PANADOL COLD&FLU NIGHT TIME CAPLET 24/CAPLET

Indications

Approved Uses

Temporary relief of cold/flu symptoms including pain and fever (headache, sore throat, body aches), nasal/sinus congestion and pressure, and runny nose/sneezing.

Dosage & Administration

Dose Adjustment Notes

Hepatic impairment: use with caution and avoid exceeding total daily paracetamol limits (often ≤2 g/day in chronic liver disease or regular alcohol use per clinical guidance); Renal impairment: generally no adjustment for mild-moderate impairment, but in severe renal impairment (CrCl/GFR <10 mL/min) extend paracetamol dosing interval (e.g., every 8 hours) and use caution due to renal elimination of pseudoephedrine/chlorpheniramine; Elderly: use lowest effective dose and monitor for anticholinergic/CNS and cardiovascular effects.

Side Effects

Side Effect Frequency

Most common: drowsiness/sedation and anticholinergic effects (e.g., dry mouth) from chlorpheniramine; plus CNS stimulation (e.g., nervousness/insomnia) and cardiovascular effects (e.g., palpitations, increased BP) can occur from pseudoephedrine. Do not assign fixed EMA-style frequency bands (e.g., 'very common >10%') for this OTC combination unless supported by the specific product label/SmPC; instead report as 'common/most common' vs 'rare/serious' (e.g., hypersensitivity, serious skin reactions, blood dyscrasias are rare/very rare, mainly associated with paracetamol).

Safety & Warnings

Warnings & Precautions

Do not exceed the recommended dose; do not use with any other paracetamol-containing product; avoid alcohol and other sedatives and use caution with driving/operating machinery (chlorpheniramine may cause drowsiness); use caution/seek advice in hypertension, heart disease, diabetes, hyperthyroidism, glaucoma, prostatic enlargement/urinary retention, hepatic disease, and renal impairment; avoid taking close to bedtime if insomnia occurs (pseudoephedrine); seek medical advice if symptoms persist/worsen or if used for more than a few days.

Driving Warning

Avoid Driving

Drug Interactions

Interaction Severity

MAJOR: MAO inhibitors (current or within 14 days) with pseudoephedrine (hypertensive crisis); duplicate paracetamol-containing products (overdose/hepatotoxicity). MODERATE: warfarin (increased INR/bleeding risk with repeated paracetamol use), alcohol/CNS depressants (additive sedation with chlorpheniramine), tricyclic antidepressants/other sympathomimetics (enhanced pressor/CNS effects), antihypertensives (reduced effect/raised BP), other anticholinergics (additive anticholinergic burden).

Food Interaction

No restriction

Alcohol Interaction

Dangerous

Special Populations

Elderly

Use with caution as the elderly are more likely to experience adverse effects. A reduction in dose or frequency may be appropriate, especially in those with renal or hepatic impairment.

Kidney Impairment

Use with caution in renal impairment; for severe renal impairment (CrCl/GFR <10 mL/min), extend the paracetamol-containing product dosing interval to at least every 8 hours and avoid prolonged use.

Storage & Patient Advice

Stopping the Medicine

May be stopped at any time; discontinue when symptoms resolve or if adverse effects occur.

Overdose

Overdose is a medical emergency: early symptoms may be nausea/vomiting/diaphoresis and can progress to delayed severe hepatotoxicity/acute liver failure (paracetamol); agitation, tremor, hypertension, tachycardia/arrhythmias, seizures (pseudoephedrine); marked anticholinergic effects, delirium, hallucinations, CNS depression/excitation, urinary retention (chlorpheniramine). Management: urgent ED/poison center; consider activated charcoal if early; obtain paracetamol level and treat with N-acetylcysteine as soon as indicated.

Monitoring Requirements

No routine monitoring for short-term OTC use; consider monitoring blood pressure/heart rate in patients with hypertension/cardiovascular disease and watch for excessive sedation/anticholinergic effects (especially in older adults).

Pharmacology

Mechanism of Action

Paracetamol: central analgesic/antipyretic via inhibition of prostaglandin synthesis in the CNS; Pseudoephedrine: sympathomimetic (direct/indirect adrenergic activity) causing alpha-mediated vasoconstriction of nasal mucosa; Chlorpheniramine: first-generation H1 receptor antagonist reducing histamine-mediated symptoms and causing sedation/anticholinergic effects.

Metabolism

Paracetamol: hepatic glucuronidation/sulfation with a minor CYP2E1 (±CYP1A2/3A4) pathway to NAPQI; Pseudoephedrine: minimal hepatic metabolism; Chlorpheniramine: hepatic metabolism (notably via CYP2D6, with other CYP contributions).

Product Information

Available Dosage Forms

Tablet (caplet)

Composition per Dose

Each tablet: Paracetamol 500mg + Pseudoephedrine hydrochloride 30mg + Chlorpheniramine maleate 2mg

OTC Alternatives

Single-ingredient options: paracetamol for pain/fever; saline/steam or topical decongestants for congestion; non-sedating antihistamines for prominent allergic symptoms. Combination options: other paracetamol + decongestant ± antihistamine cold/flu products (choose based on need for nighttime sedation vs daytime non-drowsy).

Symptom Target

Multi-symptom

Sedating

Yes

Reviewed by Al Mujtama Pharmacy Medical Review Team. Last reviewed 20-05-2026