Grippostad C forte granules 12 sachets

Grippostad C forte is a medicine for common colds with certain symptoms. It contains as active ingredients paracetamol, ascorbic acid, caffeine and chlorphenamine hydrogen maleate.

Paracetamol is a pain reliever and fever reducer.
Chlorphenamine hydrogen maleate belongs to the group of antihistamines (medicines against allergies), supports the decongestion of the nasal mucosa and the reduction of mucus production and thus promotes unhindered nasal breathing. Caffeine has a slightly stimulating effect and increases the pain-relieving effect of paracetamol. It thus enables a reduction in the paracetamol dose, which means that the body is burdened with lower amounts of painkillers. Vitamin C (ascorbic acid) is vital for the human body and influences a large number of metabolic processes. A lack of vitamin C impairs the reactions of the immune system.

field of use

Grippostad C forte is used for
the symptomatic treatment of symptoms that occur together, such as headaches and body aches, runny nose and dry cough as part of a simple cold. If you have fever or high body temperature, Grippostad C forte granules have an antipyretic effect.
Due to the fixed combination of the active ingredients in Grippostad C forte, no individual dose adjustment can be made for complaints that predominantly relate to one of the symptoms mentioned. In such situations, drugs of a different composition are preferable.

If you do not feel better or if you feel worse after 3 days, contact your doctor.

Contraindications

Grippostad C forte must not be taken

• if you are allergic to paracetamol, ascorbic acid, caffeine, chlorphenamine hydrogen maleate, dexchlorphenamine or any of the other ingredients of this medicine (listed in section 6). 
• if you suffer from a certain hereditary metabolic disease (deficiency of glucose-6-phosphate dehydrogenase)
• if you suffer from severe kidney dysfunction
• if you suffer from severe liver impairment
• if you suffer from increased pressure in the eye (narrow-angle glaucoma).
• in prostate adenoma with residual urine formation
• if you have a tumor of the adrenal medulla
• if you are taking a medicine with the active substance chloramphenicol at the same time (see Section 2: “Other medicines and Grippostad C forte”)
• in case of excessive or regular consumption of alcohol
• if you suffer from cardiac arrhythmias
• if you have gastrointestinal ulcers
• if you suffer from kidney stones (oxalate stones).
• if you suffer from certain diseases in which too much iron is stored in the body (“thalassemia”, “haemochromatosis”, “sideroblastic anaemia”)
• by children under the age of 12
• if you are pregnant
• if you are breastfeeding 

interactions

Interactions of the active ingredients contained in Grippostad C forte are possible with:

• Medicines that slow down the emptying of the stomach (e.g. propantheline). Such medicines can delay the absorption of paracetamol into the body and cause Grippostad C forte to take effect more slowly.
• Medicines that increase gastric emptying (e.g. metoclopramide). These medicines can speed up the absorption of paracetamol into the body and make Grippostad C forte work more quickly.
• certain medicines used to treat HIV infection (zidovudine). The tendency to reduce the number of white blood cells (neutropenia) is increased. Grippostad C forte should therefore only be used concomitantly with zidovudine on medical advice.
• certain medicines for gout (Probenecid). If you are taking probenecid at the same time, your doctor may reduce the dose of Grippostad C forte, as the breakdown of Grippostad C forte in the body may be slower.
• certain medicines for pain and fever (salicylamides). With the simultaneous use of salicylamides, the breakdown of Grippostad C forte can be prolonged.
• Medicines that activate certain metabolic enzymes in the liver that are involved in breaking down medicines in the body. These include, for example, certain sleeping pills (barbiturates), medicines to treat epilepsy (phenytoin, carbamazepine) or medicines to treat tuberculosis (rifampicin). Simultaneous use of these medicines can increase the liver-damaging effect of Grippostad C forte.
• Alcohol: Simultaneous consumption of alcohol increases the liver-damaging effect of Grippostad C forte.
• Certain antibiotics = medicines against infections (chloramphenicol): the combination with Grippostad C forte increases the harmful effect due to slower elimination of the antibiotic (increased side effects possible).
• Medicines to prevent blood clotting (“anticoagulants”). Repeated intake of Grippostad C forte for more than a week can increase the effect of the anticoagulant medicines, due to the active ingredient paracetamol.
• certain medicines used to lower high blood fat levels (cholestyramine). When used at the same time as cholestyramine, the absorption and effect of Grippostad C forte may be reduced.
• Medicines with a sleep-inducing effect, such as sleeping pills (barbiturates), medicines to treat allergies (antihistamines), or medicines to treat mental illnesses (psychotropics) or alcohol. When used at the same time, the sleep-promoting effect of these medicines can be increased by Grippostad C forte.
• Medicines that increase heart rate, such as sympathomimetics (medicines that increase blood pressure) and thyroid hormones (thyroxine). The heart rate-increasing effect of these medicines may be increased when used at the same time as Grippostad C forte.
• certain medicines used to treat bronchial asthma (theophylline). The excretion of theophylline from the body may be reduced when used at the same time as Grippostad C forte and the effect of theophylline may be increased.
• Ephedrine and related substances (eg in some cold and hay fever medicines). Simultaneous use with Grippostad C forte increases the risk of possible undesirable interactions and should therefore not be used at the same time.
• Broad-spectrum drugs such as benzodiazepine-type sleeping pills and tranquilizers. When combined with Grippostad C forte, different and unpredictable interactions can occur. If you notice any interactions when taking such medicines at the same time, please inform your doctor immediately.
• certain antibiotics (quinolonecarboxylic acid-type gyrase inhibitors). These medicines can delay the elimination of Grippostad C forte from the body.
• certain medicines used to treat migraines (ergotamine). Grippostad C forte can speed up the absorption of ergotamine into the body.
• iron and aluminum. Grippostad C forte can increase the absorption of iron and aluminum from the digestive tract. This is particularly important in patients with impaired kidney function, when taking iron supplements and stomach protectors containing aluminum (agents to neutralize stomach acid).
• Medicines to prevent blood clotting. Grippostad C forte also influences the effect of anticoagulants, such as warfarin, due to the vitamin C it contains.
• certain medicines used to treat gastrointestinal ulcers (nitazidine): leads to increased plasma levels of paracetamol.
• certain medicines for gastrointestinal complaints (cisapride): increases the absorption of paracetamol in the body.
• Lamotrigine: Simultaneous administration of paracetamol and lamotrigine (certain medicine used to treat epilepsy) leads to reduced availability of lamotrigine.
• Ethinylestradiol: Due to the vitamin C it contains, Grippostad C forte can increase the blood level of ethinylestradiol (part of some oral contraceptives = “birth control pills”) and in rare cases lead to spotting.
• certain painkillers (acetylsalicylic acid): reduce the absorption of vitamin C in the body.
• certain medicines to treat too much iron in your blood (deferoxamine). If Deferoxamin is taken at the same time as Grippostad C forte, cardiac function may be impaired, which will return to normal after Grippostad C forte is discontinued.
• a certain medicine used to treat mental disorders (fluphenazine).
• certain medicines used to treat stomach ulcers such as cimetidine, oral contraceptives (the "pill") and certain alcohol cessation medicines such as disulfiram: reduce the breakdown of Grippostad C forte.
• certain sleeping pills and sedatives such as barbiturates and smoking: accelerate the breakdown of Grippostad C forte.
• Vitamin B12: The vitamin C contained in Grippostad C forte can reduce the effect of vitamin B12, which is why these preparations should be used at different times.

Taking Grippostad C forte with food, drink and alcohol
Grippostad C forte must not be taken with alcohol, as alcohol can affect the effects and side effects (especially liver damage) of Grippostad C forte.

Pregnancy and breast-feeding
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.

Pregnancy
If you are pregnant, you must not take Grippostad C forte.

Breast-feeding
If you are breast-feeding, you must not take Grippostad C forte because the components of Grippostad C forte can pass into breast milk. 

Grippostad C forte contains sodium
This medicinal product contains 5.6 mmol (128 mg) sodium per sachet. If you are on a low-salt diet, you should take this into account.

application

Always take Grippostad C forte exactly as described in this leaflet or as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

Adults and adolescents aged 12 and over
Adults and adolescents aged 12 and over take the contents of one sachet 3 times a day at least 6 hours apart.

Patients with impaired liver and/or kidney function
In patients with impaired liver and/or kidney function and a congenital disease with jaundice (“Gilbert's syndrome” or “Meulengracht's disease”), the dose must be reduced or the dose interval extended. Please speak to your doctor about this.

If you have severely impaired liver and/or kidney function, you must not take Grippostad C forte (see under 2. Grippostad C forte must not be taken).

Elderly (65 years and older)
No specific dose adjustment is required based on age. If you are underweight and/or have organ dysfunction, please follow the relevant instructions.

Method and duration of administration
For oral use after reconstitution.

Please pour the contents of one sachet into a glass of water. The granules will dissolve in about a minute without stirring. Then drink the contents of the glass completely.

The duration of use should be limited to the duration of the illness. You must not take Grippostad C forte for more than 3 days without consulting a doctor. If the symptoms persist for more than 3 days, you must consult a doctor.

Please talk to your doctor or pharmacist if you have the impression that the effect of Grippostad C forte is too strong or too weak.

side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.
When assessing side effects, the following frequency information is usually used as a basis:

Very common: affects more than 1 user in 10
Common: affects 1 to 10 users in 100
Uncommon: affects 1 to 10 users in 1,000
Rare: affects 1 to 10 users in 10,000
Very rare: affects less than 1 user in 10,000
Not known: Frequency cannot be estimated from the available data

Blood and lymphatic system disorders
Very rare: Changes in the blood picture such as reduction in white blood cells, reduced number of blood platelets and the resulting punctiform to small patchy skin bleeding, reduction in the number of all blood cells, reduced blood cell formation in the bone marrow and, with high doses, altered blood pigments (can be lead to a lack of oxygen in the tissue).

Diseases of the immune system
Very rare: For the active ingredient paracetamol (a component of Grippostad C forte) are from simple hypersensitivity reactions (simple skin reddening, wheals) to severe hypersensitivity reactions (skin and mucous membrane swelling, shortness of breath, sweating, nausea, drop in blood pressure to circulatory failure and shock) have been described.

Metabolism and nutrition disorders
Very rare: increased appetite

Psychiatric disorders
Very rare: psychotic reactions Frequency not known: restlessness, insomnia

Nervous system disorders
Uncommon: headache, fatigue and insomnia
Very rare: involuntary movements
Frequency not known: tiredness, drowsiness

Eye disorders
Very rare: triggering of glaucoma (narrow-angle glaucoma; eye disease with increased intraocular pressure), visual disturbances

Cardiac disorders
Frequency not known: irregular heartbeat, such as rapid heartbeat

Respiratory and thoracic disorders
Very rare: Hypersensitivity reactions affecting the respiratory tract, such as asthma, hay fever, swelling of the nasal mucosa, Grippostad C forte can trigger cramping of the respiratory muscles (bronchospasm) in people who have already been exposed to stress.

Gastrointestinal disorders
Common: dry mouth
Very rare: gastrointestinal complaints
Taking large amounts of Grippostad C forte often leads to diarrhea. Nausea and, very rarely, inflammation of the esophagus were observed in isolated cases.

Liver and gallbladder disorders
Rare: Increase in liver values
​​Very rare: Severe liver damage can occur with prolonged use, high doses or regular use of Grippostad C forte.

Skin and subcutaneous tissue disorders
Uncommon: allergic skin reactions (simple skin rash or hives), possibly accompanied by a rise in temperature (drug fever) and damage to the mucous membranes
. Very rare: serious skin reactions with blistering (Stevens-Johnson syndrome and toxic epidermal necrolysis = Lyell's syndrome), acute generalized pustular exanthema)

Diseases of the kidneys and urinary tract
Rarely: taking high doses of Grippostad C forte can lead to an increased urge to urinate.
Very rare: problems with urination. Long-term use of higher doses can lead to kidney damage.
Patients with kidney damage or existing kidney stones from oxalate are at increased risk of kidney stone formation.
Kidney damage can occur with prolonged use, high dosage or regular use of Grippostad C forte.

Investigations
Frequency not known: Grippostad C forte can influence various laboratory tests due to the active ingredients it contains:

Paracetamol can affect laboratory tests, such as uric acid determination, as well as blood sugar determination. Vitamin C can falsify various laboratory values ​​(e.g. detection of sugar in urine, uric acid, creatinine, inorganic phosphate).

Vitamin C can also confound the results of other laboratory tests, eg tests for trace amounts of blood in the stool can be falsely negative after high doses of vitamin C.
It is therefore recommended to discontinue Grippostad C forte 2-3 days before such tests.

Chlorphenamine reduces the response of skin allergy tests. Grippostad C forte should therefore be discontinued 4 days before the test is carried out.

Please ask your doctor before laboratory tests.

Significant side effects or signs to look out for and what to do if you are affected
At the first sign of a hypersensitivity reaction (e.g. difficulty breathing, skin reaction, etc.) Grippostad C forte must not be taken again and seek immediate medical advice ask. 

composition

The active ingredients are: paracetamol, ascorbic acid (vitamin C), caffeine and chlorphenamine hydrogen maleate.
1 sachet with 2.02 g granules contains 400 mg paracetamol, 300 mg ascorbic acid, 50 mg caffeine, 5 mg chlorphenamine hydrogen maleate.

The other ingredients are: anhydrous citric acid (Ph.Eur.), sodium bicarbonate, sodium cyclamate, saccharin sodium, povidone, riboflavin phosphate sodium (Ph.Eur.), talc, lemon flavor