Lemsip Max Cold & Flu Lemon Hot Drink, 10 Sachets, Contains Paracetamol, For Fever, Headaches, Body Aches, Blocked Nose, Sore Throat Relief

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Monoamine oxidase inhibitors (including moclobemide) (MAOIs): Hypertensive interactions occur between sympathomimetic amines such as phenylephrine and monoamine oxidase inhibitors (see section 4.3). Phenylephrine overdose is likely to result in: nervousness, headache, dizziness, insomnia, increased blood pressure, nausea, vomiting, reflex bradycardia, mydriasis, acute angle closure glaucoma (most likely to occur in those with closed angle glaucoma), tachycardia, palpitations, allergic reactions (e.g. rash, urticaria and allergic dermatitis), dysuria and urinary retention (most likely to occur in those with bladder outlet obstruction, such as prostatic hypertrophy). If you take paracetamol in the hour before or the six hours after taking colestyramine, the paracetamol is likely to be less effective. This is because colestyramine reduces the absorption of paracetamol from the gut. You should avoid taking Lemsip cold & flu sachets one hour before or six hours after taking colestyramine. 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). Paracetamol: Paracetamol is absorbed rapidly and completely mainly from the small intestine producing peak plasma levels after 15-20 minutes following oral dosing.

Kurtovic J, Riordan SM. Paracetamol-induced hepatotoxicity at recommended dosage. J Intern Med. 2003;253:240-3. Zimmerman HJ, Maddrey WC. Acetaminophen (paracetamol) hepatotoxicity with regular intake of alcohol: analysis of instances of therapeutic misadventure. Hepatology. 1995;22:767-73. Leaflet: Immediate medical advice should be sought in the event of an overdose, even if you feel well, because of the risk of delayed, serious liver damage. Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.This medicinal product contains 120.74 mg sodium per dose, equivalent to 6 % of the WHO recommended maximum daily intake for sodium. Don't take Lemsip max all in one if you're taking any of the following medicines, because the combination may increase your blood pressure:

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. influenza, including the relief of aches and pains, sore throat, headache, nasal congestion, lowering of temperature and chesty coughs

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Women who are breastfeeding. (It's not known if phenylephrine passes into breast milk, or its effect on a nursing infant. When taken by mouth, decongestants such as phenylephrine can also temporarily decrease the production of breast milk with just one or two doses. Ask your doctor or pharmacist for further advice.) Patients with rare hereditary problems of galactose intolerance, the total lactase deficiency or glucose-galactose malabsorption should not take this medicine. Monoamine oxidase inhibitors (including moclobemide): hypertensive interactions occur between sympathomimetic amines such as phenylephrine and monoamine oxidase inhibitors (see section 4.3). a) Is on long-term treatment with carbamazepine, phenobarbitone, phenytoin, primidone, rifampicin, St John's Wort or other drugs that induce liver enzymes.

Keays R, Harrison PM, Wendon JA, et al. Intravenous acetylcysteine in paracetamol induced fulminant hepatic failure: a prospective controlled trial. BMJ. 1991;303:1026-9. Rare (less than 0.1%): Serious skin reactions such as acute generalized exanthematous pustulosis, Stevens-Johnson syndrome, and toxic epidermal necrolysis You are taking or have taken within the last 14 days a medicine called a monoamine oxidase inhibitor (MAOI), usually used to treat depression.Filipe PL, Freitas JP, Decastro JC, Silva R. Drug eruption induced by acetaminophen in infectious mononucleosis. Int J Dermatol. 1995;34:220-1. Adverse effects of paracetamol are rare, but hypersensitivity including skin rash may occur. There have been a few reports of blood dyscrasias including thrombocytopenia, leucopenia, pancytopenia, neutropenia and agranulocytosis, but these were not necessarily causally related to paracetamol. The maximum daily dose of this product is equivalent to 24.1 % of the WHO recommended maximum daily intake for sodium. Cases of ischaemic optic neuropathy have been reported with pseudoephedrine. Pseudoephedrine should be discontinued if sudden loss of vision or decreased visual acuity such as scotoma occurs.