Panadol Extra Advance 500mg/65mg Tablets (GSL)

This medicine is available without prescription, but you still need to use Panadol Extra Advance Tablets carefully to get the best results from them.

• Keep this leaflet, you may need to read it again.
• If you have any questions, or if there is anything you do not understand, ask your pharmacist.
• Contains Paracetamol.

1. What Panadol Extra Advance Tablets do
2. Check before you take Panadol Extra Advance Tablets
3. How to take Panadol Extra Advance Tablets
4. Possible side effects
5. How to store Panadol Extra Advance Tablets
6. Further information

• if you have ever had an allergic reaction to paracetamol, caffeine or to any of the other ingredients (listed in Section 6)
• if you are taking any other prescription or non prescription medicines containing paracetamol to treat pain, fever, symptoms of cold and flu, or to aid sleep.

• if you have liver or kidney problems
• if you are underweight
• if you regularly drink alcohol
• If you have severe infection or illnesses, including severe renal impairment or sepsis (when bacteria and their toxins circulate in the blood leading to organ damage), or you suffer from malnutrition, chronic alcoholism or if you are also taking flucloxacillin (an antibiotic).
  A serious condition called metabolic acidosis (a blood and fluid abnormality) has been reported in patients in these situations when paracetamol is used at regular doses for a prolonged period or when paracetamol is taken together with flucloxacillin.

Symptoms of metabolic acidosis may include:

• serious breathing difficulties with deep rapid breathing
• drowsiness
• feeling sick (nausea) and being sick (vomiting)
• loss of appetite

During treatment with Panadol Extra Advance Tablets, tell your doctor straight away if you get a combination of these symptoms.

You may need to avoid using this product altogether or limit the amount of paracetamol that you take.

Talk to your doctor or pharmacist before taking these tablets if you are taking any prescribed medicines; particularly metoclopramide or domperidone (for nausea [feeling sick] or vomiting [being sick]) or colestyramine (to lower blood cholesterol). If you take blood thinning drugs (anticoagulants e.g. warfarin) and you need to take a pain reliever on a daily basis, talk to your doctor because of the risk of bleeding. But you can still take occasional doses of Panadol Extra Advance Tablets at the same time as anticoagulants. This product is not recommended if you are taking lithium.

Please inform your doctor or pharmacist if you are taking flucloxacillin (antibiotic), due to a serious risk of blood and fluid abnormality (called metabolic acidosis) that must have urgent treatment (see section 2).

Due to the caffeine content of this product it should not be used if you are pregnant or breast feeding.

Swallow 2 tablets every 4 hours as needed. Do not take more than 8 tablets in 24 hours.

Swallow 1 tablet every 4 hours as needed. Do not give more than 4 tablets in 24 hours.

• Do not take more frequently than every 4 hours.
• Do not take more than the recommended dose.
• Do not give to children under 12 years.
• Avoid too much caffeine in drinks like coffee and tea.

High caffeine intake can cause difficulty sleeping, shaking and an uncomfortable feeling in the chest. If your symptoms continue or your headache becomes persistent, see your doctor.

Talk to a doctor at once if you take too much of this medicine even if you feel well. This is because too much paracetamol can cause delayed, serious liver damage.