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Beechams Max Strength All in One Capsules
from£5.99
A higher-paracetamol three-active capsule containing paracetamol 500mg, guaifenesin 100mg (expectorant), and phenylephrine 6.1mg (decongestant) per capsule
For adults and children 16+ for short-term relief of cold, flu, and sinusitis with chesty productive cough, congestion, pain, and fever
Dose: 2 capsules every 4 hours as needed; max 8 capsules (4 doses) in 24 hours = 4g paracetamol; max 5 days without medical advice
Contraindicated in hypertension, heart disease, hyperthyroidism, diabetes, phaeochromocytoma, and glaucoma. Also contraindicated with MAOIs, tricyclic antidepressants, beta-blockers, and other decongestants
Available from Courier Pharmacy as a pharmacy medicine (P) with pharmacist support
Product description Beechams Max Strength All in One Capsules
What Beechams Max Strength All in One Capsules are
Beechams Max Strength All in One Capsules are hard gelatin capsules supplied in packs of 8, 16, or 24 capsules.
Each capsule contains three active ingredients. Paracetamol 500mg is an analgesic and antipyretic. Guaifenesin 100mg is an expectorant. Phenylephrine hydrochloride 6.1mg is a decongestant.
Firstly, the manufacturer is Haleon UK Trading Limited (formerly GlaxoSmithKline Consumer Healthcare). Beechams is a long-established UK cold and flu brand.
Also, adults take 2 capsules per dose. Each dose delivers 1000mg paracetamol, 200mg guaifenesin, and 12.2mg phenylephrine.
However, the capsule shell contains gelatin. This is not suitable for vegetarians who avoid gelatin, or for vegans.
What “Max Strength” means
The “Max Strength” label refers to the paracetamol content per adult dose. Firstly, at 2 capsules per dose (1000mg paracetamol), this is the full standard adult paracetamol dose.
Also, the maximum daily paracetamol from these capsules is 4000mg (4g), which is the full daily paracetamol budget for adults.
However, the guaifenesin and phenylephrine doses per intake are similar to those in the standard Beechams All-in-One Liquid. Only the paracetamol dose is higher.
For example, this suits patients who need stronger pain relief alongside their cold and flu symptoms. However, it also uses the full paracetamol daily budget, leaving no room for additional paracetamol from other sources.
How three actives cover different symptom groups
Cold and flu symptoms come from several different mechanisms. One capsule with three actives targets multiple symptoms at once.
Firstly, paracetamol addresses pain (headache, body aches, sore throat) and fever. Also, phenylephrine addresses congestion. Furthermore, guaifenesin addresses chesty productive cough by thinning mucus.
As a result, one dose can relieve the full spectrum of chesty cold and flu symptoms. This is the appeal of a combined product.
However, this comes with a trade-off. You receive all three actives whether you need each one or not.
Key features and specifications
Active ingredients per capsule: paracetamol 500mg + guaifenesin 100mg + phenylephrine hydrochloride 6.1mg
Form: hard gelatin capsules for oral use
Pack sizes: 8, 16, or 24 capsules
Class: combined analgesic, antipyretic, expectorant, and sympathomimetic decongestant
Legal status: Pharmacy medicine (P). Not subject to Misuse of Drugs Regulations (uses phenylephrine, not pseudoephedrine)
Age: adults and children 16 years and over (except on medical advice)
Capsule shell: gelatin with quinoline yellow (E104), indigo carmine (E132), erythrosine (E127), and titanium dioxide (E171)
Storage: store below 25°C, keep in original packaging
Distinctive features: capsule format, higher per-dose paracetamol than the Liquid version, guaifenesin for chesty productive cough, contains gelatin, phenylephrine (no MoDR pack limits)
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A higher-paracetamol three-active capsule for cold, flu, and chesty cough
Beechams Max Strength All in One Capsules are a well-known UK cold and flu remedy. Each capsule contains three active ingredients working together.
Firstly, paracetamol 500mg is an analgesic and antipyretic. It relieves headache, sinus pain, sore throat, and reduces fever.
Also, guaifenesin 100mg is an expectorant. It loosens phlegm and helps clear a chesty, productive cough.
Furthermore, phenylephrine hydrochloride 6.1mg is a decongestant. It helps unblock a stuffy nose and open blocked sinuses.
However, the “Max Strength” label refers to the higher paracetamol content per adult dose. Adults take 2 capsules per dose (1000mg paracetamol), reaching a full 4000mg per day at maximum dosing.
This is double the maximum daily paracetamol dose compared with the Beechams All-in-One Liquid (2000mg per day). It provides full standard paracetamol dosing in a single combined product.
Also, Beechams Max Strength All in One Capsules are for adults and children aged 16 years and over. Unlike the tablet version (12+), these capsules are 16+ only.
Furthermore, unlike products with pseudoephedrine, phenylephrine is not controlled under UK Misuse of Drugs Regulations. So no pack size limits apply. It is still a pharmacy medicine (P) though.
Above all, the SmPC for these capsules lists a wider set of contraindications than the Liquid version. Cardiovascular conditions, diabetes, hyperthyroidism, and use with certain antidepressants are contraindicated (not just cautions).
At Courier Pharmacy, our team can help you decide whether Beechams Max Strength All in One Capsules fit your symptoms and situation.
When to see a doctor rather than self-treat
Beechams Max Strength All in One Capsules are for short-term symptom relief only. However, some symptoms need medical assessment instead of continued self-treatment.
Sudden severe headache, seizures, sudden confusion, or visual disturbance. Stop and call 999 (rare risk of PRES or RCVS from the phenylephrine)
Chest pain, breathlessness, palpitations, or one-sided weakness. Call 999
Cold or flu symptoms lasting more than 5 to 7 days without improvement, or symptoms that improve and then worsen
Cough lasting more than 3 weeks, cough with blood, cough with thick coloured phlegm and fever, or shortness of breath
Thick coloured nasal discharge with high fever, severe facial pain, or dental pain (possible bacterial sinusitis)
Signs of paracetamol overdose (nausea, vomiting, abdominal pain, drowsiness). Contact NHS 111 or A&E even if you feel well
Facial swelling, throat swelling, hives, or difficulty breathing. Call 999 (possible severe allergic reaction)
Severe or widespread skin rash with pustules, blistering, or peeling. Stop and seek urgent help
If you are pregnant, breastfeeding, over 60, take blood thinners, or have any of the medical conditions in the warnings section below, don’t take these without pharmacist or GP advice
Five key takeaways
Beechams Max Strength All in One Capsules contain paracetamol 500mg + guaifenesin 100mg + phenylephrine 6.1mg per capsule. Adults take 2 capsules per dose.
Licensed for adults and children 16+ for short-term relief of cold, flu, and sinusitis symptoms including headache, blocked nose, sore throat, aches, and chesty productive cough.
Dose: 2 capsules every 4 hours as needed. Max 8 capsules (4 doses) in 24 hours = 4g paracetamol. Max 5 days without medical advice.
Contraindicated in hypertension, heart disease, hyperthyroidism, diabetes, phaeochromocytoma, closed-angle glaucoma, prostatic hypertrophy, severe kidney or liver disease, and with MAOIs, tricyclic antidepressants, beta-blockers, or other decongestants.
Contains gelatin (not vegan) and colouring agents E104, E127, and E132. Do not combine with other paracetamol products, other decongestants, or cough suppressants.
What are Beechams Max Strength All in One Capsules: overview
Where Beechams Max Strength All in One Capsules fit
Cold and flu produce a mix of symptoms. Options include single-active products, standard combined products, and higher-strength combined products like these capsules.
Firstly, these capsules’ specific niche is chesty cold and flu with stronger pain relief needs. The full 1000mg paracetamol per dose is the standard adult analgesic dose.
However, if you only have congestion, plain Sudafed Decongestant Tablets or a nasal spray may fit better. If pain and fever dominate without congestion or cough, plain paracetamol may suffice.
Beechams Max Strength Capsules vs Beechams All-in-One Liquid
Both products contain the same three actives, but at different per-dose paracetamol amounts.
Firstly, the Liquid has 500mg paracetamol per 20ml dose (maximum 2000mg per day).
Also, the Max Strength Capsules have 1000mg paracetamol per 2-capsule dose (maximum 4000mg per day).
However, the guaifenesin and phenylephrine per-dose amounts are similar. The main difference is double the paracetamol per dose (and per day) in the capsules.
Furthermore, the Liquid contains alcohol; the capsules do not. Both are age 16+.
Beechams Max Strength Capsules vs Beechams All-in-One Tablets
Beechams All-in-One Tablets have 250mg paracetamol per tablet; adults take 2 tablets per dose (500mg). Max Strength Capsules have 500mg paracetamol per capsule; adults take 2 capsules per dose (1000mg).
Firstly, the Max Strength Capsules deliver double the paracetamol per dose (and per day) compared with the Tablets.
However, the age licences differ. The Tablets are licensed from age 12; the Max Strength Capsules from age 16 (except on medical advice).
As a result, families with children aged 12-15 who need a combined cold and flu product may prefer the Tablets.
Beechams Max Strength Capsules vs Sudafed Sinus Pressure and Pain
Sudafed Sinus Pressure and Pain contains ibuprofen 200mg + pseudoephedrine 30mg per tablet. It focuses on congestion with pain.
Firstly, Beechams Max Strength uses paracetamol (safer than ibuprofen in NSAID-sensitive patients) with phenylephrine (milder decongestant than pseudoephedrine).
Also, Beechams Max Strength adds guaifenesin for chesty cough. Sudafed Sinus does not cover cough.
However, phenylephrine is a milder decongestant than pseudoephedrine. If severe congestion is the main issue, a pseudoephedrine product may work better.
Short-term use only
Beechams Max Strength All in One Capsules are licensed for short-term (up to 5 days) symptom relief. Symptoms that persist beyond this need medical assessment.
Firstly, prolonged decongestant use raises cardiovascular strain. Prolonged paracetamol use raises liver strain, particularly with alcohol or existing liver problems.
Also, a productive cough lasting more than 3 weeks needs medical assessment. Chronic cough has many possible causes that need proper diagnosis.
Self-medication with pharmacist support
Because Beechams Max Strength All in One Capsules are a pharmacy medicine, buying at Courier Pharmacy comes with pharmacist support. Firstly, this is a mandated feature of the pharmacy classification.
Also, the pharmacist can check that the product fits your symptoms and situation. They will confirm you are not on MAOI antidepressants, tricyclic antidepressants, beta-blockers, or other interacting medicines.
However, if this product is not right for you, we will explain why. We will then suggest safer options (single-active products, a milder combined product, or a GP appointment).
Why choose Courier Pharmacy for your Beechams Max Strength All in One Capsules
Registered, independent, and patient-led
Courier Pharmacy is a UK-registered independent pharmacy. The General Pharmaceutical Council regulates us.
Firstly, even for a well-known pharmacy medicine like Beechams, pharmacist support matters. A short conversation can prevent avoidable harm.
Also, we treat every request as a chance to check that the product fits your situation. This is not a simple retail transaction.
As a result, buying these capsules from us comes with the reassurance that a UK-qualified pharmacist has thought about your specific case.
Dr Ada Jex-Cori, our brand pharmacist
Our brand pharmacist is Dr Ada Jex-Cori. She represents the spirit of what we do. Named for Ada Lovelace, Sophia Jex-Blake, and Gerty Cori, she stands for evidence-led, unafraid-of-questions medicine. Her message is straightforward. You’re not broken. The system is. We’re here to change that.
Care that keeps showing up
Pharmacy-medicine purchases are not one-off transactions when done properly. Firstly, we are here to answer follow-up questions if the product is not working as expected.
Also, if you notice unexpected side effects or your symptoms change, contact us. If symptoms persist beyond 5 days, we can help you think through the next step.
However, we will not sell repeated packs to someone who really needs medical assessment. That is not care, it is just retail.
Buy Beechams Max Strength All in One Capsules from Courier Pharmacy
Beechams Max Strength All in One Capsules are a pharmacy medicine (P). You can order at courierpharmacy.co.uk in packs of 8, 16, or 24 capsules.
Add Beechams Max Strength All in One Capsules to your basket at courierpharmacy.co.uk
A brief pharmacist suitability check will be conducted before supply
Your order is dispensed and dispatched promptly
Follow the pack directions carefully. Contact us if you have questions
If this product is not right for your situation, we will explain why. Options include Beechams All-in-One Tablets (age 12+, lower paracetamol dose), Beechams All-in-One Liquid (age 16+, contains alcohol), plain paracetamol with a separate decongestant, or a GP appointment.
Above all, we will not dispense a product that is not suitable for you just because it was requested.
Summary
A pharmacy-sold three-active hard capsule with paracetamol (pain and fever), guaifenesin (expectorant), and phenylephrine (decongestant).
Adult and 16+ dose: 2 capsules every 4 hours (max 8/24h = 4g paracetamol). Max 5 days without medical advice.
Well-suited to chesty productive cough with cold and flu symptoms and stronger pain relief needs.
Contains gelatin (not vegan). Contraindications include cardiovascular disease, diabetes, hyperthyroidism, glaucoma, phaeochromocytoma, and prostate enlargement.
Not subject to pseudoephedrine pack size restrictions (uses phenylephrine instead). Still requires pharmacy supply.
Active ingredients in Beechams Max Strength All in One Capsules
Paracetamol 500mg per capsule (1000mg per adult dose)
Paracetamol is a widely-used analgesic (pain reliever) and antipyretic (fever reducer).
Firstly, the exact mechanism is not fully understood. It is thought to act primarily on the central nervous system, reducing prostaglandin production in the brain and spinal cord.
Also, at the 1000mg per adult dose, paracetamol provides its standard adult analgesic dose. This is the same as taking 2 plain paracetamol tablets.
However, paracetamol has a narrow safety margin in overdose. Doses just above the maximum can cause serious liver damage.
As a result, total daily paracetamol from all sources must not exceed 4 grams (4000mg) in adults. Beechams Max Strength at maximum dose uses the full 4000mg budget.
Guaifenesin 100mg per capsule (200mg per adult dose)
Guaifenesin is an expectorant. It is the active ingredient that makes these capsules suitable for chesty productive cough.
Firstly, guaifenesin works by thinning and loosening the mucus in the airways. This makes it easier to cough up and clear.
Also, at 200mg per adult dose, guaifenesin provides standard expectorant activity. It is not a cough suppressant.
However, guaifenesin needs adequate fluid intake to work well. Drink plenty of water while taking these capsules.
Furthermore, guaifenesin is generally well tolerated. Very large doses can cause nausea and vomiting.
Phenylephrine hydrochloride 6.1mg per capsule (12.2mg per adult dose)
Phenylephrine is a synthetic sympathomimetic decongestant. It acts on alpha-1 adrenergic receptors on blood vessels.
Firstly, at 12.2mg per adult dose, it narrows blood vessels in the nasal and sinus lining.
However, phenylephrine's effectiveness at oral doses has been debated. Some evidence suggests it is a weaker decongestant than pseudoephedrine, though it is widely used.
Also, phenylephrine is not controlled under the Misuse of Drugs Regulations. This is why phenylephrine-containing products have no pack size limits.
Furthermore, phenylephrine has cardiovascular effects similar to pseudoephedrine. Contraindications and cautions for cardiovascular disease still apply.
Why the three-active combination is used
Cold and flu with chesty cough involve three main problems. Pain and fever, congestion, and productive cough.
Firstly, paracetamol addresses pain and fever. Also, phenylephrine addresses congestion. Furthermore, guaifenesin addresses the chesty cough.
As a result, one capsule targets all three problems at once. This is the appeal of a full-spectrum combined product.
What are Beechams Max Strength All in One Capsules for?
Cold, flu, and sinusitis with chesty cough
Beechams Max Strength All in One Capsules are licensed for the relief of cold and flu symptoms and the pain and congestion of sinusitis. This includes aches and pains, headache, blocked nose, sore throat, chills, and feverishness.
Firstly, the combination also loosens stubborn mucus and provides relief from chesty coughs. This makes it well-suited to full cold and flu symptom relief.
However, these capsules do not treat the underlying viral infection. Colds usually resolve on their own in 7 to 10 days.
Chesty productive cough with mucus
The guaifenesin component makes these capsules particularly suited to a chesty productive cough. Firstly, it loosens the mucus, making it easier to clear.
However, if the cough is dry (no phlegm), a cough suppressant would fit better than an expectorant. These capsules are not appropriate for dry cough alone.
Also, if the cough has lasted more than 3 weeks, medical assessment is needed to identify the underlying cause.
When stronger pain relief is needed
The higher paracetamol content per dose (1000mg) provides the full standard adult analgesic dose. Firstly, this suits patients whose cold or flu comes with significant pain (headache, body aches, sore throat).
However, if pain is not a major symptom, a standard-dose product (Beechams All-in-One Liquid or Tablets) may fit better and leave paracetamol daily budget available.
What Beechams Max Strength isn't for
These capsules are not for chronic cough, chronic congestion, isolated symptoms without cough, or dry (non-productive) cough.
Also, they are not for children under 16, or for use during pregnancy or breastfeeding without medical advice.
However, if symptoms are severe, sudden, unusual, or accompanied by other concerning features (see the red flags above), these capsules are not the right response.
Furthermore, if you have hypertension, heart disease, hyperthyroidism, diabetes, glaucoma, or take an MAOI antidepressant, tricyclic antidepressant, or beta-blocker, do not use these capsules.
How does Beechams Max Strength All in One Capsules work?
Paracetamol's analgesic and antipyretic action
Paracetamol works mainly on the central nervous system. Firstly, it is thought to reduce prostaglandin production in the brain and spinal cord.
Also, this reduces pain perception and lowers the raised body temperature set-point during infection.
However, paracetamol has minimal anti-inflammatory effect in peripheral tissues. This is why it is a weaker anti-inflammatory than ibuprofen or aspirin.
Furthermore, paracetamol does not cause the stomach irritation, cardiovascular strain, or platelet effects associated with NSAIDs.
Guaifenesin's expectorant action
Guaifenesin thins and loosens mucus in the airways. Firstly, it does this by increasing the water content of respiratory secretions.
Also, thinner mucus is easier to cough up and clear. This helps a productive cough become more effective at clearing the airways.
However, guaifenesin needs adequate hydration to work well. Drink plenty of fluids while using it.
Furthermore, guaifenesin does not suppress the cough reflex. It does not reduce the urge to cough; it makes each cough more productive.
Phenylephrine's alpha-adrenergic action
Phenylephrine narrows blood vessels in the nasal and sinus lining. Firstly, it binds to alpha-1 adrenergic receptors on the vessel walls.
