{"title":"Vicks","description":"\u003cp\u003eTutta la linea Vicks per i sintomi del raffreddore e dell’influenza: spray nasali Sinex che liberano il naso, unguenti balsamici Vaporub e Babyrub da spalmare sul petto, inalanti da respirare, sciroppo Medinait per la notte e bustine Flu Action per febbre e congestione. Formati per adulti e per bambini. Spedizione veloce in 24\/48 ore.\u003c\/p\u003e","products":[{"product_id":"vicks-sinex-aloe-spray-nasale-15-ml","title":"Vicks Sinex Aloe Nasal Spray 15ml","description":"\u003cp\u003e\u003cstrong\u003eINDICATIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eDecongestant of the nasal mucosa, especially in case of colds.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eACTIVE INGREDIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e- Active ingredient: oxymetazoline hydrochloride 0.0500% w\/v. 1 ml of product contains 0.5 mg of oxymetazoline hydrochloride. 1 spray (50 microlitres) contains approximately 25 micrograms of oxymetazoline hydrochloride. - Excipients with known effects: benzalkonium chloride, benzyl alcohol For the complete list of excipients, see section 6.1.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEXCIPIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eLevomenthol, sodium citrate, anhydrous citric acid, benzalkonium chloride solution, disodium edetate, eucalyptol (cineole), non-crystallizable liquid sorbitol, aloe vera, acesulfame potassium, Lcarvone, polysorbate 80, benzyl alcohol and purified water.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONTRAINDICATIONS AND SIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eHypersensitivity to the active substance or to any of the excipients listed in paragraph 6.1, prostatic hypertrophy, severe heart disease and arterial hypertension. Glaucoma, hyperthyroidism. Do not administer during and in the two weeks following therapy with antidepressant drugs (MAOI). Inflammation or lesions of the oral mucosa or the skin around the nostrils. The drug is contraindicated in children under 12 years of age.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDOSAGE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eAdults and children over 12 years: 1-2 sprays per nostril every 8 - 12 hours, unless otherwise indicated by the doctor. Hold the bottle in a vertical position, insert its end into the nostril and press the nebulizer quickly and firmly. After application, inhale deeply with your mouth closed.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONSERVATION\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eThis medicinal product does not require any special storage conditions.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eWARNINGS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eUse with caution in the first months of pregnancy and, due to the risk of urinary retention, in the elderly. Also use with caution in patients with angina and diabetes. If symptoms persist, a clinical reassessment must be considered; in any case, treatment must not be continued for more than 4 consecutive days to avoid a rebound effect and rhinitis phenomena induced by the drug. Carefully follow the recommended doses. Accidental ingestion may cause severe sedation. It should not be used orally. Avoid contact of the liquid with the eyes. Prolonged use of vasoconstrictors can alter the normal function of the mucosa of the nose and paranasal sinuses, also inducing addiction to the drug. Repeating applications for long periods can be harmful. The use, especially if prolonged, of topical products can give rise to sensitization phenomena; in this case it is necessary to interrupt the treatment and institute suitable therapy. \u003ci\u003eImportant information about some excipients\u003c\/i\u003e Vicks Sinex Aloe 0.05% nebulizer solution contains benzalkonium chloride may cause bronchospasm. This medicine contains 0.01 mg of benzalkonium chloride per dose (1 spray) which is equivalent to 0.2 mg\/ml. Benzalkonium chloride can cause irritation and swelling inside the nose, especially if used for long periods. Vicks Sinex Aloe 0.05% spray solution contains benzyl alcohol. This medicine contains 0.1 mg of benzyl alcohol per dose (1 spray), equivalent to 2 mg\/ml. Benzyl alcohol can cause allergic reactions. Benzyl alcohol may cause mild local irritation\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eINTERACTIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eThere is the possibility of interaction between sympathomimetic amines such as oxymetazoline with anti-MAO drugs, therefore use is not recommended during or in the two weeks following treatment with anti-MAO drugs (see section 4.3). Oxymetazoline could reduce the effectiveness of beta-blocking drugs, methyl dopa or other antihypertensive drugs. Hypertension and arrhythmias may occur when tricyclic antidepressants are administered with sympathomimetic drugs such as oxymetazoline. Increased cardiovascular toxicity may occur when sympathomimetic drugs are administered concomitantly with antiparchinsonian drugs such as bromocriptines.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eSIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eIf accidentally ingested or if used for a long period in excessive doses, the product can cause toxic phenomena. The product can locally cause sensitization phenomena and rebound congestion of the mucous membranes. In general, no serious side effects were observed. Due to rapid absorption of oxymetazoline through inflamed mucous membranes, side effects may occur divided into the following frequencies: very common (≥1\/10); common (≥1\/100, \u003c1\/10); uncommon (≥1\/1000, \u003c1\/100); rare (≥1\/10000, \u003c1\/1000); very rare (\u003e1\/10000); not known (frequency cannot be estimated from the available data). \u003cb\u003e \u003cu\u003eRare:\u003c\/u\u003e \u003c\/b\u003e \u003ci\u003eEye pathologies\u003c\/i\u003e: eye irritation, discomfort or redness. \u003ci\u003eRespiratory, thoracic and mediastinal disorders\u003c\/i\u003e: discomfort or irritation of the nose, mouth or throat, sneezing. \u003cb\u003e \u003cu\u003eVery rare:\u003c\/u\u003e \u003c\/b\u003e \u003ci\u003eCardiac diseases\u003c\/i\u003e: tachycardia, palpitations, increased blood pressure, reflex bradycardia. \u003ci\u003eCentral nervous system disorders\u003c\/i\u003e: insomnia, nervousness, tremor, anxiety, agitation, irritability and headache. \u003ci\u003eGastrointestinal disorders\u003c\/i\u003e: nausea. \u003ci\u003eRenal and urinary disorders\u003c\/i\u003e: urination disorders. \u003cb\u003eReporting of suspected adverse reactions\u003c\/b\u003e Reporting suspected adverse reactions that occur after authorization of the medicine is important, as it allows continuous monitoring of the benefit\/risk balance of the medicine. Healthcare professionals are asked to report any suspected adverse reactions via the national reporting system at https:\/\/www.aifa.gov.it\/content\/segnalazioni-reazioni-avverse.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eOVERDOSE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003eSymptoms\u003c\/b\u003e Symptoms due to moderate or acute overdose may include mydriasis, nausea, cyanosis, fever, tachycardia, cardiac arrhythmias, hypertension, dyspnea, cardiac arrest, photophobia, headache, intense chest tightness and, in children, severe Central Nervous System depression with symptoms such as decreased body temperature, bradycardia, hypotension, apnea and loss of consciousness requiring the adoption of appropriate emergency measures. \u003cb\u003eTreatment\u003c\/b\u003e Treatment should be symptomatic. In more serious cases, intubation and artificial respiration are required.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003ePREGNANCY AND BREASTFEEDING\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eThere are no studies on the use of the product during pregnancy and breastfeeding. Use with caution in the first months of pregnancy. Administration should only be considered if the expected benefit to the mother outweighs the risk to the baby.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEFFECTS ON DRIVING ABILITY\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eNo effects on the ability to drive and use machines have been observed.\u003c\/p\u003e","brand":"Procter \u0026 Gamble","offers":[{"title":"Default Title","offer_id":40207824322675,"sku":"023198029","price":11.88,"currency_code":"EUR","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0564\/4989\/2467\/products\/procter-gamble-srl-vicks-sinex-aloe-spray-nasale-15-ml-farmacia-dottor-tili-1213792733.webp?v=1767126758"},{"product_id":"vicks-babyrub-50-g","title":"Vicks Babyrub 50g","description":"\u003cdiv\u003e\n      \u003cp\u003e\n        \u003cstrong\u003eVicks Babyrub\u003c\/strong\u003e is an ointment designed specifically for little ones, designed to offer comfort and relief during moments of discomfort related to colds or seasonal irritations. Its delicate formulation based on natural ingredients such as aloe vera, lavender oil and rosemary, promotes a feeling of well-being and calm, helping the child to relax and sleep better. The product is dermatologically tested and safe for use in infants aged 6 months and older.\n      \u003c\/p\u003e\n\u003cbr\u003e\u003ch2\u003eINDICATIONS\u003c\/h2\u003e\n\u003ch3\u003eWhy is Vicks Babyrub 50 g used? What is it for?\u003c\/h3\u003e\n\u003cp\u003e\u003cstrong\u003eVicks Babyrub\u003c\/strong\u003e It is indicated for: - Relieving mild respiratory discomfort during colds. - Offer a calming and relaxing sensation to aid sleep. - Gently moisturize the baby's skin thanks to the presence of aloe vera.\u003c\/p\u003e\n\u003cbr\u003e\u003ch2\u003eINGREDIENTS\u003c\/h2\u003e\n\u003ch3\u003eWhat ingredients does Vicks Babyrub 50 g contain?\u003c\/h3\u003e\n\u003cp\u003ePetrolatum, Turpentine, Parfum, Paraffinum Liquidum, Cocos Nucifera Oil, Aloe Barbadensis Leaf Extract, Lavandula Angustifolia Oil, Thymol, Limonene, Linalool, Geraniol.\u003c\/p\u003e\n\u003cbr\u003e\u003ch2\u003eHOW TO USE\u003c\/h2\u003e\n\u003ch3\u003eHow do I use Vicks Babyrub 50 g?\u003c\/h3\u003e\n\u003cp\u003eGently massage the chest and belly to calm and relax the baby.\u003c\/p\u003e\n\u003cbr\u003e\u003ch2\u003eWARNINGS\u003c\/h2\u003e\n\u003ch3\u003eWhat are the warnings of Vicks Babyrub 50 g?\u003c\/h3\u003e\n\u003cp\u003eUse only as directed. For external use only. Avoid contact with eyes. Do not apply to mouth or nostrils. Not to be used if the child is allergic to one or more components. Do not heat in: water, microwave, vaporizer or stove. Keep out of reach of children.\u003c\/p\u003e\n\u003cbr\u003e\u003ch2\u003eCONTRAINDICATIONS AND SIDE EFFECTS\u003c\/h2\u003e\n\u003ch3\u003eWhen should Vicks Babyrub 50 g not be used and what side effects can it cause?\u003c\/h3\u003e\n\u003cp\u003eDo not use \u003cstrong\u003eVicks Babyrub\u003c\/strong\u003e in children under 6 months of age. Avoid contact with eyes, mouth and nostrils. Do not apply to damaged or irritated skin.\u003c\/p\u003e\n\u003cp\u003eSide effects are rare, but may include allergic reactions or skin irritation. In case of redness or irritation, discontinue use and consult a doctor.\u003c\/p\u003e\n\u003cbr\u003e\u003ch2\u003eCONSERVATION\u003c\/h2\u003e\n\u003ch3\u003eHow is Vicks Babyrub 50 g stored?\u003c\/h3\u003e\n\u003cp\u003eStore below 25°C.\u003cbr\u003eClose the lid of the jar after use.\u003cbr\u003eLast shelf life from the date of production, in unopened packaging: 24 months.\u003c\/p\u003e\n\u003cbr\u003e\u003ch2\u003eFORMAT\u003c\/h2\u003e\n\u003ch3\u003eWhat is the format of Vicks Babyrub 50 g?\u003c\/h3\u003e\n\u003cp\u003e50 g jar\u003c\/p\u003e\n\u003c\/div\u003e","brand":"Procter \u0026 Gamble","offers":[{"title":"Default Title","offer_id":40207831564403,"sku":"974899080","price":9.49,"currency_code":"EUR","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0564\/4989\/2467\/files\/procter-gamble-vicks-babyrub-50-g-farmacia-dottor-tili-1254211156.jpg?v=1786731998"},{"product_id":"vicks-inalante-rinforzato-flacone-1-g","title":"Vicks Inhalant Reinforced Bottle 1 g","description":"\u003cp\u003e\u003cstrong\u003eINDICATIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eIn colds and congestion of the nasal mucosa, it frees the stuffy nose and promotes breathing.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eACTIVE INGREDIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eEach stick contains: 1.00 ml of medicinal liquor, absorbed onto a piece of cellulose. ACTIVE INGREDIENTS: menthol 415.4 mg, camphor 415.4 mg. For the complete list of excipients see section 6.1.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEXCIPIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eSiberian pine essential oil, methyl salicylate.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONTRAINDICATIONS AND SIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eHypersensitivity to the active substances or to any of the excipients listed in paragraph 6.1. Children up to 30 months of age. Children with a history of epilepsy or febrile seizures.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDOSAGE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eVicks Inhalant is contraindicated in children up to 30 months of age (see paragraph 4.3) and its use is not recommended in children under 6 years of age. Unscrew the cap and insert the tip of the nasal stick into one nostril, closing the other with a finger and inhale deeply. Repeat in each nostril several times a day. Do not exceed the recommended doses. \u003ci\u003eThe duration of treatment should not exceed 3 days.\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONSERVATION\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eNone.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eWARNINGS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eThis product contains terpene derivatives which, in excessive doses, can cause neurological disorders such as seizures in infants and children. Vicks Inhalant is contraindicated in children up to 30 months of age and its use is not recommended in children under 6 years of age. The treatment must not be prolonged for more than 3 days due to the risks associated with the accumulation of terpene derivatives, such as \u003ci\u003ecamphor, cineol, niaouli, wild thyme, terpineol, terpine, citral, menthol and essential oils of pine needle, eucalyptus and turpentine\u003c\/i\u003e (due to their lipophilic properties the rate of metabolism and disposal is not known) in tissues and the brain, in particular neuropsychological disorders. A higher dose than the recommended one should not be used to avoid a greater risk of adverse reactions to the medicinal product and disorders associated with overdose (see section 4.9). The product is flammable, it must not be brought close to flames. Prolonged use may cause sensitization. In this case or in the absence of therapeutic effect, discontinue use and consult your doctor. Use the product according to the instructions. External use.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eINTERACTIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eVicks Inhalant must not be used concomitantly with other products (medicines or cosmetics) containing terpene derivatives, regardless of the route of administration (oral, rectal, cutaneous, nasal or inhalation).\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eSIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eIn general, no serious or serious side effects are expected with this product. Cases of nasal pain have been reported very rarely. Due to the presence of camphor and menthol and in case of non-compliance with the recommended doses there may be a risk of convulsions in children and infants. The use, especially if prolonged, of products for topical use can cause sensitization phenomena. In this case it is necessary to interrupt the treatment and institute suitable therapy. \u003cu\u003eReporting of suspected adverse reactions\u003c\/u\u003e Reporting suspected adverse reactions that occur after authorization of the medicine is important, as it allows continuous monitoring of the benefit\/risk balance of the medicine. Healthcare professionals are asked to report any suspected adverse reaction via the national reporting system reported on the website: www.agenziafarmaco.gov.it\/it\/responsabili dell'Agenzia Italiana del Farmaco.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eOVERDOSE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eNo clinically significant cases of overdose have been reported. \u003ci\u003eIn case of accidental oral intake or incorrect administration in newborns and children there may be a risk of neurological disorders.\u003c\/i\u003e \u003ci\u003eIf necessary, administer appropriate symptomatic treatment in specialized treatment centers.\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003ePREGNANCY AND BREASTFEEDING\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cu\u003ePregnancy\u003c\/u\u003e There are no or limited data available on the use of camphor and menthol in pregnant women. Vicks Inhalant is not recommended during pregnancy and in women of childbearing potential who are not using contraceptive measures. \u003cu\u003eBreastfeeding\u003c\/u\u003e There is insufficient information on the excretion of camphor and menthol in breast milk. Vicks Inhalant should not be used during breastfeeding.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEFFECTS ON DRIVING ABILITY\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eNot applicable.\u003c\/p\u003e","brand":"Procter \u0026 Gamble","offers":[{"title":"Default Title","offer_id":40207831597171,"sku":"003136025","price":7.42,"currency_code":"EUR","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0564\/4989\/2467\/files\/procter-gamble-srl-vicks-inalante-rinforzato-flacone-1-g-farmacia-dottor-tili-1213793061.jpg?v=1767128289"},{"product_id":"vicks-vaporub-unguento-inalante-50-g","title":"Vicks Vaporub Inhalant Ointment 50 g","description":"\u003cp\u003e\u003cstrong\u003eINDICATIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eBalsamic treatment for diseases of the upper respiratory tract.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eACTIVE INGREDIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e100 g of ointment contains: \u003ci\u003eactive ingredients\u003c\/i\u003e: camphor 5 g; turpentine essential oil 5 g; menthol 2.75 g; eucalyptus essential oil 1.5 g. For the complete list of excipients see section 6.1.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEXCIPIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eThymol, cedarwood essential oil, white petrolatum.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONTRAINDICATIONS AND SIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eHypersensitivity to the active substances or to any of the excipients listed in paragraph 6.1. Children up to 30 months of age. Administration through steam inhalation is contraindicated in children under 12 years of age. Children with a history of epilepsy or febrile convulsions. Generally contraindicated during pregnancy and breastfeeding (see section 4.6).\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDOSAGE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eVicks Vaporub is contraindicated in children up to 30 months of age and vapor inhalation is contraindicated in children under 12 years (see section 4.3). Children must always be supervised. Vicks Vaporub ointment can be used in two ways: \u003cb\u003e1) Topical use (\u003cu\u003eadults and children over 30 months of age\u003c\/u\u003e)\u003c\/b\u003e Apply externally by first rubbing the chest, throat and back for 3 - 5 minutes and then spreading a thick layer on the chest. Repeat the treatment 2 times a day, one in the evening before going to sleep. Do not rub more than twice a day on the front of the chest, neck and back. Wear loose clothing to facilitate inhalation of vapours. \u003cb\u003e2) Inhalations (\u003cu\u003eadults and children over 12 years of age\u003c\/u\u003e)\u003c\/b\u003e Dissolve 2 teaspoons (2x5 ml) in half a liter of hot (not boiling) water and aspirate the released steam for a time not exceeding 10 minutes. To avoid the risk of serious burns, do not heat the mixture a second time or heat the mixture during inhalation (see section 4.4). Do not heat in the microwave. Do not exceed the recommended doses. The duration of treatment should not exceed 3 days. \u003ci\u003eTHE PRODUCT MUST NOT BE INGESTED\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONSERVATION\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eThis medicinal product does not require any special storage conditions.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eWARNINGS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eUse the product according to the instructions. For external use only. Do not apply on wounds, abrasions and mucous membranes. Do not ingest or apply directly into the nostrils, eyes, mouth or face. Do not make a tight bandage. Do not use with hot compress or any type of heat. This product contains terpene derivatives which, in excessive doses, can cause neurological disorders such as seizures in infants and children. If symptoms persist, consult your doctor. The product should be used with caution or under medical suggestion by patients who present: • hypersensitivity reactions to perfumes or solvents; • convulsions or epilepsy (it is contraindicated in children with a history of epilepsy or febrile convulsions, see section 4.3); • Marked hypersensitivity of the respiratory tract including those conditions such as asthma and chronic obstructive pulmonary disease (COPD) as it can cause bronchospasm in these patients Inhalations: In order to avoid the risk of serious burns, do not use boiling water to prepare inhalations. Do not heat the mixture in the microwave and do not heat it again during and after use (see also section 6.6). The treatment must not be prolonged for more than 3 days due to the risks associated with the accumulation of terpene derivatives, such as \u003ci\u003ecamphor, cineol, niaouli, wild thyme, terpineol, terpine, citral, menthol and essential oils of pine needle, eucalyptus and turpentine\u003c\/i\u003e (due to their lipophilic properties the rate of metabolism and disposal is not known) in tissues and the brain, in particular neuropsychological disorders. A higher than recommended dose should not be used to avoid an increased risk of adverse drug reactions and disorders associated with overdose (see section 4.9). The product is flammable, it must not be brought near flames.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eINTERACTIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eVicks Vaporub must not be used concomitantly with other products (medicines or cosmetics) containing terpene derivatives, regardless of the route of administration (oral, rectal, cutaneous, nasal or inhalation).\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eSIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eSide effects may occur with the use of the medicine. Such effects may occur with the following frequency categories: Very common (≥1\/10) Common (≥1\/100; \u003c1\/10) Uncommon (≥1\/1,000; \u003c1\/100) Rare (≥1\/10,000; \u003c1\/1,000) Very rare (\u003c1\/10,000) Not known (frequency cannot be predicted from the available data). \u003cb\u003ePathologies of the skin and subcutaneous tissue\u003c\/b\u003e Not known: erythema or heat erythema (redness and sensation of heat in the skin caused by camphor and menthol, which have rubefacient effects), skin irritation, allergic dermatitis, itching. \u003cb\u003eImmune system disorders\u003c\/b\u003e Not known: hypersensitivity, symptom of respiratory allergy (dyspnea and cough). If such events occur, treatment should be suspended and the necessary clinical measures adopted. \u003cb\u003eEye pathologies\u003c\/b\u003e Not known: eye irritation (following topical use or inhalation). \u003ci\u003eSystemic pathologies and conditions relating to the administration site\u003c\/i\u003e: Due to the recommended route of administration, systemic exposure is very low and no undesirable effects due to systemic exposure have been observed. Not known: burns at the application site. Other adverse events may be linked to improper use of the product (ingestion), in this regard see paragraph 4.9. \u003cb\u003e \u003cu\u003ePediatric population\u003c\/u\u003e \u003c\/b\u003e Due to the presence of camphor, turpentine essential oil, menthol and eucalyptus essential oil and in case of non-compliance with the recommended doses there may be a risk of convulsions in children and infants. \u003cb\u003eReporting of suspected adverse reactions\u003c\/b\u003e Reporting suspected adverse reactions that occur after authorization of the medicine is important, as it allows continuous monitoring of the benefit\/risk balance of the medicine. Healthcare professionals are asked to report any suspected adverse reactions via the national reporting system at: http:\/\/www.agenziafarmaco.gov.it\/content\/comesegnalare-una-sospetti-reazione-avversa.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eOVERDOSE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eIn case of accidental oral intake or incorrect administration in newborns and children there may be a risk of neurological disorders. If necessary, administer appropriate symptomatic treatment in specialized treatment centers. Overdose can cause skin irritation. \u003cu\u003eImproper use\u003c\/u\u003e: Ingestion of the ointment may cause gastrointestinal symptoms such as vomiting and diarrhea. Treatment is symptomatic. Acute poisoning has been observed following significant accidental intake with nausea, vomiting, abdominal pain, headache, dizziness, feeling hot\/hot flashes, convulsions, respiratory depression and coma. Patients with severe gastrointestinal or neurologic symptoms of poisoning should be observed and treated symptomatically. Do not induce vomiting. A) Topical administration: in the event of application of an excessive dose topically, skin irritation reactions may rarely occur. In this case, remove the excess product with a paper towel and administer, if necessary, an adequate therapy for such reactions. B) Inhalation: the symptoms and treatment are the same as in case of accidental ingestion. C) Accidental ingestion: the symptoms are mainly due to the presence of camphor. These include gastrointestinal problems such as nausea, vomiting and diarrhea. In the event of significant overdose, effects on the central nervous system are possible, such as ataxia, convulsions and respiratory depression. Treatment must be symptomatic and gastric lavage can be performed if necessary. In the presence of serious symptoms of poisoning at a gastrointestinal or neurological level, the patient must immediately consult his doctor for appropriate therapeutic measures.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003ePREGNANCY AND BREASTFEEDING\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e \u003cu\u003ePregnancy\u003c\/u\u003e \u003c\/b\u003e There are no or limited data available on the use of camphor, turpentine essential oil, menthol, eucalyptus essential oil in pregnant women. There are no clinical data relating to the use of the components of Vicks Vaporub during pregnancy. Camphor is able to cross the placenta but there is no data on the other components. Animal studies do not indicate harmful effects, direct or indirect, on pregnancy, embryonic\/foetal development, parturition or postnatal development (see section 5.3). However, Vicks Vaporub is not recommended during pregnancy and in women of childbearing potential who are not using contraceptive measures. The use of the drug during pregnancy should only take place after consulting your doctor. \u003cb\u003e \u003cu\u003eBreastfeeding\u003c\/u\u003e \u003c\/b\u003e There is insufficient information on the excretion of camphor, turpentine essential oil, menthol, eucalyptus essential oil in breast milk. There are no clinical data relating to the use of the components of Vicks Vaporub during breastfeeding. Vicks Vaporub should not be used during breastfeeding. The product, applied to the mother's chest during breastfeeding, poses a potential risk of apneic reflex in the breast-fed infant.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEFFECTS ON DRIVING ABILITY\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eVicks Vaporub does not affect the ability to drive or use machines.\u003c\/p\u003e","brand":"Procter \u0026 Gamble","offers":[{"title":"Default Title","offer_id":40207831629939,"sku":"021625064","price":11.02,"currency_code":"EUR","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0564\/4989\/2467\/files\/procter-gamble-vicks-vaporub-unguento-inalante-50-g-farmacia-dottor-tili-1254211152.jpg?v=1786731971"},{"product_id":"vicks-flu-tripla-azione-500mg-200mg-10mg-10-bustine-polvere-per-soluzione-orale","title":"Vicks Flu Triple Action 500mg\/200mg\/10mg 10 sachets powder for oral solution","description":"\u003cp\u003e\u003cstrong\u003eINDICATIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eShort-term symptomatic treatment of mild to moderate pain, fever, nasal congestion with expectorant effect in case of wet cough, associated with colds, chills and flu.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eACTIVE INGREDIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eOne sachet contains: 500 mg of paracetamol 200 mg of guaifenesin 10 mg of phenylephrine hydrochloride Excipients: Sucrose 2000 mg Aspartame 6 mg Sodium 157 mg For the complete list of excipients, see section 6.1.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEXCIPIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eSucrose Citric acid Tartaric acid Sodium cyclamate Sodium citrate Aspartame (E951) Acesulfame potassium (E950) Menthol powder Lemon flavor Lemon juice flavor Quinoline yellow (E104)\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONTRAINDICATIONS AND SIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eHypersensitivity to paracetamol, guaifenesin, phenylephrine hydrochloride or to any of the excipients. Severe hepatic or renal impairment Hypertension Hyperthyroidism Diabetes Heart disease. Angle-closure glaucoma Porphyria Use in patients who are taking tricyclic antidepressants Use in patients who are taking, or who have taken in the previous 2 weeks, monoamine oxidase inhibitors (MAOIs). Use in patients who are taking beta-blocking drugs. Use in patients who are taking other sympathomimetic drugs. Children under 12 years of age.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDOSAGE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eDissolve the contents of one sachet in a medium-sized cup and add hot, non-boiling water (approximately 250 ml). Allow to cool to a drinkable temperature. Adults and children from 12 years of age: one sachetRepeat every four hours according to the indications, without exceeding four doses (sachets) within 24 hours. Do not administer to children under 12 years of age without medical advice. Do not administer to patients with hepatic impairment or severe renal impairment (see section 4.3). Consult your doctor if symptoms persist for more than 3 days.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONSERVATION\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eDo not store above 25°C.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eWARNINGS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eProlonged use of the product is not recommended. Patients should be advised not to take other products containing paracetamol or containing the same active ingredients as this preparation. Patients should also be advised to avoid the concomitant use of alcohol, other decongestant products or cough or cold products. The doctor or pharmacist is required to verify that preparations containing sympathomimetics are not administered simultaneously through multiple routes, i.e. orally and topically (nasal, auricular and ocular preparations). This medicine should only be recommended in the presence of all symptoms (pain and\/or fever, nasal congestion and bronchial cough). The risks related to overdose are greater in patients with non-cirrhotic alcoholic liver disease. Use with caution in patients taking digitalis, beta-adrenergic blockers, methyldopa or other antihypertensive agents (see section 4.5). Use with caution in patients with prostatic hypertrophy as they are potentially subject to urinary retention. Products containing sympathomimetics should be used with great care in patients taking phenothiazines. Use in patients with Raynaud's phenomenon. Consult your doctor before use in case of persistent or chronic cough such as that manifested by smoking, asthma, chronic bronchitis or emphysema. Contains sucrose. Patients suffering from rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrasisomaltase insufficiency should not take this medicine. Contains 157 mg sodium per dose. To be taken into consideration in people with reduced kidney function or who follow a low sodium diet. Contains aspartame (E951). This medicine contains a source of phenylalanine. It may be harmful to you if you suffer from phenylketonuria.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eINTERACTIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eThe hepatotoxicity of paracetamol can be potentiated by excessive alcohol intake. The rate of absorption of paracetamol can be increased with metoclopramide or domperidone and the absorption reduced with cholestyramine. Substances that induce hepatic microsomal enzymes, such as alcohol, barbiturates, monoamine oxidase inhibitors and tricyclic antidepressants, may increase the hepatotoxicity of paracetamol, particularly following overdosage. Isoniazid reduces the elimination of paracetamol, with possible enhancement of its activity and\/or toxicity, through the inhibition of its metabolism in the liver. Probenecid causes a halving of the elimination of paracetamol, inhibiting its binding with glucuronic acid. A reduction in paracetamol should be considered if probenecid is being taken. Regular use of paracetamol may reduce the metabolism of Zidovudine (increasing the risk of neutropenia). Interactions between sympathomimetic amines, such as phenylephrine, and monoamine oxidase inhibitors cause hypertensive effects. Phenylephrine may interact negatively with sympathomimetic agents and may reduce the effectiveness of beta-blocking drugs, methyldopa and other antihypertensive drugs (see section 4.4). The conditions in which these drugs are taken constitute contraindications to the use of the product. The anticoagulant effect of warfarin and other coumarin drugs can be enhanced by regular and prolonged intake of paracetamol, with an increased risk of bleeding; doses taken occasionally have no significant effects. Drug interactions have been reported between acetaminophen and several other drugs. Such interactions are considered unlikely to be clinically significant in temporary use and in accordance with the suggested dosing regimen. Salicylates\/aspirin can prolong the elimination (t ½) of paracetamol. Paracetamol may decrease the bioequivalence of lamotrigine, with a possible decrease in its effect, due to a possible increase in its metabolism in the liver. It is possible that digitalis may sensitize the myocardium to sympathomimetic-like effects. Paracetamol can alter the uric acid phosphotungstate test and the blood sugar test.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eSIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eThe incidence of side effects is usually classified as follows: Very common (\u003e10) Common (\u003e1\/100 to \u003c1\/10) Uncommon (\u003e1\/1000 to \u003c1\/100) Rare (\u003e1\/10,000 to \u003c1\/1000) Very rare (\u003c1\/10,000) Not known (the incidence cannot be classified from the available data) Cardiac disorders: Phenylephrine may be rarely associated with tachycardia (≥1\/10,000 to ≤1 in 1000). Blood and lymphatic system disorders: very rarely (\u003c1 in 10,000) blood dyscrasias such as thrombocytopenia, agranulocytosis, hemolytic anemia, neutropenia, leukopenia and pancytopenia have been reported following the intake of paracetamol, although there may not be a causal relationship. Nervous system disorders: As with other sympathomimetic amines, insomnia, nervousness, tremor, anxiety, restlessness, confusion, irritability and headache may occur rarely (≥1\/10,000 to ≤1 in 1000). It is also known that guaifenesin can rarely (≥1\/10,000 to ≤1 in 1000) cause headache and dizziness. Gastrointestinal disorders: Anorexia, nausea and vomiting are common with sympathomimetics (≥1 in 100 to ≤1 in 10) and may occur with phenylephrine. Gastrointestinal disorders, nausea, vomiting, and diarrhea are the most common side effects associated with guaifenesin, but occur rarely (≥1\/10,000 to ≤1 in 1000). The gastrointestinal effects of paracetamol are very rare but cases of acute pancreatitis have been reported following ingestion of higher than normal doses. Renal and urinary disorders: Interstitial nephritis has been reported randomly after prolonged use of high doses of paracetamol. Skin and subcutaneous tissue disorders: hypersensitivity, including skin rash, and urticaria may rarely occur following the intake of paracetamol (from ≥1\/10,000 to ≤1 in 1000). Vascular disorders: following the intake of phenylephrine, increased blood pressure associated with headache, vomiting and palpitations may rarely occur (from ≥1\/10,000 to ≤1 in 1000). Immune system disorders: Rare cases (≥1\/10,000 to ≤1 in 1000) of allergic or hypersensitivity reactions have been reported following intake of both phenylephrine and paracetamol, including skin rashes, urticaria, anaphylaxis and bronchospasm. Hepatobiliary disorders: rarely (≥ 1\/10,000 to ≤ 1\/1000), abnormalities in liver function tests (increased liver transaminases).\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eOVERDOSE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003ePARACETAMOL There is a risk of poisoning particularly in elderly patients, young children, in patients with liver disease, in chronic alcoholics, in patients with chronic malnutrition. In these cases, an overdose can be fatal. In adults, a quantity of paracetamol equal to or greater than 10 g can cause liver damage. If the patient has one of the risk factors (see below), ingesting 5 g or more of paracetamol may cause liver damage. Risk factors If the patient: a) is on prolonged therapy with carbamazepine, phenobarbital, phenytoin, primidone, rifampicin, St. John's wort or other liver enzyme-inducing drugs, or b) regularly takes ethanol in excess of recommended amounts, or c) has a glutathione deficiency, e.g. in case of eating disorders, cystic fibrosis, HIV infection, inanition, cachexia. Symptoms The symptoms of paracetamol overdose that appear in the first 24 hours are paleness, nausea, vomiting, anorexia and abdominal pain. Liver damage may appear 12–48 hours after ingestion. Abnormalities of glucose metabolism and metabolic acidosis may occur. In cases of severe poisoning, liver failure may progress to encephalopathy, hemorrhage, hypoglycemia, brain edema, and death. Even in the absence of severe liver damage, acute renal failure with acute tubular necrosis may occur, which is highly likely if accompanied by low back pain, hematuria, and proteinuria. Cases of cardiac arrhythmia and pancreatitis have been reported. Treatment In case of paracetamol overdose it is essential to treat the patient immediately. Even in the absence of significant initial symptoms, the patient must be urgently transferred to hospital. Symptoms may be limited to nausea or vomiting and may not reflect the severity of the overdose or the risk of organ damage. Patient treatment must be carried out in compliance with current guidelines. If no more than an hour has passed since the overdose was taken, treatment with activated charcoal may be considered. The plasma concentration of paracetamol must be measured no earlier than 4 hours after ingestion (plasma concentrations measured at earlier times are not reliable). Within 24 hours of ingesting paracetamol the patient can be treated with N-acetylcysteine; however, the maximum protective effect is obtained within 8 hours of ingestion. After this time, the effectiveness of the antidote decreases drastically. If necessary, the patient should be administered N-acetylcysteine ​​intravenously, in line with the established dosing schedule. If vomiting is not a problem and the patient is away from the hospital, taking oral methionine can be a valid alternative. Treatment of patients with severe hepatic dysfunction presenting within 24 hours of ingestion should be discussed with the poison control center or hepatology department. Phenylephrine hydrochloride Symptoms of phenylephrine overdose include irritability, headache, arterial hypertension, reflex bradycardia and arrhythmias. Hypertension must be treated with an alpha-blocker such as phentolamine IV. The reduction in blood pressure can increase, as a reflex mechanism, the heart rate but, if necessary, this can be facilitated by taking atropine. GUAIFENESIN Mild to moderate overdose may cause dizziness and gastrointestinal disturbances. Very high doses can produce excitation, confusion and respiratory depression. Urinary stones have been reported in patients consuming large quantities of guaifenesin-containing preparations. Treatment is symptomatic and includes gastric lavage and general supportive measures.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003ePREGNANCY AND BREASTFEEDING\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eEpidemiological studies on pregnant women have demonstrated the absence of negative effects due to the use of paracetamol in the recommended dosages; however, pregnant patients are required to follow their doctor's instructions regarding the use of the drug. Paracetamol is excreted in breast milk, although not in clinically significant quantities. The available published data do not report contraindications regarding breastfeeding. Data on the use of phenylephrine in pregnancy are limited. Vasoconstriction of the uterine vessels and reduction in uterine blood flow associated with the use of phenylephrine may cause fetal hypoxia. Until further information is available, taking phenylephrine during pregnancy should be avoided, except when your doctor deems it essential. There are no data available regarding the possible release of phenylephrine into breast milk nor are there any reports regarding the effects of phenylephrine on breast-fed infants. Until further data become available, taking phenylephrine during breastfeeding should be avoided, except when your doctor deems it essential. The safety of guaifenesin during pregnancy and breastfeeding has not yet been fully defined. During pregnancy, the product must be taken only when the doctor deems it essential.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEFFECTS ON DRIVING ABILITY\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eNo studies on the effects on the ability to drive and use machines have been performed. When carrying out these activities, the possibility of adverse events, such as dizziness and confusion, must be considered.\u003c\/p\u003e","brand":"Procter \u0026 Gamble","offers":[{"title":"Default Title","offer_id":51131272331591,"sku":"039773027","price":9.43,"currency_code":"EUR","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0564\/4989\/2467\/files\/procter-gamble-srl-vicks-flu-tripla-azione-500mg-200mg-10mg-10-bustine-polvere-per-soluzione-orale-farmacia-dottor-tili-1213792260.jpg?v=1767133270"},{"product_id":"vicks-flu-action-200-30-mg-12-compresse-rivestite","title":"Vicks Flu Action 200 + 30 mg 12 coated tablets","description":"\u003cp\u003e\u003cstrong\u003eINDICATIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eSymptomatic relief of nasal\/sinus congestion with headache, fever and pain associated with colds and flu. Vicks Flu Action is indicated in adults and adolescents aged 15 years and older.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eACTIVE INGREDIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eOne tablet contains 200 mg of ibuprofen and 30 mg of pseudoephedrine hydrochloride equivalent to 24.6 mg of pseudoephedrine. For the full list of excipients, see section 6.1.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEXCIPIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cu\u003eTablet core\u003c\/u\u003e: Microcrystalline cellulose, Pregelatinized corn starch, Povidone K-30, Colloidal anhydrous silica, Stearic acid 95, Croscarmellose sodium, Sodium lauryl sulfate. \u003cu\u003eCoating film\u003c\/u\u003e: Polyvinyl alcohol - Parz. hydrolysate, Talc (E553b), Macrogol 3350, Pearlescent pigment based on MICA (Mixture of potassium aluminum silicate (E555)-[mica], titanium dioxide (E171)), Polysorbate 80 (E433), Hypromellose, Titanium dioxide (E 171), Macrogol 400, Yellow iron oxide (E 172), Red iron oxide (E 172), Black iron oxide (E 172).\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONTRAINDICATIONS AND SIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e- Hypersensitivity to ibuprofen, pseudoephedrine or to any of the excipients listed in section 6.1. - Patients under the age of 15. - Pregnancy and breastfeeding (see section 4.6). - A history of hypersensitivity reactions (e.g. bronchospasm, asthma, nasal polyposis, rhinitis or urticaria) associated with aspirin, other analgesics, antipyretics or other non-steroidal anti-inflammatory drugs (NSAIDs). - Active peptic ulcer or history of recurrent ulcer\/hemorrhage (two or more distinct episodes of proven ulcer or bleeding). - History of gastrointestinal bleeding or perforation, including cases associated with NSAIDs. - Cerebrovascular hemorrhage or other type of hemorrhage. - Unexplained hematopoietic abnormalities. - Severe renal insufficiency (eGFR \u003c30 mL\/minute\/1.73 m²). - Severe hepatic impairment such as cirrhosis or end-stage liver disease - Severe heart failure (NYHA Class IV). - Severe cardiovascular disorders such as coronary artery disease (e.g. angina pectoris), severe or uncontrolled hypertension, tachycardia and other serious cardiac and\/or vascular disorders. - History of myocardial infarction. - History of stroke or presence of risk factors for stroke (due to the α-sympathomimetic activity of pseudoephedrine hydrochloride). - Hyperthyroidism, diabetes, pheochromocytoma. - Closed-angle glaucoma. - Urinary retention related to urethro-prostatic disorders. - History of seizures. - Disseminated systemic lupus erythematosus and mixed connective tissue disease (increased risk of aseptic meningitis, see section 4.8). - Concomitant use of other vasoconstrictor drugs used as nasal decongestants, administered orally or nasally (e.g. phenylpropanolamine, phenylephrine and ephedrine), and methylphenidate (see section 4.5). - Concomitant use of NSAIDs or aspirin with a daily dose exceeding 75 mg, analgesics and selective COX 2 inhibitors \u003cb\u003e(see paragraph 4.5).\u003c\/b\u003e - Concomitant or previous use of monoamine oxidase inhibitors (MAOIs) in the previous 2 weeks (see section 4.5). This medicine should generally not be used in combination with: - oral anticoagulants, - corticosteroids, - heparins at curative doses or in the elderly, - anti-platelet agents, - lithium, - selective serotonin reuptake inhibitors (SSRIs), - methotrexate (used at doses higher than 20 mg\/week)\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDOSAGE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cu\u003eDosage\u003c\/u\u003e Adults and adolescents aged 15 years and older: 1 tablet (equivalent to 200 mg of ibuprofen and 30 mg of pseudoephedrine hydrochloride) every 4-6 hours as needed. For more severe symptoms, 2 tablets (equivalent to 400 mg of ibuprofen and 60 mg of pseudoephedrine hydrochloride) every 6-8 hours as needed, up to the maximum total daily dose. The lowest effective dose should be used for the shortest period necessary to relieve symptoms (see section 4.4). The maximum total daily dose of 6 tablets (equivalent to 1200 mg ibuprofen and 180 mg pseudoephedrine hydrochloride) should not be exceeded. Do not exceed 5 days of therapy for the adult population. Do not exceed 3 days of therapy for adolescents (15-18 years). This combination product must be used when both the decongestant action of pseudoephedrine hydrochloride and the analgesic and\/or anti-inflammatory action of ibuprofen are necessary. If one symptom is predominant (nasal congestion or headache and\/or fever), therapy with a single active ingredient is preferable. In older patients, start therapy with the lowest possible dose because the risk of gastrointestinal bleeding, ulcer or perforation is greater with increasing doses of NSAIDs. In these patients, or in patients taking other drugs capable of increasing the risk of gastrointestinal events (see below and in section 4.5), the concomitant use of protective agents (misoprostol or proton pump inhibitors) should be considered. In patients with chronic kidney disease with eGFR \u003e30 mL\/min\/1.73m² \u003c 90 mL\/min\/1.73m² or stage 1 or 2 hepatocellular disease (hepatic inflammation or liver fibrosis) it is necessary to adapt the dosage to the individual patient. Undesirable effects can be reduced by using the lowest effective dose for the minimum duration needed to relieve symptoms (see section 4.4). \u003ci\u003ePediatric population\u003c\/i\u003e Vicks Flu Action is contraindicated in children under 15 years of age (see section 4.3). \u003cu\u003eMethod of administration\u003c\/u\u003e For oral use. The tablets should be swallowed with water, preferably on a full stomach. Do not break or crush the tablets.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONSERVATION\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eThis medicinal product does not require any special storage conditions.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eWARNINGS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eThe concomitant use of Vicks Flu Action and other NSAIDs containing COX-2 inhibitors should be avoided (see section 4.3). Patients with chronic kidney disease or stage 1 or 2 hepatocellular disease (hepatic inflammation or hepatic fibrosis) require dose adjustment on an individual basis (see section 4.2). \u003cb\u003e \u003ci\u003eSevere skin reactions\u003c\/i\u003e \u003c\/b\u003e Severe skin reactions, such as acute generalized exanthematous pustulosis (PEAG), may occur with medicines containing ibuprofen and pseudoephedrine. This acute pustular eruption can occur within the first 2 days of treatment, with fever and numerous small pustules, mostly non-follicular, appearing on a very widespread edematous erythema and localized mainly on the skin folds, trunk and upper limbs. Patients should be carefully monitored. If signs and symptoms such as pyrexia, erythema or numerous small pustules are observed, the administration of Vicks Flu Action should be stopped and appropriate measures taken if necessary. Other skin manifestations potentially associated with this medicine and requiring urgent medical attention are: Stevens-Johnson syndrome, erythema multiforme and toxic epidermal necrolysis (Lyell's syndrome), Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS syndrome). These serious conditions present with additional involvement of mucous membranes and skin erosion, or systemic reactions, such as lymphadenopathy, arthritis or general malaise, facial and acral edema, involvement of multiple organs, particularly liver and kidneys, and hematological abnormalities. The first symptoms develop within a few hours\/days up to two to six weeks, in case of DRESS syndrome, after exposure. \u003cb\u003eMasking of symptoms of underlying infections\u003c\/b\u003e Vicks Flu Action can mask the symptoms of infection, which could delay the initiation of appropriate treatment and therefore worsen the outcome of the infection. This has been observed in community-acquired bacterial pneumonia and bacterial complications of chickenpox. When Vicks flu Action is given for the relief of fever or pain related to infection, monitoring of the infection is advised. In non-hospital settings, the patient should seek medical attention if symptoms persist or worsen. \u003cb\u003e \u003ci\u003eSpecial warnings regarding pseudoephedrine hydrochloride\u003c\/i\u003e \u003c\/b\u003e: • The dosage, maximum recommended duration of treatment (see section 4.2) and contraindications must be strictly respected (see section 4.8). • Patients should be informed that treatment should be discontinued if hypertension, tachycardia, palpitations, cardiac arrhythmias, nausea or any neurological signs such as onset or worsening headache appear. Before using this product, patients should consult their doctor in case of: • Well-controlled mild to moderate hypertension and heart disease (see section 4.3) • Psychosis • Concomitant administration of anti-migraine drugs, in particular ergot alkaloid vasoconstrictors (due to the a-sympathomimetic activity of pseudoephedrine). Neurological symptoms such as convulsions, hallucinations, behavioral disturbances, agitation and insomnia have been described following the systemic administration of vasoconstrictors, especially during feverish episodes or in case of overdose. These symptoms have been commonly reported in the pediatric population. The following is therefore advisable: • avoid the administration of Vicks Flu Action both in association with medicines capable of lowering the epileptogenic threshold, such as terpene derivatives, clobutinol, atropine-like substances and local anaesthetics, and where there is a history of convulsions; • strictly respect the recommended dosage in all cases and inform patients about the risk of overdose if Vicks Flu Action is taken in combination with other medicinal products containing vasoconstrictors. Patients with urethro-prostatic disorders are more susceptible to the development of symptoms such as dysuria and urinary retention (see section 4.3). Elderly patients may be more sensitive to effects on the central nervous system (CNS). \u003cu\u003eIschemic colitis\u003c\/u\u003e Some cases of ischemic colitis have been reported with pseudoephedrine. If sudden abdominal pain, rectal bleeding, or other symptoms of ischemic colitis develop, pseudoephedrine should be discontinued and a physician should be consulted. \u003cb\u003e \u003ci\u003ePrecautions for use relating to pseudoephedrine hydrochloride\u003c\/i\u003e \u003c\/b\u003e: • In patients undergoing elective surgery during which volatile halogenated anesthetics will be used, it is preferable to suspend therapy with Vicks Flu Action several days before surgery due to the risk of acute hypertension (see section 4.5). • Athletes should be informed that treatment with pseudoephedrine hydrochloride may cause positive doping test results. \u003cb\u003eIschemic optic neuropathy\u003c\/b\u003e Cases of ischemic optic neuropathy have been reported with pseudoephedrine. Pseudoephedrine should be discontinued if sudden loss of vision or reduction in visual acuity occurs, for example in the case of a scotoma. \u003cu\u003eInterference with serological tests\u003c\/u\u003e Pseudoephedrine may potentially reduce iobenguane I-131 reuptake in neuroendocrine tumors, thereby interfering with scintigraphy. \u003cb\u003e \u003ci\u003eSpecial warnings regarding ibuprofen\u003c\/i\u003e \u003c\/b\u003e: In patients suffering from, or with a history of bronchial asthma or allergies, ibuprofen may trigger bronchospasm. The product must not be administered in case of asthma without prior medical consultation (see section 4.3). Patients suffering from asthma associated with chronic rhinitis, chronic sinusitis and\/or nasal polyposis are at greater risk of allergic reactions when taking acetylsalicylic acid and\/or NSAIDs. The administration of Vicks Flu Action can trigger an acute asthma attack, particularly in some patients allergic to acetylsalicylic acid or an NSAID (see section 4.3). In dehydrated adolescents there is a risk of kidney failure. \u003ci\u003eGastrointestinal effects\u003c\/i\u003e: With all NSAIDs, cases of gastrointestinal bleeding, ulceration or perforation, which may be fatal, have been reported at any time during treatment, with or without warnings or previous history of gastrointestinal events. The risk of gastrointestinal bleeding, ulceration or perforation, which may be fatal, is greater with increasing doses of NSAIDs, in patients with a history of ulcer (particularly if complicated by haemorrhage or perforation - see section 4.3) and in patients over 60 years of age. These older patients should start treatment at the lowest available dose (see section 4.2). For these patients and for those taking concomitant treatment with low-dose acetylsalicylic acid or other drugs that may increase gastrointestinal risk, combination therapy with gastroprotectors (e.g. misoprostol or proton pump inhibitors) should be considered (see below and sections 4.3 and 4.5). Patients with a history of gastrointestinal disorders, particularly if elderly, may experience unusual abdominal symptoms (particularly gastrointestinal bleeding) in the initial stages of treatment. The administration of NSAIDs must be carefully evaluated in patients with coagulation disorders, since a reduction in coagulation capacity is possible. Particular caution is advised in patients receiving concomitant therapy. Some drugs may increase the risk of ulcer or bleeding such as oral corticosteroids, anticoagulants such as warfarin, SSRIs or antiplatelets such as acetylsalicylic acid (see sections 4.3 and 4.5). Treatment with Vicks Flu Action must be stopped immediately if bleeding or gastrointestinal ulceration occurs. NSAIDs should be administered with caution to patients with a history of gastrointestinal disorders (ulcerative colitis, Crohn's disease) as these conditions may worsen (see section 4.8). The concomitant use of alcohol and NSAIDs may increase side effects related to the active ingredient, in particular those relating to the gastrointestinal tract or central nervous system. \u003ci\u003eCardiovascular and cerebrovascular effects\u003c\/i\u003e: Clinical studies suggest that the use of ibuprofen, particularly at high doses (2400 mg\/day), may be associated with a small increased risk of arterial thrombotic events (such as 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. Patients with uncontrolled hypertension, congestive heart failure (NYHA II-III), demonstrated ischemic heart disease, peripheral arterial disease and\/or cerebrovascular disease should be treated with ibuprofen, after careful examination and at high doses (2400 mg\/day) its administration should be avoided. \u003cb\u003e \u003ci\u003ePrecautions for use relating to ibuprofen\u003c\/i\u003e \u003c\/b\u003e: • Elderly patients: The pharmacokinetics of ibuprofen are not modified by age, therefore dosage adjustments are not necessary in the elderly. However, elderly patients must be kept under close medical supervision as they are more sensitive to side effects from NSAIDs, and in particular to gastrointestinal bleeding and perforation, which can be fatal. • Particular caution and medical supervision are required when administering ibuprofen to patients with a history of gastrointestinal disease. The use of Vicks Flu Action is contraindicated in some gastrointestinal pathologies (see section 4.3). • During the initial phases of treatment, careful monitoring of urinary excretion and renal function is required in patients with heart failure, chronic impairment of renal or hepatic function, in patients on diuretic therapy, in those hypovolemic due to major surgery and, in particular, in elderly patients. The renal function of these patients may be adversely affected by treatment with NSAIDs. • If visual disturbances occur during treatment, the patient will need to undergo a complete ophthalmological examination. If symptoms persist or worsen, the patient should consult his doctor. Vicks Flu Action contains 1.65 mg sodium per tablet.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eINTERACTIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eNon-selective monoamine oxidase inhibitors (MAOIs) - Possible reactions: Vicks Flu Action must not be taken by patients on current or past (last two weeks) therapy with monoamine oxidase inhibitors (MAOIs), as there is a risk of hypertensive episodes such as paroxysmal hypertension and hyperthermia, which can be fatal (see section 4.3).\u003c\/p\u003e\n\u003cp\u003eOther sympathomimetics or vasoconstrictors with indirect action, administered orally or nasally, α-sympathomimetic drugs, phenylpropanolamine, phenylephrine, ephedrine, methylphenidate - Possible reactions: Pseudoephedrine may potentiate the effect of other sympathomimetics (vasoconstrictors) and cause a risk of vasoconstriction and\/or hypertensive crisis.\u003c\/p\u003e\n\u003cp\u003eReversible monoamine oxidase A inhibitors (RIMA), Linezolid, ergot alkaloids with dopaminergic action, ergot alkaloid vasoconstrictors - Possible reactions: Risk of vasoconstriction and\/or hypertensive crisis.\u003c\/p\u003e\n\u003cp\u003eHalogenated volatile anesthetics - Possible reactions: Acute perioperative hypertension. In scheduled surgical interventions, suspend treatment with Vicks Flu Action several days before the operation.\u003c\/p\u003e\n\u003cp\u003eGuanethidine, reserpine and methyldopa - Possible reactions: The effect of pseudoephedrine may be reduced.\u003c\/p\u003e\n\u003cp\u003eTricyclic antidepressants - Possible reactions: The effect of pseudoephedrine may be reduced or increased.\u003c\/p\u003e\n\u003cp\u003eDigitalis, quinidine or tricyclic antidepressants - Possible reactions: Increased frequency of arrhythmia.\u003c\/p\u003e\n\u003cp\u003eTerpene derivatives, clobutinol, atropine-like substances and local anesthetics - Possible reactions: Reduction of the epileptogenic threshold.\u003c\/p\u003e\n\u003cp\u003eOther NSAIDs, salicylates, analgesics, antipyretics and COX 2 inhibitors - Possible reactions: The concomitant administration of various NSAIDs, analgesics, antipyretics and selective COX 2 inhibitors may increase the risk of adverse reactions such as ulcers and gastrointestinal bleeding due to a synergistic effect. The concomitant use of Vicks Flu Action with these drugs should therefore be avoided (see sections 4.3 and 4.4).\u003c\/p\u003e\n\u003cp\u003eCardiac glycosides (such as digoxin) - Possible reactions: Concomitant use with digoxin preparations may increase serum levels of cardiac glycosides (digoxin). With correct use (a maximum of 5 days), monitoring of serum digoxin levels is usually not necessary.\u003c\/p\u003e\n\u003cp\u003eCorticosteroids - Possible reactions: Corticosteroids may increase the risk of adverse reactions, particularly of the gastrointestinal tract (ulcer or gastrointestinal bleeding) (see section 4.3).\u003c\/p\u003e\n\u003cp\u003eAntiplatelets - Possible reactions: Increased risk of gastrointestinal bleeding (see section 4.3).\u003c\/p\u003e\n\u003cp\u003eAcetylsalicylic acid (low dose) - Possible reactions: Concomitant administration of acetylsalicylic acid should be avoided (see section 4.3). Coadministration of ibuprofen and acetylsalicylic acid (aspirin) is generally not recommended due to the potential for increased adverse effects. Experimental data indicate that ibuprofen can competitively inhibit the effect of low doses of acetylsalicylic acid on platelet aggregation, when they are administered simultaneously. Although there are uncertainties regarding the extrapolation of these data from the clinical situation, the possibility cannot be excluded that regular and long-term use of ibuprofen may reduce the cardioprotective effect of low doses of acetylsalicylic acid. No clinically relevant effect is considered likely for occasional use of ibuprofen (see section 5.1).\u003c\/p\u003e\n\u003cp\u003eAnticoagulants (e.g. warfarin, ticlopidine, clopidogrel, Tirofiban, eptifibatide, abciximab, iloprost) - Possible reactions: Increased risk of gastrointestinal bleeding, because NSAIDs such as ibuprofen can increase the effect of anticoagulants (see sections 4.3 and 4.4).\u003c\/p\u003e\n\u003cp\u003ePhenytoin - Possible reactions: The concomitant use of Vicks Flu Action and phenytoin preparations could increase the serum levels of these medicinal products. With correct use (a maximum of 5 days), monitoring of phenytoin serum levels is usually not necessary.\u003c\/p\u003e\n\u003cp\u003eSelective serotonin reuptake inhibitors (SSRIs) - Possible reactions: Increased risk of gastrointestinal bleeding (see section 4.3).\u003c\/p\u003e\n\u003cp\u003eLithium - Possible reactions: The concomitant use of Vicks Flu Action and lithium preparations may increase the serum levels of these medicinal products (see section 4.3).\u003c\/p\u003e\n\u003cp\u003eProbenecid and sulfinpyrazone - Possible reactions: Medicinal products containing probenecid or sulfinpyrazone may delay the excretion of ibuprofen.\u003c\/p\u003e\n\u003cp\u003eDiuretics, ACE inhibitors, beta blockers and angiotensin-II antagonists - Possible reactions: NSAIDs can reduce the effect of diuretics and other antihypertensive drugs. In some patients with impaired renal function (e.g. dehydrated patients or elderly patients with impaired renal function) the concomitant administration of an ACE inhibitor, a beta blocker or an angiotensin-II antagonist and drugs that inhibit cyclo-oxygenase may cause further deterioration of renal function, including possible acute renal failure, which is usually reversible. Therefore, the administration of these drugs in combination must be carried out with caution, especially in elderly patients. Patients should be adequately hydrated and consideration should be given to monitoring renal function after initiation of treatment and on a periodic basis thereafter.\u003c\/p\u003e\n\u003cp\u003ePotassium-sparing diuretics - Possible reactions: Concomitant administration of Vicks Flu Action and potassium-sparing diuretics may cause hyperkalemia (monitoring of serum potassium levels is recommended).\u003c\/p\u003e\n\u003cp\u003eMethotrexate - Possible reactions: Administration of Vicks Flu Action within 24 hours before or after administration of methotrexate may cause high concentrations of methotrexate and an increase in its toxic effects (see section 4.3).\u003c\/p\u003e\n\u003cp\u003eCiclosporin - Possible reactions: The risk of a harmful effect on the kidneys due to ciclosporin increases with concomitant administration of some non-steroidal anti-inflammatory drugs. This effect cannot be excluded even for the association between ciclosporin and ibuprofen.\u003c\/p\u003e\n\u003cp\u003eTacrolimus - Possible reactions: The risk of nephrotoxicity increases if the two medicinal products are administered in combination.\u003c\/p\u003e\n\u003cp\u003eZidovudine - Possible reactions: Cases of an increased risk of hemarthrosis and hematoma have been reported in HIV (+) hemophiliac patients receiving concomitant therapy with zidovudine and ibuprofen.\u003c\/p\u003e\n\u003cp\u003eSulfonylureas - Possible reactions: Clinical studies have demonstrated interactions between nonsteroidal anti-inflammatory drugs and antidiabetics (sulfonylureas). Although no interactions have been described between sulphonylureas and ibuprofen, as a precaution during concomitant use it is recommended to monitor blood glucose values.\u003c\/p\u003e\n\u003cp\u003eQuinolone antibiotics - Possible reactions: Animal data indicate that NSAIDs may increase the risk of seizures associated with quinolone antibiotics. Patients treated with NSAIDs and quinolones may have an increased risk of developing seizures.\u003c\/p\u003e\n\u003cp\u003eHeparins; Gingko biloba - Possible reactions: Increased risk of bleeding (see section 4.3).\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eSIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eThe most commonly observed adverse events related to ibuprofen are gastrointestinal in nature. In general, the risk of presenting adverse events (in particular the risk of presenting serious gastrointestinal complications) increases with increasing dose and duration of treatment. Cases of hypersensitivity reactions have been reported following treatment with ibuprofen. These may consist of: (a) Nonspecific allergic reactions and anaphylaxis; (b) Respiratory tract reactivity, including asthma, worsening of asthma, bronchospasm, or dyspnea; (c) Skin disorders of various nature, including rash of various types, pruritus, urticaria, purpura, angioedema and, more rarely, exfoliative dermatitis and bullous dermatitis (including epidermal necrolysis and erythema multiforme). In patients with pre-existing autoimmune disease (such as systemic lupus erythematosus, mixed connective tissue disease), single cases of symptoms of aseptic meningitis, such as neck stiffness, headache, nausea, vomiting, fever or disorientation have been reported during treatment with ibuprofen. Edema, hypertension and heart failure have been reported in association with treatment with NSAIDs. Clinical studies and epidemiological data suggest that the use of ibuprofen (particularly at high doses 2400 mg\/day) and in long-term therapy may be associated with a slight increase in the risk of arterial thrombotic events (e.g. myocardial infarction or stroke), (see section 4.4). The following list of adverse events relates to those occurring with ibuprofen and pseudoephedrine hydrochloride at normal over-the-counter doses, for short-term use. In the treatment of chronic pathologies and long-term treatment, further adverse events may occur. Patients should be informed of the need to immediately stop taking Vicks Flu Action and consult their doctor if a serious adverse drug reaction occurs. The frequency of adverse reactions is defined using the following convention: Very common (≥1\/10); common (≥1\/100 to \u003c1\/10); uncommon (≥1\/1,000 to \u003c1\/100); rare (≥1\/10,000 to \u003c1\/1,000); very rare (\u003c1\/10,000), frequency not known (frequency cannot be estimated from the available data).\u003c\/p\u003e\n\u003cp\u003eInfections and infestations: Ibuprofen Very rare Exacerbation of infectious inflammations (e.g. necrotizing fasciitis), Aseptic meningitis (neck stiffness, headache, nausea, vomiting, fever or disorientation in patients with pre-existing autoimmune diseases (SLE, mixed connective tissue disease).\u003c\/p\u003e\n\u003cp\u003eBlood and lymphatic system disorders: Ibuprofen Very rare Hematopoietic disorders (anaemia, leukopenia, thrombocytopenia, pancytopenia, agranulocytosis, neutropenia).\u003c\/p\u003e\n\u003cp\u003eImmune system disorders: Ibuprofen and pseudoephedrine hydrochloride Very rare Severe generalized hypersensitivity reactions: signs may be facial edema, angioedema, dyspnoea, bronchospasm, tachycardia, sharp drop in blood pressure, anaphylactic shock.\u003c\/p\u003e\n\u003cp\u003ePsychiatric disorders: Ibuprofen Very rare Psychotic reactions, depression.\u003c\/p\u003e\n\u003cp\u003ePsychiatric disorders: Pseudoephedrine hydrochloride Frequency not known Hallucinations, behavioral anomalies.\u003c\/p\u003e\n\u003cp\u003eNervous system disorders: Ibuprofen Uncommon Central nervous system disorders such as headache, dizziness, insomnia, agitation, irritability or tiredness.\u003c\/p\u003e\n\u003cp\u003eNervous system disorders: Pseudoephedrine hydrochloride Rare Insomnia, nervousness, anxiety, agitation, restlessness, tremors.\u003c\/p\u003e\n\u003cp\u003eNervous system disorders: Pseudoephedrine hydrochloride Frequency not known Haemorrhagic stroke, ischemic stroke, convulsions, headache.\u003c\/p\u003e\n\u003cp\u003eEye disorders: Ibuprofen Uncommon Visual disturbances.\u003c\/p\u003e\n\u003cp\u003eEye disorders: Pseudoephedrine hydrochloride Not Known Ischemic optic neuropathy.\u003c\/p\u003e\n\u003cp\u003eEar and labyrinth disorders: Ibuprofen Rare Tinnitus.\u003c\/p\u003e\n\u003cp\u003eCardiac disorders: Ibuprofen Rare Edema, hypertension, palpitations, heart failure, myocardial infarction Clinical studies suggest that the use of ibuprofen, particularly at high doses (2400 mg\/day), may be associated with a small increase in the risk of arterial thrombotic events (such as myocardial infarction or stroke) (see section 4.4).\u003c\/p\u003e\n\u003cp\u003eCardiac disorders: Pseudoephedrine hydrochloride Rare Palpitations, tachycardia, chest pain, arrhythmia.\u003c\/p\u003e\n\u003cp\u003eVascular disorders: Ibuprofen Rare Arterial hypertension.\u003c\/p\u003e\n\u003cp\u003eVascular disorders: Pseudoephedrine hydrochloride Frequency not known Hypertension.\u003c\/p\u003e\n\u003cp\u003eRespiratory, thoracic and mediastinal disorders: Pseudoephedrine hydrochloride Rare Asthma exacerbation or hypersensitivity reactions with bronchospasm.\u003c\/p\u003e\n\u003cp\u003eGastrointestinal disorders: Ibuprofen Uncommon Gastrointestinal discomfort, dyspepsia, nausea, vomiting, diarrhea, anorexia.\u003c\/p\u003e\n\u003cp\u003eGastrointestinal disorders: Ibuprofen Rare Abdominal pain, flatulence, constipation.\u003c\/p\u003e\n\u003cp\u003eGastrointestinal disorders: Ibuprofen Very rare Peptic ulcer, perforation or gastrointestinal haemorrhage (with melena or haematemesis, gastritis, ulcerative stomatitis). Exacerbation of colitis and Crohn's disease (see section 4.4).\u003c\/p\u003e\n\u003cp\u003eGastrointestinal disorders: Ibuprofen Very rare Esophagitis, pancreatitis, intestinal diaphragm stenosis.\u003c\/p\u003e\n\u003cp\u003eGastrointestinal disorders: Pseudoephedrine hydrochloride Uncommon Dry mouth, thirst, nausea, vomiting.\u003c\/p\u003e\n\u003cp\u003eGastrointestinal disorders: Peudoephedrine hydrochloride Frequency not known Ischemic colitis.\u003c\/p\u003e\n\u003cp\u003eHepatobiliary disorders: Ibuprofen Very rare Liver dysfunction, liver damage, particularly in long-term therapy, liver failure, acute hepatitis.\u003c\/p\u003e\n\u003cp\u003eSkin and subcutaneous tissue disorders: Ibuprofen Rare Various skin rashes.\u003c\/p\u003e\n\u003cp\u003eSkin and subcutaneous tissue disorders: Ibuprofen Very rare Severe forms of skin reactions such as exfoliative dermatitis or bullous rash such as Stevens-Johnson syndrome, erythema multiforme and toxic epidermal necrolysis (Lyell's syndrome), alopecia, severe skin infections, soft tissue complications in a chickenpox infection.\u003c\/p\u003e\n\u003cp\u003eSkin and subcutaneous tissue disorders: Ibuprofen Not known Drug reaction with eosinophilia and systemic symptoms (DRESS syndrome).\u003c\/p\u003e\n\u003cp\u003eSkin and subcutaneous tissue disorders: Pseudoephedrine hydrochloride Rare Skin rash, urticaria, pruritus, erythema, hyperhidrosis.\u003c\/p\u003e\n\u003cp\u003eSkin and subcutaneous tissue disorders: Ibuprofen Not known Serious skin reactions, including acute generalized exanthematous pustulosis (PEAG).\u003c\/p\u003e\n\u003cp\u003eSkin and subcutaneous tissue disorders: Pseudoephedrine hydrochloride Not known Serious skin reactions, including acute generalized exanthematous pustulosis (PEAG).\u003c\/p\u003e\n\u003cp\u003eSkin and subcutaneous tissue disorders: Ibuprofen Not Known Photosensitivity Reaction\u003c\/p\u003e\n\u003cp\u003eRenal and urinary disorders: Ibuprofen Rare Damage to renal tissue (papillary necrosis) and high blood concentrations of uric acids.\u003c\/p\u003e\n\u003cp\u003eRenal and urinary disorders: Ibuprofen Very rare Increased serum creatinine, edema (particularly in patients with arterial hypertension or renal failure) edema, nephrotic syndrome, interstitial nephritis, acute renal failure.\u003c\/p\u003e\n\u003cp\u003eRenal and urinary disorders: Pseudoephedrine hydrochloride Frequency not known Urinary retention in men with prostatic hypertrophy.\u003c\/p\u003e\n\u003cp\u003e\u003cu\u003eReporting of suspected adverse reactions\u003c\/u\u003e Reporting suspected adverse reactions that occur after authorization of the medicine is important, as it allows continuous monitoring of the benefit\/risk balance of the medicine. Healthcare professionals are asked to report any suspected adverse reactions via the national reporting system https:\/\/www.aifa.gov.it\/content\/segnalazioni-reazioni-avverse.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eOVERDOSE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cu\u003eSymptoms\u003c\/u\u003e The most frequent manifestations of ibuprofen overdose are abdominal pain, nausea, vomiting, lethargy, thirst, muscle weakness, drowsiness, blurred vision and dizziness. Other side effects may occur, including headache, tinnitus, CNS depression, seizures, hypotension, bradycardia, tachycardia, supraventricular and ventricular arrhythmia, and atrial fibrillation. Coma, acute renal failure, hyperkalemia, apnea (especially in young children), respiratory depression and respiratory failure have been reported rarely. In asthmatics, worsening of asthma is possible. \u003cb\u003eIn cases of severe poisoning, metabolic acidosis may occur\u003c\/b\u003e. Signs and symptoms of pseudoephedrine overdose include irritability, insomnia, fever, sweating, anxiety, restlessness, tremors, seizures, palpitations (sinus arrhythmia), high blood pressure, dry mouth, and difficulty urinating. Hallucinations (more likely in children) have been reported. \u003cu\u003eTreatment\u003c\/u\u003e Treatment of overdose is supportive. Within 1 hour of ingesting a potentially toxic amount you may benefit from gastric lavage and activated charcoal and, if necessary, correction of serum electrolytes. Symptomatic and supportive treatment should be undertaken, particularly regarding the cardiovascular and respiratory systems. For example, severe hypertension may need to be treated with an alpha-blocker drug, while the use of a beta blocker may be necessary to control cardiac arrhythmias. Seizures can be controlled with intravenous diazepam, while for extreme excitability and hallucinations chlorpromazine can be used.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003ePREGNANCY AND BREASTFEEDING\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cu\u003ePregnancy\u003c\/u\u003e: \u003cb\u003eVicks Flu Action is contraindicated during pregnancy\u003c\/b\u003e (see paragraph 4.3). Inhibition of prostaglandin synthesis can negatively affect pregnancy and\/or embryonic\/fetal development. Data from epidemiological studies suggest an increased risk of spontaneous abortion, cardiac malformation and gastroschisis following the use of a prostaglandin synthesis inhibitor during the first months of pregnancy. The absolute risk of cardiovascular malformation increased from less than 1% to approximately 1.5%. The risk is thought to increase with the dose and duration of therapy. In animals it has been demonstrated that the administration of a prostaglandin synthesis inhibitor causes an increase in the rate of pre- and post-implantation spontaneous abortion and embryo-foetal lethality. Furthermore, increased incidences of various malformations, including cardiovascular ones, have been reported in animals to which an inhibitor of prostaglandin synthesis was administered during the organogenetic period. During the third trimester of pregnancy all prostaglandin synthesis inhibitors can expose the fetus to: - cardiopulmonary toxicity (with premature closure of the ductus arteriosus and pulmonary hypertension); - renal dysfunction, which may progress to renal failure with oligohydramnios; They can expose mother and newborn, at the end of pregnancy, to: - possible prolongation of bleeding time, an anti-aggregating effect which can occur even at very low doses; - inhibition of uterine contractions resulting in delay or prolongation of labor. There is the possibility of an association between the appearance of fetal anomalies and the intake of pseudoephedrine during the first trimester of pregnancy. \u003cu\u003eBreastfeeding\u003c\/u\u003e \u003cb\u003eVicks Flu Action is contraindicated during breastfeeding\u003c\/b\u003e (see paragraph 4.3). Ibuprofen\/pseudoephedrine has been identified in breastfed newborns\/infants of treated patients. There is limited data on the effects of ibuprofen\/pseudoephedrine on infants\/children. \u003cu\u003eFertility\u003c\/u\u003e The effects of this drug on fertility have not been studied. The use of ibuprofen may impair fertility and is not recommended in women who are trying to conceive. Women with difficulty conceiving or undergoing fertility tests should consider discontinuing ibuprofen. There are no adequate reproductive toxicology studies on pseudoephedrine.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEFFECTS ON DRIVING ABILITY\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eVicks Flu Action has no known effects on the ability to drive or use machinery. However, given that dizziness or hallucinations may occur due to the presence of pseudoephedrine, this possibility must be taken into account if you intend to drive a vehicle or use machinery.\u003c\/p\u003e","brand":"Procter \u0026 Gamble","offers":[{"title":"Default Title","offer_id":51730213994823,"sku":"042499032","price":9.2,"currency_code":"EUR","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0564\/4989\/2467\/files\/procter-gamble-srl-vicks-flu-action-200-30-mg-12-compresse-rivestite-farmacia-dottor-tili-1213791348.jpg?v=1767156347"},{"product_id":"vicks-medinait-0-5-0-25-20-mg-ml-180-ml-sciroppo","title":"Vicks Medinait 0.5 + 0.25 + 20 mg\/ml 180 ml syrup","description":"\u003cp\u003e\u003cstrong\u003eINDICATIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eTreatment of cold and flu symptoms.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eACTIVE INGREDIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e100 ml of syrup contains: \u003cb\u003e \u003cu\u003eActive ingredients\u003c\/u\u003e \u003c\/b\u003e Dextromethorphan hydrobromide 0.05 g; Doxylamine succinate 0.025 g; Paracetamol 2 g. Excipients with known effects: sucrose, sodium, sodium benzoate, propylene glycol. For the full list of excipients, see section 6.1\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEXCIPIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003ePropylene glycol, sodium citrate, citric acid monohydrate, potassium sorbate, sodium benzoate, macrogol, sucrose, glycerol, anethole, quinoline yellow (E 104), brilliant blue FCF (E 133) and purified water.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONTRAINDICATIONS AND SIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e- Hypersensitivity to the active substances or to any of the excipients listed in paragraph 6.1. - Children and adolescents under 12 years of age. - Asthma, diabetes, glaucoma, prostatic hypertrophy, stenosis of the gastrointestinal and urogenital system, epilepsy, severe liver disease or severe renal impairment. - Glucose-6-phosphate dehydrogenase deficiency and hemolytic anemia (due to the paracetamol content). - History of gastrointestinal haemorrhage or perforation due to previous treatment with medicinal products with anti-inflammatory, anti-pyretic and pain-relieving activity or history of recurrent peptic haemorrhage\/ulcer (two or more distinct episodes of demonstrated ulceration or bleeding). - Severe heart failure. Do not administer at the same time as or in the two weeks following therapy with MAO inhibitor antidepressant drugs.