Bell's Healthcare Dual Action Pain Relief 200mg/500mg Tablets contain two active ingredients, ibuprofen 200mg and paracetamol 500mg, for the temporary relief of mild to moderate pain that has not been relieved by either ibuprofen or paracetamol when used individually.

Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) that reduces pain, inflammation and high temperature. Paracetamol is an analgesic that works differently to relieve pain and fever.

These dual action pain relief tablets are used for headaches, migraines, backache, period pain, dental pain, rheumatic and muscular pain, sore throat, fever, and cold and flu symptoms.

Suitable for adults aged 18 years and over, Bell's Dual Action Pain Relief should only be used after trying ibuprofen or paracetamol individually in accordance with the product instructions.

The recommended dose is 1 tablet, or 2 tablets if required, up to three times daily with food. Leave at least 6 hours between doses.

Each pack contains 16 film-coated tablets for oral administration.

Do not take more than 6 tablets in 24 hours or use for longer than 3 days without medical advice.

As a pharmacy medicine, a pharmacist can provide advice on appropriate use where necessary.

Always read the enclosed Patient Information Leaflet before use.

Main ingredients: Ibuprofen 200mg, Paracetamol 500mg per film-coated tablet.

Bell's Healthcare Dual Action Pain Relief 200mg/500mg Tablets are used for the temporary relief of mild to moderate pain that has not been relieved by ibuprofen or paracetamol when used individually.

Before using this medicine:

• For the first day of treatment, try either ibuprofen or paracetamol individually in accordance with the instructions for that medicine.
• If the pain has not been relieved, Bell's Dual Action Pain Relief may be used from the following day.
• Do not take this combination if your pain has been relieved by either medicine individually.

Adults aged 18 years and over, including the elderly:

• Take 1 tablet with water and food, up to three times daily.
• If 1 tablet does not provide sufficient relief, 2 tablets may be taken per dose.
• Leave at least 6 hours between doses.
• Do not exceed 6 tablets in 24 hours.
• The maximum daily dose is 1200mg ibuprofen and 3000mg paracetamol.
• Use for no longer than 3 days without medical advice.

Children and adolescents under 18 years: Do not give this medicine to anyone under 18 years of age.

How to take:

1. Take the tablets by mouth with water.
2. Take with food to reduce the likelihood of stomach-related side effects.
3. Leave at least 6 hours between doses.
4. Do not exceed the recommended maximum daily dose.

Missed dose: This medicine is taken when required for pain relief. If you miss a dose, take the next dose only when needed, provided the recommended interval is maintained. Do not take a double dose to make up for a missed dose.

Important advice:

• Use the lowest effective dose for the shortest possible time.
• Do not take with other medicines containing paracetamol or ibuprofen.
• Avoid taking alongside other NSAID painkillers unless advised by a healthcare professional.
• This medicine is intended for short-term use only.
• If symptoms persist for more than 3 days or worsen, consult your doctor.
• If you have an infection and symptoms such as fever or pain persist or worsen, seek medical advice.

Overdose: If you take more than the recommended amount, seek immediate medical advice, even if you feel well. Excess paracetamol can cause delayed, serious liver damage.

Take the medicine packaging with you when seeking medical assistance.

Always follow the instructions provided in the Patient Information Leaflet.

Do not take Bell's Healthcare Dual Action Pain Relief 200mg/500mg Tablets if you:

• Are allergic to ibuprofen, paracetamol, aspirin, other NSAIDs or any of the other ingredients.
• Have previously experienced asthma, wheezing, facial swelling or allergic reactions after taking aspirin or other NSAIDs.
• Have or have previously had two or more episodes of stomach ulcers, gastrointestinal bleeding or perforation.
• Have previously experienced stomach or intestinal bleeding associated with NSAID use.
• Have severe heart, liver or kidney failure.
• Have a blood clotting disorder.
• Are taking other medicines containing paracetamol or ibuprofen.
• Are taking other NSAID painkillers or aspirin at doses above 75mg daily.
• Are in the last 3 months of pregnancy.
• Are under 18 years of age.