Also, this makes the vessels tighten (vasoconstriction), reducing the swelling that causes a blocked nose. Sinus drainage improves too.
However, phenylephrine acts throughout the body, not just in the nose. This is why cardiovascular contraindications and cautions apply.
Furthermore, phenylephrine is a weaker oral decongestant than pseudoephedrine but is widely used because it is not subject to Misuse of Drugs Regulations.
Why the capsule format matters
The hard capsule format has specific properties. Firstly, capsules are usually easier to swallow than large tablets.
Also, the capsule shell protects the contents until they reach the stomach. This can reduce taste issues.
However, the capsule shell contains gelatin. This is a consideration for vegetarians who avoid gelatin and for vegans.
How to take Beechams Max Strength All in One Capsules
Adult and 16+ dose
Take 2 capsules with water every 4 hours as needed. Do not take more than 4 doses (8 capsules) in any 24-hour period.
Also, leave at least 4 hours between doses. At the maximum daily dose, you receive 4000mg paracetamol, 800mg guaifenesin, and 48.8mg phenylephrine.
However, do not take these capsules for more than 5 days without medical advice.
Children under 16 (not for use)
Beechams Max Strength All in One Capsules are not for children under 16 years of age except on medical advice.
However, for cold and flu symptoms in children under 16, paediatric paracetamol (Calpol) or ibuprofen for pain and fever, plus saline nasal drops for congestion, are the standard options.
Also, Beechams All-in-One Tablets are licensed from age 12, if a Beechams format is needed.
How to swallow the capsules
Swallow the capsules whole with a glass of water. Firstly, do not chew or crush the capsules.
Also, take with plenty of water. The guaifenesin works best with adequate hydration.
However, capsules can be taken with or without food. Taking with food may reduce any mild stomach upset.
How quickly they work
Paracetamol usually starts to reduce pain and fever within 30 to 60 minutes. Phenylephrine relieves congestion within about 30 minutes.
Also, the guaifenesin's expectorant effect builds up over the first few doses.
However, peak effect for pain and fever relief is reached at about 1 to 2 hours. The effect usually lasts around 4 hours per dose.
Timing during the day
These capsules do not contain a sedating antihistamine, so timing is flexible. Firstly, morning, midday, and afternoon doses generally work well.
However, the phenylephrine has mild central nervous system effects. Avoid a dose close to bedtime as this could disturb sleep.
Also, if you take an evening dose, leave several hours before bedtime.
Missed doses and stopping
These capsules are taken as needed, not on a fixed schedule. So there is no missed-dose concern in the usual sense.
Also, you can stop the capsules whenever your symptoms have resolved. There is no need to taper.
However, if you find yourself needing them for more than 5 days, medical assessment is warranted. The underlying cause of ongoing symptoms matters.
Do not take with other paracetamol, decongestants, or cough suppressants
Above all, do not take Beechams Max Strength All in One Capsules alongside any other product containing paracetamol. This includes plain paracetamol tablets, Panadol, Anadin Extra, Lemsip, Day Nurse, Night Nurse, Benylin Day and Night, Benylin 4 Flu, Sinutab Non-Drowsy, co-codamol, or co-dydramol.
Also, do not combine with any other product containing pseudoephedrine, phenylephrine, or ephedrine (Sudafed products, Actifed, Nurofen Cold and Flu, other Beechams cold products).
Furthermore, do not combine with a cough suppressant (dextromethorphan, pholcodine). Guaifenesin loosens mucus for you to cough it up; suppressing the cough while thinning the mucus does not fit.
However, plain ibuprofen for extra pain or inflammation can be taken alongside, following ibuprofen's own directions.
If in doubt, ask the pharmacist before combining any cold, flu, cough, or pain medicines.
Warnings and precautions for Beechams Max Strength All in One Capsules
MHRA safety alert relevant to decongestants: PRES and RCVS
Above all, the MHRA issued a safety alert in February 2024 for pseudoephedrine-containing medicines. It highlighted rare but serious cases of PRES and RCVS.
Firstly, PRES stands for posterior reversible encephalopathy syndrome. RCVS stands for reversible cerebral vasoconstriction syndrome.
Also, although the specific alert focused on pseudoephedrine, phenylephrine has similar vasoconstricting properties. Symptoms to watch for include sudden severe headache, seizures, sudden confusion, visual disturbances, or slurred speech.
However, if any of these develop while taking these capsules, stop immediately. Seek urgent medical assessment (call 999 for severe symptoms).
Cardiovascular disease (contraindicated)
These capsules are contraindicated in hypertension and heart disease. Firstly, phenylephrine's vasoconstricting effect can worsen these conditions.
Also, this is a stricter position than in the Liquid version, where cardiovascular disease is a caution. The capsule SmPC treats it as an absolute contraindication.
However, if you take any regular medicine for high blood pressure or heart conditions, disclose this before buying.
