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Paramax 500mg/5mg
Effervescent Powder

Metoclopramide hydrochloride
Read all of this leaflet carefully before you start
taking this medicine because it contains important
information for you.
• Keep this leaflet. You may need to read it again
• If you have any further questions, ask your doctor or
• This medicine has been prescribed for you only. Do
not pass it on to others. It may harm them, even if
their signs of illness are the same as yours
• If you get any side effects talk to your doctor or
pharmacist. This includes any possible side effects
not listed in this leaflet
What is in this leaflet:
1. What Paramax is and what it is used for
2. What you need to know before you take Paramax
3. How to take Paramax
4. Possible side effects
5. How to store Paramax
6. Contents of the pack and other information

1. What Paramax is and what it is
used for
The name of your medicine is Paramax 500mg/5mg,
Effervescent Powder (called Paramax in this leaflet).

If you are not sure if any of the above apply to you, talk
to your doctor or pharmacist before taking Paramax

Other medicines and Paramax
Tell your doctor or pharmacist if you are taking or have
recently taken any other medicines. This includes
medicines obtained without a prescription, including
herbal medicines. This is because Paramax can affect the
way some other medicines work. Also, some other
medicines can affect the way Paramax works.
While taking Paramax you should not take any other
medicines which contain paracetamol.
This includes some painkillers, cough and cold remedies.
It also includes a wide range of other medicines
available from your doctor and more widely in shops.
Do not take this medicine, and tell your doctor, if
you are taking:
Levodopa - used for Parkinson’s disease
Tell your doctor if you are taking any of the
Paramax may increase the effects of the following
• Medicines for mental illness known as ‘antipsychotics’
• Medicines to calm or reduce anxiety (hypnotics,
• Medicines to help you sleep (sedatives, barbiturates)
• Some medicines used for depression such as
mirtazapine or trazodone
• Chloramphenicol - an antibiotic used for infections
• Medicines to prevent blood clotting (anti-coagulants)
such as warfarin
• Ciclosporin - used to help prevent rejection of
transplants. Your doctor may change your dose of
• Clonidine - used for high blood pressure,
migraine or hot flushes in the menopause
• Some medicines for moderate to severe pain
(morphine products) such as codeine, dihydrocodeine
or dextropropoxyphene
• Medicines that can make you sleepy that are
used for hay fever, rashes or other allergies called
sedative antihistamines such as chlorphenamine or

What Paramax contains
Paramax contains two different medicines. These are called:
• Metoclopramide hydrochloride: this belongs to a
group of medicines called anti-emetics. It works on
muscles in the upper part of the digestive system
causing your stomach to empty. It also works on a
part of your brain that prevents you from feeling sick
(nausea) or being sick (vomiting)
• Paracetamol: this belongs to a group of medicines
called painkillers (analgesics). It works by stopping
substances that naturally occur in your body called Paramax can make the following medicine work less
prostaglandins from being made. Prostaglandins well:
Digoxin - used for heart problems. Your doctor may
cause pain. If they are blocked, pain is relieved
change your dose of digoxin
What Paramax is used for
Paramax is used to treat the signs of migraine, such as The following medicine can increase the effects of
headache, feeling sick (nausea) or being sick (vomiting) Paramax:
in adults 18 years and over.
Domperidone (a similar medicine to metoclopramide) used to stop you feeling sick (nausea) or being sick
2. What you need to know before you take


Do not take this medicine and tell your
doctor if:
• You are allergic to the active substances or any of
the other ingredients (listed in section 6)
Signs of an allergic reaction include: rash, swallowing or
breathing problems, swelling of your lips, face, throat or
• You have a blockage or bleeding in your stomach or
intestine (gut)
• You have had movements that you cannot control,
mainly of the tongue, mouth, jaw, arms and legs
after taking metoclopramide or medicines used to
calm emotional and mental problems
• You have epilepsy
• You have had an operation on your stomach or
intestine (gut). Do not take during the first 3 to 4 days
after your operation
• You have a tumour on the adrenal gland (called
• You are taking a medicine called levodopa used to treat
Parkinson’s disease (see ‘Other medicines and Paramax’)
Paramax must not be given to patients under
18 years of age.
Do not take this medicine if any of the above apply to
you. If you are not sure, talk to your doctor or pharmacist
before taking Paramax.

The following medicines can make Paramax work
less well:
• Oral contraceptive pill
• Colestyramine - for lowering blood cholesterol levels
• Medicines used to treat muscle spasms
(anticholinergics) for irritable bowel syndrome (IBS)
such as mebeverine or hyoscine
• Medicines used to treat incontinence such as
oxybutynin, propiverine or tolterodine
• Some medicines for moderate to severe pain
(morphine products) such as codeine, dihydrocodeine
or dextropropoxyphene
Paramax with alcohol
You should not drink alcohol while you are taking these
sachets. Drinking alcohol while taking Paramax may
make you feel very sleepy.
Pregnancy and breast-feeding
Talk to your doctor before taking this medicine if:
• You are pregnant, think you may be pregnant or plan
to get pregnant. You must not take Paramax during
the first six months of pregnancy
• You are breast-feeding or planning to breast feed.
Do not breast-feed if you are taking Paramax. This is
because small amounts may pass into mothers’ milk.
Ask your doctor or pharmacist for advice before taking
any medicine if you are pregnant or breast-feeding.

Driving and using machines
You may feel sleepy after taking this medicine. This is
Warnings and precautions
more likely if you have drunk alcohol or taken other
Take special care with Paramax
medicines that cause drowsiness. If this happens, do not
Check with your doctor or pharmacist before drive or use any tools or machines.
taking your medicine if:
 You have severe kidney problems
 You have severe liver problems including alcoholic
liver disease
 You are elderly (65 years of age or older)

Paramax contains:
Sodium: There is 387.7 mg of sodium per sachet. This may
be harmful to people on a low sodium or low salt diet.

