Panadol Advance

a. Do not take Panadol Advance in case of:

• Known or previous hypersensitivity to Paracetamol or any other ingredients in this product.

b. Take special care with Panadol Advance:

• Contains paracetamol. Do not use with any other paracetamol-containing products. The concomitant use with other products containing paracetamol may lead to an overdose. Paracetamol overdose may cause liver failure which can lead to liver transplant or death. Underlying liver disease increases the risk of paracetamol related liver damage.
• Patients who have been diagnosed with liver or kidney impairment must seek medical advice before taking this medication. 
• Cases of hepatic dysfunction/failure have been reported in patients with depleted glutathione levels, such as those who are severely malnourished, anorexic, have a low body mass index or are chronic heavy users of alcohol.
• Caution in patients with glutathione depleted states such as sepsis; the use of paracetamol may increase the risk of metabolic acidosis.
• Caution is advised if paracetamol is administered concomitantly with flucloxacillin due to increased risk of high anion gap metabolic acidosis (HAGMA), particularly in patients with severe renal impairment, sepsis, malnutrition and other sources of glutathione deficiency (e.g. chronicalcoholism), as well as those using maximum daily doses of paracetamol. Close monitoring, including measurement of urinary 5-oxoproline, is recommended.
• Do not exceed the stated dose.
• If symptoms persist, consult your doctor. Prolonged use except under medical
  supervision may be harmful.
• This product should only be used when clearly necessary.
• Keep out of the sight and reach of children.

c. Taking other medicines:

The speed of absorption of paracetamol may be increased by metoclopramide or domperidone and absorption reduced by cholestyramine. The anticoagulant effect of warfarin and other coumarins may be enhanced by prolonged regular daily use of paracetamol with increased risk of bleeding; occasional doses have no significant effect. Please inform your doctor or pharmacist if you are taking:

• flucloxacillin (antibiotic), due to a serious risk of blood and fluid abnormality (high
  anion gap metabolic acidosis) that must have urgent treatment and which may
  occur particularly in case of severe renal impairment, sepsis (when bacteria and
  their toxins circulate in the blood leading to organ damage), malnutrition, chronic
  alcoholism, and if the maximum daily doses of paracetamol are used.

d. Pregnancy & breast feeding:

Pregnancy
There is epidemiological evidence of the safety of paracetamol in human pregnancy.
Paracetamol is the mild analgesic of choice during pregnancy. However as with all drugs, caution should be exercised in its use during the first trimester.
If clinically needed, paracetamol can be used during pregnancy however it should be used at the lowest effective dose for the shortest possible time and at the lowest possible frequency.

Lactation
Paracetamol is excreted in breast milk. However, the level of paracetamol present is not considered to be harmful.

e. Driving and using machines:
Unlikely to cause an effect on ability to drive and use machines.