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDOSAGE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003ci\u003e \u003cu\u003eDosage\u003c\/u\u003e \u003c\/i\u003e \u003cu\u003eAdults and adolescents over 12 years:\u003c\/u\u003e The recommended dose is 30 ml once a day. 30 ml contains 0.015 g of dextromethorphan hydrobromide, 0.0075 g of doxylamine succinate and 0.6 g of paracetamol. Do not exceed the recommended doses. \u003ci\u003eDuration of treatment\u003c\/i\u003e After 3 days of continuous use, in the absence of appreciable results, re-evaluate the clinical picture. \u003ci\u003eMethod of administration\u003c\/i\u003e Vicks MediNait should be taken before bedtime for a night's rest and on a full stomach. Use the measuring cup included in the package.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONSERVATION\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eKeep the bottle in the outer carton in order to protect the medicine from light. Any variation in the color of the syrup does not alter the quality of the product.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eWARNINGS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eSide effects can be minimized with the shortest possible treatment duration needed to control symptoms. Elderly people have a greater susceptibility to the onset of side effects. A chronic or persistent cough due to smoking, emphysema, asthma requires clinical evaluation. In case of irritating cough with significant mucus production, Vicks MediNait must be used with particular caution and after a careful risk-benefit assessment. High or prolonged doses of paracetamol, present in the product, can cause high-risk liver disease and even serious alterations to the kidney and blood. Paracetamol should be used with caution in subjects with renal or hepatic insufficiency, including those with non-cirrhotic alcoholic liver disease. The damage from overdose is greater in subjects suffering from alcoholic liver disease. Vicks MediNait must not be used with other products containing paracetamol or medicines with anti-inflammatory, anti-pyretic and pain-relieving properties. In the rare cases of allergic reactions, administration should be suspended and suitable treatment instituted. The use of antihistamines with ototoxic antibiotics can mask the first signs of ototoxicity, which can be perceived late, when the damage is irreversible. Vicks MediNait should be used with caution in patients with cardiovascular disease, hypertension and hyperthyroidism. Patients with uncontrolled hypertension, congestive heart failure, established ischemic heart disease, peripheral arterial disease and\/or cerebrovascular disease should only be treated with Vicks MediNait after careful consideration given the risk of fluid retention and edema. Alcohol intake during treatment should be avoided. \u003ci\u003eRisks arising from the concomitant use of sedative medicines such as benzodiazepines or related medicines\u003c\/i\u003e Concomitant use of Vicks MediNait and sedative medicines such as benzodiazepines, or related drugs, may cause sedation, respiratory depression, coma and death. Because of these risks, concomitant prescribing of sedative medicinal products should be limited to patients for whom alternative treatments are not possible. If the decision is made to prescribe Vicks MediNait together with sedative medicines, the duration of treatment should be as short as possible. Patients should be followed closely for signs and symptoms of respiratory depression and sedation. In this regard, it is strongly recommended to inform patients and anyone caring for them (where applicable) so that they are aware of these symptoms (see section 4.5). Dextromethorphan can be habit-forming. Following prolonged use, patients may develop tolerance to the medicine, as well as mental and physical dependence. Patients with a tendency towards abuse or dependence should take Vicks MediNait for short periods and be carefully monitored. Cases of abuse and dependence on dextromethorphan have been reported. Caution is particularly recommended for adolescents and young adults, as well as in patients with a history of drug or psychoactive substance abuse. Serotonin syndrome Serotonergic effects, including the development of life-threatening serotonin syndrome, have been reported for dextromethorphan with concomitant administration of serotonergic agents, such as selective serotonin reuptake inhibitors (SSRIs), drugs that alter serotonin metabolism (including monoamine oxidase inhibitors [MAOIs]), and CYP2D6 inhibitors. Serotonin syndrome may include mental status changes, autonomic instability, neuromuscular abnormalities, and\/or gastrointestinal symptoms. If serotonin syndrome is suspected, treatment with Vicks Medinait should be discontinued. The concomitant use of medicinal products with anti-inflammatory, anti-pyretic and pain-relieving activity, including selective COX-2 inhibitors, should be avoided. Dextromethorphan is metabolised by hepatic cytochrome P450 2D6 (see section 5.2). The activity of this enzyme is genetically determined. Approximately 10% of the population slowly metabolizes CYP2D6. Exaggerated and\/or prolonged effects of dextromethorphan may occur in poor metabolizers and patients with concomitant use of CYP2D6 inhibitors. Caution is required in patients who are poor metabolisers of CYP2D6 or who use CYP2D6 inhibitors (see section 4.5). \u003cu\u003eElderly:\u003c\/u\u003e Elderly people have an increased frequency of adverse reactions to medicinal products with anti-inflammatory, anti-pyretic and pain-relieving activity, especially gastrointestinal bleeding and perforation, which can be fatal. \u003cu\u003eGastrointestinal bleeding, ulceration and perforation:\u003c\/u\u003e During treatment with all anti-inflammatory, anti-pyretic and pain-relieving medicinal products, gastrointestinal haemorrhage, ulceration and perforation, which may be fatal, have been reported at any time, with or without warning symptoms or previous history of serious gastrointestinal events. In patients with a history of ulcer, especially if complicated by haemorrhage or perforation (see section 4.3), the risk of gastrointestinal haemorrhage, ulceration or perforation is higher with increased doses of medicinal products with anti-inflammatory, anti-pyretic and pain-relieving activity. These patients should start treatment with the lowest available dose. The concomitant use of protective agents (misoprostol or proton pump inhibitors) should be considered for these patients and also for patients taking low doses of acetylsalicylic acid or other drugs that may increase the risk of gastrointestinal events (see below and section 4.5). Patients with a history of gastrointestinal toxicity, particularly the elderly, should report any gastrointestinal symptoms (especially gastrointestinal haemorrhage) even at the start of treatment. Caution should be exercised in patients taking concomitant medications that may increase the risk of ulceration or haemorrhage, such as oral corticosteroids, anticoagulants such as warfarin, selective serotonin reuptake inhibitors or antiplatelet agents such as acetylsalicylic acid (see section 4.5). When gastrointestinal bleeding or ulceration occurs in patients taking Vicks MediNait, treatment should be discontinued. Medicines with anti-inflammatory, anti-pyretic and pain-relieving activity should be administered with caution in patients with a history of gastrointestinal disease (ulcerative colitis, Crohn's disease) as these conditions may be exacerbated (see section 4.8). Serious skin reactions, some of them fatal, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis, have been reported very rarely in association with the use of medicinal products with anti-inflammatory, anti-pyretic and pain-relieving activity (see section 4.8). At the beginning of treatment patients appear to be at higher risk. Vicks MediNait should be discontinued at the first appearance of skin rash, mucosal lesions or any other sign of hypersensitivity. Invite the patient to contact the doctor before combining any other drug. Caution is advised if acetaminophen is administered concurrently with flucloxacillin due to the 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., chronic alcoholism), as well as in those using maximum daily doses of acetaminophen. Close monitoring, including measurement of urinary 5-oxoproline, is recommended. \u003cu\u003eImportant information about some excipients \u003c\/u\u003e Vicks MediNait contains 8.25 g of \u003cb\u003esucrose\u003c\/b\u003e per dose (equal to 30 ml). To be taken into consideration in people suffering from diabetes mellitus. Patients suffering from rare hereditary problems of fructose intolerance, glucose-galactose malabsorption, or sucrase isomaltase insufficiency should not take this medicine. This medicine contains approximately 75 mg of \u003cb\u003esodium\u003c\/b\u003e per dose (equal to 30 ml) equivalent to approximately 3.8% of the maximum daily intake recommended by the WHO which corresponds to 2 g of sodium for an adult. Vicks MediNait contains 30 mg of \u003cb\u003esodium benzoate\u003c\/b\u003e per dose (equal to 30 ml). This medicine contains 3 g of \u003cb\u003epropylene glycol\u003c\/b\u003e per dose (equal to 30 ml). Clinical monitoring is required for patients with hepatic or renal insufficiency due to various adverse events attributed to propylene glycol such as renal dysfunction (acute tubular necrosis), acute kidney injury, and hepatic dysfunction. Although propylene glycol has not shown toxic effects on reproduction and development in animals or humans, it can reach the fetus and has been found in breast milk. As a consequence, the administration of propylene glycol to pregnant or breastfeeding patients should be considered on a case-by-case basis. Interference with serological tests The administration of paracetamol can interfere with the determination of uric acid (using the phosphotungstic acid method) and blood sugar (using the glucose-oxidase-peroxidase method).\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eINTERACTIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eConcomitant administration with MAO inhibitor drugs is contraindicated (see section 4.3). Use with extreme caution and under strict control during chronic treatment with drugs that can cause the induction of hepatic monooxygenases or in case of exposure to substances that can have this effect (for example, rifampicin, cimetidine, antiepileptics such as glutethimide, phenobarbital, carbamazepine and alcohol) due to an increased risk of hepatotoxicity from paracetamol. The rate of absorption of paracetamol may be increased by metoclopramide or domperidone and the absorption may be reduced by cholestyramine. The anticoagulant effect of warfarin and other coumarin drugs can be strengthened by prolonged and regular use of paracetamol, increasing the risk of bleeding. Liver enzyme inducers (e.g. alcohol and antiepileptics) may increase the hepatotoxicity of paracetamol, particularly after an overdose. \u003ci\u003eCYP2D6 inhibitors\u003c\/i\u003e There is a possibility of interaction between dextromethorphan and medicinal products that inhibit the CYP2D6 isoenzyme such as SSRIs (e.g., fluoxetine, paroxetine). Dextromethorphan is metabolised by CYP2D6 and has extensive first pass metabolism. Concomitant use of strong inhibitors of the CYP2D6 enzyme can increase dextromethorphan concentrations in the body to levels many times higher than the normal value. This increases the patient's risk for toxic effects of dextromethorphan (agitation, confusion, tremor, insomnia, diarrhea, and respiratory depression) and for the development of serotonin syndrome. Potent inhibitors of CYP2D6 are fluoxetine, paroxetine, quinidine and terbinafine. During concomitant use with quinidine, plasma concentrations of dextromethorphan are increased up to 20-fold, resulting in increased adverse effects on the central nervous system of the agent. Amiodarone, flecainide and propafenone, sertraline, bupropion, methadone, cinacalcet, haloperidol, perphenazine and thioridazine also have similar effects on the metabolism of dextromethorphan. If concomitant use of CYP2D6 inhibitors and dextromethorphan is necessary, the patient should be monitored and the dose of dextromethorphan may need to be reduced. \u003ci\u003eDiuretics, ACE inhibitors and Angiotensin II antagonists:\u003c\/i\u003e Medicines with anti-inflammatory, anti-pyretic and pain-relieving activity can reduce the effect of diuretics and other antihypertensive drugs. In subjects with compromised renal function (for example dehydrated or elderly patients) co-administration with an ACE inhibitor or an angiotensin II antagonist may lead to a further deterioration of renal function. Hydration before initiating concomitant therapy and close monitoring of renal function after initiation of treatment are recommended. \u003ci\u003eCorticosteroids:\u003c\/i\u003e co-administration may increase the risk of gastrointestinal ulceration or haemorrhage (see section 4.4). \u003ci\u003eAnticoagulants:\u003c\/i\u003e Medicines with anti-inflammatory, anti-pyretic and pain-relieving activity may increase the effects of anticoagulants, such as warfarin (see section 4.4). \u003ci\u003eAntiplatelet agents and selective serotonin reuptake inhibitors (SSRIs):\u003c\/i\u003e co-administration may lead to an increased risk of gastrointestinal bleeding (see section 4.4). \u003ci\u003eMedicines with sedative action such as benzodiazepines or related medicines\u003c\/i\u003e The concomitant use of opioids and sedative medicines such as benzodiazepines, or related medicines, increases the risk of sedation, respiratory depression, coma and death due to additive CNS depressant effect. The dose and duration of concomitant use should be limited (see section 4.4). Caution should be exercised when paracetamol is used concomitantly with flucloxacillin as concomitant use has been associated with high anion gap metabolic acidosis, especially in patients with risk factors (see section 4.4).\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eSIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eUndesirable effects are classified according to their frequency and listed in order of decreasing severity. The frequency of adverse reactions is defined using the following convention: Very common (≥1\/10); common (≥1\/100 to \u003c1\/10); uncommon (≥1\/1,000 to \u003c1\/100); rare (≥1\/10,000 to \u003c1\/1,000); very rare (\u003c1\/10,000), not known (frequency cannot be estimated from the available data).\u003c\/p\u003e\n\u003cp\u003eBlood and lymphatic system disorders - Frequency: Very rare. Side effects: thrombocytopenia, leukopenia, agranulocytosis, hemolytic anemia, neutropenia, pancytopenia, epistaxis, increased propensity for wound bleeding.\u003c\/p\u003e\n\u003cp\u003eImmune system disorders - Frequency: Rare. Side effects: hypersensitivity, anaphylactic shock, anaphylaxis, angioedema, laryngeal edema, bronchospasm.\u003c\/p\u003e\n\u003cp\u003eNervous system disorders - Frequency: Common. Side effects: drowsiness, headache, blurred vision, psychomotor impairment.\u003c\/p\u003e\n\u003cp\u003eNervous system disorders - Frequency: Rare. Side effects: dizziness, insomnia.\u003c\/p\u003e\n\u003cp\u003eNervous system disorders - Frequency: Not known. Side effects: psychomotor hyperactivity*.\u003c\/p\u003e\n\u003cp\u003eGastrointestinal disorders - Frequency: Common. Side effects: dry mouth, constipation, gastric reflux.\u003c\/p\u003e\n\u003cp\u003eGastrointestinal disorders - Frequency: Rare. Side effects: nausea, vomiting, abdominal pain, diarrhea.\u003c\/p\u003e\n\u003cp\u003eGastrointestinal disorders - Frequency: Not known. Side effects: exacerbation of colitis and Crohn's disease (see section 4.4), peptic ulcer, gastrointestinal perforation or haemorrhage** (see section 4.4), gastritis, melena, haematemesis, ulcerative stomatitis, flatulence, dyspesia.\u003c\/p\u003e\n\u003cp\u003eHepatobiliary disorders - Frequency: Not known. Side effects: hepatitis, increased aminotransferases, jaundice, hepatic necrosis.\u003c\/p\u003e\n\u003cp\u003eSkin and subcutaneous tissue disorders - Frequency: Rare. Side effects: skin rashes, urticaria, erythema, pruritus, fixed drug eruption.\u003c\/p\u003e\n\u003cp\u003eSkin and subcutaneous tissue disorders - Frequency: Very Rare. Side effects: erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis.\u003c\/p\u003e\n\u003cp\u003eRenal and urinary disorders - Frequency: Not known. Side effects: acute renal failure, interstitial nephritis, hematuria, anuria, urinary retention, dysuria.\u003c\/p\u003e\n\u003cp\u003e*Paradoxical stimulation of the central nervous system, especially in children **sometimes fatal, especially in elderly patients \u003cu\u003eClass side effects: \u003c\/u\u003e \u003ci\u003eAntihistamines\u003c\/i\u003e Asthenia, photosensitivity, convulsions (at high doses), breathing difficulties due to increased bronchial secretions, and, especially in the elderly, hypotension and rhythm disturbances (extrasystoles and tachycardia). \u003ci\u003eMedicines with anti-inflammatory, anti-pyretic and pain-relieving activity\u003c\/i\u003e Edema, hypertension and heart failure. \u003cu\u003eReporting of suspected adverse reactions\u003c\/u\u003e Reporting suspected adverse reactions that occur after authorization of the medicine is important, as it allows continuous monitoring of the benefit\/risk balance of the medicine. Healthcare professionals are asked to report any suspected adverse reaction via the national reporting system reported on the site https:\/\/www.aifa.gov.it\/content\/segnalazioni-reazioni-avverse.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eOVERDOSE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eIn case of overdose, paracetamol can cause hepatic cytolysis, which can evolve towards massive and irreversible necrosis. \u003cu\u003eSymptoms and signs\u003c\/u\u003e \u003ci\u003eParacetamol:\u003c\/i\u003e Symptoms of paracetamol overdose in the first 24 hours are paleness, nausea, vomiting, anorexia and abdominal pain. Liver damage may occur 12 to 48 hours after ingestion. Abnormalities in glucose metabolism and metabolic acidosis may occur. In cases of severe poisoning, liver failure can progress to encephalopathy, coma and death. Acute renal failure with acute tubular necrosis can develop even in the absence of severe liver damage. Cardiac arrhythmias have been reported. Other symptoms may include CNS depression, cardiovascular effects, and kidney damage. \u003ci\u003eDextromethorphan or Doxylamine:\u003c\/i\u003e Symptoms such as excitation, mental confusion, convulsions and respiratory depression may occur following an overdose with doxylamine. Dextromethorphan overdose may be associated with nausea, vomiting, dystonia, agitation, confusion, drowsiness, stupor, nystagmus, cardiotoxicity (tachycardia, abnormal ECG including QTc interval prolongation), ataxia, toxic psychosis with visual hallucinations, hyperexcitability. In case of massive overdose, the following symptoms may be observed: coma, respiratory depression, convulsions. \u003cu\u003eManagement: \u003c\/u\u003e Immediate treatment is essential for the management of acetaminophen overdose. Despite the lack of significant early symptoms, patients should urgently go to hospital for immediate medical attention and any patient who has ingested approximately 7.5 g or more of paracetamol in the previous 4 hours should undergo gastric lavage. The administration of oral methionine or intravenous N-acetylcysteine ​​may be necessary, which may have a beneficial effect for up to at least 48 hours after the overdose. General supportive measures must be available. Activated charcoal may be administered to asymptomatic patients who have ingested overdoses of dextromethorphan within the previous hour. For patients who have ingested dextromethorphan and are sedated or comatose, naloxone, in doses usual for the treatment of opioid overdose, may be considered. Benzodiazepines may be used for seizures and benzodiazepines and external cooling measures for serotonin syndrome hyperthermia.