Paramax sachets

How does it work?

This medicine contains two active ingredients, paracetamol and metoclopramide hydrochloride. Paracetamol is a medicine used in the treatment of mild to moderate pain. It is also useful for reducing fever. It is not fully understood how paracetamol produces these effects. Paracetamol is effective at relieving the pain of headaches and migraine. During a migraine attack sufferers can often feel sick or vomit. Metoclopramide is used to treat this symptom of the migraine. It is an antisickness medicine (antiemetic). Metoclopramide works primarily by blocking dopamine receptors that are found in an area of the brain known as the chemoreceptor trigger zone (CTZ). The CTZ sends messages to another area of the brain, known as the vomiting centre, which in turn sends nerve messages to the gut that cause vomiting. By blocking dopamine receptors in the CTZ, metoclopramide prevents messages from being sent to the vomiting centre. This reduces the sensation of nausea and prevents vomiting. Metoclopramide also acts in the upper gut, where it enhances the action of a chemical called acetylcholine. Increasing the action of acetylcholine results in the tightening of the muscles at the entry to the stomach, as well as relaxing the muscles at the exit of the stomach. It also increases the contraction of the muscles in the stomach itself, which speeds the passage of food through the stomach into the intestine. This physically helps to prevent vomiting, but is also useful in migraine attacks because it speeds the passage of the paracetamol into the intestine, allowing it to be absorbed and relieve the headache more quickly. This combination of paracetamol and metoclopramide is most effective at relieving migraine when it is taken as soon as possible after the onset of an attack.

What is it used for?

Relieving symptoms of migraine

Warning!

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 vomiting persists, consult your doctor.

Do not exceed the recommended dose of this medicine, which will be stated in the product packaging or information leaflet supplied with the medicine.

Do not take this medicine with any other paracetamol containing products.

This medicine may cause drowsiness and this may be made worse by alcohol. If affected, do not drive or operate machinery

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 the 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.

Use with caution in

Children or young adults under 20 years of age

Elderly people

Life long inherited blood diseases which can cause a variety of symptoms, including mental health problems (porphyrias)

Severely decreased kidney function

Severely decreased liver function

Not to be used in

Abnormal hole in the stomach or intestines (gastrointestinal perforation)

Bleeding from the gut (gastrointestinal haemorrhage)

Children under 12 years of age

Epilepsy

Obstruction of the stomach or intestines

People who have experienced a side effect called tardive dyskinesia during previous treatment with metoclopramide or antipsychotic medicines

People who have had certain types of gut surgery (pyloroplasty or gut anastomosis) in the previous 3 to 4 days

Tumour of the adrenal gland (phaeochromocytoma)

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 in pregnancy has not been established. It should only be used during pregnancy, particularly in the first trimester, if the expected benefit to the mother outweighs any potential risk to the developing foetus. Seek medical advice from your doctor.

This medicine passes into breast milk. Breastfeeding is not recommended when taking this medicine. Seek medical advice from your doctor.

Label warnings

Dissolve or mix this medication with water before taking.

Do not take this medication with any other products containing paracetamol.

Refer to the printed instructions for maximum daily intake.

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