Paracetamol is rapidly and almost completely absorbed from the gastro-intestinal tract. Peak plasma concentrations are reached 30-90 minutes post dose. Most patients who have ingested clinically important amounts of NSAIDs will develop no more than nausea, vomiting, epigastric pain, or more rarely diarrhoea. Tinnitus, headache and gastrointestinal bleeding are also possible. In more serious poisoning, toxicity is seen in the central nervous system, manifesting as drowsiness, occasionally excitation and disorientation or coma. Occasionally patients develop convulsions. In serious poisoning metabolic acidosis may occur and the prothrombin time/ INR may be prolonged, probably due to interference with the actions of circulating clotting factors. Acute renal failure and liver damage may occur. Exacerbation of asthma is possible in asthmatics. Prescriptions must be written on an Authority Prescription Form, and the approval number must be noted on the prescription. Pharmacists cannot dispense the item as a pharmaceutical benefit unless it has been approved by Medicare Australia (indicated by the presence of the approval number). Anticoagulants. NSAIDs may enhance the effects of anti-coagulants, such as warfarin (see section 4.4). Low level transaminase elevations may occur in some patients taking therapeutic doses of paracetamol; these elevations are not accompanied with liver failure and usually resolve with continued therapy or discontinuation of paracetamol.

In limited studies, ibuprofen appears in the breast milk in very low concentration and is unlikely to affect the breast-fed infant adversely. Please be aware that Nurofen Meltlets contains ibuprofen. You should not take any other medicines that also contain these ingredients (or other anti-inflammatories, such as Aspirin or Naproxen) at the same time as Nurofen Meltlets. Caution is required in patients with phenylketonuria or who are intolerant to phenylalanine. The product contains aspartame which is a source of phenylalanine. Each orodispersible tablet contains a source equivalent to 14 mg of phenylalanine. Mifepristone: NSAIDs should not be used for 8-12 days after mifepristone administration as NSAIDs can reduce the effect of mifepristone.

Table Of contents

This medicine contains 0.00064mg benzyl alcohol in each tablet. Benzyl alcohol may cause allergic reactions. Ask your doctor or pharmacist for advice if you are pregnant or breastfeeding, or if you have a liver or kidney disease. This is because large amounts of benzyl alcohol can build-up in your body and may cause side effects (called "metabolic acidosis")."

Corticosteroids: as these may increase the risk of gastrointestinal ulceration or bleeding (see Section 4.4). Bronchospasm may be precipitated in patients suffering from, or with a previous history of bronchial asthma or allergic disease. Caution (discussion with doctor or pharmacist) is required prior to starting treatment in patients with a history of hypertension and/or heart failure as fluid retention, hypertension and oedema have been reported in association with NSAID therapy. As with other medication, Nurofen Meltlets can cause some people to experience unwanted side effects. Please ensure that you have read the Patient Information Leaflet thoroughly for full details of reported side effects. If you have been consuming this medicine for more than three days and it shows some adverse symptoms, you must consult a doctor. It is advised not to consume this medicine for a stretch of 10 or more days as it is not suitable for your health.

Pregnancy & Breastfeeding use

The mechanism may be due to a combined local effect as well as inhibition of prostaglandins leading to decreased integrity of the GI lining. Signs of a serious allergic reaction such as difficulties breathing, unexplained wheezing, dizziness, faster heartbeat, severe forms of skin reactions such as itchiness, skin rash with redness, peeling, flaking or blistering, swelling of your face, tongue or throat

Clinical studies suggest that use of ibuprofen, particularly at high doses (2400 mg/day) may be associated with a small increased risk of arterial thrombotic events (for example myocardial infarction or stroke). Overall, epidemiological studies do not suggest that low dose ibuprofen (e.g. ≤1200 mg/day) is associated with an increased risk of arterial thrombotic events. Taking this product with other paracetamol-containing medicines could lead to overdose and should therefore be avoided. Ibuprofen is a propionic acid derivative, having analgesic, anti-pyretic and anti-inflammatory activity. The drug's therapeutic effects as a non-steroidal anti-inflammatory drug are thought to result from inhibitory activity on prostaglandin synthesis. Furthermore, ibuprofen reversibly inhibits platelet aggregation.Patients with a history of GI toxicity, particularly the elderly, should report any unusual abdominal symptoms (especially GI bleeding) particularly in the initial stages of treatment. The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss.

This product can be used to treat a range of aches and pains from children aged 12 and over, including:

Anticoagulants: NSAIDs may enhance the effects of anti-coagulants, such as warfarin (See section 4.4). Anti-platelet agents and selective serotonin reuptake inhibitors (SSRIs): increased risk of gastrointestinal bleeding (see section 4.4).