Nurofen cold and flu

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How does it work?

Nurofen cold and flu tablets contain two active ingredients, ibuprofen (200mg) and pseudoephedrine hydrochloride (30mg).

Ibuprofen is a type of medicine called a non-steroidal anti-inflammatory drug (NSAID). It is a simple painkilling medicine used to relieve mild to moderate pain, inflammation and fever.

Ibuprofen works by blocking the action of a substance in the body called cyclo-oxygenase (COX). Cyclo-oxygenase is involved in the production of various chemicals in the body, some of which are known as prostaglandins. Prostaglandins are produced in response to injury and certain diseases and conditions, and cause pain, swelling and inflammation. NSAIDs block the production of these prostaglandins and are therefore effective at reducing inflammation and pain.

Ibuprofen also reduces fever by reducing the production of prostaglandins. Fever is associated with an increase in prostaglandins in the brain, and these prostaglandins cause the body temperature to increase. By reducing prostaglandins in the brain, ibuprofen lowers body temperature and hence reduces fever.

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, helping to relieve a blocked nose.

The combination of active ingredients in Nurofen cold and flu tablets helps to relieve the symptoms of colds and flu, such as headache, aches and pains, fever, sore throat and nasal or sinus congestion. For adults and children over 12 years of age, initially two tablets should be taken, followed by one or two tablets every four hours as necessary, up to a maximum of six tablets in 24 hours.

What is it used for?

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

Warning!

- Do not exceed the recommended dose of this medicine. This medicine is for short-term use only. If symptoms persist despite treatment, seek medical advice from your doctor or pharmacist.
- Ibuprofen is generally well-tolerated and most people do not experience any side effects. The most common side effects are related to stomach irritation and include abdominal pain, indigestion and nausea. These can mainly be avoided by taking the ibuprofen with food. Rarely, serious side effects such as ulceration or bleeding of the stomach or intestines may occur. These are more likely with high doses and in elderly people. If any signs of bleeding from the stomach or bowels are experienced, such as vomiting blood and/or passing black/tarry/bloodstained stools, you should consult your doctor immediately.

Use with caution in

- Elderly people
- History of disorders affecting the stomach or intestines
- Inflammatory bowel disease such as Crohn's disease or ulcerative colitis
- Kidney disease
- Liver disease
- Heart disease
- History of asthma
- History of allergies
- People with blood clotting problems or taking anticoagulant medicines
- Diseases affecting connective tissue, eg systemic lupus erythematosus .
- Enlarged prostate gland
- Overactive thyroid gland
- Raised pressure within the eye ball, eg glaucoma
- Tumour of the adrenal gland (phaeochromocytoma)
- Diabetes.

Not to be used in

- Children under 12 years of age
- People in whom aspirin or other NSAIDs, eg ibuprofen, cause allergic reactions such as asthma attacks, itchy rash (urticaria), nasal inflammation (rhinitis) or swelling of the lips, tongue and throat (angioedema)
- Active peptic ulcer or history of peptic ulcer
- People who have experienced bleeding from the gut or a hole (perforation) in the gut, as a result of previous use of an NSAID
- Severe kidney disease
- Severe heart disease
- Blood circulation problems
- High blood pressure
- People who have taken a monoamine-oxidase inhibitor antidepressant (MAOI) in the last 14 days
- Pregnancy.

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.

- This medicine is not recommended for use during pregnancy, unless considered essential by your doctor. In particular, it should not be taken in the third trimester, as ibuprofen may delay labour, increase the length of labour and cause complications in the newborn baby. The safety of pseudoephedrine during pregnancy has not been established. Some evidence suggests that NSAIDs should also be avoided by women attempting to conceive, as they may temporarily reduce female fertility during treatment and may also increase the risk of miscarriage or malformations. Seek medical advice from your doctor.
- Small amounts of ibuprofen and pseudoephedrine may pass into breast milk, but this is not expected to be harmful to a nursing infant. However, as with all medicines, you should seek medical advice from your doctor or pharmacist 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.

- Disturbances of the gut such as nausea, vomiting, diarrhoea, indigestion or abdominal pain
- Skin rashes
- Difficulty in sleeping (insomnia)
- Shaking, usually of the hands (tremor)
- Anxiety and restlessness
- Dizziness
- Increased heart rate (tachycardia)
- Palpitations
- Dry mouth
- Headache
- Difficulty in passing urine (urinary retention)
- Ulceration or bleeding of the stomach or intestines
- Liver or kidney disorders
- False perceptions of things that are not really there (hallucinations)
- Hypersensitivity reactions such as narrowing of the airways (bronchospasm), swelling of the lips, throat and tongue (angioedema), itchy blistering rash or anaphylactic shock

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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