Hepatic damage is possible in adults who have taken 10 grams or more of paracetamol. Taking 5 grams or more of paracetamol can affect the liver if the following risk factors are present: prolonged treatment with carbamazepine phenobarbitone phenytoin primidone rifampicin St. John’s wort or other drugs which activate liver enzymes alcohol abuse glutanione deficiency (eg poor diet) cystic fibrosis HIV infection fasting cachexia.

Symptoms of paracetamol overdose in the first 24 hours: pale skin nausea vomiting anorexia and abdominal pain.

Elevated activity of “hepatic” transaminases increased prothrombin time.

Liver damage may appear 12-48 hours after intake, so it is necessary to see a doctor even if there are no symptoms. Impaired glucose metabolism and metabolic acidosis are possible. In severe poisoning liver failure may progress with complications such as encephalopathy hemorrhage hypoglycemia cerebral edema and death. Acute renal failure with acute tubular necrosis (defined by lumbar hematuria pain and proteinuria) can develop even in the absence of severe liver damage. There have been reports of abnormal heart rhythm and pancreatitis.

Phenylephrine

Phenylephrine overdose symptoms include irritability headache increased blood pressure and associated reflex bradycardia and heart rhythm disturbances.

If the above symptoms of overdose occur, a physician should be consulted.

Guaifenesin

Small to moderate overdose may cause dizziness gastrointestinal upset (nausea vomiting and diarrhea). Very high overdose may cause agitation, confusion, and respiratory depression. Treatment

Gastric lavage activated charcoal acetylcysteine (paracetamol antidote) symptomatic therapy.

In case of paracetamol overdose, immediate treatment is necessary. Despite the lack of significant early symptoms, patients should be rushed to the hospital for immediate medical evaluation. Symptoms may be limited to nausea or vomiting and not consistent with the severity of the overdose or risk of organ damage. Liver damage can occur 12 to 48 hours after ingestion of paracetamol, so you should see a doctor even if there are no symptoms.

The treatment of activated charcoal and gastric lavage should be considered if the excessive dose was taken less than 1 hour ago. Plasma concentrations of paracetamol should be measured 4 hours or more after ingestion (earlier concentrations are unreliable).

The treatment with N-acetylcysteine can be given up to 2 hours after paracetamol ingestion; however, the maximum protective effect is achieved about 8 hours after taking the drug. The effectiveness of the antidote gradually decreases after this time. If necessary, intravenous N-acetylcysteine is administered according to the established regimen. Outside the hospital, oral methionine may be administered if there is no vomiting. Patients presenting with severe hepatic dysfunction should be referred to a specialist in poisoning within 24 hours after taking the drug.

In case of hypertensive effects of phenylephrine overdose, intravenous alpha-adrenoreceptor blockers such as phentolamine may be used. Decrease in blood pressure will be reflexively accompanied by an increase in heart rate, but if necessary this effect can be increased by administration of atropine.

Pregnancy use

Additional information

Weight	0.040 kg
Shelf life	3 years. Do not use after the expiration date.
Conditions of storage	Store at temperatures under 25 ° C. Keep out of reach of children.
Manufacturer	Rafton Laboratories Limited, United Kingdom
Medication form	Powder for preparation of solution for oral administration
Brand	Rafton Laboratories Limited