Liver damage is possible in adults who have taken 10 g or more of paracetamol. Ingestion of 5 g or more of paracetamol may lead to liver damage if the patient has risk factors (see below). LEMSIP MAX ALL IN ONE COLD & FLU CAPSULES, LEMSIP COUGH MAX FOR MUCUS COUGH & COLD: 500mg/100 MG/6.1 MG CAPSULES: Each capsule http://www.medicines.org.uk/emc/medicine/28101 for Honey & Ginger, and https://www.medicines.org.uk/emc/medicine/23354 for Lemon. Don't take Lemsip max cold & flu capsules if you're taking any of the following medicines, because the combination may increase your blood pressure: Common (1% to 10%): Peripheral edema, hypertension, hypotension, tachycardia, chest pain [ Ref] Metabolic

Monoamine oxidase inhibitors (including moclobemide) (MAOIs): Hypertensive interactions occur between sympathomimetic amines such as phenylephrine and monoamine oxidase inhibitors (see section 4.3). Phenylephrine should be used with care in patients with closed angle glaucoma and prostatic enlargement. 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, allergic dermatitis), dysuria, urinary retention (most likely to occur in those with bladder outlet obstruction, such as prostatic hypertrophy).Shoenfeld Y, Shaklai M, Livni E, Pinkhas J. Thrombocytopenia from acetaminophen. N Engl J Med. 1980;303:47. Shriner K, Goetz MB. Severe hepatotoxicity in a patient receiving both acetaminophen and zidovudine. Am J Med. 1992;93:94-6. Sympathomimetic amines: concomitant use of phenylephrine with other sympathomimetic amines can increase the risk of cardiovascular side effects. influenza, including the relief of aches and pains, sore throat, headache, nasal congestion, lowering of temperature and chesty coughs Indications: For the relief of symptoms associated with the common cold and influenza, including relief of aches and pains, sore throat,

This product also contains 1973.3mg sucrose per dose (total sugars 2g). Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine.Contraindicated in patients currently receiving or within two weeks of stopping therapy with monoamine oxidase inhibitors because of a risk of hypertensive crisis. Monoamine oxidase inhibitors (including moclobemide): hypertensive interactions occur between sympathomimetic amines such as phenylephrine and monoamine oxidase inhibitors (see section 4.3). Phenylephrine hydrochloride: Phenylephrine is absorbed from the gastrointestinal tract, but has reduced bioavailability by the oral route due to first-pass metabolism. It retains activity as a nasal decongestant when given orally, the drug distributing through the systemic circulation to the vascular bed of the nasal mucosa. When taken by mouth as a nasal decongestant phenylephrine is usually given at intervals of 4–6 hours. Hartleb M. Do thyroid hormones promote hepatotoxicity to acetaminophen? Am J Gastroenterol. 1994;89:1269-70. a)Is on long term treatment with carbamazepine, phenobarbitone, phenytoin, primidone, rifampicin, St John's Wort or other drugs that induce liver enzymes, or

Caution is advised if paracetamol is 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), as well as those using maximum daily doses of paracetamol. Close monitoring, including measurement of urinary 5-oxoproline, is recommended.contains Paracetamol 500 mg, Guaifenesin 100 mg Phenylephrine hydrochloride 6.1 mg Indications: For the relief of symptoms of colds and Adults aged 16 years and over should take two capsules every four to six hours as necessary, up to a maximum of four doses in 24 hours. Do not take more than eight capsules in 24 hours. Kawada A, Hiruma M, Noguchi H, Ishibashi A. Fixed drug eruption induced by acetaminophen in a 12-year-old girl. Int J Dermatol. 1996;35:148-9. The rate of absorption of paracetamol may be increased by metoclopramide or domperidone and absorption may be reduced by cholestyramine.

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. 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. Lemsip cough max for mucus cough and cold capsules and hot drinks contain the painkiller paracetamol, a cough expectorant called guaifenesin and a decongestant called phenylephrine hydrochloride. These three active ingredients have different actions to relieve your symptoms.

Summary of medicine characteristics - LEMSIP COUGH MAX FOR CHESTY COUGH & COLD RELIEF CAPSULES

The anticoagulant effect of warfarin and other coumarins may be enhanced by prolonged regular use of paracetamol with increased risk of bleeding; occasional doses have no significant effect. Caution should be taken when paracetamol is used concomitantly with flucloxacillin as concurrent intake has been associated with high anion gap metabolic acidosis, especially in patients with risks factors (see section 4.4). Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that may be associated with pseudoephedrine and paracetamol. Just because a side effect is stated here doesn't mean that all people taking Lemsip max flu lemon will experience that or any side effect.