Lemsip Cough Max for Chesty Cough & Cold, Lemon & Menthol Flavour 10 Sachets

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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.

Using paracetamol or paracetamol containing products such as Lemsip Max long-term may potentially increase the anti-blood-clotting effect of warfarin, leading to an increased risk of bleeding. Lemsip max capsules should only be used for the short period to relief the symptoms of cold or flu. Other medicines containing the same active ingredientsThe 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). Phenylephrine overdose is likely to result in: nervousness, headache, dizziness, insomnia, increased blood pressure, nausea, vomiting, Mydriasis, acute angle closure glaucoma (most likely to occur in those with closed angle glaucoma), tachycardia, palpitations, allergic reactions (e.g. rash, urticarial and allergic dermatitis), dysuria and urinary retention (most likely to occur in those with bladder outlet obstruction, such as prostatic hypertrophy). Tricyclic antidepressants: Tricyclic antidepressants (e.g. amitriptyline) may increase the risk of cardiovascular side effects with phenylephrine (see section 4.3). 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 further advice on how to treat cold and flu symptoms during pregnancy.

Bougie DW, Benito AI, Sanchez-Abarca LI, Torres R, Birenbaum J, Aster RH. Acute thrombocytopenia caused by sensitivity to the glucuronide conjugate of acetaminophen. Blood. 2007;109:3608-9. 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. LEMSIP MAX ALL IN ONE LEMON: Each sachet contains Paracetamol 1000 mg, Guaifenesin 200mg Phenylephrine hydrochloride 12.2 mg, 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 24 hours from ingestion should be discussed with the NPIS or a liver unit.Common (1% to 10%): Dyspnea, abnormal breath sounds, pulmonary edema, hypoxia, pleural effusion, stridor, wheezing, coughing [ Ref] Cardiovascular There are limited data on the use of guaifenesin in pregnant women. Guaifenesin has been linked with an increased risk of neural tube defects in a small number of women with febrile illness in the first trimester of pregnancy. Information about this product, including adverse reactions, precautions, contra-indications, and method of use can be found at: Care is advised in the administration of paracetamol to patients with severe renal or severe hepatic impairment. The hazard of overdose is greater in those with non-cirrhotic alcoholic liver disease. Antiemetics: The speed of absorption of paracetamol may be increased by metoclopramide or domperidone and absorption reduced by cholestyramine.

Patients with rare hereditary problems of fructose intolerance, glucose- galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine.

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Tricyclic antidepressants (e.g. amitriptyline): may increase the risk of cardiovascular side effects with phenylephrine (see section 4.3). Monoamine oxidase inhibitors (including moclobemide) (MAOIs): Hypertensive interactions occur between sympathomimetic amines such as phenylephrine and monoamine oxidase inhibitors (see section 4.3).

Kurtovic J, Riordan SM. Paracetamol-induced hepatotoxicity at recommended dosage. J Intern Med. 2003;253:240-3.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. Indications: For the relief of symptoms of colds and influenza, including the relief of aches and pains, sore throat, headache, nasal If you're taking medicines for high blood pressure you shouldn't take Lemsip max flu lemon as well, because the pseudoephedrine may make your blood pressure medicine less effective. Along with its needed effects, acetaminophen (the active ingredient contained in Lemsip Max) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. 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: