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What you need to know before you take Veganin

This medicine contains codeine which can cause addiction if you take it continuously for more than three days. This can give you withdrawal symptoms from the medicine when you stop taking it. If you take a pain killer for headaches for more than three days it can make them worse. Do not take Veganin: • if you are allergic (hypersensitive ) to any of the ingredients of Veganin (see section 6) • if you have asthma or very shallow breathing • if you su‑er from alcoholism • If you experience or have had the type of chronic constipation called paralytic ileus • if you have a head injury or increased pressure in your skull • if you have had surgery on your bile duct • if you are already taking a medicine containing paracetamol • for a child younger than 12 years old • for pain relief in children and adolescents (0-18 years of age) after removal of their tonsils or adenoids due to obstructive sleep apnoea syndrome • if you know that you metabolise very rapidly codeine into morphine • if you are breastfeeding. Warnings and precautions Tell your doctor or pharmacist if: • you have severe liver or kidney problems. The risk of overdose is higher if you have alcoholic liver disease • you are elderly because you may be more likely to get some side e‑ects (see section 4) • you have prostate problems • you have had your gall bladder removed • you have bowel problems, particularly those causing in­ammation or blockage, or you have had recent bowel surgery. If you have any of these conditions, your doctor or pharmacist will advise you about how best to use Veganin. Codeine is transformed to morphine in the liver by an enzyme. Morphine is the substance that produces pain relief. Some people have a variation of this enzyme and this can a‑ect people in di‑erent ways. In some people, morphine is not produced or produced in very small quantities, and it will not provide enough pain relief. Other people are more likely to get serious side e‑ects because a very high amount of morphine is produced. If you notice any of the following side e‑ects, you must stop taking this medicine and seek immediate medical advice: slow or shallow breathing, confusion, sleepiness, small pupils, feeling or being sick, constipation, lack of appetite. Children and adolescents Use in children and adolescents after surgery: Codeine should not be used for pain relief in children and adolescents after removal of their tonsils or adenoids due to Obstructive Sleep Apnoea Syndrome. Use in children with breathing problems: Codeine is not recommended in children with breathing problems, since the symptoms of morphine toxicity may be worse in these children. Other medicines and Veganin Before using Veganin, tell your doctor or pharmacist if you are taking any of the following: • metoclopramide or domperidone – used to treat nausea and vomiting • colestyramine – used to treat high cholesterol • anti-coagulants (such as warfarin) – used to thin the blood. It is alright to take occasional doses of Veganin, but not if Veganin is required daily over a long period • sedatives (also known as sleeping tablets) containing barbiturates • certain medicines prescribed for depression (called MAOIs) or have been taking them in the last 2 weeks • decongestants (e.g. pseudoephedrine or ephedrine, found in some cough and cold remedies) • sedatives and tranquilisers, such as benzodiazepine and non-benzodiazepine hypnotics • medicines for diarrhoea and tummy cramps as taking these at the same time as Veganin may make you constipated • medicines such as atropine, procyclidene or hyoscine which are used to treat problems with gut movements. Taking these at the same time as Veganin may make you severely constipated and may make it dicult for you to pass urine. • some antihistamines which may be used in cough/cold remedies and anti-allergy products. Taking these at the same time as Veganin may make you severely constipated and may make it dicult for you to pass urine. • quinidine or mexiletine – used to regulate heart rhythm • cimetidine – used to treat stomach ulcers • naltrexone – used in the treatment of drug dependence. If you are taking any of the following medicines, you may ‑nd the eectiveness of Veganin is reduced: • oral contraceptives (‘the pill’) • medicines used to treat epilepsy, such as carbamazepine, fosphenytoin, phenytoin or phenobarbital. If you are unsure if any medicine you are taking is one of those mentioned above, check with your pharmacist. Veganin and food and drink Excessive intake of ca‑eine (e.g. co‑ee, tea and some canned drinks) should be avoided while taking this product. Veganin and alcohol Do not drink alcohol while taking Veganin as it can make liver damage and breathing diculties more likely and more serious. Pregnancy, breast-feeding and fertility If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. Do not take Veganin while you are breast-feeding. Codeine and morphine passes into breast milk. Driving and using machines This medicine can a‑ect your ability to drive as it may make you sleepy or dizzy. • Do not drive while taking this medicine until you know how it a‑ects you. • It is an o‑ence to drive if this medicine a‑ects your ability to drive. • However, you would not be committing an o‑ence if: – The medicine has been prescribed to treat a medical or dental problem – You have taken it according to the instructions given by the prescriber or in the information provided with the medicine and – It was not a‑ecting your ability to drive safely. Talk to your doctor or pharmacist if you are not sure whether it is safe for you to drive while taking this medicine.