SNIP Tablet Ref.[28276] Active ingredients: Chlorphenamine Paracetamol Pseudoephedrine

Posology

Adults

Two tablets up to four times daily as required for relief of symptoms. The dose should not be repeated more frequently than every four hours nor should more than four doses be given in any 24 hour period.

Paediatric population

• Children 12 years and over: as for adults.
• For children 6 to 11 years old: 1 tablet every 4 to 6 hours, not to exceed 6 tablets per day. For children between 6 to 8 years old the maximum recommended dose is 5 tablets per day.
• Children under 6 years old: As with any antihistamine-containing product, use of Snip tablets in children under 6 years of age should be only under the advice and supervision of a physician.

Elderly

As for adults.

Renal / hepatic impairment

Consideration should be given to a reduced total daily dosage in patients with hepatic or renal impairment.

Method of administration

For oral use.

Paracetamol

Symptoms

Symptoms of paracetamol overdose in the first 24 hours are pallor, nausea, vomiting, anorexia and abdominal pain. Liver damage may become apparent 12 to 48 hours after ingestion. Abnormalities of glucose metabolism and metabolic acidosis may occur. In severe poisoning, hepatic failure may progress to encephalopathy, coma and death. Acute renal failure with acute tubular necrosis may develop even in the absence of severe liver damage. Cardiac arrhythmias and pancreatitis have been reported. Liver damage is possible in adults who have taken 10g or more of paracetamol. It is considered that excess quantities of a toxic metabolite (usually adequately detoxified by glutathione when normal doses of paracetamol are ingested) become irreversibly bound to liver tissue.

Management

Immediate treatment is essential in the management of paracetamol overdose. Despite a lack of significant early symptoms, patients should be referred to hospital urgently for immediate medical attention. Gastric lavage or the administration of activated charcoal may be beneficial when performed within one hour of the overdose but can be considered for up to four hours after the overdose. Antidotes such as N acetylcysteine (NAC) and methionine protect the liver if administered within 12 hours of overdose. NAC is effective up to and possibly beyond 24 hours. General supportive measures must be available.

Pseudoephedrine

Symptoms

As with other sympathomimetics pseudoephedrine overdose will result in symptoms due to central nervous system and cardiovascular stimulation e.g. excitement, irritability, restlessness, tremor, hallucinations, hypertension, palpitations, arrhythmias and difficulty with micturition. In severe cases, psychosis, convulsions, coma and hypertensive crisis may occur. Serum potassium levels may be low due to extracellular to intracellular shifts in potassium.

Management

Treatment should consist of standard supportive measures. Beta-blockers should reverse the cardiovascular complications and the hypokalaemia.

Chlorpheniramine

Symptoms

Symptoms and signs of chlorpheniramine overdose include sedation, paradoxical stimulation of CNS, toxic psychosis, seizures, apnoea, convulsions, anticholinergic effects, dystonic reactions and cardiovascular collapse including arrhythmias.

Management

Symptomatic and supportive measures should be provided with special attention to cardiac, respiratory, renal and hepatic functions and fluid and electrolyte balance. If overdosage is by the oral route treatment should include gastric lavage or induced emesis. Following these measures activated charcoal and cathartics may be administered to minimise absorption. Treat hypotension and arrhythmias vigorously. CNS convulsions may be treated with i.v. diazepam or phenytoin. Haemoperfusion may be used in severe cases.

5 years.

Store below 25°C in the original package, in order to protect from light and moisture.

Packs containing 10, 20 and 30 tablets in PVC/Alu blisters are available.

No special requirements for disposal.