Beechams Cold & Flu Tablets, Pain & Congestion Relief Medicine with Paracetamol, 16 tablets

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Beechams flu plus caplets contain three active ingredients, paracetamol (500mg), phenylephrine (5mg) and caffeine (25mg). 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.) Don't take Beechams flu plus caplets 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, safinamide and rasagiline. This is because the combination of phenylephrine with these medicines could cause a dangerous increase in blood pressure (hypertensive crisis). Alcohol increases the risk of liver damage that can occur if an overdose of paracetamol is taken. The hazards of paracetamol overdose are greater in persistant heavy drinkers and in people with alcoholic liver disease.

Caffeine can increase the elimination of lithium from the body. If taken concomitantly, it is recommended to reduce or moderate the intake of caffeine. Phenylephrine overdosage is likely to result in effects similar to those listed under advserse reactions. Additional symptoms may include hypertension and possibly reflux bradycardia. In severe cases confusion, hallucinations, seizures and arrhythmias may occur. However the amount required to produce serious phenylephrine toxicity would be greater than required to cause paracetamol- related toxicity. 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 and have peaked after 4-6 days. 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 a simple painkilling medicine used to relieve mild to moderate pain and fever. Despite its widespread use for over 100 years, we still don't fully understand how paracetamol works to relieve pain and reduce fever. However, it is now thought that it works by reducing the production of prostaglandins in the brain and spinal cord. Excessive intake of caffeine (e.g. coffee, tea and some canned drinks) should be avoided while taking this product.

Caffeine is a mild stimulant that helps reduce fatigue. Caffeine is also thought to enhance the painkilling effect of paracetamol.

No specific antidote is available, but supportive measures such as beta adrenoceptor antagonists to reverse the cardiotoxic effects may be used. An overdose of paracetamol is dangerous and capable of causing serious damage to the liver and kidneys. You should never exceed the dose stated in the information leaflet supplied with this medicine. Immediate medical advice should be sought in the event of an overdose with this medicine, even if you feel well, because of the risk of delayed, serious liver damage. Pre-clinical safety data on these active ingredients in the literature have not revealed any pertinent and conclusive findings which are of relevance to the recommended dosage and use of the product and which have not already been mentioned elsewhere in this Summary. 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 24h from ingestion should be discussed with the NPIS or a liver unit. It's fine to take Beechams flu plus caplets with plain ibuprofen or aspirin (assuming these are appropriate for you). However, don't take them with co-codamol, co-dydramol or Tramacet because these contain paracetamol.Combination products are marketed as comprehensive cold-fighting remedies, but the main benefit is convenience. This product should not be used by patients taking other sympathomimetics (such as decongestants, appetite suppressants and amphetamine-like psychostimulants). The capsules should be swallowed whole with a drink. They can be taken either with or without food. Allergic reactions such as a rash or itching. Stop using this medicine and get medical advice if you think you've had an allergic reaction to it.

Don't be afraid to ask the pharmacist if there's a cheaper generic version of a medicine you're considering, or for advice on the evidence behind certain treatments, as they should be able to help with any queries you have about cold and flu medicines. Women who are pregnant. (Phenylephrine has blood vessel constricting effects that could restrict blood supply to the placenta, or cause problems for women with a history of pre-eclampsia. Ask your doctor or pharmacist for advice on how to treat cold and flu symptoms during pregnancy.) Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

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Cholestyramine reduces the absorption of paracetamol from the gut. It should not be taken within an hour of taking this medicine or the effect of the paracetamol will be reduced. A wealth of other cold and flu remedies are available to buy without a prescription. Many of these will also contain paracetamol, phenylephrine or caffeine in their ingredients.

Long-term or regular use of paracetamol may increase the anti-blood-clotting effect of warfarin and other anticoagulant medicines, leading to an increased risk of bleeding. This effect does not occur with occasional pain-killing doses. Other medicines containing the same active ingredients What to know about getting a flu jab - who's eligible for a free one, and where's cheapest otherwiseContains paracetamol. Patients should be advised not to take other paracetamol-containing products concurrently. The concomitant use with other products containing paracetamol may lead to an overdose. Paracetamol overdose may cause liver failure which may require liver transplant or lead to death. Concomitant use of other decongestants or cold and flu medicines should be avoided. It must be noted that for clinically significant symptoms of caffeine overdose to occur with this product, the amount ingested would be associated with serious paracetamol-related liver toxicity. It's also worth bearing in mind that some standard-strength combination remedies, such as Lemsip sachets, only contain 650mg paracetamol, which is less than the recommended 1,000mg dosage for adults. Max strength formulations usually have the full amount. For the cheapest option, seek out own-brand or generic painkillers. Supermarkets and discount stores are often cheapest, and branded versions can cost nearly five times as much. Don't take Beechams flu plus caplets if you're taking any of the following medicines, because the combination may increase your blood pressure: