities.


  1. Rehabilitation psychology studies the process of de-addiction and helps addicts blend with the normal lifestyle. Rehab centers offer several forms of therapy to reduce substance usage.
  2. Group therapy is always the go to form of therapeutic technique to deal with cases of addiction owing to the common feeling among users that people who aren’t addicted and do not know what they’re going through. In those cases, it is rather important to have support from a group of people who are exactly where they are.
  3. Family therapy is also essential to make the individual know how their loved ones feel and also remind them of the unconditional support. Some rehab centers also use the horse therapy (focuses on interaction with horses which facilitates emotional and occupational development in patients) which is rather interesting to witness.
  4. In addition to therapy, rehab centers teach life skills and cooperation. Apart from all this, drugs are also prescribed to deal with addiction along with the weekly scheduled personal therapy sessions.

Although an unfamiliar concept in India, halfway homes are the next step after the rehab. The individuals learn different skills and ways to manage themselves outside the house while still continuing their therapy. This is done to make sure one doesn’t relapse right after the rehabilitation has been completed. Most rehabs also suggest support group meetings. Even otherwise support groups are extremely effective in the de-addiction process. ‘Alcoholics Anonymous’ and ‘Narcotics Anonymous’ are two of the most widely managed support groups around the world.

Addiction is an immense issue which has spiraled out of control in today’s times. However, it is necessary to understand it isn’t the question of the individual’s morality. The removal of labels and stigma is essential in the entire process. Support from loved ones is an extremely important step towards de-addiction, right after the acceptance that one is addicted. If you wish to discuss about any specific problem, you can consult a psychiatrist.

4103 people found this helpful

Simple Steps To Help You Say No!

B.A.(H)Psychology, M.A.Psychology, Ph. D - Psychology
Psychologist, Noida
Simple Steps To Help You Say No!

Humans are social animals who thrive on reciprocality. It is in our basic nature to be socially courteous, and the word 'No' feels like a conflict that warns a potential relationship. Many of us tend to comply with every single request that is put forward to us by our peers, family, or at the workplace by our superiors. We choose to take up more jobs than we can efficiently handle and put unnecessary stress on ourselves even at the cost of our time and well-being. Must we always do that? 

Why is it so hard to say 'No'?

People have the notion that saying 'No' can come across as rude or uncaring. You may feel that you are letting someone down by turning down their request or risking a relationship. But, it has mostly to do with your self-confidence than your relationships with people. It may branch from overbearing parents, high expectations set by your peers and mentors or experiencing parenthood yourself and setting unreasonable standards for yourself. Childhood influences are usually the biggest cause of people always saying ‘yes’ all the time.

People who have low self-confidence tend to value their own needs less than the needs of others. Saying 'No' feels rude, and no one wants to be impolite.

Well... saying 'No' does not mean you are being rude or disagreeable.

At the end of the day, it is more about how you say 'no', rather than just saying the word 'No'. Saying 'No' is about valuing and respecting your own time and priorities. 

How to start saying say 'No'?
If you want to take a step back and start saying 'No' to make sure your own needs are valued, here’s what you need to do.

  1. Refuse politely, when it seems not possible: Do not overcomplicate responses and try to be as simple in your responses as you can be. If you are asked to do something, and you want to say 'no', try to be polite in your body language and state that it is not convenient for you at the moment and that you would rather get back to it later.
  2. Seek time before committing: The transition from saying ‘yes’ all the time to saying no does take time! Start to give yourself more time and ask people to get back to you later. This way you can begin to build more self-confidence and learn to say no over time. This also allows you to evaluate your response instead of immediately saying yes or no to the person asking the favor or task.
  3. Do not feel guilty: Deep down if you want to do a favor, you can go ahead with it, but you should also understand that it is okay to say no, and there is no need to associate guilt with it. You should set boundaries and allow people around you to understand how much favors they can ask you for instead of presenting you with an endless amount of favors from you.
  4. Set your boundaries: Refusal does not amount to rejection as you have just as much right to say ‘no’ as the person who is asking the favor from you. You are simply turning down a request, and in most situations, there is a middle ground for compromises where both you and the requester can be satisfied. If you have limited time to fulfill a request, let the person know and help out only as much as you can without overstepping your boundaries.

Bringing in these changes can help you be more self-confident, and at the same time enable you to say no when you need to without weighing yourself down with expectations and fear or rejection.

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Smart living through simple steps!

Urologist, Kolkata
Smart living through simple steps!
Drink plenty of water and add a little more vegetables to your daily diet to keep your kidneys as well as your digestive system healthy throughout your life.

A small step today. A big impact tomorrow. Stay healthy:)
43 people found this helpful

Table of Content

About 4-Steps 0.5% W/W Gel
When is 4-Steps 0.5% W/W Gel prescribed?
What are the contraindications of 4-Steps 0.5% W/W Gel?
What are the side effects of 4-Steps 0.5% W/W Gel?
Key highlights of 4-Steps 0.5% W/W Gel
What are the dosage instructions?
Where is the 4-Steps 0.5% W/W Gel approved?
What are the interactions for 4-Steps 0.5% W/W Gel?