Nurofen Plus contains the active ingredients Ibuprofen and Codeine phosphate. Ibuprofen belongs to a family of medicines called non-steroidal anti-inflammatory drugs (NSAIDS). These medicines work by relieving pain and/or inflammation (swelling, redness, soreness) and fever. Codeine is an opioid analgesic that works in the brain and spinal cord to relieve pain. The risk of GI bleeding, ulceration or perforation is higher with increasing NSAID doses and patients with a history of ulcer, particularly if complicated with haemorrhage or perforation (see Section 4.3 Contraindications) and in the elderly. These patients should commence treatment on the lowest dose available. Hypotensive effects of antihypertensive agents may be potentiated when used concurrently with codeine and lead to orthostatic hypotension. NSAIDs may diminish the effects of antihypertensives and diuretics. Diuretics can increase the risk of nephrotoxicity of NSAIDs. For the temporary relief of acute moderate pain and inflammation in patients over the age of 12 years. 4.2 Dose and Method of Administration Antiperistaltic antidiarrhoeals (including kaolin, pectin, loperamide). Concurrent use of these agents with codeine may increase the risk of severe constipation.

If you're taking liquid, it will come with a plastic syringe or spoon to measure your dose. If you do not have a syringe or spoon, ask your pharmacist for one. Do not use a kitchen spoon, as it will not measure the right amount. More instructions can be found in Section 4. How do I use Nurofen Plus? in the full CMI. 5. What should I know while using Nurofen Plus? Things you should do

Tranquillizers, sedatives and hypnotics. Codeine may potentiate the effects of these drugs (see Section 4.4, Risks from concomitant use of benzodiazepines or other CNS depressants, including alcohol).

Hyperalgesia should not be confused with tolerance (see Tolerance, dependence and withdrawal). If opioid induced hyperalgesia is suspected, the dose should be reduced and tapered off if possible. A change to a different opioid may be required.For more information, see Section 5. What should I know while using Nurofen Plus? in the full CMI. 6. Are there any side effects? Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with short-term use of ibuprofen in non-prescription doses. Additional side effects may occur when ibuprofen is used long-term, for chronic conditions, or in prescription doses. Read more about this here. Uncommon side effects Nurofen liquid capsules, Nurofen express liquid capsules and Nurofen express period pain capsules should be swallowed with a drink. These capsules contain ibuprofen in liquid form. These start to work faster than all the other Nurofen dose forms mentioned here. If you are currently taking a Monoamine oxidase inhibitors (MAOIs) or within 14 days of stopping treatment with a MAOI.

Other precautions. As with other drugs of this class, ibuprofen may mask the usual signs of infection.Respiratory. Bronchospasm may be precipitated in patients suffering from, or with a history of bronchial asthma or allergic disease. Always make sure you speak to your doctor or pharmacist before you decide to stop taking any of your medicines. 7. Product details Some variants of Nurofen contain additional active ingredients; for example, 'Nurofen Cold & Flu' contains the non- sedating decongestant pseudoephedrine. Others are advertised as being targeted for specific pain types, for example period pain. [1] Nurofen Plus [ edit ] 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 Plus

Side effects from codeine are theoretical warnings based on drug class. No clinical data is available to determine frequency. Anticholinergics. Concurrent use of codeine and anticholinergic agents may increase the risk of severe constipation and/or urinary retention. 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. Ibuprofen is good for relieving period pain because it reduces the production of the prostaglandins that are involved in making the womb contract during your period. How do I take Nurofen? Treatment of perioperative pain in setting of coronary artery bypass surgery (CABG). 4.4 Special Warnings and Precautions for Use

6.5 Nature and Contents of Container

Oligohydramnios and neonatal renal impairment. Use of NSAIDs from about 20 weeks gestation may cause neonatal renal dysfunction leading to oligohydramnios and, in some cases, neonatal renal impairment. you are allergic to ibuprofen, codeine, other opioids, or any medicine containing ibuprofen, aspirin or other NSAIDs or any of the ingredients listed at the end of this leaflet. Nurofen Plus given to the mother during labour can cause breathing problems and signs of withdrawal in the newborn. Looking after your medicine Do not take high doses of the medicine for long periods of time unless your doctor tells you to. Products containing codeine should not be taken for prolonged periods. Codeine may be habit forming.