CETIRIZINE DIHYDROCHLORIDE + PHENYLEPHRINE HYDROCHLORIDE + PARACETAMOL

This product should not be used by patients with known hypersensitivity to any of the ingredients, asthma, COPD, diabetes and liver, kidney and heart ailments. Pregnant and breastfeeding women should not take this product. Do not exceed the stated dose.

Phenylephrine: fast and irregular heartbeat, hypertension, nausea, vomiting, headache and occasionally urinary retention in males.

Paracetamol (rare): hypersensitivity including skin rash

Precautions

Cetirizine: Some patients taking cetirizine experience drowsiness; therefore, due caution should be exercised when driving a car or operating potentially dangerous machinery. Concurrent use of cetirizine with alcohol or other CNS depressants should be avoided because additional reductions in alertness and additional impairment of CNS performance may occur.

Phenylephrine: Should be used with caution in patients with occlusive vascular disease including Raynaud’s phenomenon. Do not take for longer than 7 days, unless your doctor agrees. If symptoms do not go away talk to your doctor. Keep all medicines out of the reach of children.

Paracetamol: Care is advised in the administration of paracetamol to patients with severe renal or severe hepatic impairment. The hazards of overdose are greater in those with non-cirrhotic alcoholic liver disease. Do not take with any other paracetamol-containing products. If symptoms persist for more than 3 days or get worse consult your doctor.

Interactions

Cetirizine: No clinically significant drug interactions have been found with theophylline at a low dose, azithromycin, pseudoephedrine, ketoconazole, or erythromycin. There was a small decrease in the clearance of cetirizine caused by a 400-mg dose of theophylline; it is possible that larger theophylline doses could have a greater effect.

Cetirizine hydrochloride may heighten the effects of alcohol. Therefore caution is recommended with concomitant use of alcohol. Caution is recommended during concomitant use of CNS depressants.

Phenylephrine: Should not be given to patients being treated with monoamine oxidase inhibitors or within 14 days of stopping such treatment. May enhance the effects of anticholinergic drugs such as tricyclic antidepressants. May increase the possibility of arrhythmias (irregular heartbeat) in patients taking digitalis. May enhance the cardiovascular effects of other sympathomimetic amines (e.g. decongestants).

This medicine should not be taken together with vasodilators, Beta-blockers or enzyme inducers such as alcohol.

Paracetamol: The speed of absorption of paracetamol is reduced by cholestyramine. Therefore, the cholestyramine should not be taken within one hour if maximal analgesia is required.

The absorption of paracetamol is increased by metoclopramide and domperidone. However, concurrent use need not be avoided.

The anticoagulant effect of warfarin and other coumarins may be enhanced by prolonged regular use of paracetamol with increased risk of bleeding; occasional doses have no significant effect.

Paracetamol may result in increased plasma concentration of chloramphenicol.

Symptoms of overdose include irritability, restlessness, palpitations, hypertension, difficulty in urinating, nausea, vomiting, thirst, abdominal pain and convulsions. If overdose is suspected, bring the patient to the nearest hospital.