Beechams flu-plus hot drinks

How does it work?

Beechams flu-plus sachets (hot lemon or hot berry fruits) contain three active ingredients, paracetamol (1000mg), phenylephrine hydrochloride (10mg) and vitamin C.

Paracetamol is a simple painkilling medicine used to relieve mild to moderate pain and fever. Despite its widespread use for over 100 years, we still don't fully understand how paracetamol works to relieve pain and reduce fever. However, it is now thought that it works by reducing the production of prostaglandins in the brain and spinal cord.

The body produces prostaglandins in response to injury and certain diseases. One of the effects of prostaglandins is to sensitise nerve endings, causing pain (presumably to prevent us from causing further harm to the area). As paracetamol reduces the production of these nerve sensitising prostaglandins it is thought it may increase our pain threshold, so that although the cause of the pain remains, we can feel it less.

It is thought paracetamol reduces fever by affecting an area of the brain that regulates our body temperature (the hypothalamic heat-regulating center). The paracetamol in Beechams flu-plus sachets helps relieve aches, pains, sinus pain, sore throats and fever associated with colds and flu.

Phenylephrine is a type of medicine called a decongestant. It works by acting on alpha receptors that are found in the walls of blood vessels in the linings of the nasal passages and sinuses. It causes these blood vessels to contract and narrow, thereby decreasing blood flow into the linings of the nose and sinuses. This reduces the feeling of congestion and also reduces the production of mucus, helping to relieve a blocked nose.

Vitamin C is involved, amongst many things, in maintaining a healthy immune system. It is normally obtained in the diet as the body is unable to produce its own. A balanced diet, that includes different types of food, is likely to provide adequate amounts of vitamin C, and supplements are given when dietary vitamin C is not adequate. Vitamin C is included in many cold and flu remedies as studies have shown it may reduce the severity of symptoms of colds and flu.

The combination of active ingredients in Beechams flu-plus sachets helps to relieve the symptoms of colds and flu. For adults and children over 12 years of age, one sachet should be taken every four to six hours as necessary, up to a maximum of 4 sachets in 24 hours. Dissolve the contents of the sachet in a mug of hot (not boiling) water before drinking.

What is it used for?

Relieving the symptoms of colds and flu, such as headache, sore throat, aches and pains, fever and nasal congestion.

Use with caution in

Severely decreased kidney function

Severely decreased liver function

An inherited disorder of protein metabolism called phenylketonuria (the sachets contain aspartame, which is a source of phenylalanine).

Not to be used in

Children under 12 years of age

Severe coronary artery disease

High blood pressure

Overactive thyroid gland

Diabetes

People who have taken a monoamine oxidase inhibitor antidepressant (MAOI) in the last 14 days.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy. If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

Although paracetamol is generally considered safe for occasional use during pregnancy, the safety of phenylephrine has not been established. Therefore, as with all medicines, this medicine should not be taken during pregnancy unless your doctor considers the expected benefit is greater than any possible risk to the developing baby. Seek medical advice from your doctor before taking this medicine if you are pregnant.

Although paracetamol is considered safe for use during breastfeeding, it is not known if phenylephrine passes into breast milk, or its effect on a nursing infant. As a result, this medicine should not be used by breastfeeding mothers, unless your doctor considers the expected benefit is greater than any possible risk to the nursing baby. Seek medical advice from your doctor before taking this medicine if you are breastfeeding.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Nausea

Headache

Increase in blood pressure

Increased heart rate

Awareness of your heart beat (palpitations)

Difficulty sleeping (insomnia)

Restlessness

Difficulty passing urine

Skin rashes

The side effects listed above may not include all of the side effects reported by the drug's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

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.

You should not take other medicines that contain paracetamol in combination with this medicine, 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.

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. This is because the combination of phenylephrine and an MAOI could cause a dangerous increase in blood pressure (hypertensive crisis).

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

beta-blockers, eg propranolol

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

tricyclic antidepressants, eg amitriptyline

appetite suppressants

amphetamine-like stimulants.

Phenylephrine can reduce the effects of medicines to treat high blood pressure (antihypertensives). If you are taking medicines for high blood pressure you should not take this medicine.

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.

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