Lemsip Cough Max for Chesty Cough & Cold, Lemon & Menthol Flavour 10 Sachets

Product Information

Paracetamol: Liver damage is possible in adults who have taken 10 g or more of paracetamol. Ingestion of 5g or more paracetamol may lead to liver damage if the patient has risk factors (see below). a)Is on long term treatment with carbamazepine, phenobarbitone, phenytoin, primidone, rifampicin, St John's Wort or other drugs that induce liver enzymes, or Common (1% to 10%): Peripheral edema, hypertension, hypotension, tachycardia, chest pain [ Ref] Metabolic 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. Don't take Lemsip max flu lemon if you have taken a type of medicine called a monoamine oxidase inhibitor (MAOI) in the last 14 days. MAOIs include the antidepressants phenelzine, tranylcypromine, isocarboxazid and moclobemide, and the anti-Parkinson's medicines selegiline and rasagiline. This is because the combination of pseudoephedrine with these medicines could cause a dangerous increase in blood pressure (hypertensive crisis).

Patients with rare hereditary problems of fructose intolerance, glucose- galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine. Using paracetamol or paracetamol containing products such as Lemsip Max long-term may potentially increase the anti-blood-clotting effect of warfarin, leading to an increased risk of bleeding. Lemsip max capsules should only be used for the short period to relief the symptoms of cold or flu. Other medicines containing the same active ingredients Get emergency help immediately if any of the following symptoms of overdose occur while taking acetaminophen: Symptoms of overdose This product contains 129.0mg (5.6mmol) sodium per dose - to be taken into consideration for patients on a controlled sodium diet.Brotodihardjo AE, Batey RG, Farrell GC, Byth K. Hepatotoxicity from paracetamol self-poisoning in Western Sydney: a continuing challenge. Med J Aust. 1992;157:382-5. Caution should be taken when paracetamol is used concomitantly with flucloxacillin as concurrent intake has been associated with high anion gap metabolic acidosis, especially in patients with risks factors (see section 4.4). The medicine comes as capsules and sachets for making hot drinks. Both are licensed for adults and adolescents aged 12 years and over. Monoamine oxidase inhibitors (including moclobemide) (MAOIs): Hypertensive interactions occur between sympathomimetic amines such as phenylephrine and monoamine oxidase inhibitors (see section 4.3).

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. Epidemiological studies in human pregnancy have shown no ill effects due to paracetamol used in the recommended dosage, but patients should follow the advice of their doctor regarding its use. Paracetamol is generally considered safe for use during pregnancy. However, the safety of pseudoephedrine has not been established and some studies have suggested that use of pseudoephedrine in the first trimester may be associated with defective closure of the abdominal wall (gastroschisis) in the baby. As a result, Lemsip max flu lemon is not usually recommended for use by women who are pregnant. Get further medical advice from your doctor, pharmacist or midwife. Filipe PL, Freitas JP, Decastro JC, Silva R. Drug eruption induced by acetaminophen in infectious mononucleosis. Int J Dermatol. 1995;34:220-1. Taken during pregnancy it appears that the half-life of caffeine is prolonged. This is a possible contributing factor in hyperemesis gravidarum.Phenylephrine hydrochloride: Due to the vasoconstrictive properties of phenylephrine, the product should be used with caution in patients with a history of pre-eclampsia. Phenylephrine may reduce placental perfusion and the product should be used in pregnancy only if the benefits outweigh this risk. There is no information on use in lactation. Wong V, Daly M, Boon A, Heatley V. Paracetamol and acute biliary pain with cholestasis. Lancet. 1993;342:869. Hull, HU8 7DS. Information about this product, including adverse reactions, precautions, contra-indications, and method of use can be

Adults aged 16 years and over should take two capsules every four to six hours as necessary, up to a maximum of four doses in 24 hours. Do not take more than eight capsules in 24 hours. There have been reports of blood dyscrasias including thrombocytopenia, leucopenia, pancytopenia, neutropenia and agranulocytosis, but these were not necessarily causally related to paracetamol.

Koulouris Z, Tierney MG, Jones G. Metabolic acidosis and coma following a severe acetaminophen overdose. Ann Pharmacother. 1999;33:1191-4. Further information The product should not be used during pregnancy unless recommended by a healthcare professional (see section 4.6). It is safe to take Lemsip max cold & flu capsules with ibuprofen or aspirin. However, do not take them with co-codamol, co-dydramol or Tramacet because these contain paracetamol.

http://www.medicines.org.uk/emc/medicine/25517 for Lemon and http://www. medicines.org.uk/emc/medicine/23371 for Wild Berry and Hot Orange.

The anticoagulant effect of warfarin and other coumarins may be enhanced by prolonged regular use of paracetamol with increased risk of bleeding; occasional doses have no significant effect. Indications: For the relief of symptoms associated with the common cold and influenza, including relief of aches and pains, sore throat, Symptoms of paracetamol overdosage 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. Paracetamol is excreted in breast milk, but not in a clinically significant amount. Available published data do not contraindicate breastfeeding. If you're taking medicines for high blood pressure you shouldn't take Lemsip cough max for mucus cough and cold, because the decongestant may make your blood pressure medicine less effective.