Before taking paracetamol and metoclopramide

Before taking paracetamol and metoclopramide make sure your doctor or pharmacist knows:

• If you are under 12 years of age.
• If you are pregnant, trying for a baby or breast-feeding.
• If you have liver or kidney problems.
• If you have asthma or any other allergy.
• If you have epilepsy.
• If you think you may have a blockage in your bowel, or if there is any bleeding from your bowel.
• If you have had surgery on your stomach or bowels within the last four days.
• If you have porphyria (a rare blood disorder).
• If you have been told you have phaeochromocytoma (a growth on your adrenal glands).
• If you are taking other medicines, including those available to buy without a prescription, herbal and complementary medicines.
• If you have ever had an allergic reaction to either paracetamol or metoclopramide, or to any other medicine.

How to take paracetamol and metoclopramide

• Before starting this treatment, read the manufacturer's printed information leaflet from inside the pack.
• Take this preparation exactly as your doctor has told you.
• If you are 20 years of age or older: take two sachets or two tablets as soon as you feel the start of a migraine attack. You may take a further two sachets or two tablets every four hours if needed, but do not take more than six sachets or six tablets in any 24-hour period.
• If you are between 12 and 19 years of age: take one sachet or one tablet as soon as you feel the start of a migraine attack. You may take a further one sachet or one tablet every four hours if needed, but do not take more than three sachets or three tablets in any 24-hour period.
• If you have been given sachets to take, pour the powder from the sachet(s) into about a quarter of a glass of water, mix well and then drink the liquid.
• You should not take this preparation for a period of more than three months. If you have migraines frequently, discuss this with your doctor as there are other medicines that are available that may help prevent you having migraines.

Getting the most from your treatment

• Many things can trigger migraines. These can include some foods (for example, cheese, chocolate, and red wine), worry, bright sunlight, too much or too little sleep, and skipping meals. Try to avoid the things that you know trigger your migraines.
• Do not take any other medicines containing paracetamol at the same time as this medicine. Remember many common 'over-the-counter' preparations also contain paracetamol. Always read the label to check, or ask your pharmacist for advice.
• If you find that these tablets or sachets do not relieve your migraine, make an appointment to discuss this with your doctor, as an alternative preparation may prove to be more effective for you.
• If you are having an operation or dental treatment, tell the person carrying out the treatment which medicines you are taking.

Can paracetamol and metoclopramide cause problems?

Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.

• A high temperature with stiff muscles, fast breathing, sweating, confusion, and sleepiness.
• Any body or face movements which you cannot control.

If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.

How to store paracetamol and metoclopramide

• Keep all medicines out of the reach and sight of children.
• Store in a cool, dry place, away from direct heat and light.

Important information about all medicines

References

• Manufacturer's PIL, Paramax® 500 mg/5 mg Tablets, sanofi-aventis, electronic Medicines Compendium. Dated November 2008.
• Manufacturer's PIL, Paramax® 500 mg/5 mg Effervescent Powder; Manufacturer's PIL, Paramax® 500 mg/5 mg Effervecent Powder, sanofi-aventis, electronic Medicines Compendium. Dated March 2009.
• British National Formulary; 62nd Edition (Sep 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London (link to current BNF)