Heart (see Section 4.4 Special Warnings and Precautions for Use, Cardiovascular and cerebrovascular effects) or renal problems (see Section 4.4 Special Warnings and Precautions for Use, Use in renal impairment). Nurofen Plus should only be used when your doctor decides that other treatment options are not able to effectively manage your pain or you cannot tolerate them. Immediate-release products should not be used to treat chronic pain, but may be used for a short period in opioid-naïve patients to develop a level of tolerance before switching to a modified-release formulation. Careful and regular assessment and monitoring is required to establish the clinical need for ongoing treatment. Discontinue opioid therapy if there is no improvement of pain and/or function during the trial period or if there is any evidence of misuse or abuse. Treatment should only continue if the trial has demonstrated that the pain is opioid responsive and there has been functional improvement. The patient's condition should be reviewed regularly and the dose tapered off slowly if opioid treatment is no longer appropriate (see Ceasing opioids). Depending on your body's individual ability to break down codeine, you may be getting reduced benefit or experience signs of overdose even when you take Nurofen Plus as recommended by your doctor. If overdose symptoms occur, seek immediate medical advice. If you use too much Nurofen Plus The usual dose of Nurofen Plus is 2 tablets then, if necessary 1 or 2 tablets every 4 to 6 hours. Do not take more than six tablets in 24 hours.

If you have not told your doctor about any of the above, tell him/her before you start taking Nurofen Plus. Anticoagulants. Concurrent use of NSAIDs and warfarin has been associated with severe, sometimes fatal haemorrhage. The mechanism of this interaction is not known but may involve increased bleeding from NSAID-induced gastrointestinal ulceration or an additive effect of NSAID inhibition of platelet function with the anticoagulant effect of warfarin. Nurofen Plus should only be used in patients taking warfarin if absolutely necessary. Patients taking this combination must be closely monitored. This leaflet provides important information about using Nurofen Plus. You should also speak to your doctor or pharmacist if you would like further information or if you have any concerns or questions about using Nurofen Plus. Where to find information in this leaflet:People who suffer from persistent headaches. Taking a painkiller for headaches or migraines too often or for too long can actually make the headaches worse. Oligohydramnios and neonatal renal impairment. Use of NSAIDs from about 20 weeks gestation may cause neonatal renal dysfunction leading to oligohydramnios and, in some cases, neonatal renal impairment. Antiplatelet agents and selective serotonin reuptake inhibitors (SSRls). Increased risk of gastrointestinal bleeding (see Section 4.4 Special Warnings and Precautions for Use).

selective serotonin reuptake inhibitors (SSRIs), and monoamine oxidase inhibitors (MAOIs), medicines used to treat some types of depression Use of opioids in chronic (long-term) non-cancer pain (CNCP). Opioid analgesics have an established role in the treatment of acute pain, cancer pain and palliative and end-of-life care. Current evidence does not generally support opioid analgesics in improving pain and function for most patients with chronic non-cancer pain. The development of tolerance and physical dependence and risks of adverse effects, including hazardous and harmful use, increase with the length of time a patient takes an opioid. The use of opioids for long-term treatment of CNCP is not recommended. The white capsule-shaped tablets are marked 'N+' on one side and plain on the other. 4 Clinical ParticularsHazardous and harmful use. Nurofen Plus contains the opioid codeine and is a potential drug of abuse, misuse and addiction. Addiction can occur in patients appropriately prescribed Nurofen Plus at recommended doses. During treatment, you may be at risk of developing certain side effects. It is important you understand these risks and how to monitor for them. See additional information under Section 6. Are there any side effects? Pregnancy and breastfeeding

a b Moore, Susan (14 December 2015). "Targeted painkillers zero in on one vital organ – the wallet". The Guardian. London . Retrieved 14 December 2015.

For the temporary relief of acute moderate pain and inflammation in patients over the age of 12 years. 4.2 Dose and Method of Administration Ibuprofen is good for relieving period pain because it reduces the production of the prostaglandins that are involved in making the womb contract during your period. How do I take Nurofen?

If you are prescribed ibuprofen as a regular medicine and forget to take a dose, take the missed dose as soon as you remember, unless it's almost time for your next dose. In this case, skip the missed dose and take your next dose at the usual time. Nuromol Dual Action Pain Relief 200/500mg tablets. Contains ibuprofen & paracetamol. For pain relief not relieved by ibuprofen or paracetamol individually. For more information, including what to do if you have any side effects, see Section 6. Are there any side effects? in the full CMI.Drugs that inhibit CYP2D6 such as quinidine, phenothiazines and antipsychotic agents. Can interfere with the metabolism of codeine to morphine, reducing the analgesic effect of codeine.