Aspartate aminotransferase increased, blood alkaline phosphatase increased, blood creatine phosphokinease increased, haemoglobin decreased and platelet count increased. Undesirable effects such as dizziness, drowsiness, fatigue and visual disturbances are possible after taking NSAIDs. Symptoms of paracetamol overdose in the first 24 hours include pallor, nausea, vomiting, anorexia and abdominal pain.

The MHRA regulates medicines and medical devices in the UK, on behalf of the UK Licensing Authority. Some pharmacodynamic studies show that when single doses of ibuprofen 400 mg was taken within 8 h before or within 30 min after immediate release acetylsalicylic acid dosing (81 mg), a decreased effect of acetylsalicylic acid on the formation of thromboxane or platelet aggregation occurred.

This product has a fast onset of action with 'confirmed perceptible pain relief' achieved in a median of 15.

g dehydrated patients or elderly patients with compromised renal function) the co-administration of an ACE inhibitor or Angiotensin II antagonist and agents that inhibit cyclo-oxygenase may result in further deterioration of renal function, including possible acute renal failure, which is usually reversible. During the last trimester of pregnancy due to risk of premature closure of the foetal ductus arteriosus with possible pulmonary hypertension (see Section 4. Acute generalised exanthematous pustulosis (AGEP) has been reported in relation to ibuprofen-containing products.The hazard of paracetamol overdose is greater in patients with non-cirrhotic alcoholic liver disease. Antihypertensives: (ACE inhibitors and Angiotensin II Antagonists) and diuretics: NSAIDs may reduce the effects of these drugs.

If you are allergic to paracetamol, ibuprofen, aspirin or other anti-inflammatory medicines or medicines for pain relief. The bioavailability and pharmacokinetic profiles of ibuprofen and paracetamol taken as this product are not altered when taken in combination as a single or repeat dose. In serious poisoning metabolic acidosis may occur and the prothrombin time / INR may be prolonged, probably due to interference with the actions of circulating clotting factors. Other NSAIDs including cyclo-oxygenase-2 selective inhibitors as these may increase the risk of adverse effects (see Section 4. Alanine aminotransferase increased, gamma-glutamyltransferase increased and liver function tests abnormal with paracetamol.If you are pregnant, trying to become pregnant, or breastfeeding, speak to your doctor or our pharmacist before taking this product. In patients with active, or a history of recurrent peptic ulcer/haemorrhage (two or more distinct episodes of proven ulceration or bleeding).

Gastrointestinal (GI) bleeding, ulceration and perforation, which can be fatal, has been reported with all NSAIDs at any time during treatment, with or without warning symptoms or a previous history of serious GI events.The views of the PEAG were summarised and provided for CHM when they considered the reclassification application. 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. The elderly have an increased frequency of adverse reactions to NSAIDs especially gastrointestinal bleeding and perforation which may be fatal (see section 4.