Day nurse

How does it work?

Day nurse liquid and capsules contain three active ingredients, paracetamol, pseudoephedrine and pholcodine.

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 Day nurse helps relieve aches, pains, sore throats and fever associated with colds and flu.

Pseudoephedrine 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.

Pholcodine is a type of medicine called a cough suppressant. It is used to suppress a dry, tickly, unproductive cough. It works by reducing the nerve signals sent from a part of the brain called the coughing centre to the muscles that produce coughing.

Coughing is a reflex response to irritation of the airways. It is useful for clearing mucus, dust and other particles from the throat and lungs. It is important because it reduces the amount of mucus, dust and bacteria in the airways that would otherwise make breathing difficult. However, sometimes coughing can become overstimulated even when there is no mucus to clear from the lungs or throat. In this situation coughing serves no purpose and can become painful and frustrating. Pholcodine can be used to block the cough reflex in situations where the cough serves no purpose, ie when no plegm is being coughed up.

The combination of active ingredients in Day nurse helps to relieve the symptoms of colds and flu, including nasal congestion and dry, tickly coughs.

What is it used for?

Relief from the symptoms of colds and flu, including tickly, unproductive coughs, blocked or runny nose, fever, headache, aches and pains and sore throats.

Warning!

Do not take this medicine with any other products that contain paracetamol. Many over-the-counter painkillers and cold and flu remedies contain paracetamol. It is important to check the ingredients of any medicines you buy without a prescription before taking them in combination with this medicine. Seek further advice from your pharmacist.

An overdose of paracetamol is dangerous and capable of causing serious damage to the liver and kidneys. You should never exceed the dose stated in the information leaflet supplied with this medicine. Immediate medical advice should be sought in the event of an overdose with this medicine, even if you feel well, because of the risk of delayed, serious liver damage.

Alcohol increases the risk of liver damage that can occur if an overdose of paracetamol is taken. The hazards of paracetamol overdose are greater in persistant heavy drinkers and in people with alcoholic liver disease.

If symptoms persist despite treatment, seek medical advice from your doctor or pharmacist. Do not use for longer than seven days unless your doctor agrees.

If you have any of the following symptoms you should consult your doctor so that the cough can be investigated further: coughing up phlegm that is green, rusty brown, yellow, blood-stained or foul smelling; shortness of breath, wheezing or difficulty breathing; chest pain; pain and swelling in the calf; sudden weight loss; recurrent night-time cough; or a long-term persistent cough.

Day nurse liquid contains alcohol.

Use with caution in

Decreased liver function

Decreased kidney function

Asthma.

Not to be used in

Children under six years of age

Severe liver disease

Severe kidney disease

Disease involving the heart and blood vessels

High blood pressure

Overactive thyroid gland

Tumour of the adrenal gland (phaeochromocytoma)

Enlarged prostate gland

Closed angle glaucoma

Diabetes

Epilepsy

Chronic bronchitis

Condition called bronchiectasis, in which there is persistent widening of the airways as a result of lung disease, eg infection, inflammation, tumours or cystic fibrosis

Pregnancy

Breastfeeding

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.

The safety of this medicine for use during pregnancy has not been established. It should not be used by pregnant women unless your doctor considers that the potential benefits outweigh any possible risks to the developing baby. Seek medical advice from your doctor.

Small amounts of paracetamol and pseudoephedrine may pass into breast milk, but this is not expected to be harmful to a nursing infant. However, it is not known if pholcodine passes into breast milk. As a result, this medicine should be avoided by women who are breastfeeding. Seek medical advice from your doctor.

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.

Disturbances of the gut such as diarrhoea, constipation, nausea, vomiting or abdominal pain

Headache

Difficulty sleeping (insomnia)

Restlessness

Shakiness (tremor)

Skin rash

Increased heart rate (tachycardia)

Difficulty in passing urine (urinary retention)

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.

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