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JUNIOR PARACETAMOL 120MG CAPSULES
Active substance(s): PARACETAMOL
NAME OF THE MEDICINAL PRODUCT
Junior Paracetamol 120mg Capsules
QUALITATIVE AND QUANTITATIVE COMPOSITION Paracetamol 120 mg. For a full list of excipients, see section 6.1.
Pharmaceutical Form Capsule Hard gelatin white capsules
Therapeutic indications For the treatment of mild to moderate pain including headache, migraine, pain of teething, toothache, sore throat, period pains, neuralgia, aches and pains including muscle pains and backache. Symptomatic relief of rheumatic aches and pains, influenza, feverishness, feverish colds and feverishness associated with childhood infections such as chicken pox, whooping cough, measles and mumps.
Posology and Method of Administration Route of administration: oral. This product is intended for the administration to children between the ages of 3 years and 14 years. Children: 3 years to under 6 years: 1 to 2 capsules. 6 years to under 14 years: 2 to 4 capsules. Dose should not be repeated more frequently then 4 times in any 24 hours period.
The dosage should not be continued for more than 3 days without consulting a doctor. 4.3. Contra-indications Hypersensitivity to Paracetamol and/or other constituents.
Special warnings and special precautions for use Care is advised in the administration of paracetamol to patients with renal or hepatic impairment. The hazards of overdose are greater in those with alcoholic liver disease. Paracetamol should be given with care to patients with alcoholic dependence. Paracetamol is well tolerated by the majority of people with asthma. However, a small percentage of aspirin sensitive asthmatics are also sensitive to paracetamol. The likelihood of a reaction to paracetamol increases with a patients level of sensitivity to aspirin (see also 4.8 Undesirable effects). Do not exceed the recommended dose. Patients should be advised not to take other paracetamol-containing products concurrently. If symptoms persist consult your doctor. Keep out of the sight and reach of children. Do not take for more than three days unless your doctor agrees. The product label will carry the warnings: Do not take with any other paracetamol-containing products. Immediate medical advice should be sought in the event of an overdose, even if the child seems well.
Interaction with other medicinal products and other forms of interaction Alcohol: Paracetamol should be given with care to patients with alcohol dependence (see section 4.4) Analgesics: Diflunisal increases blood concentrations of paracetamol. Anion exchange resins: Absorption reduced by colestyramine; administration should be separated by at least one hour.
Antibacterials: Isoniazid may increase the risk of hepatotoxicity with therapeutic doses of paracetamol. Anticoagulants: 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. Antiepileptics: Carbamazepine, phenobarbital, phenytoin and primidone can reduce the effects of paracetamol and increase the risk of hepatotoxicity. Paracetamol may increase lamotrigine metabolism.
Motility stimulants: The speed of absorption of paracetamol may be increased by metoclopramide or domperidone. Oral contraceptives: Paracetamol is cleared from the body more quickly in women taking oral contraceptives and the analgesic effects may be reduced. Uricosurics: Probenecid can reduce the loss of paracetamol from the body.
Pregnancy and lactation 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. 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 None.
Undesirable effects Adverse effects of paracetamol are rare. Haematological: There have been reports of blood dyscrasias including thrombocytopenia and agranulocytosis, but these were not necessarily causally related to paracetamol. Immune system: Hypersensitivity including skin rash may occur. A small percentage of aspirin-sensitive asthmatics are also sensitive to paracetamol. In such cases, the deterioration in respiratory function induced by paracetamol is milder and shorter than with aspirin (see also 4.4 Special warnings and precautions for use).
Renal and urinary disorders: Nephropathy has been associated with chronic high dose use.
Liver damage is possible in adults who have taken 10g or more of paracetamol. Ingestion of 5g or more of paracetamol may lead to liver damage if the patient has risk factors (see below) Risk Factors. If the patient: a. Is on long term treatment with carbmazepine, phenobarbital, phenytoin, primidone, rifampicin, St Johns Wort or other drugs that induce liver enzymes.
Or b. Or c.
Regularly consumes ethanol in excess of recommended amounts
Is likely to be glutathione depleted e.g. eating disorders, cystic fibrosis, HIV infection, starvation, cachexia.
Symptoms Symptoms of paracetamol overdose 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 oedema 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 arrythmias and pancreatitis have been reported.
Treatment 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 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 one hour. Plasma paracetamol concentration should be measured at four hours or later after ingestion (earlier concentrations are unreliable). Treatment with N-acetylcysteine may be used up to 24 hours after ingestion of paracetamol, however, the maximum protective effect is obtained up to eight hours post ingestion. The effectiveness of the antidote declines sharply after this time. If required the patient should be given intravenous Nacetylcysteine in line with the established dosing schedule. If vomiting is not a problem, oral methionine may be suitable alternative for remote areas, outside hospital. Management of patients who present with serious hepatic dysfunction beyond 24 hours from ingestion should be discussed with the NPIS or a liver unit.
Paracetamol has analgesic and antipyretic actions 5.2. Pharmacokinetic properties Paracetamol is readily absorbed from the gastrointestinal tract with peak plasma concentrations occurring about 30 minutes to two hours after ingestion. It is metabolised in the liver and excreted in the urine mainly as the glucuronide and sulphate conjugates. Less than 5% is excreted as unchanged paracetamol. The elimination half-life varies from about one hour to four hours. At usual therapeutic concentrations plasma-protein binding is negligible. 5.3. Preclinical safety data There is no pre-clinical data of relevance to the prescriber that are additional to those already included in other sections.
List of excipients Maize Starch Magnesium Stearate Sodium Lauryl Sulphate Capsule Cap - Gelatin Body - Gelatin Colorant - Titanium Dioxide CI Number - 77891 EEC Number - E171
Incompatibilities None known.
Shelf Life 3 years from the date of manufacture.
Special Precautions for Storage Store in a dry place below 25C. Protect from light.
Nature and contents of container Blister Packs: 8,10, 12, 16 Capsules - GSL ONLY. Blister Packs: Pack of 20, 24, 28, 30 & 32 Capsules - AS PHARMACY. Blister strips consist of a 35gsm paper/9 soft tempered aluminium foil lid and 250 PVC film base in cartons.
Instruction for Use/Handling Return any leftover capsules to the pharmacist.
MARKETING AUTHORISATION HOLDER
Wockhardt UK Ltd Ash Road North Wrexham LL13 9UF United Kingdom
MARKETING AUTHORISATION NUMBER(S)
DATE OF FIRST AUTHORISATION/RENEWAL OF THE AUTHORISATION
DATE OF REVISION OF THE TEXT