Care Night Cold & Flu Relief Oral Solution 200ml

Always use the measuring cup supplied with the pack. Shake the bottle before use. Always take the product exactly as directed. You should check with your doctor or pharmacist if you are not sure

• Adults and children aged 16 years and over: One 20ml dose to be taken just before going to bed.
• Children aged 12 to 15 years: A 10ml to 15ml dose to be taken just before going to bed.
• Children under 12 years: Do not give to children under 12 years of age.
• Elderly: Dose as for 'Adults' above

Do not take anything else containing paracetamol while taking this medicine. If you have taken other paracetamol containing products during the day, this night time dose is considered as part of the maximum daily dose and should not be taken if you have already taken four doses of paracetamol during the day.

Do not take with any other flu, cold or decongestant product.

Only take one dose of Care Night Cold & Flu Relief Oral Solution per night.

Do not take for any longer than 3 days.

Carers should be aware that this medicine should not be given to Elderly patients with confusion. The elderly are more likely to develop adverse effects including confusion with this medicine.

Do not take more medicine than the label tells you to.

• Active Ingredients (per 20ml): Paracetamol 1000mg, promethazine hydrochloride 20mg ,  and dextromethorphan hydrobromide 15mg.
• Other Ingredients: Ethanol, propylene glycol, liquid maltitol (E965), sodium citrate, ascorbic acid, acesulfame K, citric acid monohydrate, natural mint flavour, patent blue V (E131), quinoline yellow (E104), purified water.

• Do not take with any other paracetamol containing products.
• Do not take with any other flu, cold or decongestant product.
  This medicine can lead to dependence. Therefore the treatment should be of short duration.
• Taking this medicine regularly, particularly for a long time, can lead to addiction. Only use this medicine as described in the leaflet. Addiction can cause withdrawal symptoms when you stop taking this medicine. Withdrawal symptoms can include restlessness, difficulty sleeping, irritability, agitation, anxiety, feeling your heartbeat (palpitations), increased blood pressure, feeling or being sick, diarrhoea, loss of appetite, shaking, shivering or sweating. Speak to your doctor if you experience withdrawal symptoms.
  If you do not get better, talk to your doctor.
• Do not consume alcoholic drinks while you are taking Care Night Cold & Flu Relief Oral Solution.
• Promethazine may interfere with pregnancy tests to produce false results.
• Ask your doctor or pharmacist for advice before taking any medicines during pregnancy. If necessary, Care Night Cold & Flu Relief Oral Solution can be used during pregnancy. If you are pregnant or breastfeeding, think you may be pregnant or planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. You should use the lowest possible dose that reduces your pain and/or your fever and use it for the shortest time possible. Contact your doctor if the pain and/or fever are not reduced or if you need to take the medicine more often.
• The medicine can affect your ability to drive as it may make you sleepy or dizzy. Do not drive while taking this medicine until you know how it affects you. It is an offence to drive if this medicine affects your ability to drive. Talk to your doctor or pharmacist if you are not sure whether it is safe for you to drive while taking this medicine. There is further information for patients who are intending to drive in the UK - go to https://www.gov.uk/drug-driving-law.

Do not take Care Night Cold & Flu Relief Oral Solution if you:

• Are allergic (hypersensitive) to paracetamol, promethazine hydrochloride, dextromethorphan hydrobromide or any of the other ingredients.
• Suffer from lung disease.
• Are taking, or have taken in the last two weeks, drugs for depression known as Monoamine Oxidase Inhibitors (MAOIs).
• Are taking selective serotonin re-uptake inhibitors (used to treat depression and anxiety such as fluoxetine, paroxetine and sertraline).
• If your child is under 12 years old.

Tell your doctor before taking Care Night Cold & Flu Relief Oral Solution if you:

• Have kidney or liver problems.
• Have a chronic or persistent cough such as occurs with asthma or produces a lot of mucus (phlegm).
• Are taking any other cough and cold medicines.
• Have difficulty in passing urine (urinary retention).
• Have glaucoma.
• Have prostate problems.
• Have heart problems.
• Have epilepsy.
• Are elderly and suffer from confusion.
• Have an intolerance to some sugars.
• If your child is susceptible to developing certain allergic reactions.
• If you have been told by your doctor that you are a slow metabolizer of CYP2D6.
• If you are or have ever been addicted to opioids, alcohol, prescription medicines, or illegal drugs.
• If you have previously suffered from withdrawal symptoms such as agitation, anxiety, shaking or sweating, when you have stopped taking alcohol or drugs.

Tell your doctor or pharmacist if you are taking or have recently taken any other medicines, even medicines obtained without a prescription. In particular, tell your doctor if you are taking medicines which:

• Thin the blood (e.g. warfarin).
• Control nausea or vomiting (e.g. domperidone or metoclopramide).
• Reduce levels of cholesterol and other fats in the blood (e.g. cholestyramine).
• Have been prescribed by your doctor to improve sleep, for anxiety or depression (including monoamine oxidase inhibitors (MAOIs) and antimuscarinic drugs).
• Medicines to control your heart rhythm e.g. quinide, amiodarone, flecainide or propafenone.
• Antifungal medicines e.g. terbinafine.
• Medicines to help with quitting smoking e.g. bupropion.
• Medicines to help with certain addictions or treat pain e.g. methadone.
• Medicines to help with overactive parathyroid e.g. cinacalcet.
• Antipsychotic medicines e.g. haloperidol, perphenazine and thioridazine.

If you are taking medicines such as certain antidepressants or antipsychotics. Care Night Cold & Flu Relief Oral Solution may interact with these medicines and you may experience mental status changes (e.g. agitation, hallucinations, coma), and other effects such as body temperature above 38°C, increase in heart rate, unstable blood pressure, and exaggeration of reflexes, muscular rigidity, lack of coordination and/or gastrointestinal symptoms (e.g. nausea, vomiting, diarrhoea).

Important information about some of the ingredients of Care Night Cold & Flu Relief Oral Solution. This medicinal product contains:

• Ethanol: 2916mg of alcohol (ethanol) in each 20ml of this medicine, which is equivalent to 18.08 v/v %. The amount in 20ml of this medicine is equivalent to 73ml of beer, or 29ml of wine. The alcohol in this preparation is likely to affect children. These effects may include feeling sleepy and changes in behaviour. It may also affect their ability to concentrate and take part in physical activities. The amount of alcohol in this medicine can affect your ability to drive or use machines. This is because it may affect your judgement and how fast you react. If you have epilepsy or liver problems, talk to your doctor or pharmacist before taking this medicine. The amount of alcohol in this medicine may alter the effects of other medicines. Talk to your doctor or pharmacist if you are taking other medicines. If you are pregnant or breast-feeding, talk to your doctor or pharmacist before taking this medicine. If you are addicted to alcohol, talk to your doctor or pharmacist before taking this medicine.
• Liquid maltitol (hydrogenated glucose syrup): If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product. May have a mild laxative effect.
• Sodium: This medicine contains 23.52mg of sodium (main component of cooking salt) in each 20ml dose. This is equivalent to 1.2% of the recommended maximum daily dietary intake of sodium for an adult.
• Propylene glycol: 5180mg propylene glycol in each 20ml of this medicine, which is equivalent to 259mg/ml or 220mg/g. If you are pregnant or breas-feeding, do not take this medicine unless recommended by your doctor. Your doctor may carry out extra checks while you are taking this medicine. If you suffer from a liver or kidney disease, do not take this medicine unless recommended by your doctor. Propylene glycol in this medicine can have the same effects as drinking alcohol and increase the likelihood of side effects. Your doctor may carry out extra checks while you are taking this medicine.