What you need to know before you take it

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• have a serious heart condition or this medicine cardiovascular disorder(s) 3. How to take this medicine
• have high blood pressure (hypertension) 4. Possible side effects
• are taking medicines to lower blood pressure,

How to take it

this medicine

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. Swallow the capsules whole with water. Do not chew. Age What to take and when Adults, the 2 Day capsules elderly every 4 to 6 hours and during the daytime, children as required aged 16 and years and 2 Night capsules at over: bedtime. Leave at least 4 to 6 hours between doses. Do not take more than 8 capsules (4 doses) in any 24 hour period. Do not give to children under 16 years. Do not take more medicine than the label tells you to. If you do not get better, talk to your doctor. Do not take for longer than 3 days, unless advised by your doctor. The Day time capsules contain caffeine which may disrupt sleep if taken at night. If you take more of this medicine than you should

Talk to a doctor at once if you take too much of this medicine even if you feel well. This is because too much paracetamol can cause delayed, serious liver damage. Go to your nearest hospital casualty department. Take your medicine and this leaflet with you.

4. Possible side effects

Like all medicines, this medicine can cause

Possible side effects

, although not everybody gets them. Stop taking the medicine immediately and see your doctor or pharmacist. Rare side effects are:

• allergic reactions such as skin rash
• fast, slow or irrelegular heartbeat (palpitations)
• eye disorders such as dilated pupils, acute angle closure glaucoma, most likely to occur in those with closed angle glaucoma. Very rare side effects are:
• blood and lymphatic system disorders such as leukopenia, neutropenia and pancytopenia
• a severe allergic reaction known as anaphylaxis
• problems with your liver
• skin issues such as rashes, severe itching, sweating, hives
• purpura (small blood vessels leak blood under the skin)
• bronchospasm (muscles in your chest tighten)
• angioedema (swelling of the skin caused by build-up of fluid.)
• toxic epidermal necrolysis
• stevens-Johnson syndrome (rare condition arising from over reaction of the immune system)
• kidney and urinary disorders. Frequency not known (frequency cannot be estimated from the available data):
• tingling and coolness of the skin

Contents of the pack and other information

beta blockers (e.g. atenolol) 1. What this medicine is and what • have severe hepatic impairment

• have severe renal impairment it is used for
• have an overactive thyroid This medicine contains:
• have an enlarged prostate
• paracetamol which is a pain reliever
• have diabetes (analgesic) and helps reduce your
• have pheochromocytoma temperature when you have a fever
• have glaucoma, including closed angle
• phenylephrine which is a decongestant to glaucoma reduce swelling in the passages of the nose
• are taking antidepressant drugs called

monoamine oxidase inhibitors (MAOI's), or have taken them within the last 14 days these are medicines such as phenelzine and isocarboxazid

• are taking tricyclic antidepressants such as imipramine, amitriptyline
• are taking medicines belonging to a group called sympathomimetic amines such as dopamine, epinephrine. Warnings and precautions Talk to your doctor or pharmacist before taking this medicine if you:
• are pregnant or breast-feeding
• suffer from kidney or liver problems, including alcoholic liver disease
• have circulatory disorders such as a condition called Raynaud's Phenomenon, which results from poor circulation in the fingers and toes
• are dehydrated
• have difficulty passing urine
• have a blood condition called Haemolytic anaemia
• have genetic conditions such as Gilbert's syndrome or Glucose-6-phosphate dehydrogenase deficiency
• have Glutathione deficiency. During treatment with this medicine, tell your doctor straight away if:
• you have severe illnesses, including severe renal impairment or sepsis (when bacteria and their toxins circulate in the blood leading to organ damage), or you suffer from malnutrition, chronic alcoholism or if you are also taking flucloxacillin (an antibiotic). A serious condition called metabolic acidosis (a blood and fluid abnormality) has been reported in patients in these situations when paracetamol is used at regular doses for a prolonged period or when paracetamol is taken together with flucloxacillin. Symptoms of metabolic acidosis may include: serious

breathing difficulties with deep rapid breathing, drowsiness, feeling sick (nausea) and being sick (vomiting). Other medicines and this medicine Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines especially:

• medicines to treat high cholesterol levels which reduce the amount of fat in the blood such as colestyramine
• medicines to control feeling sick or being sick such as metoclopramide or domperidone
• medicines called anti-coagulants, which are used to thin the blood such as warfarin or other coumarins – you may take occasional doses of paracetamol but should consult your doctor if you need to take it on a regular basis
• barbiturates (for epilepsy or to help you sleep), such as phenobarbitones
• medicines used to treat gout such as probenacid
• medicines to treat irregular heartbeats (arrhythmias) e.g. digoxin
• medicines called ergot alkaloids, which are used to treat severe headaches
• other decongestant drugs such as ephedrine or xylometazoline
• flucloxacillin (antibiotic), due to a serious risk of blood and fluid abnormality (called metabolic acidosis) that must have urgent treatment (see section 2). Contains paracetamol. Do not take anything else containing paracetamol while taking this medicine. This medicine with food and alcohol Do not drink alcohol (beer, wine, spirits etc) while taking this product. Information about some of the ingredients in this medicine This medicine contains less than 1 mmol

sodium (23 mg) per capsule, that is to say essentially 'sodium-free'. Pregnancy, breast-feeding and fertility If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, you should not take this medicine.