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.
If your symptoms persist, see your doctor or pharmacist.
Do Not Take Night Nurse Capsules Pack of 10 If:
- You have ever had an allergic reaction to paracetamol, promethazine hydrochloride, dextromethorphan hydrobromide, or any of the other ingredients.
- You have a chest infection, worsening asthma, or severe respiratory problems.
- You are taking or have taken monoamine oxidase inhibitors (MAOIs) prescribed for depression in the last two weeks.
- You are having a pregnancy test carried out on your urine.
- You are pregnant or breast-feeding.
- You are taking any other paracetamol-containing products.
- You are taking any other flu, cold, or decongestant products.
Important Precautions:
- This medicine can lead to dependence. Therefore, the treatment should be of short duration.
- Do not drink alcohol while using Night Nurse Capsules Pack of 10.
- If your symptoms are accompanied by a high temperature, skin rash, or persistent headache, see your doctor or pharmacist.
- This medicine may affect pregnancy tests based on urine samples, to give false results.
- This medicine can affect your ability to drive as it may cause drowsiness, dizziness, difficulty concentrating, movement difficulties, or blurred vision. If affected, do not drive or operate machinery until you know how it affects you. It may be an offence to drive when taking this medicine.
Consult Your Doctor or Pharmacist Before Taking If:
- You have an intolerance to some sugars.
- You have heart, kidney, or liver problems.
- You have glaucoma, epilepsy, difficulty passing urine, or prostate problems.
- You have a chronic or persistent cough accompanied by excessive phlegm or respiratory problems.
- You are elderly and suffer from confusion.
- You are taking certain antidepressants or antipsychotics as Night Nurse may interact with these medicines and cause mental status changes (e.g., agitation, hallucinations, coma), body temperature above 38°C, increase in heart rate, unstable blood pressure, and exaggeration of reflexes, muscular rigidity, lack of coordination, and/or gastrointestinal symptoms (e.g., nausea, vomiting, diarrhoea). Contact a doctor immediately if you get a combination of these symptoms.
- You are or have ever been addicted to opioids, alcohol, prescription medicines, or illegal drugs.
- You have previously suffered from withdrawal symptoms such as agitation, anxiety, shaking, or sweating when you have stopped taking alcohol or drugs.
- You have any serious heart problems.
- You have any personal or family history of heart disease.
- You have an irregular heartbeat.
Please talk to your doctor or pharmacist before taking Night Nurse Capsules Pack of 10 if you are taking any prescribed medicines, particularly metoclopramide or domperidone (for nausea or vomiting); colestyramine (to lower blood cholesterol); medicines which give you blurred vision, a dry mouth or make you drowsy; blood thinning drugs (anticoagulants, e.g., warfarin); quinidine or amiodarone (to control your heart rhythm); medicines for anxiety or depression (e.g., selective serotonin reuptake inhibitor (SSRI) or tricyclic antidepressant) or to help you sleep. Also, inform your doctor or pharmacist if you are taking flucloxacillin (an antibiotic) due to a serious risk of blood and fluid abnormality (metabolic acidosis) or medicines that can affect your heart rhythm.
You should also tell your doctor or pharmacist if you have abused drugs or other substances in the past or have specific metabolism characteristics (slow metabolizer of CYP2D6).
Possible Side Effects:
Like all medicines, Night Nurse Capsules Pack of 10 can have side effects, but not everyone gets them. Older people are more prone to these side effects. Common side effects may include:
- Drowsiness, dizziness, blurred vision, difficulty concentrating, unsteadiness, clumsiness, headache, dry mouth.
Stop taking this medicine and tell your doctor immediately if you experience:
- Allergic reactions (severe skin rash, itching, swelling of the mouth or face, shortness of breath).
- Skin rash or peeling or mouth ulcers.
- Breathing problems (more likely if you have experienced them before when taking other painkillers such as ibuprofen and aspirin).
- Unexplained bruising and bleeding.
- Confusion, feeling restless, sweating, shaking, shivering, sudden jerks of muscles or increased blood pressure (these may be symptoms of serotonin syndrome).
- Difficulty passing urine.
- Nausea, vomiting, stomach ache, sudden weight loss, loss of appetite, and yellowing of the eyes and skin.
- Restlessness, nervousness, feeling irritable, increased energy, and sleep disturbances (more likely to affect children).
- Dependence and addiction (see 'How do I know if I am addicted?' section in the PIL).
- Metabolic acidosis in patients with severe illness using paracetamol (see section 2 of PIL).
- Abnormal electrical activity of the heart.
- Serious reaction with fever, rigid muscles, changing blood pressure, and coma (neuroleptic malignant syndrome).
- Low levels of blood platelets (can lead to bleeding and bruising).
- Hallucinations or aggression.
These effects are rare.
If you do get any side effects, even those not mentioned, tell your doctor or pharmacist.
Storage Information:
- Keep Night Nurse Capsules Pack of 10 out of the sight and reach of children.
- Do not store above 25°C.
- Do not take this medicine after the 'EXP' date shown on the pack.
