Acute renal failure, papillary necrosis, especially in long-term use, associated with increased serum urea and oedema. This medicine contains less than 1mmol sodium (23 mg) per dose that is to say essentially 'sodium-free'. Other NSAIDs including cyclooxygenase-2 selective inhibitors: Avoid concomitant use of two or more NSAIDs as this may increase the risk of adverse effects (see section 4.4) Please be aware that Nurofen Meltlets contains ibuprofen. You should not take any other medicines that also contain these ingredients (or other anti-inflammatories, such as Aspirin or Naproxen) at the same time as Nurofen Meltlets. This product can be used to treat a range of aches and pains from children aged 12 and over, including:

Caution is required in patients with phenylketonuria or who are intolerant to phenylalanine. The product contains aspartame which is a source of phenylalanine. Each orodispersible tablet contains a source equivalent to 14 mg of phenylalanine. The concurrent use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) and ethanol may lead to gastrointestinal (GI) blood loss. Clinical studies suggest that use of ibuprofen, particularly at high dose (2400 mg/day) may be associated with a small increased risk of arterial thrombotic events (for example myocardial infarction or stroke). Overall, epidemiological studies do not suggest that low dose ibuprofen (e.g. ≤1200 mg/day) is associated with an increased risk of arterial thrombotic events.The list of the following adverse events relates to those experienced with ibuprofen at OTC doses, for short-term use. In the treatment of chronic conditions, under long-term treatment, additional adverse events may occur.

If you are concerned about addiction to 'over the counter' medication, we urge you to visit the below links for professional help and advice: Nurofen Cold & Flu Relief 200mg/5mg Tablets, Nurofen Day & Night Cold & Flu 200mg/5mg Tablets, Contains ibuprofen & phenylephrine hydrochloride, For cold & flu relief. Clinical studies suggest that use of ibuprofen, particularly at high doses (2400 mg/day) may be associated with a small increased risk of arterial thrombotic events (for example myocardial infarction or stroke). Overall, epidemiological studies do not suggest that low dose ibuprofen (e.g. ≤1200 mg/day) is associated with an increased risk of arterial thrombotic events. This medicinal product can mask symptoms of infection, which may lead to delayed initiation of appropriate treatment and thereby worsening the outcome of the infection. This has been observed in bacterial community acquired pneumonia and bacterial complications to varicella. When this medicine is administered for pain or fever in relation to infection, monitoring of infection is advised. In non-hospital settings, the patient should consult a doctor if symptoms persist or worsen. During the third trimester of pregnancy, all prostaglandin synthesis inhibitors may expose the foetus to:Nurofen contains 200mg Ibuprofen which belongs to a group of medicines known as Non-Steroidal Anti-Inflammatory Drugs (NSAIDS). This medication provides pain relief by changing the body’s response to pain by reducing the hormones that cause pain and swelling in the body. Ibuprofen takes around 20-30 minutes to work if taken orally. Inhibition of prostaglandin synthesis may adversely affect the pregnancy and/or the embryo/foetal development. Data from epidemiological studies suggest an increased risk of miscarriage and of cardiac malformation and gastroschisis after use of a prostaglandin synthesis inhibitor in early pregnancy. The absolute risk for cardiovascular malformation was increased from less than 1%, up to approximately 1.5%. The risk is believed to increase with dose and duration of therapy. In animals, administration of a prostaglandin synthesis inhibitor has been shown to result in increased pre- and post-implantation loss and embryofoetal lethality. In addition, increased incidences of various malformations, including cardiovascular, have been reported in animals given a prostaglandin synthesis inhibitor during the organogenetic period. Nurofen Meltlets is a non-selective inhibitor of cyclooxygenase, an enzyme invovled in prostaglandin synthesis via the arachidonic acid pathway. Its pharmacological effects are believed to be due to inhibition cylooxygenase-2 (COX-2) which decreases the synthesis of prostaglandins involved in mediating inflammation, pain, fever and swelling. Antipyretic effects may be due to action on the hypothalamus, resulting in an increased peripheral blood flow, vasodilation, and subsequent heat dissipation. Inhibition of COX-1 is thought to cause some of the side effects of ibuprofen including GI ulceration. Nurofen Meltlets is administered as a racemic mixture. The R-enantiomer undergoes extensive interconversion to the S-enantiomerin vivo. The S-enantiomer is believed to be the more pharmacologically active enantiomer. Aspirin (Acetylsalicylic acid): Concomitant administration of ibuprofen and acetylsalicylic acid is not generally recommended because of the potential of increased adverse effects, unless low-dose aspirin (not above 75 mg daily) has been advised by a doctor (see Section 4.4). Experimental data suggest that ibuprofen may competitively inhibit the effect of low dose aspirin (acetylsalicylic acid) on platelet aggregation when they are dosed concomitantly. Although there are uncertainties regarding extrapolation of these data to the clinical situation, the possibility that regular, long-term use of ibuprofen may reduce the cardioprotective effect of low-dose acetylsalicylic acid cannot be excluded. No clinically relevant effect is considered to be likely for occasional ibuprofen use (see section 5.1).

The elderly have an increased frequency of adverse reactions to NSAIDs especially gastrointestinal bleeding and perforation which may be fatal. Chronic hepatic necrosis has been reported in a patient who took daily therapeutic doses of paracetamol for about a year and liver damage has been reported after daily ingestion of excessive amounts for shorter periods. A review of a group of patients with chronic active hepatitis failed to reveal differences in the abnormalities of liver function in those who were long-term users of paracetamol nor was the control of their disease improved after paracetamol withdrawal. It contains highly inflammatory ingredients, which can cause tension in your stomach. In case of severe aches, You must always ask your doctor and not rely on medicines like this. When to not use this medicine?possible prolongation of bleeding time, an anti-aggregating effect which may occur even at very low doses;