Diabetes (contraindicated)
These capsules are contraindicated in diabetes. Phenylephrine can raise blood glucose levels through its sympathomimetic effects.
However, if you have diabetes and need cold or flu symptom relief, ask the pharmacist for safer options.
Hyperthyroidism (contraindicated)
Patients with an overactive thyroid should not use these capsules. Sympathomimetic drugs can compound the effects of excess thyroid hormone.
Phaeochromocytoma (contraindicated)
Contraindicated in phaeochromocytoma (a rare tumour that affects heart rate and blood pressure). Phenylephrine can precipitate serious cardiovascular events in these patients.
Closed-angle glaucoma (contraindicated)
These capsules are contraindicated in closed-angle glaucoma. Phenylephrine can precipitate an acute glaucoma attack in susceptible patients.
Prostatic hypertrophy (contraindicated)
Contraindicated in enlargement of the prostate gland. Phenylephrine can worsen urinary retention.
Severe kidney or liver disease (contraindicated)
Contraindicated in hepatic or severe renal impairment. Firstly, paracetamol is metabolised by the liver, and severe impairment raises toxicity risk.
Also, phenylephrine is metabolised in the liver and excreted by the kidneys. Severe impairment of either affects clearance.
MAOI antidepressants (contraindicated)
Above all, do not take these capsules if you are on an MAOI antidepressant, or within 14 days of stopping one.
Also, MAOIs include phenelzine, isocarboxazid, tranylcypromine, and moclobemide. Rasagiline and selegiline (Parkinson's medicines) carry the same concern.
However, the combination of an MAOI with phenylephrine can cause hypertensive crisis, a life-threatening rise in blood pressure.
Tricyclic antidepressants (contraindicated)
Do not take with tricyclic antidepressants (amitriptyline, nortriptyline, imipramine, clomipramine).
Also, tricyclics can enhance the pressor effect of phenylephrine, raising blood pressure and cardiac arrhythmia risk.
Beta-blockers (contraindicated)
Do not take with beta-blockers (propranolol, atenolol, bisoprolol, metoprolol). The combination with phenylephrine can cause paradoxical high blood pressure.
Other decongestants (contraindicated)
Do not combine with any other sympathomimetic decongestant. This includes pseudoephedrine, phenylephrine, ephedrine, oxymetazoline, or xylometazoline (both oral products and nasal sprays).
Firstly, combining these overloads the sympathomimetic dose. This raises the risk of cardiovascular events.
Paracetamol overdose and HAGMA with flucloxacillin
Paracetamol overdose can cause serious liver damage. Doses just above the maximum can be harmful.
Also, high anion gap metabolic acidosis (HAGMA) due to pyroglutamic acidosis has been reported when paracetamol is used with flucloxacillin (an antibiotic), especially in severe illness, severe renal impairment, sepsis, or malnutrition.
However, if you are taking flucloxacillin or have any of these conditions, discuss with the pharmacist or GP before use.
Colouring agents E104, E127, and E132
The capsule shell contains quinoline yellow (E104), erythrosine (E127), and indigo carmine (E132). These colour additives may cause allergic reactions in susceptible patients.
However, if you have a history of allergy or intolerance to food colours, discuss with the pharmacist before use.
Gelatin content
The capsule shell contains gelatin. This is derived from animal sources.
However, vegetarians who avoid gelatin, and vegans, should not use these capsules. Alternative formulations (Beechams All-in-One Liquid or Tablets) do not contain gelatin.
Alcohol (caution)
Avoid alcohol while taking these capsules. Firstly, alcohol raises the risk of paracetamol-related liver injury, particularly with regular use.
Also, alcohol has its own cardiovascular effects that can add to phenylephrine's blood-pressure-raising effect.
Pregnancy (not recommended)
These capsules are not recommended during pregnancy without medical advice. The safety of guaifenesin and phenylephrine during pregnancy has not been established.
However, paracetamol alone at the lowest effective dose is generally preferred for pain and fever in pregnancy. Ask your midwife, GP, or pharmacist.
Breastfeeding (not without medical advice)
These capsules should not be used in breastfeeding without medical advice. Paracetamol and phenylephrine are excreted in breast milk, though not in clinically significant amounts.
However, the safety of guaifenesin during breastfeeding has not been established.
Elderly patients (caution)
Use with caution in adults over 60. Firstly, older adults are more sensitive to phenylephrine's cardiovascular effects.
However, if these capsules are considered in older adults, discuss with the pharmacist. Safer options usually exist.
Duration of use (short-term only)
Do not take these capsules for more than 5 days without medical advice. Ongoing symptoms need medical assessment.
Also, a productive cough lasting more than 3 weeks needs medical assessment.
