Paracetamol

Paediatric Paracetamol Elixir BP

Each 5ml contains Paracetamol BP 120mg

Oral solution: Pale clear to slightly opalescent yellow, viscous liquid with an odour and taste of banana.

For the treatment of mild to moderate pain, anti-pyretic and post immunisation pyrexia.

Children aged 3 months – 6 years:

It is important to shake the bottle for at least 10 seconds before use.

Hypersensitivity to paracetamol and/or other constituents.

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.

The label should contain the following statements:

• Contains paracetamol.

• Do not give this medicine with any other paracetamol-containing product.

• For oral use only.

• Never give more medicine than shown in the table.

• Do not overfill the spoon.

• Always use the spoon supplied with the pack.

• Do not give more than 4 doses in any 24 hour period.

• Leave at least 4 hours between doses.

• Do not give this medicine to your child for more than 3 days without speaking to your doctor or pharmacist.

• If your baby still needs this medicine two days after receiving the vaccine talk to your doctor or pharmacist (leaflet).

• As with all medicines, if your child is currently taking any medicine consult your doctor or pharmacist before taking this product.

• Do not store above 25°C. Store in the original package.

• Keep all medicines out of the sight and reach of children

• Talk to a doctor at once if your child takes too much of this medicine, even if they seem well (label).

• Talk to a doctor at once if your child takes too much of this medicine, even if they seem well. This is because too much paracetamol can cause delayed, serious liver damage (leaflet).

Patients with rare hereditary problems of fructose intolerance should not take this medicine.

The speed of absorption of paracetamol may be increased by metoclopramide or domperidone and absorption reduced by cholestyramine.

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.

Epidemiological studies in human pregnancy have shown no ill effects due to paracetamol used in the recommended dosage, but patients should follow the advice of their doctor regarding its use. A large amount of data on pregnant women indicate neither malformative, nor feto/neonatal toxicity. Epidemiological studies on neurodevelopment in children exposed to paracetamol in utero show inconclusive results. If clinically needed, paracetamol can be used during pregnancy however it should be used at the lowest effective dose for the shortest possible time and at the lowest possible frequency.

Paracetamol is excreted in breast milk but not in a clinically significant amount. Available published data do not contraindicate breast feeding.

No effects are known.

Very rare cases of serious skin reactions have been reported. Adverse effects of paracetamol are rare but hypersensitivity including skin rash may occur. There have been reports of blood dyscrasias including thrombocytopenia and agranulocytosis, but these are not necessarily causally related to paracetamol.

Reporting of suspected adverse reactions

Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at www.mhra.gov.uk/yellowcard or search for the MHRA Yellow Card in Google Play or Apple App store.

Immediate treatment is essential in the management of paracetamol overdose. Despite a lack of significant early symptoms, patients should be referred to hospital urgently for immediate attention and any patient who had ingested around 7.5 g or more of paracetamol in the preceding 4 hours should undergo gastric lavage. Administration of oral methionine or intravenous N-acetylcysteine which may have a beneficial effect up to at least 48 hours after the overdose may be required. General supportive measures must be available.

Symptoms of paracetamol overdosage in the first 24 hours are pallor, nausea, vomiting, anorexia and abdominal pain. Liver damage may become apparent 12 to 48 hours after ingestion. Abnormalities of glucose metabolism and metabolic acidosis may occur. In severe poisoning, hepatic failure may progress to encephalopathy, coma and death. Acute renal failure with acute tubular necrosis may develop even in the absence of severe liver damage. Cardiac arrhythmias and pancreatitis have been reported.

Liver damage is possible in adults who have taken 10 g or more of paracetamol.

Paracetamol has analgesic and anti-pyretic properties but no anti-inflammatory properties except at very high doses. Paracetamol inhibits prostaglandin synthesis, more centrally than peripherally.

Paracetamol is rapidly absorbed from the upper gastrointestinal tract after oral administration.

It is rapidly distributed throughout the body and is primarily metabolised in the liver. About 85% is conjugated with glucuronide and sulphate and about 10% is conjugated with glutathione.

Excretion of the biotransformation products is via the kidney. The elimination half life is approximately 2-3 hours.

In overdose glucuronide pathways become saturated and excess paracetamol is metabolised via the glutathione pathway. Hepatic glutathione is rapidly depleted and an intermediate hydroxylamine metabolite accumulates and binds to liver proteins causing irreversible damage.

Conventional studies using the currently accepted standards for the evaluation of toxicity to reproduction and development are not available.

Ethanol 96%

Propylene Glycol

Glycerol (E422)

Sorbitol Solution 70%

Acesulfame K

Saccharin Sodium (E954)

Xanthan Gum

Quinoline yellow (E104)

Banana Liquid Flavour

Sodium Citrate

Citric Acid

Purified Water

None known

Amber glass bottles – 3 years

High density polyethylene bottles – 2 years

Warning: Do not refrigerate. Do not store above 25°C. Store in the original container.

Amber Glass bottles: 70 ml, 100 ml, 150 ml, 200 ml, 500 ml, 1L and 2L with pilfer proof screw cap.

Virgin HDPE bottles: 500 ml, 1L and 2L with tamper evident screw cap.

Do not refrigerate.

Pinewood Laboratories Ltd., trading as Pinewood Healthcare

Ballymacarbry

Clonmel

Co. Tipperary

Ireland

PL 04917/0008

5^th April 1991/28^th May 2008

05/08/2019