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Post-operative use in children. There have been reports in the published literature that codeine given post-operatively in children after tonsillectomy and/or adenoidectomy for obstructive sleep apnoea, led to rare, but life-threatening adverse events including death (see Section 4.3 Contraindications). All children received doses of codeine that were within the appropriate dose range; however there was evidence that these children were either ultra-rapid or extensive metabolisers in their ability to metabolise codeine to morphine. Respiratory. Bronchospasm may be precipitated in patients suffering from, or with a history of bronchial asthma or allergic disease.
Lithium. Ibuprofen has been shown to decrease the renal clearance and increase plasma concentrations of lithium. Lithium plasma concentrations should be monitored in patients on concurrent ibuprofen therapy. Depending on your body's individual ability to break down codeine, you may be getting reduced benefit or experience signs of overdose even when you take Nurofen Plus as recommended by your doctor. If overdose symptoms occur, seek immediate medical advice. If you use too much Nurofen PlusNurofen Plus should be administered with caution in patients with hypertension or fluid retention (see Section 4.3 Contraindications, Heart). If, after careful consideration of alternative treatment options for pain management, NSAID treatment is necessary from about 20 weeks, limit use to the lowest effective dose and shortest duration possible. Consider ultrasound monitoring of amniotic fluid if treatment extends beyond 48 hours. Discontinue treatment with NSAIDs if oligohydramnios occurs.
You may develop addiction, dependence and tolerance. For more information, see Section 2. What should I know before I use Nurofen Plus? in the full CMI. 3. What if I am taking other medicines? If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine. If you take too much ibuprofen tablets, capsules, granules or liquid You may need to take ibuprofen for longer if you have a long-term health problem, such as rheumatoid arthritis.Use in renal impairment. Renal impairment as renal function may deteriorate, especially in dehydrated paediatric patients (see Section 4.3 Contraindications; Section 4.8 Adverse Effects (Undesirable Effects)). When GI bleeding or ulceration occurs in patients receiving Nurofen Plus, the treatment should be withdrawn. Nuromol Dual Action Pain Relief 200/500mg tablets. Contains ibuprofen & paracetamol. For pain relief not relieved by ibuprofen or paracetamol individually.
Nurofen Plus should be administered with caution in patients who have recently had gastrointestinal surgery, paralytic ileus, as codeine may reduce gastrointestinal motility. Treatment of perioperative pain in setting of coronary artery bypass surgery (CABG). 4.4 Special Warnings and Precautions for Use
Nurofen Plus should be administered with caution in patients with mild to moderate hepatic impairment (see Section 4.3 Contraindications for severe hepatic impairment). Patients should be advised to remain alert for hepatotoxicity and be informed about the signs and/or symptoms of hepatotoxicity (e.g. nausea, fatigue, lethargy, pruritus, jaundice, abdominal tenderness in the right upper quadrant and "flu-like" symptoms) and the steps to take should these signs and/or symptoms occur. Corticosteroids. An increased risk of gastrointestinal ulceration or bleeding may occur with corticosteroids (see Section 4.4 Special Warnings and Precautions for Use). Tell your doctor or pharmacist if you are taking any other medicines, including any medicines, vitamins or supplements that you buy without a prescription from your pharmacy, supermarket or health food shop.
The risk of addiction is increased in patients with a personal or family history of substance abuse (including alcohol and prescription and illicit drugs) or mental illness. The risk also increases the longer the drug is used and with higher doses. Patients should be assessed for their risks for opioid abuse or addiction prior to being prescribed Nurofen Plus. Take ibuprofen granules by emptying the contents of the sachet into a glass full of water to make an orange flavoured fizzy drink, stir and drink straight away.Nurofen Express 200mg Tablets contain ibuprofen as sodium dihydrate. For mild to moderate pain and fever. Ibuprofen may oppose the blood pressure lowering effects of certain medicines to treat high blood pressure, such as the following: If ibuprofen is used with quinolone antibiotics, such as ciprofloxacin or norfloxacin, there may be an increased risk of seizures (fits). This may occur in people with or without a previous history of epilepsy or convulsions. Other medicines containing ibuprofen Continue taking your medicine for as long as your doctor tells you. If you stop having this medicine suddenly, your pain may worsen and you may experience some or all of the following withdrawal symptoms:
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