Side effects of Beechams Max Strength All in One Capsules
Common side effects
Common side effects come from the different actives. From the phenylephrine: insomnia if taken too late, mild restlessness, mild palpitations, or mild headache.
Also, from the guaifenesin: mild nausea or stomach upset (rare at recommended doses).
However, paracetamol at recommended doses is generally well tolerated. Rarely, allergic skin reactions can occur.
Less common but significant side effects
Some side effects need attention. Firstly, palpitations or a noticeable rise in blood pressure warrant stopping the capsules.
Also, unusual bruising or bleeding may indicate a rare paracetamol-related blood disorder. Seek medical advice.
However, difficulty passing urine (particularly in men over 50) may indicate developing acute urinary retention from phenylephrine.
Serious side effects requiring urgent help
Above all, seek urgent medical help for signs of severe cardiovascular events. These include sudden severe headache, chest pain, one-sided weakness, or difficulty speaking. Call 999.
Also, signs of severe allergic reaction (facial or throat swelling, breathing difficulty, widespread rash) need 999.
Furthermore, signs of paracetamol overdose (nausea, vomiting, abdominal pain, drowsiness, confusion) need urgent assessment even if only slightly above the maximum dose.
However, severe skin reactions with pustules, blistering, or peeling need urgent assessment.
Drug interactions with Beechams Max Strength All in One Capsules
MAOI antidepressants (contraindicated)
Above all, do not take these capsules if you are on an MAOI antidepressant, or within 14 days of stopping one.
Also, MAOIs include phenelzine, isocarboxazid, tranylcypromine, and moclobemide. Rasagiline and selegiline (Parkinson's medicines) and linezolid (an antibiotic) carry the same concern.
Tricyclic antidepressants (contraindicated)
Do not take with tricyclic antidepressants. Firstly, tricyclics can enhance the pressor effect of phenylephrine.
Also, this raises blood pressure and cardiac arrhythmia risk.
Beta-blockers (contraindicated)
Do not combine with beta-blockers. Firstly, the combination with phenylephrine can cause paradoxical high blood pressure.
Other sympathomimetic decongestants (contraindicated)
Do not combine with any other decongestant containing pseudoephedrine, phenylephrine, ephedrine, oxymetazoline, or xylometazoline.
Also, this includes both systemic products (Sudafed, Actifed, Sinutab, Nurofen Cold and Flu) and topical nasal sprays.
Other paracetamol products
Above all, do not combine with other paracetamol-containing products. This includes plain paracetamol, Panadol, Anadin Extra, Lemsip Max, Day Nurse, Night Nurse, Benylin Day and Night, Sinutab Non-Drowsy, Nurofen Plus, co-codamol, and co-dydramol.
Also, paracetamol overdose from combined products is a common cause of accidental liver damage. Always check ingredient labels.
Cough suppressants
Do not combine with cough suppressants (dextromethorphan, pholcodine, codeine linctus). Firstly, guaifenesin loosens mucus to make it easier to cough up.
However, suppressing the cough while thinning the mucus does not fit. It could trap loosened mucus in the airways.
Flucloxacillin (HAGMA risk)
Concurrent use with flucloxacillin has been linked to high anion gap metabolic acidosis (HAGMA) due to pyroglutamic acidosis.
However, this is particularly risky in patients with severe illness, severe renal impairment, sepsis, or malnutrition.
Warfarin (long-term paracetamol interaction)
Regular paracetamol use can enhance the anticoagulant effect of warfarin, raising INR and bleeding risk.
However, occasional use is usually acceptable. Discuss with your anticoagulation clinic if you take warfarin regularly.
Metoclopramide, domperidone, and colestyramine
Metoclopramide and domperidone speed up paracetamol absorption. Colestyramine slows it down.
However, these interactions are usually clinically minor. Ask your pharmacist if you take any of these medicines regularly.
Digoxin
Use with caution with digoxin. Phenylephrine can potentially interact and raise the risk of cardiac arrhythmias.
Alcohol
Avoid alcohol while taking these capsules. Firstly, alcohol raises the risk of paracetamol-related liver injury.
Also, alcohol has its own cardiovascular effects that can add to phenylephrine's blood-pressure-raising effect.
Frequently asked questions about Beechams Max Strength All in One Capsules
What does "Max Strength" mean?
The "Max Strength" label refers to the paracetamol content per adult dose. Firstly, at 2 capsules per dose (1000mg paracetamol), this is the full standard adult paracetamol dose.
Also, the maximum daily paracetamol is 4000mg (4g), which is the full daily paracetamol budget for adults.
However, the guaifenesin and phenylephrine per-dose amounts are similar to those in the standard Beechams All-in-One Liquid. Only the paracetamol dose is higher.
How quickly do the capsules work?
Paracetamol usually starts to reduce pain and fever within 30 to 60 minutes. Phenylephrine relieves congestion within about 30 minutes.
