Nurofen Plus Tablets for Pain Relief - 32

Product Summary

Nurofen Plus works both at the site of pain and also reduces the body's response to pain signals. They offer fast and powerful relief from migraine, headache, cramping period pain, dental pain, back pain, neuralgia, rheumatic pain, muscular pain, cold & flu.

Dosage Instructions

• This medicine should not be taken for more than 3 days. If the pain does not improve after 3 days, talk to your doctor for advice.
• Adults, the elderly and children aged 12 years and older: Swallow 1 or 2 tablets with water, up to three times a day as required.
• Leave at least four hours between doses.
• Do not take more than 6 tablets in any 24 hour period.

Nurofen Plus should not be taken by children below the age of 12 years, due to the risk of severe breathing problems.

Do not take for longer than 3 days unless your doctor tells you to.

If symptoms persist or the pain or fever worsen, or if any new symptoms occur, consult your doctor or pharmacist.

This product is for short-term use only.

You should take the lowest dose for the shortest time necessary to relieve your symptoms

Warnings and Restrictions

Speak to a pharmacist or your doctor before taking this product if you:

• have or have had asthma
• have kidney, heart, liver or bowel problems or are dehydrated
• have low or high blood pressure
• have a head injury or raised intracranial pressure
• suffer from a thyroid disorder
• have systemic lupus erythematosus (a condition of the immune system causing joint pain, skin changes and other organ disorders)
• have high cholesterol
• have had a heart attack or stroke
• have a history of gastrointestinal disease (such as ulcerative colitis, Crohn’s disease)
• are a smoker
• have gallstones
• suffer from myasthenia gravis (a condition that causes muscle weakness).

Care should be taken in elderly patients due to the increased risk of breathing problems.

Do not take if you:

• have a stomach ulcer or perforation or bleeding of the stomach
• have breathing difficulties
• are allergic to any of the ingredients or to aspirin or other painkillers
• suffer from severe liver, kidney or heart problems
• suffer from chronic constipation
• are taking other NSAID pain killers, or aspirin with a daily dose above 75mg daily
• are in the last 3 months of pregnancy
• are under 12 years old.

Codeine is used only in combination with other analgesics, and the above warnings and side effects should be adhered to.

Codeine can cause constipation.

If you have any questions, please contact your doctor.

If you need to use this product for more than three days at a time, see your doctor, pharmacist or healthcare professional.

Taking codeine/dihydrocodeine regularly for a long time can lead to addiction, which might cause you to feel restless and irritable when you stop the tablets.

Taking a painkiller for headaches too often or for too long can make them worse.

Taking other medicines

Ask your doctor or pharmacist before taking ibuprofen if you are allergic to Aspirin, suffer from asthma, may be pregnant or receiving regular medical treatment, for example, Warfarin for blood clots (thrombosis).

Nurofen Plus can interact with other medicines, such as:

• some anticoagulant medicines (thin blood/prevent clotting e.g. Aspirin / Acetylsalicylic acid, Warfarin, Ticlopidine)
• some medicines that reduce high blood pressure (ACE-inhibitors such as Captopril, beta-blockers such as Atenolol, or angiotensin-II receptor antagonists such as Losartan)

The following medicines are known to interact with codeine (present in this medicine):

• Moclobemide (for depression)
• Hydroxyzine (an anti-anxiety medicine)
• Loperamide and Kaolin (medicines to treat diarrhoea)
• Quinidine or Mexiletine (to treat abnormal heart rhythms)
• Metoclopramide or Domperidone (anti-sickness medicines)
• Cimetidine (to treat stomach ulcers)
• Naloxone
• medicines called monoamine oxidase inhibitors (MAOIs) for the treatment of depression may affect or be affected by treatment with Codeine.

You should therefore always seek the advice of your doctor or pharmacist before you take Nurofen Plus with other medicines.

Storage

• Do not store above 25°C.
• Store in the original pack
• Do not use after the expiry date stated on the carton after EXP. The expiry date refers to the last day of that month.
• Keep all medicines out of the sight and reach of children.

Pharmacist FAQs Answered

What made Nurofen Plus different?

Nurofen Plus contains two active ingredients: ibuprofen and codeine phosphate. Ibuprofen is a non-steroidal anti-inflammatory painkiller that relieves pain, inflammation, and fever. Codeine is an opioid ,but a weak one that works by acting on the pain signals in the brain, giving an extra amount of pain relief. Combined, this makes Nurofen Plus more potent. for certain types of moderate to severe pain than regular ibuprofen alone. But because codeine can lead to dependence or addiction if used excessively, Nurofen Plus should only be taken for a few days (not more than three days) unless on medical advice.

What are the risks of taking Nurofen Plus for a prolonged period?

Taking Nurofen Plus for longer than three days is risky owing to its codeine content. Taking codeine daily can cause your body to depend on it so that you get irritable, fidgety, or even experience withdrawal symptoms when you put it down. Excessive codeine also causes constipation, drowsiness, and difficulty in breathing, especially in elderly people or those who are sensitive. Taking too many painkillers such as Nurofen Plus can even cause something called "medication overuse headache," wherein headaches become worse and more frequent. Always take the dose as directed.

Will Nurofen Plus cause me to sleep or affect my driving?

Yes, Nurofen Plus is likely to cause drowsiness, sleepiness, or dizziness because it contains codeine. This will affect your ability to drive or operate machines safely. You should not drive, cycle, or engage in any activity involving concentration until you know how the medicine will make you feel. Drink a glass of alcohol with Nurofen Plus and you are more likely to become drowsy and experience breathing problems, so you must not drink alcohol at all. If you feel very sleepy or confused after taking the tablets, consult a doctor or pharmacist.

May I take Nurofen Plus when I am pregnant or breastfeeding?

Nurofen Plus must not be taken if you are pregnant, especially in the last three months, as it harms your baby or affects delivery. It must also be avoided when breastfeeding since codeine passes into breast milk and can injure the baby by slowing down breathing or causing sleepiness. If you become pregnant or are breastfeeding, always discuss your use of any drug, including over-the-counter drugs like Nurofen Plus, with your doctor or pharmacist.

What if I have an overdose of Nurofen Plus accidentally?

If you or someone else have had a few too many of Nurofen Plus, call for medical help immediately, even if you feel well. Suppose you consume more than the prescribed dose of ibuprofen, stomach pain, nausea, vomiting, or ulcers can occur. In that case, excessive codeine intake can lead to serious side effects like intense drowsiness, confusion, shallow or slow breathing, or loss of consciousness. Never wait for symptoms to appear—telephone your doctor, pharmacist, or emergency services immediately for advice.

Can I take Nurofen Plus together with other cold and flu medicines?

Nearly all cold and flu medications already contain painkillers like paracetamol or ibuprofen, or antihistamines, which can contribute to drowsiness. Combining these with Nurofen Plus will also increase the danger of overdose or side effects. Make sure to read the label on each medicine you are taking simultaneously, and if unsure, have your pharmacist help you check for any dangerous combinations. Never mix medicines without your professional's advice, even if they are over-the-counter.

How do I store Nurofen Plus safely at home?

Nurofen Plus should be stored in its original packaging, away from direct sunlight and heat below 25°C, and out of the reach and sight of children. Because it contains codeine, a controlled medicine, it's extra important to keep it safely so it can't be taken accidentally by children or others. Don't leave it where it is handy, such as a handbag or bathroom cabinet. If you have any tablets remaining after treatment, please dispose of them safely at your pharmacy, rather than flushing them down the toilet or putting them in the waste bin.