EFFERALGAN*20EFF TABS 330+200MG

EFFERALGAN 330 mg effervescent tablets with Vitamin C
paracetamol/ascorbic acid

What it is and what it is used for
Efferalgan contains the active ingredient paracetamol, which works by relieving pain (analgesic) and reducing fever (antipyretic).

Efferalgan is used in adults, adolescents, and children weighing over 26 kg for:
- the treatment of symptoms of feverish conditions;
- the symptomatic treatment of mild to moderate pain.

Consult your doctor if the person taking the medicine does not feel better or feels worse after 3 days of treatment.

What you need to know before taking the medicine
Do not use Efferalgan
• if the person taking the medicine is allergic to paracetamol or propacetamol hydrochloride (a precursor to paracetamol) or any of the other ingredients of this medicine (listed in section 6)

Warnings and precautions
Use with caution and consult your doctor or pharmacist before using Efferalgan if the person taking the medicine:
• chronically consumes alcohol. Alcohol consumption during therapy is not recommended;
• suffers from anorexia (an eating disorder characterized by a lack or reduction of appetite);
• suffers from bulimia (an eating disorder where a person ingests an excessive amount of food and then resorts to various methods to eliminate it to avoid gaining weight);
• suffers from cachexia (a state characterized by extreme thinness, reduction of muscle mass, and thinning of the skin due to chronic diseases);
• suffers from chronic malnutrition;
• suffers from dehydration (severe loss of water/fluids from the body);
• suffers from hypovolemia (reduced blood volume circulating in the body);
• suffers from mild/moderate reduction in liver function (including Gilbert's syndrome, a disease characterized by excessive bilirubin production, a substance that causes yellowish skin and eyes);
• suffers from severe liver problems;
• is affected by acute hepatitis (acute inflammation of the liver);
• is taking medicines that stimulate liver enzymes (increase the way the liver works);
• suffers from glucose-6-phosphate dehydrogenase deficiency (a substance normally present in the human body, whose deficiency can cause hemolytic anemia);
• suffers from hemolytic anemia (a disease due to the destruction of certain blood cells, red blood cells);
• suffers from renal insufficiency (kidney diseases);
• suffers from iron metabolism disorders (problems related to deficiency or accumulation or poor distribution of iron in the body such as hemochromatosis, sideroblastic anemia, and thalassemia);
• has a predisposition to form urinary tract stones.

Paracetamol can cause serious skin reactions that can be fatal. The use of Efferalgan should be discontinued at the first appearance of skin rash or any other sign of hypersensitivity/allergy.

Use of high doses and/or for prolonged periods
The use of high or prolonged doses of this medicine can cause severe liver disorders and even serious kidney and blood disorders. In these cases, the doctor will monitor liver and kidney function and blood composition through appropriate tests.

Prolonged use of analgesics (for a period longer than 3 months) in patients with chronic headache, especially if repeated and frequent, can increase or worsen the headache. In these cases, it is necessary to consult a doctor.

Children and adolescents
This medicine can be given to children weighing over 26 kg and adolescents (see section 3 "How to use Efferalgan").

Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.

If the person taking the medicine experiences the following side effects, STOP treatment with this medicine and contact your doctor immediately:
• skin reactions that may manifest as:
- urticaria (appearance of wheals on the skin accompanied by itching);
- skin rash;
- erythema (redness of the skin);
- erythema multiforme (appearance of red spots on the skin with a bull's-eye appearance associated with itching);
- purpura (appearance of purple skin patches of different sizes);
- Stevens-Johnson syndrome (a severe form of erythema multiforme);
- epidermal necrolysis (a severe skin disease characterized by redness, blistering lesions with areas of detachment and death of the skin);
- acute generalized exanthematous pustulosis (eruption of hundreds of superficial pustules spread all over the body);

• allergic reactions that may manifest as:
- laryngeal edema (swelling of the throat);
- angioedema (swelling of hands, feet, ankles, face, lips, tongue, and/or throat);
- anaphylactic reaction (severe allergic reaction) including hypotension (low blood pressure);
- hypersensitivity;
- anaphylactic shock (severe allergic reaction).
In addition, the following side effects may occur, for which there are not enough data to establish the frequency.
• thrombocytopenia (reduction in the number of platelets in the blood);
• leukopenia/agranulocytosis/neutropenia (reduction in the number of white blood cells in the blood);
• anemia (reduction of hemoglobin in the blood, a substance that carries oxygen in the blood);
• diarrhea;
• abdominal pain;
• stomach and intestinal reactions;
• abnormal liver function;
• hepatitis (inflammation of the liver);
• altered INR (a value used to express the time it takes for blood to clot);
• increased liver enzymes;
• headache;
• dizziness;
• acute renal failure (reduction of kidney function);
• interstitial nephritis (inflammation of the kidneys);
• hematuria (blood in the urine);
• anuria (cessation or reduction of urine production by the kidney).

Reporting of side effects
If you get any side effects, including any not listed in this leaflet, tell your doctor or pharmacist. You can also report side effects directly via the national reporting system at: https://www.aifa.gov.it/content/segnalazionireazioni-avverse.
By reporting side effects, you can help provide more information on the safety of this medicine.