Day Nurse Tablets 18s

Always take this medicine exactly as described in the leaflet or as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

Take the tablets with a glass of water.

• Adults (including the elderly): Swallow 2 tablets up to 3 times daily. Leave at least 4 hours between doses. Do not take more than 6 tablets in 24 hours.
• Adolescents aged 16 to 18 years: Give 1 to 2 tablets up to 3 times daily. Leave at least 4 hours between doses. Do not give more than 6 tablets in 24 hours.
• Adolescents aged 12 to 15 years: Give 1 tablets up to 3 times daily. Leave at least 4 hours between doses. Do not give more than 3 tablets in 24 hours.

Always use the lowest effective dose to relieve your symptoms for the shortest period of time necessary. Do not take more frequently than every 4 hours. Do not take for more than 5 days. Do not take more medicine than the label tells you to. If you do not get better, talk to your doctor.

• Active Ingredients: Paracetamol 500mg and bPseudoephedrine Hydrochloride 30mg.
• Other Ingredients: Cellulose microcrystalline (E460), silica, colloidal anhydrous (E551), stearic acid (E570), magnesium stearate (E572), starch pregelatinised, povidone, crospovidone, croscarmellose sodium (E468), hypromellose (E464), macrogol, carnauba wax (E903), indigo carmine (E132).

• Day Nurse Tablets are not recommended during pregnancy or whilst breastfeeding. If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.
• This product can cause dizziness as a side effect which could affect your ability to drive or use machines. Do not drive or operate machinery if affected.
• Do not take anything else containing paracetamol while taking this medicine.
• Contains paracetamol. Do not take more than the recommended dose as it may cause serious harm to your liver. Do not use this medicine if you are taking any other medicines which may contain paracetamol including prescription or non-prescription medicines to treat pain, fever, symptoms of cold and flu.
• Do not take with other flu, cold or decongestant products.
• One of the active ingredients in Day Nurse Tablets, pseudoephedrine, has the potential to be abused and large doses of pseudoephedrine can be toxic. Continuous use may lead to taking more Day Nurse Tablets than the recommended dose to get the desired effect, resulting in an increased risk of overdosing. The recommended maximum dose and treatment duration should not be exceeded.
• Pseudoephedrine causes narrowing of blood vessels (vasoconstriction). This action may be associated with the occurrence of the following sudden medical conditions. These conditions require immediate medical attention:
  • Acute Coronary Syndrome (ACS): This includes conditions such as a heart attack or unstable angina. Both are associated with a type of severe chest pain caused by blocked blood supply to parts of the heart. The sudden chest pain or discomfort (a feeling of pressure or tightness) can spread from your chest to your arms, jaw, neck, back or tummy. You may also feel lightheaded or
    dizzy, be sweating or experience shortness of breath while at rest. Stop using this medicine immediately and seek immediate medical assistance if you develop symptoms that may be signs of ACS.
  • Cases of posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS) have been reported following use of medicines containing pseudoephedrine. PRES and RCVS are rare conditions that can involve reduced blood supply to the brain. Stop using this medicine immediately and seek immediate medical assistance if you develop symptoms that may be signs of PRES or RCVS.
  • Sudden abdominal pain or rectal bleeding may occur with Day Nurse Tablets, due to inflammation of the colon (ischaemic colitis). If you develop these gastrointestinal symptoms, stop taking Day Nurse Tablets and contact your doctor or seek medical attention immediately.
• This medicine contains less than 1 mmol sodium (23mg) per tablet, that is to say essentially 'sodium-free'.
• Reduction of blood flow to your optic nerve may occur with Day Nurse Tablets. If you develop sudden loss of vision, stop taking Day Nurse Tablets and contact your doctor or seek medical attention immediately. 

Do not take Day Nurse Tablets:

• If you are allergic to paracetamol, pseudoephedrine hydrochloride or any of the other ingredients in the product.
• If you are taking other sympathomimetics (such as decongestants, tricyclic antidepressants).
• If you have very high blood pressure (severe hypertension) or hypertension not controlled by your medication.
• If you have an overactive thyroid gland, enlarged prostate, heart problems, glaucoma (excessive pressure inside your eyes).
• If you have severe acute (sudden) or chronic (long term) kidney disease or kidney failure.
• If you have taken monoamine oxidase inhibitors (MAOIs), usually prescribed for depression, in the last two weeks.
• If you are taking the drug moclobemide for depression, beta-blockers for high blood pressure, the oxazolidinone class of antibiotics (e.g. furazolidone or linezolid), appetite suppressants, stimulant drugs called amphetamines (sometimes used to treat attention deficit disorders or excessive sleepiness).
• If you develop a feverish generalised erythema associated with pustules, stop taking Day Nurse Tablets and contact your doctor or seek medical attention immediately.
• If you are under 12 years.

Talk to your doctor or pharmacist before taking Day Nurse Tablets:

• If you are due to undergo general anaesthesia, or have liver disease, including alcoholic liver disease, or kidney problems, diabetes (too much sugar in your blood), psychosis (severe mental health problems in which the person loses contact with reality and is unable to think and judge clearly) irregular heart beat or phaeochromocytoma (a tumour near the kidney). You may need to avoid using this product altogether or limit the amount of paracetamol that you take.
• If you suffer from glutathione depletion due to metabolic deficiencies.
• If you are more than 60 years old, as there is increased possibility of unwanted effects.
• If you are taking medicines that affect your liver. Check with your doctor before use if you have liver or kidney problems, are underweight (<50kg), become malnourished or regularly drink alcohol, as this may increase your risk of liver damage. You may need to reduce the amount of paracetamol that you take or avoid using this product altogether.

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines particularly:

• Anticoagulants (used to thin the blood, e.g. warfarin).
• Metoclopramide or domperidone (for nausea [feeling sick] or vomiting [being sick]).
• Colestyramine (to lower blood cholesterol).
• Medicines for high blood pressure; or vasoconstrictor agents such as ergot derivates (sometimes prescribed for migraine or hyperprolactinemia)
• Medicines for depression (tricyclic antidepressants e.g. amitriptyline).
• Sodium bicarbonate (used to treat indigestion and certain kidney conditions).
• In case of surgery, it is advisable to stop treatment at least 24 hours before.
• The pseudoephedrine content in this product may induce a positive reaction during antidoping control tests.
• Flucloxacillin (antibiotic), due to a serious risk of blood and fluid abnormality (high anion gap metabolic acidosis) that must have urgent treatment and which may occur particularly in case of severe renal impairment, sepsis (when bacteria and their toxins circulate in the blood leading to organ damage), malnutrition, chronic alcoholism, and if the maximum daily doses of paracetamol are used.