Also, peak effect for pain and fever relief is reached at about 1 to 2 hours. The effect usually lasts around 4 hours per dose.
Will these capsules make me drowsy?
No. These capsules do not contain a sedating antihistamine or opioid cough suppressant. Their actives are not known to cause sedation.
However, the phenylephrine has mild central effects. Some patients notice mild alertness rather than drowsiness.
Can I drive after taking these capsules?
Yes, generally. The actives in these capsules are not sedating.
However, if you notice any unusual side effects (dizziness, palpitations), do not drive until they resolve.
Are the capsules suitable for vegetarians or vegans?
No. The capsule shell contains gelatin, which is derived from animal sources.
However, vegetarians who avoid gelatin, and vegans, should consider Beechams All-in-One Liquid or Tablets. These do not contain gelatin.
Can I take these with paracetamol?
No. These capsules already contain paracetamol 500mg per capsule (1000mg per adult dose). Adding more paracetamol from another product can lead to overdose and serious liver damage.
However, always check the ingredients of any other pain or cold medicine before combining.
Can I take these with ibuprofen?
Yes, generally. Ibuprofen and paracetamol work through different mechanisms and can be combined for extra pain relief.
However, always follow ibuprofen's own dose directions. Do not take another product that also contains ibuprofen or another NSAID.
Can I take these with other cold and flu products?
No, do not combine with other cold and flu remedies without pharmacist advice. Firstly, most contain paracetamol or a decongestant. Combining overloads the doses.
Also, do not combine with cough suppressants (dextromethorphan, pholcodine). Guaifenesin and cough suppressants work against each other.
Can I take these if I take antidepressants?
Discuss with the pharmacist first. If you take an MAOI antidepressant OR a tricyclic antidepressant, these capsules are contraindicated.
Also, some SSRIs may add to CNS effects. Ask the pharmacist for guidance based on your specific medicine.
Can children take these capsules?
No. Beechams Max Strength All in One Capsules are for adults and children 16+ only (except on medical advice).
However, for children 12-15 who need a combined cold and flu product, Beechams All-in-One Tablets are licensed from age 12.
Can I take these during pregnancy or breastfeeding?
Not without medical advice. These capsules are not recommended in pregnancy or breastfeeding.
However, paracetamol alone at the lowest effective dose is generally preferred for pain and fever in pregnancy. Ask your midwife, GP, or pharmacist.
How long can I take these capsules for?
Do not take these capsules for more than 5 days without medical advice. Ongoing symptoms need medical assessment.
What's the difference between the capsules and the Liquid?
Both products contain the same three actives. However, the capsules deliver 1000mg paracetamol per adult dose (max 4000mg/day); the liquid delivers 500mg per adult dose (max 2000mg/day).
Also, the Liquid contains alcohol; the capsules do not. Both are age 16+.
What's the difference between the Max Strength Capsules and the Tablets?
Tablets have 250mg paracetamol per tablet; adults take 2 tablets per dose (500mg). Capsules have 500mg paracetamol per capsule; adults take 2 capsules per dose (1000mg).
Also, Tablets are licensed from age 12; the Max Strength Capsules from age 16.
What's the difference between phenylephrine and pseudoephedrine?
Both are sympathomimetic decongestants. Phenylephrine acts mainly on alpha-1 receptors; pseudoephedrine acts on both alpha and beta receptors.
Also, pseudoephedrine is generally stronger as an oral decongestant. However, pseudoephedrine is controlled under the Misuse of Drugs Regulations with pack size limits; phenylephrine is not.
Can I take these if I have high blood pressure or diabetes?
No. Both conditions are listed as contraindications in the SmPC for these capsules.
However, this is stricter than the Liquid version, where they are cautions. Ask the pharmacist for safer options.
Are these capsules addictive?
No. Neither paracetamol, guaifenesin, nor phenylephrine cause chemical dependence at therapeutic doses.
However, prolonged use of any analgesic can lead to medication-overuse headache. Stick to short-term use.
What if I've taken too much?
Contact NHS 111 or A&E immediately. Firstly, paracetamol overdose can cause serious liver damage even at doses just above the maximum.
Also, phenylephrine overdose can cause severe hypertension, confusion, and (rarely) seizures or cardiac arrhythmias.
However, take the pack with you so medical staff can see exactly what and how much you have taken.
Do I need a prescription from Courier Pharmacy?
No. Beechams Max Strength All in One Capsules are a pharmacy medicine (P), not prescription-only.
However, this means they can be supplied without a prescription but only via a pharmacy with pharmacist involvement.
Disclaimer
Disclaimer: This information is for education only and isn't a substitute for personal medical advice. Always follow the packaging directions, and ask your pharmacist or GP if you're unsure whether Beechams Max Strength All in One Capsules are suitable for you.
