Panmigrol Migraine Relief Tablets 20s

Always take Panmigrol Migraine Relief exactly as stated in this package leaflet or as your doctor or pharmacist has told you. You should check with your doctor or pharmacist if you are not sure.

Do not take more medicine than the label tells you to. If you do not get better, talk to your doctor.

Adults (18 years of age and over):

• For headache treatment:
  
  • Take 1 tablet with a full glass of water when headache pain appears. If needed, you can take another 1 tablet 4 to 6 hours later.
  • In case of more intense pain, take 2 tablets with a full glass of water when headache pain appears. If needed, you can take another 2 tablets 4 to 6 hours later.
  • Do not use Panmigrol Migraine Relief for more than 4 days for headache without consulting your doctor
• For migraine treatment:
  
  • Take 2 tablets with a full glass of water when migraine symptoms or migraine aura appear. If needed, you can take additional 2 tablets, with 4 to 6 hours between doses.
  • If you get no migraine relief within 2 hours from the first 2 tablet dose of Panmigrol Migraine Relief, you should seek the advice of a doctor.
  • Do not use Panmigrol Migraine Relief for more than 3 days for migraine without consulting your doctor.
• For both headache and migraine treatment, do not exceed 6 tablets over a period of 24 hours. This corresponds to a dose of 1500mg acetylsalicylic acid (aspirin), 1500mg paracetamol and 390mg caffeine.
• Prolonged use except under medical supervision may be harmful.
• Do not take more than the stated dose. Use the smallest dose that you need to treat your symptoms and use this medicine for the shortest period of time necessary.

Elderly:

• There are no special dosage recommendations. If you have low body weight you should seek the advice of a doctor or pharmacist.

Patients with kidney or liver problems:

• You should tell your doctor if you have kidney or liver problems. Your doctor may need to adjust the dose interval or treatment duration.
• Do not take Panmigrol Migraine Relief if you suffer from severe liver or kidney problems.

• Active Ingredients: Acetylsalicylic acid (aspirin), 250mg, paracetamol 250mg and caffeine 65mg.
• Other Ingredients: Tablet core: hydroxypropyl cellulose low substitution,  cellulose microcrystalline (E460), stearic acid. Film coating: hypromellose (E464), titanium dioxide (E171), propylene glycol, benzoic acid (E210), carnauba wax (E903).

• Acetylsalicylic acid (aspirin) may cause bleeding. You must tell a doctor if you experience any unusual bleeding.
• As with any type of painkiller for headaches, taking Panmigrol Migraine Relief too often (meaning on more than 10 days per month for this product) with concurrent chronic headaches (15 days or more per month), for more than 3 months, could worsen your headache or migraine. If you think that this may be the case, please contact your doctor for advice. You may need to stop taking Panmigrol Migraine Relief to resolve the problem.
• Panmigrol Migraine Relief may reduce the symptoms of an infection (e.g. headache, high temperature) and may therefore make it more difficult to detect. If you feel unwell and need to see a doctor, remember to tell him or her that you are taking Panmigrol Migraine Relief.
• Panmigrol Migraine Relief may affect the results of laboratory tests. If you have been asked to have blood, urine or other laboratory testing, remember to tell that you are taking Panmigrol Migraine Relief.
• Panmigrol Migraine Relief contains 0.03 mg benzoic acid (E210) per tablet. Benzoic acid may increase jaundice (yellowing of the skin and eyes) in newborn babies (up to 4 weeks old).
• Taking Panmigrol Migraine Relief is not known to affect your ability to drive and use machines. If you notice side effects such as dizziness or drowsiness, you should not drive or use machines. Tell your doctor as soon as possible.

Do not take Panmigrol Migraine Relief Tablets if you:

• Are allergic (hypersensitive) to acetylsalicylic acid (aspirin), paracetamol, caeine or any of the other ingredients.
• Are taking any other prescription or non prescription medicines containing paracetamol to treat pain, fever, symptoms of cold and flu, or to aid sleep.
• Have ever had an allergic reaction to other medicines used to treat pain, inflammation or fever, such as acetylsalicylic acid and salicylates, or any other anti-inflammatory medicines known as NSAIDs such as diclofenac or ibuprofen. Reactions may include asthma, wheezing or shortness of breath; skin rash or hives; swelling of the face or tongue; runny nose. If you are not sure, ask your doctor or pharmacist.
• Have a stomach or intestinal ulcer, or if you have a history of peptic ulceration.
• Have noticed blood in your stools or black stools (symptoms of gastrointestinal bleeding or perforation).
• Are a haemophiliac or suering from other blood disorders.
• Have severe heart, liver and kidney problems.
• Take more than 15 mg methotrexate per week.
• Are in the last 3 months of pregnancy.