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003ePREGNANCY AND BREASTFEEDING\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eData on the safety of use of Vicks MediNait during pregnancy and during breastfeeding are limited. Vicks MediNait during pregnancy and breastfeeding is not recommended. The use of should be considered only if the expected benefit to the mother outweighs the risk to the fetus or child. \u003ci\u003ePregnancy\u003c\/i\u003e The numerous data relating to the use of paracetamol during pregnancy do not indicate either malformative or fetal\/neonatal toxicity. Epidemiological studies on neurodevelopment in children exposed to paracetamol in utero show inconclusive results. If clinically necessary, paracetamol can be used during pregnancy, however it should be used for as short a time as possible and as frequently as possible. Literature data do not show a proven increase in the frequency of malformations or other direct or indirect harmful effects on the fetus induced by dextromethorphan. Use during late pregnancy may expose the newborn to respiratory depression. Epidemiological studies do not indicate doxylamine-induced malformation toxicity. Given the anticholinergic and sedative activity of doxylamine, monitoring of the newborn is strongly recommended in case of use of Vicks MediNait close to birth. \u003ci\u003eBreastfeeding \u003c\/i\u003e Although it is excreted in breast milk, the use of paracetamol is compatible with breastfeeding. Dextromethorphan and doxylamine are not known to be excreted in breast milk.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEFFECTS ON DRIVING ABILITY\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eVicks MediNait may affect the ability to drive and use machines. The product may cause drowsiness (especially in conjunction with the intake of alcohol or other medicines that can reduce reaction times), this must be taken into account by those who may drive motor vehicles or carry out operations requiring an intact level of vigilance, who will have to abstain from such tasks after taking the product.\u003c\/p\u003e","brand":"Procter \u0026 Gamble","offers":[{"title":"Default Title","offer_id":51730214027591,"sku":"024449062","price":14.56,"currency_code":"EUR","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0564\/4989\/2467\/files\/procter-gamble-srl-vicks-medinait-0-5-0-25-20-mg-ml-180-ml-sciroppo-farmacia-dottor-tili-1213791347.jpg?v=1767156328"},{"product_id":"vicks-medinait-0-5-0-25-20-mg-ml-90-ml-sciroppo","title":"Vicks Medinait 0.5 + 0.25 + 20 mg\/ml 90 ml syrup","description":"\u003cp\u003e\u003cstrong\u003eINDICATIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eTreatment of cold and flu symptoms.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eACTIVE INGREDIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e100 ml of syrup contains: \u003cb\u003e \u003cu\u003eActive ingredients\u003c\/u\u003e \u003c\/b\u003e Dextromethorphan hydrobromide 0.05 g; Doxylamine succinate 0.025 g; Paracetamol 2 g. Excipients with known effects: sucrose, sodium, sodium benzoate, propylene glycol. For the full list of excipients, see section 6.1\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEXCIPIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003ePropylene glycol, sodium citrate, citric acid monohydrate, potassium sorbate, sodium benzoate, macrogol, sucrose, glycerol, anethole, quinoline yellow (E 104), brilliant blue FCF (E 133) and purified water.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONTRAINDICATIONS AND SIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e- Hypersensitivity to the active substances or to any of the excipients listed in paragraph 6.1. - Children and adolescents under 12 years of age. - Asthma, diabetes, glaucoma, prostatic hypertrophy, stenosis of the gastrointestinal and urogenital system, epilepsy, severe liver disease or severe renal impairment. - Glucose-6-phosphate dehydrogenase deficiency and hemolytic anemia (due to the paracetamol content). - History of gastrointestinal haemorrhage or perforation due to previous treatment with medicinal products with anti-inflammatory, anti-pyretic and pain-relieving activity or history of recurrent peptic haemorrhage\/ulcer (two or more distinct episodes of demonstrated ulceration or bleeding). - Severe heart failure. Do not administer at the same time as or in the two weeks following therapy with MAO inhibitor antidepressant drugs.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDOSAGE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003ci\u003e \u003cu\u003eDosage\u003c\/u\u003e \u003c\/i\u003e \u003cu\u003eAdults and adolescents over 12 years:\u003c\/u\u003e The recommended dose is 30 ml once a day. 30 ml contains 0.015 g of dextromethorphan hydrobromide, 0.0075 g of doxylamine succinate and 0.6 g of paracetamol. Do not exceed the recommended doses. \u003ci\u003eDuration of treatment\u003c\/i\u003e After 3 days of continuous use, in the absence of appreciable results, re-evaluate the clinical picture. \u003ci\u003eMethod of administration\u003c\/i\u003e Vicks MediNait should be taken before bedtime for a night's rest and on a full stomach. Use the measuring cup included in the package.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONSERVATION\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eKeep the bottle in the outer carton in order to protect the medicine from light. Any variation in the color of the syrup does not alter the quality of the product.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eWARNINGS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eSide effects can be minimized with the shortest possible treatment duration needed to control symptoms. Elderly people have a greater susceptibility to the onset of side effects. A chronic or persistent cough due to smoking, emphysema, asthma requires clinical evaluation. In case of irritating cough with significant mucus production, Vicks MediNait must be used with particular caution and after a careful risk-benefit assessment. High or prolonged doses of paracetamol, present in the product, can cause high-risk liver disease and even serious alterations to the kidney and blood. Paracetamol should be used with caution in subjects with renal or hepatic insufficiency, including those with non-cirrhotic alcoholic liver disease. The damage from overdose is greater in subjects suffering from alcoholic liver disease. Vicks MediNait must not be used with other products containing paracetamol or medicines with anti-inflammatory, anti-pyretic and pain-relieving properties. In the rare cases of allergic reactions, administration should be suspended and suitable treatment instituted. The use of antihistamines with ototoxic antibiotics can mask the first signs of ototoxicity, which can be perceived late, when the damage is irreversible. Vicks MediNait should be used with caution in patients with cardiovascular disease, hypertension and hyperthyroidism. Patients with uncontrolled hypertension, congestive heart failure, established ischemic heart disease, peripheral arterial disease and\/or cerebrovascular disease should only be treated with Vicks MediNait after careful consideration given the risk of fluid retention and edema. Alcohol intake during treatment should be avoided. \u003ci\u003eRisks arising from the concomitant use of sedative medicines such as benzodiazepines or related medicines\u003c\/i\u003e Concomitant use of Vicks MediNait and sedative medicines such as benzodiazepines, or related drugs, may cause sedation, respiratory depression, coma and death. Because of these risks, concomitant prescribing of sedative medicinal products should be limited to patients for whom alternative treatments are not possible. If the decision is made to prescribe Vicks MediNait together with sedative medicines, the duration of treatment should be as short as possible. Patients should be followed closely for signs and symptoms of respiratory depression and sedation. In this regard, it is strongly recommended to inform patients and anyone caring for them (where applicable) so that they are aware of these symptoms (see section 4.5). Dextromethorphan can be habit-forming. Following prolonged use, patients may develop tolerance to the medicine, as well as mental and physical dependence. Patients with a tendency towards abuse or dependence should take Vicks MediNait for short periods and be carefully monitored. Cases of abuse and dependence on dextromethorphan have been reported. Caution is particularly recommended for adolescents and young adults, as well as in patients with a history of drug or psychoactive substance abuse. Serotonin syndrome Serotonergic effects, including the development of life-threatening serotonin syndrome, have been reported for dextromethorphan with concomitant administration of serotonergic agents, such as selective serotonin reuptake inhibitors (SSRIs), drugs that alter serotonin metabolism (including monoamine oxidase inhibitors [MAOIs]), and CYP2D6 inhibitors. Serotonin syndrome may include mental status changes, autonomic instability, neuromuscular abnormalities, and\/or gastrointestinal symptoms. If serotonin syndrome is suspected, treatment with Vicks Medinait should be discontinued. The concomitant use of medicinal products with anti-inflammatory, anti-pyretic and pain-relieving activity, including selective COX-2 inhibitors, should be avoided. Dextromethorphan is metabolised by hepatic cytochrome P450 2D6 (see section 5.2). The activity of this enzyme is genetically determined. Approximately 10% of the population slowly metabolizes CYP2D6. Exaggerated and\/or prolonged effects of dextromethorphan may occur in poor metabolizers and patients with concomitant use of CYP2D6 inhibitors. Caution is required in patients who are poor metabolisers of CYP2D6 or who use CYP2D6 inhibitors (see section 4.5). \u003cu\u003eElderly:\u003c\/u\u003e Elderly people have an increased frequency of adverse reactions to medicinal products with anti-inflammatory, anti-pyretic and pain-relieving activity, especially gastrointestinal bleeding and perforation, which can be fatal. \u003cu\u003eGastrointestinal bleeding, ulceration and perforation:\u003c\/u\u003e During treatment with all anti-inflammatory, anti-pyretic and pain-relieving medicinal products, gastrointestinal haemorrhage, ulceration and perforation, which may be fatal, have been reported at any time, with or without warning symptoms or previous history of serious gastrointestinal events. In patients with a history of ulcer, especially if complicated by haemorrhage or perforation (see section 4.3), the risk of gastrointestinal haemorrhage, ulceration or perforation is higher with increased doses of medicinal products with anti-inflammatory, anti-pyretic and pain-relieving activity. These patients should start treatment with the lowest available dose. The concomitant use of protective agents (misoprostol or proton pump inhibitors) should be considered for these patients and also for patients taking low doses of acetylsalicylic acid or other drugs that may increase the risk of gastrointestinal events (see below and section 4.5). Patients with a history of gastrointestinal toxicity, particularly the elderly, should report any gastrointestinal symptoms (especially gastrointestinal haemorrhage) even at the start of treatment. Caution should be exercised in patients taking concomitant medications that may increase the risk of ulceration or haemorrhage, such as oral corticosteroids, anticoagulants such as warfarin, selective serotonin reuptake inhibitors or antiplatelet agents such as acetylsalicylic acid (see section 4.5). When gastrointestinal bleeding or ulceration occurs in patients taking Vicks MediNait, treatment should be discontinued. Medicines with anti-inflammatory, anti-pyretic and pain-relieving activity should be administered with caution in patients with a history of gastrointestinal disease (ulcerative colitis, Crohn's disease) as these conditions may be exacerbated (see section 4.8). Serious skin reactions, some of them fatal, including exfoliative dermatitis, Stevens-Johnson syndrome and toxic epidermal necrolysis, have been reported very rarely in association with the use of medicinal products with anti-inflammatory, anti-pyretic and pain-relieving activity (see section 4.8). At the beginning of treatment patients appear to be at higher risk. Vicks MediNait should be discontinued at the first appearance of skin rash, mucosal lesions or any other sign of hypersensitivity. Invite the patient to contact the doctor before combining any other drug. Caution is advised if acetaminophen is administered concurrently with flucloxacillin due to the 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., chronic alcoholism), as well as in those using maximum daily doses of acetaminophen. Close monitoring, including measurement of urinary 5-oxoproline, is recommended. \u003cu\u003eImportant information about some excipients \u003c\/u\u003e Vicks MediNait contains 8.25 g of \u003cb\u003esucrose\u003c\/b\u003e per dose (equal to 30 ml). To be taken into consideration in people suffering from diabetes mellitus. Patients suffering from rare hereditary problems of fructose intolerance, glucose-galactose malabsorption, or sucrase isomaltase insufficiency should not take this medicine. This medicine contains approximately 75 mg of \u003cb\u003esodium\u003c\/b\u003e per dose (equal to 30 ml) equivalent to approximately 3.8% of the maximum daily intake recommended by the WHO which corresponds to 2 g of sodium for an adult. Vicks MediNait contains 30 mg of \u003cb\u003esodium benzoate\u003c\/b\u003e per dose (equal to 30 ml). This medicine contains 3 g of \u003cb\u003epropylene glycol\u003c\/b\u003e per dose (equal to 30 ml). Clinical monitoring is required for patients with hepatic or renal insufficiency due to various adverse events attributed to propylene glycol such as renal dysfunction (acute tubular necrosis), acute kidney injury, and hepatic dysfunction. Although propylene glycol has not shown toxic effects on reproduction and development in animals or humans, it can reach the fetus and has been found in breast milk. As a consequence, the administration of propylene glycol to pregnant or breastfeeding patients should be considered on a case-by-case basis. Interference with serological tests The administration of paracetamol can interfere with the determination of uric acid (using the phosphotungstic acid method) and blood sugar (using the glucose-oxidase-peroxidase method).\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eINTERACTIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eConcomitant administration with MAO inhibitor drugs is contraindicated (see section 4.3). Use with extreme caution and under strict control during chronic treatment with drugs that can cause the induction of hepatic monooxygenases or in case of exposure to substances that can have this effect (for example, rifampicin, cimetidine, antiepileptics such as glutethimide, phenobarbital, carbamazepine and alcohol) due to an increased risk of hepatotoxicity from paracetamol. The rate of absorption of paracetamol may be increased by metoclopramide or domperidone and the absorption may be reduced by cholestyramine. The anticoagulant effect of warfarin and other coumarin drugs can be strengthened by prolonged and regular use of paracetamol, increasing the risk of bleeding. Liver enzyme inducers (e.g. alcohol and antiepileptics) may increase the hepatotoxicity of paracetamol, particularly after an overdose. \u003ci\u003eCYP2D6 inhibitors\u003c\/i\u003e There is a possibility of interaction between dextromethorphan and medicinal products that inhibit the CYP2D6 isoenzyme such as SSRIs (e.g., fluoxetine, paroxetine). Dextromethorphan is metabolised by CYP2D6 and has extensive first pass metabolism. Concomitant use of strong inhibitors of the CYP2D6 enzyme can increase dextromethorphan concentrations in the body to levels many times higher than the normal value. This increases the patient's risk for toxic effects of dextromethorphan (agitation, confusion, tremor, insomnia, diarrhea, and respiratory depression) and for the development of serotonin syndrome. Potent inhibitors of CYP2D6 are fluoxetine, paroxetine, quinidine and terbinafine. During concomitant use with quinidine, plasma concentrations of dextromethorphan are increased up to 20-fold, resulting in increased adverse effects on the central nervous system of the agent. Amiodarone, flecainide and propafenone, sertraline, bupropion, methadone, cinacalcet, haloperidol, perphenazine and thioridazine also have similar effects on the metabolism of dextromethorphan. If concomitant use of CYP2D6 inhibitors and dextromethorphan is necessary, the patient should be monitored and the dose of dextromethorphan may need to be reduced. \u003ci\u003eDiuretics, ACE inhibitors and Angiotensin II antagonists:\u003c\/i\u003e Medicines with anti-inflammatory, anti-pyretic and pain-relieving activity can reduce the effect of diuretics and other antihypertensive drugs. In subjects with compromised renal function (for example dehydrated or elderly patients) co-administration with an ACE inhibitor or an angiotensin II antagonist may lead to a further deterioration of renal function. Hydration before initiating concomitant therapy and close monitoring of renal function after initiation of treatment are recommended. \u003ci\u003eCorticosteroids:\u003c\/i\u003e co-administration may increase the risk of gastrointestinal ulceration or haemorrhage (see section 4.4). \u003ci\u003eAnticoagulants:\u003c\/i\u003e Medicines with anti-inflammatory, anti-pyretic and pain-relieving activity may increase the effects of anticoagulants, such as warfarin (see section 4.4). \u003ci\u003eAntiplatelet agents and selective serotonin reuptake inhibitors (SSRIs):\u003c\/i\u003e co-administration may lead to an increased risk of gastrointestinal bleeding (see section 4.4). \u003ci\u003eMedicines with sedative action such as benzodiazepines or related medicines\u003c\/i\u003e The concomitant use of opioids and sedative medicines such as benzodiazepines, or related medicines, increases the risk of sedation, respiratory depression, coma and death due to additive CNS depressant effect. The dose and duration of concomitant use should be limited (see section 4.4). Caution should be exercised when paracetamol is used concomitantly with flucloxacillin as concomitant use has been associated with high anion gap metabolic acidosis, especially in patients with risk factors (see section 4.4).\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eSIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eUndesirable effects are classified according to their frequency and listed in order of decreasing severity. The frequency of adverse reactions is defined using the following convention: Very common (≥1\/10); common (≥1\/100 to \u003c1\/10); uncommon (≥1\/1,000 to \u003c1\/100); rare (≥1\/10,000 to \u003c1\/1,000); very rare (\u003c1\/10,000), not known (frequency cannot be estimated from the available data).\u003c\/p\u003e\n\u003cp\u003eBlood and lymphatic system disorders - Frequency: Very rare. Side effects: thrombocytopenia, leukopenia, agranulocytosis, hemolytic anemia, neutropenia, pancytopenia, epistaxis, increased propensity for wound bleeding.\u003c\/p\u003e\n\u003cp\u003eImmune system disorders - Frequency: Rare. Side effects: hypersensitivity, anaphylactic shock, anaphylaxis, angioedema, laryngeal edema, bronchospasm.\u003c\/p\u003e\n\u003cp\u003eNervous system disorders - Frequency: Common. Side effects: drowsiness, headache, blurred vision, psychomotor impairment.\u003c\/p\u003e\n\u003cp\u003eNervous system disorders - Frequency: Rare. Side effects: dizziness, insomnia.\u003c\/p\u003e\n\u003cp\u003eNervous system disorders - Frequency: Not known. Side effects: psychomotor hyperactivity*.\u003c\/p\u003e\n\u003cp\u003eGastrointestinal disorders - Frequency: Common. Side effects: dry mouth, constipation, gastric reflux.\u003c\/p\u003e\n\u003cp\u003eGastrointestinal disorders - Frequency: Rare. Side effects: nausea, vomiting, abdominal pain, diarrhea.\u003c\/p\u003e\n\u003cp\u003eGastrointestinal disorders - Frequency: Not known. Side effects: exacerbation of colitis and Crohn's disease (see section 4.4), peptic ulcer, gastrointestinal perforation or haemorrhage** (see section 4.4), gastritis, melena, haematemesis, ulcerative stomatitis, flatulence, dyspesia.\u003c\/p\u003e\n\u003cp\u003eHepatobiliary disorders - Frequency: Not known. Side effects: hepatitis, increased aminotransferases, jaundice, hepatic necrosis.\u003c\/p\u003e\n\u003cp\u003eSkin and subcutaneous tissue disorders - Frequency: Rare. Side effects: skin rashes, urticaria, erythema, pruritus, fixed drug eruption.\u003c\/p\u003e\n\u003cp\u003eSkin and subcutaneous tissue disorders - Frequency: Very Rare. Side effects: erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis.\u003c\/p\u003e\n\u003cp\u003eRenal and urinary disorders - Frequency: Not known. Side effects: acute renal failure, interstitial nephritis, hematuria, anuria, urinary retention, dysuria.\u003c\/p\u003e\n\u003cp\u003e*Paradoxical stimulation of the central nervous system, especially in children **sometimes fatal, especially in elderly patients \u003cu\u003eClass side effects: \u003c\/u\u003e \u003ci\u003eAntihistamines\u003c\/i\u003e Asthenia, photosensitivity, convulsions (at high doses), breathing difficulties due to increased bronchial secretions, and, especially in the elderly, hypotension and rhythm disturbances (extrasystoles and tachycardia). \u003ci\u003eMedicines with anti-inflammatory, anti-pyretic and pain-relieving activity\u003c\/i\u003e Edema, hypertension and heart failure. \u003cu\u003eReporting of suspected adverse reactions\u003c\/u\u003e Reporting suspected adverse reactions that occur after authorization of the medicine is important, as it allows continuous monitoring of the benefit\/risk balance of the medicine. Healthcare professionals are asked to report any suspected adverse reaction via the national reporting system reported on the site https:\/\/www.aifa.gov.it\/content\/segnalazioni-reazioni-avverse.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eOVERDOSE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eIn case of overdose, paracetamol can cause hepatic cytolysis, which can evolve towards massive and irreversible necrosis. \u003cu\u003eSymptoms and signs\u003c\/u\u003e \u003ci\u003eParacetamol:\u003c\/i\u003e Symptoms of paracetamol overdose in the first 24 hours are paleness, nausea, vomiting, anorexia and abdominal pain. Liver damage may occur 12 to 48 hours after ingestion. Abnormalities in glucose metabolism and metabolic acidosis may occur. In cases of severe poisoning, liver failure can progress to encephalopathy, coma and death. Acute renal failure with acute tubular necrosis can develop even in the absence of severe liver damage. Cardiac arrhythmias have been reported. Other symptoms may include CNS depression, cardiovascular effects, and kidney damage. \u003ci\u003eDextromethorphan or Doxylamine:\u003c\/i\u003e Symptoms such as excitation, mental confusion, convulsions and respiratory depression may occur following an overdose with doxylamine. Dextromethorphan overdose may be associated with nausea, vomiting, dystonia, agitation, confusion, drowsiness, stupor, nystagmus, cardiotoxicity (tachycardia, abnormal ECG including QTc interval prolongation), ataxia, toxic psychosis with visual hallucinations, hyperexcitability. In case of massive overdose, the following symptoms may be observed: coma, respiratory depression, convulsions. \u003cu\u003eManagement: \u003c\/u\u003e Immediate treatment is essential for the management of acetaminophen overdose. Despite the lack of significant early symptoms, patients should urgently go to hospital for immediate medical attention and any patient who has ingested approximately 7.5 g or more of paracetamol in the previous 4 hours should undergo gastric lavage. The administration of oral methionine or intravenous N-acetylcysteine ​​may be necessary, which may have a beneficial effect for up to at least 48 hours after the overdose. General supportive measures must be available. Activated charcoal may be administered to asymptomatic patients who have ingested overdoses of dextromethorphan within the previous hour. For patients who have ingested dextromethorphan and are sedated or comatose, naloxone, in doses usual for the treatment of opioid overdose, may be considered. Benzodiazepines may be used for seizures and benzodiazepines and external cooling measures for serotonin syndrome hyperthermia.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003ePREGNANCY AND BREASTFEEDING\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eData on the safety of use of Vicks MediNait during pregnancy and during breastfeeding are limited. Vicks MediNait during pregnancy and breastfeeding is not recommended. The use of should be considered only if the expected benefit to the mother outweighs the risk to the fetus or child. \u003ci\u003ePregnancy\u003c\/i\u003e The numerous data relating to the use of paracetamol during pregnancy do not indicate either malformative or fetal\/neonatal toxicity. Epidemiological studies on neurodevelopment in children exposed to paracetamol in utero show inconclusive results. If clinically necessary, paracetamol can be used during pregnancy, however it should be used for as short a time as possible and as frequently as possible. Literature data do not show a proven increase in the frequency of malformations or other direct or indirect harmful effects on the fetus induced by dextromethorphan. Use during late pregnancy may expose the newborn to respiratory depression. Epidemiological studies do not indicate doxylamine-induced malformation toxicity. Given the anticholinergic and sedative activity of doxylamine, monitoring of the newborn is strongly recommended in case of use of Vicks MediNait close to birth. \u003ci\u003eBreastfeeding \u003c\/i\u003e Although it is excreted in breast milk, the use of paracetamol is compatible with breastfeeding. Dextromethorphan and doxylamine are not known to be excreted in breast milk.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEFFECTS ON DRIVING ABILITY\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eVicks MediNait may affect the ability to drive and use machines. The product may cause drowsiness (especially in conjunction with the intake of alcohol or other medicines that can reduce reaction times), this must be taken into account by those who may drive motor vehicles or carry out operations requiring an intact level of vigilance, who will have to abstain from such tasks after taking the product.\u003c\/p\u003e","brand":"Procter \u0026 Gamble","offers":[{"title":"Default Title","offer_id":51730214060359,"sku":"024449050","price":9.02,"currency_code":"EUR","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0564\/4989\/2467\/files\/procter-gamble-srl-vicks-medinait-0-5-0-25-20-mg-ml-90-ml-sciroppo-farmacia-dottor-tili-1213791346.jpg?v=1767156310"},{"product_id":"vicks-tosse-sedativo-1-33-mg-ml-180-ml-sciroppo","title":"Vicks Cough Sedative 1.33 mg\/ml 180 ml syrup","description":"\u003cp\u003e\u003cstrong\u003eINDICATIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eCough suppressant.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eACTIVE INGREDIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cu\u003e100 ml of syrup contain\u003c\/u\u003e: \u003ci\u003eActive ingredient\u003c\/i\u003e: dextromethorphan hydrobromide 0.133% w\/V (0.133 g). Excipients with known effects: • Sucrose: 5.55g\/15 ml • Sodium: 28.2 mg\/15 ml • Ethanol 96%: 0.592g\/15 ml • Invert sugar (honey): 0.570 g\/15 ml • Propylene glycol: 0.850 g\/15 ml • Sodium Benzoate 15 mg\/15 ml • Phenylalanine (honey) For the full list of excipients, see section 6.1.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEXCIPIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eSucrose; sodium saccharin; propylene glycol; 96 percent ethanol; carmellose sodium; sodium citrate; anhydrous citric acid; honey flavoring (containing honey); verbena aroma; sodium benzoate; polyethylene oxide; mentoxypropanediol; polyoxystearate 40; purified water.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONTRAINDICATIONS AND SIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eHypersensitivity to the active substance, to structurally similar compounds, or to any of the excipients listed in paragraph 6.1. Do not use simultaneously and in the two weeks following therapy with MAO inhibitor antidepressant drugs (see section 4.5). Bronchial asthma, COPD (chronic obstructive pulmonary disease), pneumonia, breathing difficulties, respiratory depression, cardiovascular diseases, hypertension, hyperthyroidism, diabetes, glaucoma, prostatic hypertrophy, stenosis of the gastrointestinal and urogenital system, epilepsy, serious liver diseases. Do not administer to children under 12 years of age. Pregnancy, particularly in the first trimester, breastfeeding (see section 4.6).\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDOSAGE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eAdults and adolescents over 12 years: 15 ml (equivalent to 3 teaspoons). These doses can be repeated every 6 hours, up to 4 times a day. Do not exceed the recommended doses. Children up to 12 years: Dextromethorphan should not be used.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONSERVATION\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eStore at a temperature not exceeding 25°C.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eWARNINGS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eTreatment with dextromethorphan should not be continued beyond 5-7 days. If there is no therapeutic response within a few days, the doctor must reevaluate the situation. Dextromethorphan can be habit-forming. Following prolonged use, patients may develop tolerance to the medicinal product, as well as mental and physical dependence (see section 4.8). Cases of abuse and dependence on dextromethorphan have been reported. Caution is particularly recommended for adolescents and young adults, as well as with patients with a history of drug or psychoactive substance abuse. \u003ci\u003eRisks deriving from the concomitant use of sedative medicines such as benzodiazepines or related drugs\u003c\/i\u003e Concomitant use of Vicks Cough Sedative and sedative medicines such as benzodiazepines, or related drugs, may cause sedation, respiratory depression, coma and death. Because of these risks, concomitant prescribing with sedative medicinal products should be reserved for patients for whom alternative treatment options are not available. If Vicks Cough is prescribed concomitantly with sedative medicinal products, the lowest effective dose should be used and the duration of treatment should be as short as possible. Patients should be carefully monitored for signs and symptoms of respiratory depression and sedation. In this regard, it is strongly recommended to inform patients and anyone caring for them to make them aware of these symptoms (see section 4.5). Dextromethorphan is metabolised by hepatic cytochrome P450 2D6. The activity of this enzyme is genetically determined. Approximately 10% of the population slowly metabolizes CYP2D6. Exaggerated and\/or prolonged effects of dextromethorphan may occur in poor metabolizers and patients with concomitant use of CYP2D6 inhibitors. Caution is therefore necessary in patients who are poor metabolisers of CYP2D6 or who use CYP2D6 inhibitors (see also section 4.5). \u003cb\u003e \u003cu\u003eSerotonin syndrome\u003c\/u\u003e \u003c\/b\u003e Serotonergic effects, including the development of life-threatening serotonin syndrome, have been reported for dextromethorphan with concomitant administration of serotonergic agents, such as selective serotonin reuptake inhibitors (SSRIs), drugs that alter serotonin metabolism (including monoamine oxidase inhibitors [MAOIs]), and CYP2D6 inhibitors. Serotonin syndrome may include mental status changes, autonomic instability, neuromuscular abnormalities, and\/or gastrointestinal symptoms. If serotonin syndrome is suspected, treatment with Vicks Cough Sedative should be discontinued. A chronic cough can be an early symptom of asthma and therefore dextromethorphan is not indicated for the suppression of chronic or persistent cough (e.g. due to smoking, emphysema, asthma, etc.). Dextromethorphan must be administered with particular caution and only on medical advice if the cough is accompanied by other symptoms such as: fever, rash, headache, nausea and vomiting. In case of irritating cough with significant mucus production, treatment with dextromethorphan should be administered with particular caution and only on medical advice after a careful risk-benefit assessment. Administer with caution in subjects with impaired hepatic or renal function, especially in patients with severe impairment. Information on excipients with known effect: - \u003cb\u003eSucrose and invert sugar (honey):\u003c\/b\u003e Patients suffering from rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency should not take this medicine. This medicine contains approximately 5.55 g of sucrose (sugar) and 0.570 g of invert sugar (honey) per 15 ml dose of syrup (equal to 3 teaspoons). To be taken into consideration in people suffering from diabetes mellitus or who are following low-calorie diets. - \u003cb\u003eethanol (alcohol)\u003c\/b\u003e: This medicine contains 5 vol% ethanol (alcohol), e.g. up to approximately 592 mg per dose of 15 ml of syrup (equal to 3 teaspoons), equivalent to less than 15 ml of beer, 6 ml of wine per dose of 15 ml of syrup. It can be harmful to alcoholics. To be taken into consideration in pregnant or breastfeeding women, children and high-risk groups such as people with liver disease or epilepsy. - \u003cb\u003esodium\u003c\/b\u003e: this medicine contains 28.2 mg of sodium per 15 ml of syrup (equal to 3 teaspoons of coffee), equivalent to 1.40% of the maximum daily intake recommended by the WHO, which corresponds to 2 g of sodium for an adult. - \u003cb\u003epropylene glycol:\u003c\/b\u003e This medicine contains 850.50 mg of propylene glycol per 15 ml of syrup (equal to 3 teaspoons). Although propylene glycol has not shown toxic effects on reproduction and development in animals or humans, it can reach the fetus and has been found in breast milk. As a consequence, the administration of propylene glycol to pregnant or breastfeeding patients should be considered on a case-by-case basis. Additionally, clinical monitoring is required for patients with hepatic or renal insufficiency due to various adverse events attributed to propylene glycol such as renal dysfunction (acute tubular necrosis), acute kidney injury, and hepatic dysfunction. - \u003cb\u003esodium benzoate:\u003c\/b\u003e This medicine contains 15 mg of sodium benzoate per 15 ml dose of syrup (equal to 3 teaspoons). - Honey is a source of phenylalanine. It can be harmful to those suffering from Phenylketonuria. It is inadvisable to consume alcohol during therapy.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eINTERACTIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003eMAO inhibitor drugs\u003c\/b\u003e Concomitant administration of dextromethorphan with MAO inhibitor drugs is contraindicated. Furthermore, dextromethorphan should not be administered during or in the two weeks following the administration of monoamine oxidase inhibitor drugs. The association of these drugs can, in fact, induce the development of a serotonin syndrome characterized by the following symptoms: nausea, hypotension, neuromuscular hyperactivity (tremor, clonic spasm, myoclonus, increased reflex response and rigidity of pyramidal origin), hyperactivity of the autonomic nervous system (diaphoresis, fever, tachycardia, tachypnea, mydriasis) and altered mental state (agitation, excitation, confusion), leading to cardiac arrest and death. \u003cb\u003eLinezolid and sibutramine\u003c\/b\u003e Cases of serotonin syndrome have also been reported following concomitant administration of dextromethorphan with linezolid or sibutramine. \u003cb\u003eCYP2D6 inhibitors\u003c\/b\u003e Dextromethorphan is metabolised by CYP2D6 and has extensive first pass metabolism. Concomitant use of strong inhibitors of the CYP2D6 enzyme can increase dextromethorphan concentrations in the body to levels many times higher than the normal value. This increases the patient's risk for toxic effects of dextromethorphan (agitation, confusion, tremor, insomnia, diarrhea, and respiratory depression) and for the development of serotonin syndrome. Potent inhibitors of CYP2D6 are fluoxetine, paroxetine, quinidine and terbinafine. In concomitant use with quinidine, plasma concentrations of dextromethorphan are increased up to 20-fold, resulting in increased adverse central nervous system effects of the agent. Amiodarone, flecainide and propafenone, sertraline, bupropion, methadone, cinacalcet, haloperidol, perphenazine and thioridazine also have similar effects on the metabolism of dextromethorphan. If concomitant use of CYP2D6 inhibitors and dextromethorphan is necessary, the patient should be monitored and the dose of dextromethorphan may need to be reduced. \u003cb\u003eCentral nervous system inhibitor drugs\u003c\/b\u003e Concomitant administration of dextromethorphan with drugs with an inhibitory effect on the central nervous system such as hypnotics, sedatives or anxiolytics, or with alcohol, may lead to additive effects on the central nervous system. Concomitant use of opioids and sedative medicines such as benzodiazepines, or related drugs, increases the risk of sedation, respiratory depression, coma and death due to additive CNS depressant effect. The dosage and duration of concomitant treatment should be limited (see section 4.4). \u003cb\u003eSecretolytic drugs\u003c\/b\u003e If dextromethorphan is used in combination with secretolytic drugs, the reduction of the cough reflex can lead to severe mucus accumulation. \u003cb\u003eGrapefruit juice\u003c\/b\u003e Grapefruit juice may increase the absorption, bioavailability and elimination of dextromethorphan, resulting in an increase in its toxicity and a decrease in its effect.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eSIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eAdverse reactions are listed below by system organ class and frequency, according to the following categories: very common ≥ 1\/10; common ≥ 1\/100, \u003c1\/10; uncommon ≥ 1\/1,000, \u003c1\/100; rare ≥ 1\/10,000, \u003c1\/1,000; very rare \u003c1\/10,000; not known the frequency cannot be estimated from the available data. \u003ci\u003eImmune system disorders:\u003c\/i\u003e Not known: hypersensitivity reactions including anaphylactic reaction, angioedema, urticaria, pruritus, rash and erythema. \u003ci\u003eMetabolism and nutrition disorders:\u003c\/i\u003e Not known: diabetes mellitus. \u003ci\u003ePsychiatric disorders:\u003c\/i\u003e Very rare: hallucinations; Not known: psychosis. \u003ci\u003eNervous system disorders:\u003c\/i\u003e Common: dizziness; Rare: drowsiness. \u003ci\u003eGastrointestinal disorders:\u003c\/i\u003e Common: nausea, vomiting, gastrointestinal disorders and decreased appetite. \u003ci\u003eSkin and subcutaneous tissue disorders:\u003c\/i\u003e Rare: skin rashes. \u003ci\u003eSystemic disorders and conditions relating to the administration site:\u003c\/i\u003e Common: fatigue; Not known: hyperpyrexia. Cases of dependence and abuse have been reported with dextromethorphan. \u003cb\u003eReporting of suspected adverse reactions\u003c\/b\u003e Reporting suspected adverse reactions that occur after authorization of the medicine is important, as it allows continuous monitoring of the benefit\/risk balance of the medicine. Healthcare professionals are asked to report any suspected adverse reactions via the national reporting system at https:\/\/www.aifa.gov.it\/content\/segnalazioni-reazioni-avverse.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eOVERDOSE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e \u003ci\u003eSymptoms and signs\u003c\/i\u003e \u003c\/b\u003e Dextromethorphan overdose may be associated with nausea, vomiting, dystonia, agitation, confusion, drowsiness, stupor, nystagmus, cardiotoxicity (tachycardia, abnormal ECG including QTc interval prolongation), ataxia, toxic psychosis with visual hallucinations, hyperexcitability. In case of massive overdose, the following symptoms may be observed: coma, respiratory depression, convulsions. Management: -Activated charcoal may be administered to asymptomatic patients who have ingested overdoses of dextromethorphan within the previous hour. -For patients who have ingested dextromethorphan and are sedated or comatose, naloxone, in doses usual for the treatment of opioid overdose, may be considered. Benzodiazepines may be used for seizures and benzodiazepines and external cooling measures for serotonin syndrome hyperthermia. In extreme cases, urinary retention and respiratory depression may occur. If necessary, resort to intensive medical care (in particular intubation, ventilation). Precautions may be necessary to safeguard heat loss and replenish fluids. Treatment of overdose may require gastric lavage and treatment of specific symptoms. Do not administer centrally acting emetics.