3. How to take Paramax
Always take Paramax exactly as your doctor has told you.
Check with your doctor or pharmacist if you are not sure.
Taking this medicine
• Take this medicine by mouth
• Pour the contents of the sachet into about a quarter
of a glass of water mix well and drink straight away
• Do not take more than the recommended dose
• If you continue being sick (vomiting) after taking this
medicine, tell your doctor
• If you feel the effect of your medicine is too weak or
too strong do not change the dose yourself, but ask
your doctor
How much to take
Adults (18 years and older) and the elderly:
• The usual dose is 2 sachets when you have the first
warning of a migraine attack
• Wait at least 4 hours before taking another dose
• Do not take more than 6 sachets in any 24 hour
Use in children and adults under 18
Do not take if you are under 18 years of age.
If you take more Paramax than you should
• 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
• Remember to take any remaining sachets and the
pack with you. This is so the doctor knows what you
have taken
The following effects may happen:
• Feeling sick (nausea) and being sick (vomiting);
unusually pale complexion; loss of appetite; stomach
pains. Other effects such as drowsiness, rapid
uncontrollable shaking (convulsions), muscle spasms
and ‘jerks’ may also occur
• Severe stomach pain which may reach through to
your back. This could be a sign of pancreatitis
• You may also feel that your limbs are swollen (fluid
retention). This is a sign of changes in the way your
kidneys are working
• In some cases an uneven heart beat; increased or
heavy breathing and feeling weak. You may also
develop liver problems that may cause the eyes or
skin to go yellow and in severe cases lack of
awareness (disorientation), confusion, bleeding in
your stomach or gut, loss of consciousness (coma)
and death may occur
If you have any further questions on the use of
this medicine, ask your doctor or pharmacist.

4. Possible side effects
Like all medicines, this medicine can cause side effects,
although not everybody gets them.
Stop taking Paramax and see a doctor or go to a
hospital straight away if:
• You have an allergic reaction. Severe allergic
reactions can occur very rarely and usually happen
soon after taking Paramax. These can involve
difficulty breathing, tightness in the throat, rapidly
spreading rashes, dizziness, very fast heart beat or
even loss of consciousness.
• You are short of breath, have bluish skin colouration,
headache, tiredness, dizziness and loss of
consciousness. These could be signs of a very rare but
serious side effect called methaemoglobinaemia
• You have very high blood pressure (hypertension),
symptoms of which may include a dull headache,
dizziness, confusion, fatigue.
• You are paler than normal, are sweating, have a high
temperature, fast heartbeat, stiff muscles, fast
breathing and feel confused, drowsy or agitated.
These could be signs of a serious side effect called
neuroleptic malignant syndrome.
• Shortness of breath, slow heart beat and chest pain
• You have a fit (seizure)
• You get serious skin reactions. Very rare cases have
been reported.
Tell a doctor straight away if you notice any of the
following serious side effects:
• Problems controlling certain muscles of the body or
you have muscle spasms or ‘jerks’. The affected
muscles may include your tongue, mouth, jaw, arms
and legs. The spasms may cause unusual movements

of the face, tongue, eyes, neck and affect speech,
expression and/or lead to unnatural positioning of
the head and shoulders
Decreased level of consciousness, confusion,
Rigid or stiff muscles, trembling or shaking or
difficulty moving
You bruise more easily than usual. This could be
because of a blood disorder (thrombocytopenia)
You get infections more often and easier than
normal. This could be because you have a low
number of white blood cells (agranulocytosis)

Tell your doctor as soon as possible if you have any
of the following side effects:
• Diarrhoea
• Dizziness, lightheadedness and fainting. This could
be because of low blood pressure
Tell your doctor or pharmacist if any of the following
side effects get serious or lasts longer than a few
• Abnormal production of breast milk in men and
• Breast enlargement in men
• Loss of menstrual periods
• Feeling nervous (anxious), restless or confused
• Feeling drowsy
• Lack or loss of strength (weakness)
• Skin rash
Reporting of side effects
If you get any side effects, talk to your doctor or
pharmacist. This includes any possible side effects not
listed in this leaflet. You can also report side effects
directly via the Yellow card Scheme at: By reporting side effects,
you can help provide more information on the safety of
this medicine.

5. How to store Paramax
Keep this medicine out of the sight and reach of children.
Do not use Paramax after the expiry date which is stated
on the sachet and carton after EXP. The expiry date refers
to the last day of that month.
Store below 25°C. Keep the sachets in the outer carton.
Do not throw away any medicines via wastewater or
household waste. Ask your pharmacist how to throw
away medicines you no longer use. These measures will
help protect the environment.

6. Contents of the pack and other information
What Paramax contains
• The active substances are metoclopramide
hydrochloride and paracetamol. Each sachet
contains 500mg paracetamol and 5mg
metoclopramide hydrochloride (as anhydrous) as the
active ingredients
• The other ingredients are gelatin, sodium carbonate,
saccharin sodium, sodium dihydrogen citrate
(anhydrous), sodium bicarbonate and lemon flavour
What Paramax looks like and contents of the pack
A white, soluble effervescent powder for oral solution.
Cartons containing 6, 30 or 42 sachets. Not all pack sizes
may be marketed.
Marketing Authorisation Holder and Manufacturer
Marketing Authorisation Holder
One Onslow Street
Guildford, Surrey
Sanofi-Aventis Sp. z o.o.
ul. Lubelska 52
35-233 Rzeszów, Poland
This leaflet was last revised in September 2016.
© Zentiva 2016


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