Day & night nurse

How can this medicine affect other medicines?

If you are already taking any other medicines, including herbal medicines and those bought without a prescription, you should check with your pharmacist before taking this medicine, to ensure that the combination is safe.

This medicine should not be used by people who are currently taking a monoamine oxidase inhibitor antidepressant, eg phenelzine, tranylcypromine, isocarboxazid or moclobemide, or who have taken one of these medicines in the last 14 days.

You should not take other medicines that contain paracetamol in combination with the day or night nurse capsules, as this can easily result in exceeding the maximum recommended daily dose of paracetamol. Many cold and flu remedies and over-the-counter painkillers contain paracetamol, so be sure to check the ingredients of any other medicines before taking them with this one.

If pseudoephedrine is taken with any of the following, the combination may cause an increase in blood pressure. If you are already taking any of these medicines you should avoid taking day nurse capsules as well:

other decongestants (often found in other non-prescription cough and cold remedies)

tricyclic antidepressants, eg amitriptyline

appetite suppressants

amphetamine-like stimulants.

Pseudoephedrine may reduce the effects of medicines to treat high blood pressure (antihypertensives). If you are taking medicines for high blood pressure you should not take the day nurse capsules.

The night nurse capsules may cause drowsiness. If this occurs, it may be made worse if the medicine is taken in combination with any of the following, which can also cause drowsiness:

alcohol

benzodiazepines, eg temazepam, diazepam

sedating antihistamines, eg chlorphenamine, diphenhydramine, triprolidine (these are often found in other non-prescription cough and cold or hayfever remedies)

sleeping tablets, eg zopiclone

strong opioid painkillers, eg codeine, dihydrocodeine, morphine

tricyclic antidepressants, eg amitriptyline.

There may be an increased risk of side effects such as dry mouth, blurred vision, constipation or difficulty passing urine if the night nurse capsules are taken with any of the following medicines:

anticholinergic medicines for urinary incontinence, eg oxybutynin, flavoxate, tolterodine, propiverine, trospium

anticholinergic medicines for Parkinson's disease, eg trihexyphenidyl, orphenadrine, procyclidine

antipsychotic medicines, eg chlorpromazine, clozapine

antispasmodics, eg atropine, hyoscine

certain antisickness medicines, eg prochlorperazine, meclozine, cyclizine

muscle relaxants, eg baclofen

tricyclic or related antidepressants, eg amitriptyline, maprotiline.

Cholestyramine reduces the absorption of paracetamol from the gut. It should not be taken within an hour of taking paracetamol or the effect of the paracetamol will be reduced.

Metoclopramide and domperidone may increase the absorption of paracetamol from the gut.

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

Day nurse and Night nurse are also available separately.

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