BOOTS COLD AND FLU RELIEF HOT BLACKCURRANT
Active substance(s): ASCORBIC ACID / PARACETAMOL
NAME OF THE MEDICINAL PRODUCT
Boots Cold and Flu Relief Hot Blackcurrant
QUALITATIVE AND QUANTITATIVE COMPOSITION
Quantity/Dose Unit (mg)
Paracetamol Fine crystals EP
Ascorbic Acid Fine powder EP
For the symptomatic relief of colds and influenza and to provide extra vitamin C
during such infections.
Posology and method of administration
For oral administration, following solution in hot water.
Adults And Children Over 12 Years: The contents of the sachet dissolved in freshly
boiled water to be taken at bedtime and repeat every four hours during the day if
necessary, up to a maximum of 4 doses in 24 hours.
Children Under 12 Years: Not to be given without medical advice.
Elderly: There is no need for dosage reduction in the elderly.
Hypersensitivity to any of the ingredients.
Severe liver disease or kidney damage.
Special warnings and precautions for use
Immediate medical advice should be sought in the event of an overdose, even if you
Leaflet or combined label/leaflet:
Immediate medical advice should be sought in the event of an overdose even if you
feel well, because of the risk of delayed, serious liver damage.
Caution in patients with impaired liver or kidney function.
The hazards of overdose are greater in those with non-cirrhotic alcoholic liver
Do not take more than 4 doses in 24 hours.
Do not exceed the stated dose.
Children under 12 years should not be given this medicine without medical advice.
If symptoms persist, consult your doctor.
Keep all medicines out of the reach of children.
Do not take this product for more than three days without consulting your doctor.
Do not take with any other paracetamol-containing products.
Interaction with other medicinal products and other forms of interaction
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.
Pregnancy and lactation
Epidemiological studies in human pregnancy have shown no effects due to
paracetamol used in the recommended dosage, but patients must follow the advice of
their doctor regarding its use.
Paracetamol is excreted in breast milk but not in a clinically significant amount.
Available published data do not contraindicate breast feeding
Effects on ability to drive and use machines
No adverse effects stated.
Very rare cases of serious skin reactions have been reported.
Side-effects are usually rare and mild and may occasionally include skin
rashes and other allergic reactions. There have been reports of blood
dyscrasias including thrombocytopenia and agranulocytosis, but these were
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
Liver damage is possible in adults who have taken 10G or more of paracetamol.
Ingestion of 5 g or more of paracetamol may lead to liver damage if the patient has
risk factors (see below).
If the patient
a) Is on long term treatment with carbamazepine, phenobarbitone, phenytoin,
primidone, rifampicin, St John’s Wort or other drugs that induce liver
b) Regularly consumes ethanol in excess of recommended amounts OR
c) Is likely to be glutathione deplete e.g. eating disorders, cystic fibrosis, HIV
infection, starvation, cachexia
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, haemorrhage, hypoglycaemia, cerebral odema and death. Acute
renal failure with acute tubular necrosis, strongly suggested by loin pain, haematuria
and proteinuria, may develop even in the absence of severe liver damage. Cardiac
arrhythmias and pancreatitis have been reported.
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 medical attention. Symptoms may be limited to nausea or
vomiting and may not reflect the severity of the overdose or the risk of organ damage.
Management should be in accordance with established treatment guidelines, see BNF
overdose section. Treatment with activated charcoal should be considered if the
overdose has been taken within 1 hour. Plasma paracetamol concentration should be
measured at 4 hours or later after ingestion (earlier concentrations are unreliable) but
results should not delay initiation of treatment beyond 8 hours after ingestion, as the
effectiveness of the antidote declines sharply after this time. If required the patient
should be given intravenous N-acetylcysteine, in line with the established dosage
schedule. If vomiting is not a problem, oral methionine may be a suitable alternative
for remote areas, outside of hospital.
Paracetamol is a peripherally acting analgesic with antipyretic properties.
Ascorbic acid is a source of vitamin c which may be beneficial during infection when
vitamin c levels are believed to fall.
Paracetamol is readily absorbed from the gastrointestinal tract with peak plasma
concentrations occurring about 30 mins to 2 hours after ingestion. Paracetamol is
metabolised in the liver and excreted in the urine mainly as the glucuronide and
sulphate conjugates, with about 10% as glutathione conjugates. Less than 5% is
excreted as unchanged paracetamol. The elimination half-life varies from about 1 to
4 hours. Plasma protein binding is negligible at usual therapeutic concentrations,
although this is done dependent.
Ascorbic acid is readily absorbed from the gastrointestinal tract and is widely
distributed in the body tissues. Ascorbic acid is reversibly oxidised to dehydro
ascorbic acid; some is metabolised to ascorbate-2-sulphate which is inactive and
oxalic acid which is excreted in the urine. Ascorbic acid crosses the placenta and is
distributed into the breast milk.
Preclinical safety data
There are no preclinical data of relevance to the prescriber which are
additional to that already included.
List of excipients
Light Magnesium carbonate
Sodium saccharin recryst (76% saccharin)
Dried maize starch pdr
Anhydrous citric acid gran
Blackcurrant flavour 213 IFF
Special precautions for storage
Nature and contents of container
Heat sealed paper/aluminium foil/polythene sachets/ contained in a cardboard carton.
Pack size: 5 or 10 sachets.
Special precautions for disposal
MARKETING AUTHORISATION HOLDER
The Boots Company Plc
1 Thane Road West
Nottingham NG2 3AA
MARKETING AUTHORISATION NUMBER(S)
DATE OF FIRST AUTHORISATION/RENEWAL OF THE
DATE OF REVISION OF THE TEXT