Contraindications: Known hypersensitivity to any of the ingredients. Concomitant use of other sympathomimetic decongestants. Phaeochromocytoma. Closed angle glaucoma. Hepatic or severe renal impairment, hypertension, hyperthyroidism, an enlargement of the prostate gland, diabetes, heart disease or those taking tricyclic antidepressants or beta-blocking drugs and those patients who are taking MAOI or have taken within the last two weeks.
Warnings and precautions: Contains paracetamol. Concomitant use of other paracetamol-containing products or use of other cold and cough medicines, including cough suppressants and sympathomimetics (decongestants, appetite suppressants and amphetamine-like psychostimulants), should be avoided. Medical advice should be sought before use in patients with occlusive vascular disease, glutathione depletion due to metabolic deficiencies, chronic cough such as occurs with smoking, asthma, chronic bronchitis or emphysema. Caution, regarding paracetamol, if used at therapeutic doses for a prolonged period or administered concomitantly with flucloxacillin due to increased risk of high anion gap metabolic acidosis (HAGMA), particularly in patients with severe renal impairment, sepsis, malnutrition and other sources of glutathione deficiency (e.g. chronic alcoholism). If suspected, discontinue use promptly and monitor closely, including measurement of urinary 5-oxoproline. Use in caution in patients taking digoxin, cardiac glycosides and vasoconstrictor agents such as ergot alkaloids.
Side effects: See SPC for full details. Hypersensitivity reactions including skin rashes, urticaria, allergic dermatitis, angioedema, and anaphylaxis. High anion gap metabolic acidosis. Bronchospasm, hepatic dysfunction, thrombocytopenia, agranulocytosis and acute pancreatitis. Nervousness, irritability, restlessness, excitability, headache, dizziness, insomnia, increased blood pressure, nausea, vomiting, abdominal discomfort, diarrhoea, dysuria and urinary retention. Tachycardia, palpitations, dyspnoea.