Ask your doctor before you take this Panmigrol Migraine Relief Tablets if you:

• Have not been diagnosed with migraine before, as potentially serious conditions relating to the brain or nerves need to be excluded before treatment.
• Have a migraine that is so severe as to require bed rest, or a headache different from your usual migraines, or if you have vomiting with your migraine headache.
• Start having headaches after or caused by head injury, exertion, coughing or bending.
• Have chronic headaches (15 days or more per month for more than 3 months), or if you experience your first headache after the age of 50.
• Have liver or kidney problems are underweight or malnourished or regularly drink alcohol. You may need to avoid using the product altogether or limit the amount of paracetamol that you take.
• Suffer from a hereditary condition called glucose 6-phosphate dehydrogenase deficiency that affects the red blood cells and could cause anaemia, jaundice or enlargement of the spleen when exposed to certain foods, medicinal products such as certain anti-inflammatory drugs (e.g., acetylsalicylic acid
  (aspirin)), or to other diseases.
• Have ever had gastrointestinal problems such as stomach ulcer, bleeding or black stools. If you have had stomach discomfort or heartburn after taking pain relievers or anti-inflammatory medicines in the past.
• Suffer from bleeding disorders or abnormal vaginal bleeding other than your menstrual period (e.g., unusually heavy and prolonged menstrual period).
• Have recently undergone a surgical operation (including minor ones such dental surgery) or will undergo one within the next 7 days.
• Have bronchial asthma, hay fever, nasal polyps, a chronic respiratory disease or develop allergic symptoms (eg., skin reaction, itching, urticaria).
• Have gout, diabetes, hyperthyroidism, arrhythmia, uncontrolled hypertension, impaired kidney or liver function.
• Have alcohol problems.
• Are already taking other medicinal products containing acetylsalicylic acid (aspirin) or paracetamol, or other medicines, since certain may interfere with Panmigrol Migraine Relief and cause side effects.
• Are at risk of being dehydrated (e.g. by vomiting, diarrhoea, or before or after major surgery).
• Are less than 18 years of age. There is a possible association between acetylsalicylic acid (aspirin) and Reye's syndrome when given to children and adolescents. Reye’s syndrome is a rare disease, which affects the brain and liver, and can be fatal. For this reason, Panmigrol Migraine Relief should not be given to children or adolescents under 18 years unless specifically indicated by your doctor.
• Have severe infection or illnesses, including severe renal impairment or sepsis (when bacteria and their toxins circulate in the blood leading to organ damage), or you suffer from malnutrition, are severely underweight, suffer from chronic alcoholism or if you are also taking flucloxacillin (an antibiotic). A serious condition called metabolic acidosis (a blood and fluid abnormality) has been reported in patients in these situations when paracetamol is used at regular doses for a prolonged period or when paracetamol is taken together with flucloxacillin.
  Symptoms of metabolic acidosis may include: serious breathing diffculties with deep rapid breathing, drowsiness, feeling sick (nausea), being sick (vomiting) and loss of appetite. Contact a doctor immediately if you get a combination of these symptoms.

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines, including medicines obtained without a prescription. In particular, tell your doctor if you are taking any of the following:

• Any other medicinal product that contains paracetamol, acetylsalicylic acid (aspirin) or any other pain reliever/fever reducer.
• Medicines used to prevent blood-clotting ("blood thinners") such as oral anticoagulants (eg., warfarin), heparin, thrombolytics (e.g., streptokinase), or other antiplatelets (ticlopidine, clopidogrel, cilostazol).
• Corticosteroids (used to provide relief of inflammation).
• Barbiturates and benzodiazepines (to treat anxiety and insomnia).
• Lithium, selective serotonin reuptake inhibitors or fluvoxamine (to treat depression).
• Sulphonylureas and insulin (to treat diabetes).
• Methotrexate (to treat some kinds of cancer, arthritis or psoriasis).
  Some medicines used to treat infection (e.g., rifampicin, isoniazide, chloramphenicol, ciprofloxacin or pipemidic acid).
• Levothyroxine (to treat hypothyroidism).
• Metoclopramide (to treat nausea and vomiting).
• Epilepsy medication.
• High blood pressure and heart failure medication.
• Diuretics (to increase urine production and reduce excess fluid).
• Medicines to treat gout.
• Oral contraceptives.
• Zidovudine (to treat HIV).
• Medicines to treat slow gastric emptying such as propantheline.
• Clozapine (to treat schizophrenia).
• Sympathomimetics (to raise low blood pressure or to treat nasal congestion).
• Antiallergics (to prevent or relieve allergies).
• Theophylline (to treat asthma).
• Terbinafine (to treat fungal infections).
• Cimetidine (to treat heartburn and peptic ulcers).
• Disulfiram (to treat alcohol dependence).
• Nicotine (used for smoking cessation)
• Cholestyramin (to treat high cholesterol levels)
• Flucloxacillin (antibiotic), due to a serious risk of blood and fluid abnormality (called metabolic acidosis) that must have urgent treatment.

Taking Panmigrol Migraine Relief with food and drinks

• Alcohol: If you consume 3 or more alcoholic drinks every day, ask your doctor whether you should take this medicine or other pain relievers/fever reducers. Paracetamol and acetylsalicylic acid (aspirin) may cause liver damage and stomach bleeding.
• Caffeine: The recommended dose of this medicine contains about as much caffeine as a cup of coffee. Limit your intake of caffeine-containing medications, foods, or beverages while taking this medicine because too much caffeine may cause nervousness, irritability, sleeplessness, and occasionally, rapid heart beat.

Pregnancy, breastfeeding and fertility

• This medicine is not recommended during pregnancy.
• If you are pregnant or think you might be pregnant or are planning to have a baby, tell your doctor and do not take Panmigrol Migraine Relief.
• It is especially important not to take Panmigrol Migraine Relief during the last 3 months of pregnancy, as it could harm your unborn child or cause problems at delivery.
• Do not take Panmigrol Migraine Relief if you are breastfeeding as it might be harmful for your infant.
• Ask your doctor or pharmacist for advice before taking any medicine.
• Panmigrol Migraine Relief belongs to a group of medicines (NSAIDs) which may impair fertility in women. This effect is reversible on stopping the medicine.