Consult your doctor or pharmacist before taking this medicine if you:

• Are elderly.
• Have or have previously had asthma.
• Have heart, kidney, liver or bowel problems.
• Have high blood pressure, diabetes or high cholesterol.
• Have previously experienced a heart attack or stroke.
• Have ulcerative colitis or Crohn's disease.
• Have systemic lupus erythematosus (SLE).
• Smoke.
• Are pregnant, planning to become pregnant or breastfeeding.
• Have an infection or are taking other medicines.

Pregnancy: Do not take this medicine during the last 3 months of pregnancy. Ibuprofen may harm the unborn baby and cause complications during delivery.

During the first 6 months of pregnancy, do not take this medicine unless advised by your doctor.

Use of ibuprofen from 20 weeks of pregnancy may cause kidney problems in the unborn baby, potentially leading to low amniotic fluid levels or narrowing of a blood vessel in the baby's heart.

Breastfeeding: If you are breastfeeding, consult your doctor or pharmacist before taking this medicine.

Fertility: Ibuprofen may temporarily affect female fertility. This effect is reversible after stopping the medicine.

Interactions with other medicines: Consult your doctor or pharmacist before taking this medicine if you use:

• Anticoagulants such as warfarin.
• Aspirin or other NSAID painkillers.
• Corticosteroids.
• Medicines for high blood pressure or heart conditions.
• Diuretics.
• Antidepressants, including selective serotonin reuptake inhibitors (SSRIs).
• Methotrexate.
• Lithium.
• Ciclosporin or tacrolimus.
• Certain antibiotics, including flucloxacillin.

This is not a complete list of possible interactions.

Alcohol: Avoid excessive alcohol consumption while taking this medicine, as it may increase the risk of stomach irritation, gastrointestinal bleeding and liver problems.

Stomach and intestinal bleeding: Ibuprofen can cause stomach ulcers, bleeding or perforation, which may be serious.

Stop taking the medicine and seek immediate medical attention if you experience:

• Vomiting blood or material resembling coffee grounds.
• Black, tarry stools.
• Blood in your stools.
• Severe or persistent abdominal pain.

Heart and circulation: Ibuprofen may be associated with a small increased risk of heart attack or stroke, particularly at high doses or with prolonged use.

Seek urgent medical attention if you experience chest pain, sudden weakness, difficulty speaking or other symptoms suggestive of a heart attack or stroke.

Serious allergic reactions: Stop taking this medicine and seek immediate medical attention if you develop:

• Difficulty breathing or wheezing.
• Swelling of the face, lips, tongue or throat.
• Severe skin rash or blistering.
• Signs of anaphylaxis.

Serious skin reactions: Severe skin reactions, including Stevens-Johnson syndrome, toxic epidermal necrolysis, DRESS syndrome and acute generalised exanthematous pustulosis (AGEP), have been reported with ibuprofen.

Stop taking this medicine and seek immediate medical attention if you develop widespread skin redness, blistering, peeling skin or a rash accompanied by fever.

Infections: Ibuprofen may mask signs of infection, including fever and pain. If an infection persists or worsens while taking this medicine, consult a doctor without delay.

Driving and operating machinery: If you experience dizziness, drowsiness or visual disturbances, do not drive or operate machinery until the effects have passed.

Overdose: Seek immediate medical attention if you take more than the recommended dose, even if you feel well.

Too much paracetamol can cause delayed, serious liver damage. Ibuprofen overdose may cause nausea, vomiting, abdominal pain, dizziness, drowsiness or more serious complications.

Storage:

• Keep out of the sight and reach of children.
• Do not use after the expiry date shown on the packaging.
• Follow the storage instructions on the carton and enclosed leaflet.

Use the lowest effective dose for the shortest duration necessary to relieve symptoms.

Like all medicines, Bell's Healthcare Dual Action Pain Relief 200mg/500mg Tablets may cause side effects, although not everybody will experience them.

Important safety information:

Taking more than the recommended amount may increase the risk of serious gastrointestinal, liver, kidney and cardiovascular complications.

Paracetamol overdose can cause serious liver damage even when there are no immediate symptoms. Seek medical advice immediately if an overdose occurs.

Reporting side effects:

If you experience any side effects, including those not described here, speak to your doctor, pharmacist or nurse.

Suspected side effects can also be reported through the MHRA Yellow Card Scheme.

Stop taking this medicine and seek urgent medical attention if you experience symptoms of a severe allergic reaction, gastrointestinal bleeding or a serious skin reaction.