Lemsip Max Cold and Flu Blackcurrant Sachets, With Paracetamol, Pack Of 10 (Packaging May Vary)

Product Information

Sympathomimetic agents: Concomitant use of phenylephrine with other sympathomimetic amines can increase the risk of hypertension and other cardiovascular side effects (see section 4.3). Treatment with activated charcoal should be considered if the overdose has been taken within 1 hour. Plasma paracetamol concentration should be measured at 4 hours or later after ingestion (earlier concentrations are unreliable). Treatment with N-acetylcysteine may be used up to 24 hours after ingestion of paracetamol, however, the maximum protective effect is obtained up to 8 hours post-ingestion. The effectiveness of the antidote declines sharply after this time. If required the patient should be given intravenous N-acetylcysteine, in line with the established dosage schedule. If vomiting is not a problem, oral methionine may be a suitable alternative for remote areas, outside hospital. Management of patients who present with serious hepatic dysfunction beyond 24 hours from ingestion should be discussed with the NPIS or a liver unit. Immediate medical advice should be sought in the event of an overdose, even if the patient feels well because of the risk of delayed serious liver damage

Symptoms - emesis and convulsions may occur. No specific antidote. However, treatment is usually fluid therapy. Fatal poisoning is rare. If symptoms become apparent or overdose is suspected, consult a doctor immediately. Monoamine oxidase inhibitors (including moclobemide): hypertensive interactions occur between sympathomimetic amines such as phenylephrine and monoamine oxidase inhibitors (see section 4.3). Paracetamol is excreted in breast milk, but not in a clinically significant amount. Available published data do not contraindicate breast feeding.Phenylephrine should be used with care in patients with cardiovascular disease, diabetes mellitus, closed angle glaucoma and hypertension. hydrochloride 6.1 mg. Night capsule contains Paracetamol 500 mg, Phenylephrine hydrochloride 6.1 mg. Indications: For the relief of Directions How to take: For oral use. Pour one sachet of powder into a mug and fill with hot, but not boiling, water. Stir until dissolved. If preferred, sweeten to taste with sugar, honey or your usual sweetener. How much to take: Adults, the elderly and children aged 16 years and over: 1 sachet every 4-6 hours. Do not take more than 4 sachets in 24 hours. Do not give to children under 16 years of age. Do not take more medicine than the label tells you to. If you do not get better, talk to your doctor. Do not take if: you are allergic to any ingredient, you have heart disease, high blood pressure, overactive thyroid, an enlarged prostate, or if you are taking or have taken MAOI's (antidepressants) within 14 days or other sympathomimetic, decongestants. Indications: For the relief of symptoms associated with the common cold and influenza, including relief of aches and pains, sore throat,

Cetylpyridinium Chloride 3.0 mg /20ml dose Indications: Short term symptomatic relief of the symptoms of colds and flu, includingThe anticoagulant effect of warfarin and other coumarins may be enhanced by prolonged regular daily use of paracetamol with increased risk of bleeding; occasional doses have no significant effect. influenza, including the relief of aches and pains, sore throat, headache, nasal congestion, lowering of temperature and chesty coughs Due to the presence of caffeine, the product should be taken with care in patients with a history of peptic ulcers.

Anticoagulants: The anticoagulant effect of warfarin and other coumarins may be enhanced by prolonged regular daily use of paracetamol with increased risk of bleeding; occasional doses have no significant effect. Paracetamol: Paracetamol is absorbed rapidly and completely mainly from the small intestine, producing peak plasma levels after 15-20 minutes following oral dosing. The systemic availability is subject to first-pass metabolism and varies with dose between 70% and 90%. The drug is rapidly and widely distributed throughout the body and is eliminated from plasma with a T ½ of approximately 2 hours. The major metabolites are glucuronide and sulphate conjugates (>80%) which are excreted in urine. Treatment with activated charcoal should be considered if the overdose has been taken within 1 hour. Plasma paracetamol concentration should be measured at 4 hours or later after ingestion (earlier concentrations are unreliable). Treatment with N-acetylcysteine may be used up to 24 hours after ingestion of paracetamol, however, the maximum protective effect is obtained up to 8 hours post-ingestion. The effectiveness of the antidote declines sharply after this time. If required the patient should be given intravenous Nacetylcysteine, in line with the established dosage schedule. If vomiting is not a problem, oral methionine may be a suitable alternative for remote areas, outside hospital. Management of patients who present with serious hepatic dysfunction beyond 24 hours from ingestion should be discussed with the NPIS or a liver unit. Sympathomimetic amines: concomitant use of phenylephrine with other sympathomimetic amines can increase the risk of cardiovascular side effects. a) Is on long-term treatment with carbamazepine, phenobarbitone, phenytoin, primadone, rifampicin, St. John's Wort or other drugs that induce liver enzymes, or

The maximum daily dose of this product is equivalent to 23.7 % of the WHO recommended maximum daily intake for sodium. Indications: For the relief of symptoms of colds and influenza, including the relief of aches and pains, sore throat, headache, nasal

relief of aches and pains, sore throat, headache, nasal congestion and lowering of temperature Legal Category: GSL. CYP Inhibitors: Caffeine undergoes extensive metabolism by hepatic microsomal cytochrome P450, factors known to alter the activity of this enzyme system may influence caffeine clearance. Thus, caffeine elimination is enhanced in cigarette smokers and inhibited by cimetidine, disulfiram, and oral contraceptive steroids. Additional symptoms may include, hypertension, and possibly reflex bradycardia. In severe cases confusion, seizures and arrhythmias may occur. However the amount required to produce serious phenylephrine toxicity would be greater than that required to cause paracetamol-related liver toxicity. The safety of this medicine during pregnancy and lactation has not been established but in view of a possible association of foetal abnormalities with first trimester exposure to phenylephrine, the use of the product during pregnancy should be avoided. In addition, because phenylephrine may reduce placental perfusion, the product should not be used in patients with a history of preeclampsia.

Use during breastfeeding should be avoided, unless recommended by a healthcare professional (see section 4.6). The product should be avoided during lactation unless recommended by a healthcare professional. There are limited data on the use of phenylephrine in lactation. Symptoms of paracetamol overdose in the first 24 hours are pallor, nausea, vomiting, anorexia and abdominal pain. Liver damage may become apparent 12 to 48 hours after ingestion. Abnormalities of glucose metabolism and metabolic acidosis may occur. In severe poisoning, hepatic failure may progress to encephalopathy, haemorrhage, hypoglycaemia, cerebral oedema and death. Acute renal failure with acute tubular necrosis, strongly suggested by loin pain, haematuria and proteinuria, may develop even in the absence of severe liver damage. Cardiac arrhythmias and pancreatitis have been reported. Tricyclic antidepressants (e.g. amitriptyline): may increase the risk of cardiovascular side effects with phenylephrine (see section 4.3). Hull, HU8 7DS. Information about this product, including adverse reactions, precautions, contra-indications, and method of use can be