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003ePREGNANCY AND BREASTFEEDING\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003ePregnancy\u003c\/b\u003e The results of epidemiological studies on a limited sample of the population did not indicate an increase in the frequency of malformations in children who were exposed to dextromethorphan during the prenatal period. However, these studies do not adequately document the timing and duration of treatment with dextromethorphan. Reproductive toxicity studies on animals do not indicate a potential risk for humans for dextromethorphan (see section 5.3). Dextromethorphan should not be used during the first three months of pregnancy; furthermore, since the administration of high doses of dextromethorphan, even for short periods, can cause respiratory depression in newborns, in the following months the drug must be administered only in case of actual need and after a careful evaluation of the benefits and risks. \u003cb\u003eBreastfeeding\u003c\/b\u003e Since the excretion of the drug in breast milk is not known and a respiratory depressive effect on the newborn cannot be excluded, dextromethorphan is contraindicated during breastfeeding.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEFFECTS ON DRIVING ABILITY\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eVicks Cough may affect your ability to drive or use machines. The product, in fact, can cause drowsiness even if taken at the recommended doses, this must be taken into account by those who may drive vehicles or carry out operations requiring an intact level of vigilance. This effect is accentuated in case of simultaneous intake of alcohol (see paragraph 4.5).\u003c\/p\u003e","brand":"Procter \u0026 Gamble","offers":[{"title":"Default Title","offer_id":51730214093127,"sku":"028688024","price":12.05,"currency_code":"EUR","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0564\/4989\/2467\/files\/procter-gamble-srl-vicks-tosse-sedativo-1-33-mg-ml-180-ml-sciroppo-farmacia-dottor-tili-1213791345.jpg?v=1767156407"},{"product_id":"vicks-vaporub-100-g-unguento-inalatorio","title":"Vicks Vaporub 100 g inhalation ointment","description":"\u003cp\u003e\u003cstrong\u003eINDICATIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eBalsamic treatment for diseases of the upper respiratory tract.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eACTIVE INGREDIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e100 g of ointment contains: \u003ci\u003eactive ingredients\u003c\/i\u003e: camphor 5 g; turpentine essential oil 5 g; menthol 2.75 g; eucalyptus essential oil 1.5 g. For the complete list of excipients see section 6.1.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEXCIPIENTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eThymol, cedarwood essential oil, white petrolatum.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONTRAINDICATIONS AND SIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eHypersensitivity to the active substances or to any of the excipients listed in paragraph 6.1. Children up to 30 months of age. Administration through steam inhalation is contraindicated in children under 12 years of age. Children with a history of epilepsy or febrile convulsions. Generally contraindicated during pregnancy and breastfeeding (see section 4.6).\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDOSAGE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eVicks Vaporub is contraindicated in children up to 30 months of age and vapor inhalation is contraindicated in children under 12 years (see section 4.3). Children must always be supervised. Vicks Vaporub ointment can be used in two ways: \u003cb\u003e1) Topical use (\u003cu\u003eadults and children over 30 months of age\u003c\/u\u003e)\u003c\/b\u003e Apply externally by first rubbing the chest, throat and back for 3 - 5 minutes and then spreading a thick layer on the chest. Repeat the treatment 2 times a day, one in the evening before going to sleep. Do not rub more than twice a day on the front of the chest, neck and back. Wear loose clothing to facilitate inhalation of vapours. \u003cb\u003e2) Inhalations (\u003cu\u003eadults and children over 12 years of age\u003c\/u\u003e)\u003c\/b\u003e Dissolve 2 teaspoons (2x5 ml) in half a liter of hot (not boiling) water and aspirate the released steam for a time not exceeding 10 minutes. To avoid the risk of serious burns, do not heat the mixture a second time or heat the mixture during inhalation (see section 4.4). Do not heat in the microwave. Do not exceed the recommended doses. The duration of treatment should not exceed 3 days. \u003ci\u003eTHE PRODUCT MUST NOT BE INGESTED\u003c\/i\u003e\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eCONSERVATION\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eThis medicinal product does not require any special storage conditions.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eWARNINGS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eUse the product according to the instructions. For external use only. Do not apply on wounds, abrasions and mucous membranes. Do not ingest or apply directly into the nostrils, eyes, mouth or face. Do not make a tight bandage. Do not use with hot compress or any type of heat. This product contains terpene derivatives which, in excessive doses, can cause neurological disorders such as seizures in infants and children. If symptoms persist, consult your doctor. The product should be used with caution or under medical suggestion by patients who present: • hypersensitivity reactions to perfumes or solvents; • convulsions or epilepsy (it is contraindicated in children with a history of epilepsy or febrile convulsions, see section 4.3); • Marked hypersensitivity of the respiratory tract including those conditions such as asthma and chronic obstructive pulmonary disease (COPD) as it can cause bronchospasm in these patients Inhalations: In order to avoid the risk of serious burns, do not use boiling water to prepare inhalations. Do not heat the mixture in the microwave and do not heat it again during and after use (see also section 6.6). The treatment must not be prolonged for more than 3 days due to the risks associated with the accumulation of terpene derivatives, such as \u003ci\u003ecamphor, cineol, niaouli, wild thyme, terpineol, terpine, citral, menthol and essential oils of pine needle, eucalyptus and turpentine\u003c\/i\u003e (due to their lipophilic properties the rate of metabolism and disposal is not known) in tissues and the brain, in particular neuropsychological disorders. A higher than recommended dose should not be used to avoid an increased risk of adverse drug reactions and disorders associated with overdose (see section 4.9). The product is flammable, it must not be brought near flames.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eINTERACTIONS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eVicks Vaporub must not be used concomitantly with other products (medicines or cosmetics) containing terpene derivatives, regardless of the route of administration (oral, rectal, cutaneous, nasal or inhalation).\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eSIDE EFFECTS\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eSide effects may occur with the use of the medicine. Such effects may occur with the following frequency categories: Very common (≥1\/10) Common (≥1\/100; \u003c1\/10) Uncommon (≥1\/1,000; \u003c1\/100) Rare (≥1\/10,000; \u003c1\/1,000) Very rare (\u003c1\/10,000) Not known (frequency cannot be predicted from the available data). \u003cb\u003ePathologies of the skin and subcutaneous tissue\u003c\/b\u003e Not known: erythema or heat erythema (redness and sensation of heat in the skin caused by camphor and menthol, which have rubefacient effects), skin irritation, allergic dermatitis, itching. \u003cb\u003eImmune system disorders\u003c\/b\u003e Not known: hypersensitivity, symptom of respiratory allergy (dyspnea and cough). If such events occur, treatment should be suspended and the necessary clinical measures adopted. \u003cb\u003eEye pathologies\u003c\/b\u003e Not known: eye irritation (following topical use or inhalation). \u003ci\u003eSystemic pathologies and conditions relating to the administration site\u003c\/i\u003e: Due to the recommended route of administration, systemic exposure is very low and no undesirable effects due to systemic exposure have been observed. Not known: burns at the application site. Other adverse events may be linked to improper use of the product (ingestion), in this regard see paragraph 4.9. \u003cb\u003e \u003cu\u003ePediatric population\u003c\/u\u003e \u003c\/b\u003e Due to the presence of camphor, turpentine essential oil, menthol and eucalyptus essential oil and in case of non-compliance with the recommended doses there may be a risk of convulsions in children and infants. \u003cb\u003eReporting of suspected adverse reactions\u003c\/b\u003e Reporting suspected adverse reactions that occur after authorization of the medicine is important, as it allows continuous monitoring of the benefit\/risk balance of the medicine. Healthcare professionals are asked to report any suspected adverse reactions via the national reporting system at: http:\/\/www.agenziafarmaco.gov.it\/content\/comesegnalare-una-sospetti-reazione-avversa.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eOVERDOSE\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eIn case of accidental oral intake or incorrect administration in newborns and children there may be a risk of neurological disorders. If necessary, administer appropriate symptomatic treatment in specialized treatment centers. Overdose can cause skin irritation. \u003cu\u003eImproper use\u003c\/u\u003e: Ingestion of the ointment may cause gastrointestinal symptoms such as vomiting and diarrhea. Treatment is symptomatic. Acute poisoning has been observed following significant accidental intake with nausea, vomiting, abdominal pain, headache, dizziness, feeling hot\/hot flashes, convulsions, respiratory depression and coma. Patients with severe gastrointestinal or neurologic symptoms of poisoning should be observed and treated symptomatically. Do not induce vomiting. A) Topical administration: in the event of application of an excessive dose topically, skin irritation reactions may rarely occur. In this case, remove the excess product with a paper towel and administer, if necessary, an adequate therapy for such reactions. B) Inhalation: the symptoms and treatment are the same as in case of accidental ingestion. C) Accidental ingestion: the symptoms are mainly due to the presence of camphor. These include gastrointestinal problems such as nausea, vomiting and diarrhea. In the event of significant overdose, effects on the central nervous system are possible, such as ataxia, convulsions and respiratory depression. Treatment must be symptomatic and gastric lavage can be performed if necessary. In the presence of serious symptoms of poisoning at a gastrointestinal or neurological level, the patient must immediately consult his doctor for appropriate therapeutic measures.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003ePREGNANCY AND BREASTFEEDING\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003e\u003cb\u003e \u003cu\u003ePregnancy\u003c\/u\u003e \u003c\/b\u003e There are no or limited data available on the use of camphor, turpentine essential oil, menthol, eucalyptus essential oil in pregnant women. There are no clinical data relating to the use of the components of Vicks Vaporub during pregnancy. Camphor is able to cross the placenta but there is no data on the other components. Animal studies do not indicate harmful effects, direct or indirect, on pregnancy, embryonic\/foetal development, parturition or postnatal development (see section 5.3). However, Vicks Vaporub is not recommended during pregnancy and in women of childbearing potential who are not using contraceptive measures. The use of the drug during pregnancy should only take place after consulting your doctor. \u003cb\u003e \u003cu\u003eBreastfeeding\u003c\/u\u003e \u003c\/b\u003e There is insufficient information on the excretion of camphor, turpentine essential oil, menthol, eucalyptus essential oil in breast milk. There are no clinical data relating to the use of the components of Vicks Vaporub during breastfeeding. Vicks Vaporub should not be used during breastfeeding. The product, applied to the mother's chest during breastfeeding, poses a potential risk of apneic reflex in the breast-fed infant.\u003c\/p\u003e\n\u003cp\u003e \u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eEFFECTS ON DRIVING ABILITY\u003c\/strong\u003e\u003c\/p\u003e\n\u003cp\u003eVicks Vaporub does not affect the ability to drive or use machines.\u003c\/p\u003e","brand":"Procter \u0026 Gamble","offers":[{"title":"Default Title","offer_id":51730214125895,"sku":"021625076","price":16.67,"currency_code":"EUR","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0564\/4989\/2467\/files\/procter-gamble-srl-vicks-vaporub-100-g-unguento-inalatorio-farmacia-dottor-tili-1213791344.jpg?v=1767156388"},{"product_id":"vicks-sinex-0-05-spray-nasale-decongestionante-senza-conservanti-10-ml","title":"Vicks Sinex 0.05% Decongestant Nasal Spray Without Preservatives 10 ml","description":"\u003cp\u003e\u003cstrong\u003eVicks Sinex 0.05% solution to nebulize\u003c\/strong\u003e it's a \u003cstrong\u003edecongestant drug for the nasal mucosa\u003c\/strong\u003e based on \u003cstrong\u003eoxymetazoline hydrochloride\u003c\/strong\u003e, indicated to quickly reduce nasal congestion, particularly in case of colds. Each nebulization delivers approximately 25 micrograms of active ingredient, ensuring a targeted and localized action.\u003c\/p\u003e\n\u003cp\u003eThe formula is free of preservatives, making it particularly suitable for those with sensitivity to the excipients commonly used in nasal sprays. The practical spray bottle from \u003cstrong\u003e10ml\u003c\/strong\u003e is indicated for \u003cstrong\u003eadults and children over 12 years old\u003c\/strong\u003e.\u003c\/p\u003e\n\u003ch2\u003eINDICATIONS\u003c\/h2\u003e\n\u003ch3\u003eWhy use Vicks Sinex 0.05% Decongestant Nasal Spray Without Preservatives 10 ml? What is it for?\u003c\/h3\u003e\u003cp\u003eDecongestant of the nasal mucosa, especially in case of colds.\u003c\/p\u003e\n\u003ch2\u003eACTIVE INGREDIENTS AND EXCIPIENTS\u003c\/h2\u003e\n\u003ch3\u003eWhat is the composition of Vicks Sinex 0.05% Decongestant Nasal Spray Without Preservatives 10 ml?\u003c\/h3\u003e\u003cp\u003e1 mL of product contains:\u003c\/p\u003e\u003cul\u003e\u003cli\u003e\n\u003cstrong\u003eActive ingredient:\u003c\/strong\u003e oxymetazoline hydrochloride 0.5 mg.\u003c\/li\u003e\u003c\/ul\u003e\u003cp\u003e1 spray (50 microlitres) contains approximately 25 micrograms of oxymetazoline hydrochloride.\u003c\/p\u003e\u003cbr\u003e\u003cbr\u003e\u003cp\u003eCitric acid monohydrate, sodium citrate, glycerol (85%), purified water. This medicine does not contain preservatives.\u003c\/p\u003e\n\u003ch3\u003eHow to take Vicks Sinex 0.05% Decongestant Nasal Spray Without Preservatives 10 ml?\u003c\/h3\u003e\u003cp\u003eAdults and children over 12 years: 1-2 sprays per nostril every 8-12 hours, unless otherwise indicated by the doctor.\u003c\/p\u003e\u003cp\u003e\u003cstrong\u003eMethod of administration:\u003c\/strong\u003e remove the protective cap. Hold the bottle upright with your thumb at the base and the dispenser between your index and middle fingers. Introduce its end into the nostril and press the nebulizer quickly and firmly, without tilting your head. After application, inhale deeply with your mouth closed. Do not use the product while lying down.\u003c\/p\u003e\n\u003ch3\u003eWhen should Vicks Sinex 0.05% Decongestant Nasal Spray Without Preservatives 10 ml be used and what side effects can it cause?\u003c\/h3\u003e\u003cp\u003eDo not use Vicks Sinex in the following cases:\u003c\/p\u003e\u003cul\u003e\n\u003cli\u003ehypersensitivity to the active substance or to any of the excipients;\u003c\/li\u003e\n\u003cli\u003eprostatic hypertrophy;\u003c\/li\u003e\n\u003cli\u003eserious heart disease and arterial hypertension;\u003c\/li\u003e\n\u003cli\u003eincreased intraocular pressure, particularly in case of closed-angle glaucoma;\u003c\/li\u003e\n\u003cli\u003ehyperthyroidism;\u003c\/li\u003e\n\u003cli\u003edry rhinitis;\u003c\/li\u003e\n\u003cli\u003eduring and in the two weeks following therapy with antidepressant drugs (MAOI).\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003ch3\u003eWhat is the format of Vicks Sinex 0.05% Decongestant Nasal Spray Without Preservatives 10 ml?\u003c\/h3\u003e\u003cp\u003e10ml\u003c\/p\u003e\n\u003ch2\u003eDOSAGE\u003c\/h2\u003e\n\u003ch3\u003eHow to take Vicks Sinex 0.05% Decongestant Nasal Spray Without Preservatives 10 ml?\u003c\/h3\u003e\u003cp\u003eAdults and children over 12 years: 1-2 sprays per nostril every 8-12 hours, unless otherwise indicated by the doctor.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod of administration:\u003c\/strong\u003e remove the protective cap. Hold the bottle upright with your thumb at the base and the dispenser between your index and middle fingers. Introduce its end into the nostril and press the nebulizer quickly and firmly, without tilting your head. After application, inhale deeply with your mouth closed. Do not use the product while lying down.\u003c\/p\u003e\n\u003ch2\u003eCONTRAINDICATIONS AND SIDE EFFECTS\u003c\/h2\u003e\n\u003ch3\u003eWhen should Vicks Sinex 0.05% Decongestant Nasal Spray Without Preservatives 10 ml be used and what side effects can it cause?\u003c\/h3\u003e\u003cp\u003eDo not use Vicks Sinex in the following cases:\u003c\/p\u003e\n\u003cul\u003e\n\u003cli\u003ehypersensitivity to the active substance or to any of the excipients;\u003c\/li\u003e\n\u003cli\u003eprostatic hypertrophy;\u003c\/li\u003e\n\u003cli\u003eserious heart disease and arterial hypertension;\u003c\/li\u003e\n\u003cli\u003eincreased intraocular pressure, particularly in case of closed-angle glaucoma;\u003c\/li\u003e\n\u003cli\u003ehyperthyroidism;\u003c\/li\u003e\n\u003cli\u003edry rhinitis;\u003c\/li\u003e\n\u003cli\u003eduring and in the two weeks following therapy with antidepressant drugs (MAOI).\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003ch2\u003eDRUG LEGAL TEXT\u003c\/h2\u003e\n\u003cp\u003eContent responsibility\u003c\/p\u003e\u003cp\u003eThis sheet contains information that is not intended to replace a doctor's diagnosis or advice, as only the doctor can draw up any prescription and give therapeutic indications. All contents must be understood and are of an exclusively informative nature and aimed exclusively at bringing to the attention of customers or potential customers in the pre-purchase phase of the products sold through this site. In case of pathologies, disorders or allergies it is always best to consult your doctor first.\u003c\/p\u003e\u003cp\u003ePlease note\u003c\/p\u003e\u003cp\u003eThe product names, ingredients and percentages indicated in the descriptions are purely indicative and may be subject to changes or updates by the manufacturing companies. Due to the impossibility of adapting to these updates in real time, the photos and technical information of the products included on Dottortili.com may differ from those shown on the label or otherwise disseminated by the manufacturing companies. The only identification element appears to be the ministerial code MINSAN. The online pharmacy Dottortili.com does not guarantee the truthfulness and timeliness of the information published and declines any responsibility for any errors, omissions or failure to update the same. Dottortili.com assumes no responsibility for damages of any nature that may arise from access to the information published.\u003c\/p\u003e\u003cp\u003eData source: Farmadati Italia\u003c\/p\u003e\u003cp\u003eWebsite: www.farmadati.it\u003c\/p\u003e\u003cp\u003eThe Farmadati Italia database is used by almost all pharmacies, parapharmacies, herbalist shops, health shops, large-scale retail trade, computerized doctors, etc. thanks to the guarantee of historical reliability, seriousness and professionalism of the company on the national territory.\u003c\/p\u003e\u003cp\u003eThe Farmadati Italia S.r.l management system complies with the requirements of the UNI EN ISO 9001:2015 standards for quality management systems and UNI CEI ISO\/IEC 27001:2017 for information security management systems.\u003c\/p\u003e","brand":"Procter \u0026 Gamble","offers":[{"title":"Default Title","offer_id":54074594459975,"sku":"023198043","price":12.12,"currency_code":"EUR","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0564\/4989\/2467\/files\/procter-gamble-srl-vicks-sinex-0-05-spray-nasale-decongestionante-senza-conservanti-10-ml-farmacia-dottor-tili-1242512806.jpg?v=1780572338"}],"url":"https:\/\/www.dottortili.com\/en-eu\/collections\/vicks.oembed","provider":"Farmacia Dottor Tili","version":"1.0","type":"link"}